Targeting chronic recurrent low back pain from the top-down and the bottom-up: a combined transcranial direct current stimulation and peripheral electrical stimulation intervention

Schabrun, Siobhan M., Jones, Emma, Elgueta Cancino, Edith L. and Hodges, Paul W. (2014) Targeting chronic recurrent low back pain from the top-down and the bottom-up: a combined transcranial direct current stimulation and peripheral electrical stimulation intervention. Brain Stimulation, 7 3: 451-459. doi:10.1016/j.brs.2014.01.058


Author Schabrun, Siobhan M.
Jones, Emma
Elgueta Cancino, Edith L.
Hodges, Paul W.
Title Targeting chronic recurrent low back pain from the top-down and the bottom-up: a combined transcranial direct current stimulation and peripheral electrical stimulation intervention
Journal name Brain Stimulation   Check publisher's open access policy
ISSN 1876-4754
1935-861X
Publication date 2014-05
Year available 2014
Sub-type Article (original research)
DOI 10.1016/j.brs.2014.01.058
Open Access Status
Volume 7
Issue 3
Start page 451
End page 459
Total pages 9
Place of publication Philadelphia PA, United States
Publisher Elsevier
Collection year 2015
Language eng
Formatted abstract
Background

Mechanisms such as neural sensitization and maladaptive cortical organization provide novel targets for therapy in chronic recurrent low back pain (CLBP).

Objective

We investigated the effect of a transcranial direct current stimulation (tDCS) and peripheral electrical stimulation (PES) treatment on pain, cortical organization, sensitization and sensory function in CLBP.

Methods

Using a placebo-controlled crossover design, 16 individuals received four treatments in separate sessions: i) anodal tDCS/PES; ii) anodal tDCS/sham PES; iii) sham tDCS/PES; or iv) sham tDCS/sham PES. Pain was assessed at baseline, immediately following, and at 1 and 3 days after treatment. Motor cortical organization, sensitization and sensory function were measured before and immediately after treatment.

Results

Combined tDCS/PES reduced pain and sensitization, normalized motor cortical organization and improved sensory function. The reduction in pain was greater in individuals with more pronounced sensitization. Applied alone, tDCS or PES also reduced pain. However, with the exception of improved sensory function and reduced map volume following PES, clinical and neurophysiological outcomes were unaltered by tDCS or PES applied separately. No changes were observed following sham treatment.

Conclusion

Our data suggest a combined tDCS/PES intervention more effectively improves CLBP symptoms and mechanisms of cortical organization and sensitization, than either intervention applied alone or a sham control.
Keyword Chronic low back pain
Transcranial direct current stimulation
Treatment
Peripheral electrical stimulation
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Health and Rehabilitation Sciences Publications
 
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