Transcranial direct current stimulation (tDCS): pain management in end-stage renal disease - report of an early randomized controlled trial

Context. Chronic pain in end-stage renal disease (ESRD) is an increasingly neglected clinical problem affecting more than 60% of patients. Long-term chronic pain could be associated with brain imbalance in circuits of pain matrix and is associated with poor quality of life (QoL) and mood disturbance...

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Principais autores: Silva, Artur Quintiliano Bezerra da, Bikson, Marom, Oehmen, Tayanne, Pegado, Rodrigo, Kirsztajn, Gianna Mastroianni
Formato: article
Idioma:English
Publicado em: Elsevier
Assuntos:
chronic pain
quality of life
neuromodulation
noninvasive brain stimulation
hemodialysis
Endereço do item:https://repositorio.ufrn.br/handle/123456789/52483
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spelling ri-123456789-524832023-05-18T19:53:33Z Transcranial direct current stimulation (tDCS): pain management in end-stage renal disease - report of an early randomized controlled trial Silva, Artur Quintiliano Bezerra da Bikson, Marom Oehmen, Tayanne Pegado, Rodrigo Kirsztajn, Gianna Mastroianni chronic pain quality of life neuromodulation noninvasive brain stimulation hemodialysis Context. Chronic pain in end-stage renal disease (ESRD) is an increasingly neglected clinical problem affecting more than 60% of patients. Long-term chronic pain could be associated with brain imbalance in circuits of pain matrix and is associated with poor quality of life (QoL) and mood disturbance. Objectives. The aim of this study was evaluating the effects of transcranial direct current stimulation (tDCS) on pain, QoL, depression, anxiety and affectivity in ESRD patients undergoing hemodialysis (HD). Methods. This double-blind, randomized, sham-controlled trial included 30 patients with chronic pain undergoing HD. Participants were allocated to Active tDCS and Sham tDCS and received ten non-consecutive sessions of anodal motor cortex stimulation (M1/Sp2 montage) at 2 mA intensity for 20 min. The primary outcome was pain assessed using numeric rating scale (NRS) and collected at baseline, immediately after the 10th day of intervention, one week, two weeks, and four weeks after the last stimulation. Secondary outcomes included QoL, depression, anxiety and affectivity collected before and after intervention. Results. A mixed ANOVA model showed significant interaction between group and time on pain F(4.112) = 3.106, P = 0.01 with main effects of group (P = 0.03). Before and after intervention, a significant improvement was observed in QoL (P = 0.009), general health (P = 0.03), fatigue (P = 0.05), symptoms (P = 0.05) depression (P = 0.01) and anxiety (P = 0.01). No difference was found for affectivity. Conclusion. Anodal tDCS over the motor cortex emerges as a potential therapeutic approach for improving pain, QoL, and mood in patients with ESRD. J Pain Symptom Manage 2022;64:234−243. © 2022 American Academy of Hospice and Palliative Medi cine. Published by Elsevier Inc. All rights reserved. 2023-05-18T19:53:20Z 2023-05-18T19:53:20Z 2022-09 article SILVA, Artur Quintiliano Bezerra da; et al. Transcranial Direct Current Stimulation (tDCS): pain management in end-stage renal disease - report of an early randomized controlled trial. Journal Of Pain And Symptom Management, [S.L.], v. 64, n. 3, p. 234-243, set. 2022. Elsevier BV. http://dx.doi.org/10.1016/j.jpainsymman.2022.05.018. Acesso em: 18 maio 2023. https://repositorio.ufrn.br/handle/123456789/52483 10.1016/j.jpainsymman.2022.05.018 en Elsevier
institution Repositório Institucional
collection RI - UFRN
language English
topic chronic pain
quality of life
neuromodulation
noninvasive brain stimulation
hemodialysis
spellingShingle chronic pain
quality of life
neuromodulation
noninvasive brain stimulation
hemodialysis
Silva, Artur Quintiliano Bezerra da
Bikson, Marom
Oehmen, Tayanne
Pegado, Rodrigo
Kirsztajn, Gianna Mastroianni
Transcranial direct current stimulation (tDCS): pain management in end-stage renal disease - report of an early randomized controlled trial
description Context. Chronic pain in end-stage renal disease (ESRD) is an increasingly neglected clinical problem affecting more than 60% of patients. Long-term chronic pain could be associated with brain imbalance in circuits of pain matrix and is associated with poor quality of life (QoL) and mood disturbance. Objectives. The aim of this study was evaluating the effects of transcranial direct current stimulation (tDCS) on pain, QoL, depression, anxiety and affectivity in ESRD patients undergoing hemodialysis (HD). Methods. This double-blind, randomized, sham-controlled trial included 30 patients with chronic pain undergoing HD. Participants were allocated to Active tDCS and Sham tDCS and received ten non-consecutive sessions of anodal motor cortex stimulation (M1/Sp2 montage) at 2 mA intensity for 20 min. The primary outcome was pain assessed using numeric rating scale (NRS) and collected at baseline, immediately after the 10th day of intervention, one week, two weeks, and four weeks after the last stimulation. Secondary outcomes included QoL, depression, anxiety and affectivity collected before and after intervention. Results. A mixed ANOVA model showed significant interaction between group and time on pain F(4.112) = 3.106, P = 0.01 with main effects of group (P = 0.03). Before and after intervention, a significant improvement was observed in QoL (P = 0.009), general health (P = 0.03), fatigue (P = 0.05), symptoms (P = 0.05) depression (P = 0.01) and anxiety (P = 0.01). No difference was found for affectivity. Conclusion. Anodal tDCS over the motor cortex emerges as a potential therapeutic approach for improving pain, QoL, and mood in patients with ESRD. J Pain Symptom Manage 2022;64:234−243. © 2022 American Academy of Hospice and Palliative Medi cine. Published by Elsevier Inc. All rights reserved.
format article
author Silva, Artur Quintiliano Bezerra da
Bikson, Marom
Oehmen, Tayanne
Pegado, Rodrigo
Kirsztajn, Gianna Mastroianni
author_facet Silva, Artur Quintiliano Bezerra da
Bikson, Marom
Oehmen, Tayanne
Pegado, Rodrigo
Kirsztajn, Gianna Mastroianni
author_sort Silva, Artur Quintiliano Bezerra da
title Transcranial direct current stimulation (tDCS): pain management in end-stage renal disease - report of an early randomized controlled trial
title_short Transcranial direct current stimulation (tDCS): pain management in end-stage renal disease - report of an early randomized controlled trial
title_full Transcranial direct current stimulation (tDCS): pain management in end-stage renal disease - report of an early randomized controlled trial
title_fullStr Transcranial direct current stimulation (tDCS): pain management in end-stage renal disease - report of an early randomized controlled trial
title_full_unstemmed Transcranial direct current stimulation (tDCS): pain management in end-stage renal disease - report of an early randomized controlled trial
title_sort transcranial direct current stimulation (tdcs): pain management in end-stage renal disease - report of an early randomized controlled trial
publisher Elsevier
publishDate 2023
url https://repositorio.ufrn.br/handle/123456789/52483
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AT oehmentayanne transcranialdirectcurrentstimulationtdcspainmanagementinendstagerenaldiseasereportofanearlyrandomizedcontrolledtrial
AT pegadorodrigo transcranialdirectcurrentstimulationtdcspainmanagementinendstagerenaldiseasereportofanearlyrandomizedcontrolledtrial
AT kirsztajngiannamastroianni transcranialdirectcurrentstimulationtdcspainmanagementinendstagerenaldiseasereportofanearlyrandomizedcontrolledtrial
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