TY - JOUR
T1 - Transcranial direct current stimulation for the reduction of clinical and experimentally induced pain
T2 - A systematic review and meta-analysis
AU - Luedtke, Kerstin
AU - Rushton, Alison
AU - Wright, Christine
AU - Geiss, Benjamin
AU - Juergens, Tim Patrick
AU - May, Arne
PY - 2012/6
Y1 - 2012/6
N2 - Objectives: To evaluate the effectiveness of transcranial direct current stimulation on clinical and experimental pain, and to identify the most beneficial stimulation parameters. Methods: Predefined search using key terms of information sources including: MEDLINE, EMBASE, CAB Abstracts, and PsychINFO, Cochrane Register of Controlled Trials, CINAHL, and PeDRO databases; reference lists of retrieved articles, journal contents, and conference proceedings. Two reviewers independently searched and evaluated publications. English and non-English controlled trials that applied direct current stimulation to the brain published before September 30, 2010 were included. Studies using magnetic stimulation or pulsed currents were excluded. Results: Trials investigating experimental pain in healthy participants (n=6) used a wide variety of stimulation and outcome parameters that did not allow a synthesis across outcome parameters. Trials investigating chronic pain (n=8) used anodal motor cortex stimulation of 1 or 2 mA intensity, either as a single dose or on a maximum of 10 consecutive days. Four trials on chronic pain were excluded due to a high risk of bias. A meta-analysis of 4 trials on chronic pain found a pooled effect size of -2.29 with a 95% confidence interval of -3.5 to -1.08. This effect does just reach minimal clinically important difference recommendations. Discussion: The level of evidence for the efficacy of transcranial direct current stimulation in experimental and chronic pain reduction is low. Evidence from high quality randomized controlled trials is required before this treatment should be recommended.
AB - Objectives: To evaluate the effectiveness of transcranial direct current stimulation on clinical and experimental pain, and to identify the most beneficial stimulation parameters. Methods: Predefined search using key terms of information sources including: MEDLINE, EMBASE, CAB Abstracts, and PsychINFO, Cochrane Register of Controlled Trials, CINAHL, and PeDRO databases; reference lists of retrieved articles, journal contents, and conference proceedings. Two reviewers independently searched and evaluated publications. English and non-English controlled trials that applied direct current stimulation to the brain published before September 30, 2010 were included. Studies using magnetic stimulation or pulsed currents were excluded. Results: Trials investigating experimental pain in healthy participants (n=6) used a wide variety of stimulation and outcome parameters that did not allow a synthesis across outcome parameters. Trials investigating chronic pain (n=8) used anodal motor cortex stimulation of 1 or 2 mA intensity, either as a single dose or on a maximum of 10 consecutive days. Four trials on chronic pain were excluded due to a high risk of bias. A meta-analysis of 4 trials on chronic pain found a pooled effect size of -2.29 with a 95% confidence interval of -3.5 to -1.08. This effect does just reach minimal clinically important difference recommendations. Discussion: The level of evidence for the efficacy of transcranial direct current stimulation in experimental and chronic pain reduction is low. Evidence from high quality randomized controlled trials is required before this treatment should be recommended.
UR - http://www.scopus.com/inward/record.url?scp=84861024402&partnerID=8YFLogxK
U2 - 10.1097/AJP.0b013e31823853e3
DO - 10.1097/AJP.0b013e31823853e3
M3 - Scientific review articles
C2 - 22569218
AN - SCOPUS:84861024402
SN - 0749-8047
VL - 28
SP - 452
EP - 461
JO - Clinical Journal of Pain
JF - Clinical Journal of Pain
IS - 5
ER -