Adams William, Idnani Sherina, Kim Joosung
Department of Kinesiology and Sport Sciences, University of Miami, Coral Gables, FL 33146, USA.
Department of Health and Human Performance, Texas State University, San Marcos, TX 78666, USA.
Brain Sci. 2024 Jan 9;14(1):66. doi: 10.3390/brainsci14010066.
(1) Background: Transcranial direct current stimulation (tDCS) appears to alleviate chronic pain via a brain-down mechanism. Although several review studies have examined the effects of tDCS on patients with chronic pain, no systematic review or meta-analysis has comprehensively analyzed the effects of tDCS on chronic orthopedic joint pain in one study. We aim to evaluate the effectiveness of tDCS for pain reduction in chronic orthopedic patients; (2) Methods: A comprehensive search of five electronic databases (Medline, Embase, Web of Science, CINAHL, and Cochrane) was performed. Only randomized controlled trials that compared tDCS with a control intervention were included. Eighteen studies met our inclusion criteria. We identified four categories of chronic orthopedic pain: knee (k = 8), lower back (k = 7), shoulder (k = 2), and orofacial pain (k = 1). Random effect models were utilized, and a sensitivity analysis was conducted in the presence of significant heterogeneity. Studies within each pain condition were further classified according to the number of treatment sessions: 1-5 sessions, 6-10 sessions, and >10 sessions.; (3) Results: Significant reductions in chronic orthopedic joint pain were observed following tDCS compared to controls for knee ( = 0.59, = 0.005), lower back ( = 1.14, = 0.005), and shoulder ( = 1.17, = 0.020). Subgroup analyses showed pain reductions after 6-10 tDCS sessions for knee pain and after 1-5 and >10 sessions for lower back pain; (4) Conclusions: tDCS could be considered a potential stand-alone or supplemental therapy for chronic knee and lower back pain. The effectiveness of tDCS treatment varies depending on the number of treatment sessions. Our findings suggest the importance of implementing individualized treatment plans when considering tDCS for chronic pain conditions.
(1) 背景：经颅直流电刺激（tDCS）似乎通过自上而下的大脑机制缓解慢性疼痛。尽管已有多项综述研究探讨了tDCS对慢性疼痛患者的影响，但尚无系统综述或荟萃分析在一项研究中全面分析tDCS对慢性骨科关节疼痛的影响。我们旨在评估tDCS对减轻慢性骨科患者疼痛的有效性；(2) 方法：对五个电子数据库（Medline、Embase、Web of Science、CINAHL和Cochrane）进行了全面检索。仅纳入将tDCS与对照干预进行比较的随机对照试验。18项研究符合我们的纳入标准。我们确定了四类慢性骨科疼痛：膝盖（k = 8）、下背部（k = 7）、肩部（k = 2）和口面部疼痛（k = 1）。采用随机效应模型，并在存在显著异质性时进行敏感性分析。每种疼痛状况下的研究根据治疗次数进一步分类：1 - 5次、6 - 10次和>10次；(3) 结果：与对照组相比，tDCS治疗后，膝盖（ = 0.59， = 0.005）、下背部（ = 1.14， = 0.005）和肩部（ = 1.17， = 0.020）的慢性骨科关节疼痛显著减轻。亚组分析显示，膝盖疼痛在6 - 10次tDCS治疗后疼痛减轻，下背部疼痛在1 - 5次和>10次治疗后疼痛减轻；(4) 结论：tDCS可被视为慢性膝盖和下背部疼痛的一种潜在的独立或辅助治疗方法。tDCS治疗的有效性因治疗次数而异。我们的研究结果表明，在考虑将tDCS用于慢性疼痛状况时，实施个体化治疗方案的重要性。
