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The study explored the analgesic effects of transcranial direct current stimulation (tDCS) over the motor cortex on postamputation phantom limb pain (PLP).
The relief from phantom limb pain is linked to increased
movement of the phantom limb. The researchers were successful in evaluating the
benefits of 5 days treatment with transcranial direct current stimulation
(tDCS) in patients with phantom limb pain.
The study explored the analgesic effects of transcranial
direct current stimulation (tDCS) over the motor cortex on postamputation
phantom limb pain (PLP).
Eight subjects with unilateral lower or upper limb
amputation and chronic PLP were enrolled in a crossover, double-blind,
sham-controlled treatment program. For 5 consecutive days, anodal (active or sham)
tDCS was applied over the motor cortex for 15 minutes at an intensity of 1.5
mA.
The 5-day treatment with active, but not sham, tDCS induced
a sustained decrease in background PLP and in the frequency of PLP paroxysms,
which lasted for 1 week after the end of treatment. Moreover, on each day of
active tDCS, patients reported an immediate PLP relief, along with an increased
ability to move their phantom limb. Patients' immediate responses to sham tDCS,
on the contrary, were variable, marked by an increase or decrease of PLP levels
from baseline.
These results show that a 5-day treatment of motor cortex
stimulation with tDCS can induce stable relief from PLP in amputees.
Neuromodulation targeting the motor cortex appears to be a promising option for
the management of this debilitating neuropathic pain condition, which is often
refractory to classic pharmacologic and surgical treatments.
Journal of Pain 2015; 16(7):657–665
Immediate and Sustained Effects of 5-Day Transcranial Direct Current Stimulation of the Motor Cortex in Phantom Limb Pain
Nadia Bolognini et al.
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