Effect of Transcutaneous Spinal Direct Current Stimulation in Patients with Painful Polyneuropathy and Influence of Possible Predictors of Efficacy including BDNF Polymorphism: A Randomized, Sham-Controlled Crossover Study

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Rahin, HedayatLinköpings universitet,Avdelningen för neurobiologi,Medicinska fakulteten,Region Östergötland, Neurofysiologiska kliniken US (author)

Effect of Transcutaneous Spinal Direct Current Stimulation in Patients with Painful Polyneuropathy and Influence of Possible Predictors of Efficacy including BDNF Polymorphism: A Randomized, Sham-Controlled Crossover Study

Article/chapterEnglish2023

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2023-01-30
MDPI,2023
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LIBRIS-ID:oai:DiVA.org:liu-192334
https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-192334URI
https://doi.org/10.3390/brainsci13020229DOI

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Language:English
Summary in:English

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Funding Agencies|ALF Grants [LIO-936176]; Region OEstergotland [SC-2019-00155-33]; Swedish Society of medicine; Medical Council of southeast Sweden [FORSS-940600]; OEstergotland County Council; Neurofonden [F2018-0056]; Linkoeping Society of Medicine; Knut and Alice Wallenberg Foundation [2019.0047]; Wallenberg Center for Molecular Medicine-Linkoeping
Introduction: The neuromodulating effects of transcutaneous-spinal Direct Current Stimulation (tsDCS) have been reported to block pain signaling. For patients with chronic pain, tsDCS could be a potential treatment option. To approach this, we studied the effect of anodal tsDCS on patients with neuropathic pain approaching an optimal paradigm including the investigation of different outcome predictors. Methods: In this randomized, double-blinded, sham-controlled crossover study we recruited twenty patients with neurophysiologically evaluated neuropathic pain due to polyneuropathy (PNP). Variables (VAS; pain and sleep quality) were reported daily, one week prior to, and one week after the stimulation/sham period. Anodal tsDCS (2.5 mA, 20 min) was given once daily for three days during one week. BDNF-polymorphism, pharmacological treatment, and body mass index (BMI) of all the patients were investigated. Results: Comparing the effects of sham and real stimulation at the group level, there was a tendency towards reduced pain, but no significant effects were found. However, for sleep quality a significant improvement was seen. At the individual level, 30 and 35% of the subjects had a clinically significant improvement of pain level and sleep quality, respectively, the first day after the stimulation. Both effects were reduced over the coming week and these changes were negatively correlated. The BDNF polymorphism Val66Met was carried by 35% of the patients and this group was found to have a lower general level of pain but there was no significant difference in the tsDCS response effect. Neither pharmacologic treatment or BMI influenced the treatment effect. Conclusions: Short-term and sparse anodal thoracic tsDCS reduces pain and improves sleep with large inter-individual differences. Roughly 30% will benefit in a clinically meaningful way. The BDNF genotype seems to influence the level of pain that PNP produces. Individualized and intensified tsDCS may be a treatment option for neuropathic pain due to PNP.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Hälsovetenskap Sjukgymnastik hsv//swe
MEDICAL AND HEALTH SCIENCES Health Sciences Physiotherapy hsv//eng
neuromodulation; trans-spinal direct current stimulation; tsDCS; neuropathic pain; BDNF

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Jackson, WalkerLinköpings universitet,Avdelningen för neurobiologi,Medicinska fakulteten(Swepub:liu)walja90 (author)
Thordstein, MagnusLinköpings universitet,Avdelningen för neurobiologi,Medicinska fakulteten,Region Östergötland, Neurofysiologiska kliniken US(Swepub:liu)magth09 (author)
Linköpings universitetAvdelningen för neurobiologi (creator_code:org_t)

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In:Brain Sciences: MDPI13:22076-3425

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