A Pilot Study of the Tolerability and Effects of High-Definition Transcranial Direct Current Stimulation (HD-tDCS) on Pain Perception

• Published in: The journal of pain Vol. 13; no. 2; pp. 112 - 120
• Main Authors: Borckardt, Jeffrey J, Bikson, Marom, Frohman, Heather, Reeves, Scott T, Datta, Abhishek, Bansal, Varun, Madan, Alok, Barth, Kelly, George, Mark S
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2012
• Subjects: Adult; Anesthesia & Perioperative Care; Brain Mapping; Computer Simulation; electrical brain stimulation; Female; HD-tDCS; Humans; Hyperalgesia - physiopathology; Male; MCS; Models, Biological; Motor Cortex - physiology; pain; Pain Management; Pain Measurement - methods; Pain Medicine; Pain Perception - physiology; Pilot Projects; Sensory Thresholds - physiology; tDCS; TMS; Transcranial Magnetic Stimulation - instrumentation; Transcranial Magnetic Stimulation - methods; Young Adult; pain; HD-tDCS; TMS; MCS; tDCS; electrical brain stimulation
• ISSN: 1526-5900; 1528-8447; 1528-8447
• DOI: 10.1016/j.jpain.2011.07.001

Abstract Several brain stimulation technologies are beginning to evidence promise as pain treatments. However, traditional versions of 1 specific technique, transcranial direct current stimulation (tDCS), stimulate broad regions of cortex with poor spatial precision. A new tDCS design, called high definition tDCS (HD-tDCS), allows for focal delivery of the charge to discrete regions of the cortex. We sought to preliminarily test the safety and tolerability of the HD-tDCS technique as well as to evaluate whether HD-tDCS over the motor cortex would decrease pain and sensory experience. Twenty-four healthy adult volunteers underwent quantitative sensory testing before and after 20 minutes of real (n = 13) or sham (n = 11) 2 mA HD-tDCS over the motor cortex. No adverse events occurred and no side effects were reported. Real HD-tDCS was associated with significantly decreased heat and cold sensory thresholds, decreased thermal wind-up pain, and a marginal analgesic effect for cold pain thresholds. No significant effects were observed for mechanical pain thresholds or heat pain thresholds. HD-tDCS appears well tolerated, and produced changes in underlying cortex that are associated with changes in pain perception. Future studies are warranted to investigate HD-tDCS in other applications, and to examine further its potential to affect pain perception. Perspective This article presents preliminary tolerability and efficacy data for a new focal brain stimulation technique called high definition transcranial direct current stimulation. This technique may have applications in the management of pain.