Dutra Larissa Ramalho Dantas Varella, Pegado Rodrigo, Silva Luana Karyne, da Silva Dantas Hégila, Câmara Hialison Andrade, Silva-Filho Edson Meneses, Correia Grasiéla Nascimento, Micussi Maria Thereza Albuquerque Barbosa Cabral
Health Science Center, Federal University of Rio Grande do Norte, Rio Grande do Norte, Brazil.
Graduate Program in Rehabilitation Science, Federal University of Rio Grande do Norte, Rio Grande do Norte, Brazil.
Int J Womens Health. 2020 Apr 5;12:243-251. doi: 10.2147/IJWH.S226501. eCollection 2020.
Primary dysmenorrhea is a common and often debilitating condition affecting 40-90% of menstruating women. This condition reduces functionality, quality of life, and social activities. Transcranial direct current stimulation (tDCS) has been used in many chronic pain syndromes, with evidence of improved pain, functionality, and mood in women with primary dysmenorrhea. The objective of this study was to determine whether tDCS could offer clinical benefits on pain, anxiety, affectivity, and functionality in women with primary dysmenorrhea.
This parallel, sham, randomized, double-blind trial was conducted with 26 women randomized into sham tDCS and active tDCS. Anodal tDCS was applied for 5 consecutive days over F3 corresponding to the left dorsolateral prefrontal cortex (DLPFC) and the cathode electrode over Fp2 for 20 min with an intensity of 2 mA. A numeric rating scale (NRS) was used to assess pain, anxiety, positive and negative affect, and submaximal aerobic performance during two consecutive menstrual cycles.
No significant interaction was found between intervention and time on the NRS [(2,44) = 1.358, = 0.26], and a significant main effect of time [(2,44) = 4.446, = 0.01] was found. The active group showed a significant reduction in anxiety ( = 0.03) with a mean difference of 5.12 (95% CI 0.79 to 11.05). No significant differences in positive and negative affect were found ( = 0.95 and = 0.15, respectively). Submaximal aerobic performance was significantly greater in the active group [(2,21) = 5.591, = 0.02], with a mean difference of 70.87 (95% CI 8.53 to 133.21).
Anodal tDCS over the DLPFC seems to be an effective therapeutic approach for improving anxiety and functionality in women with primary dysmenorrhea.
原发性痛经是一种常见且往往使人虚弱的病症,影响40%-90%的经期女性。这种病症会降低功能、生活质量和社交活动。经颅直流电刺激(tDCS)已被用于多种慢性疼痛综合征,有证据表明其可改善原发性痛经女性的疼痛、功能和情绪。本研究的目的是确定tDCS是否能对原发性痛经女性的疼痛、焦虑、情感和功能产生临床益处。
本平行、假刺激、随机、双盲试验纳入了26名女性,她们被随机分为假刺激tDCS组和主动tDCS组。阳极tDCS连续5天施加于对应左侧背外侧前额叶皮质(DLPFC)的F3,阴极电极置于Fp2,持续20分钟,强度为2毫安。使用数字评分量表(NRS)在两个连续月经周期中评估疼痛、焦虑、正性和负性情绪以及次最大有氧运动能力。
在NRS上,干预与时间之间未发现显著交互作用[(2,44)=1.358,P=0.26],但发现了显著的时间主效应[(2,44)=4.446,P=0.01]。主动组的焦虑显著降低(P=0.03),平均差异为5.12(95%CI 0.79至11.05)。在正性和负性情绪方面未发现显著差异(分别为P=0.95和P=0.15)。主动组的次最大有氧运动能力显著更高[(2,21)=5.591,P=0.02],平均差异为70.87(95%CI 8.53至133.21)。
DLPFC上的阳极tDCS似乎是改善原发性痛经女性焦虑和功能的一种有效治疗方法。