Antônio Felipe Lopes Cavalcante , Joanna Sacha Cunha Brito Holanda , João Octávio Sales Passos , Joyce Maria Pereira de Oliveira , Edgard Morya , Alexandre H. Okano , Marom Bikson , Rodrigo Pegado
{"title":"运动皮层上的正极tDCS能改善慢性基孔肯雅关节炎患者的疼痛，但不能改善其身体功能：随机对照试验","authors":"Antônio Felipe Lopes Cavalcante , Joanna Sacha Cunha Brito Holanda , João Octávio Sales Passos , Joyce Maria Pereira de Oliveira , Edgard Morya , Alexandre H. Okano , Marom Bikson , Rodrigo Pegado","doi":"10.1016/j.rehab.2024.101826","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Chikungunya virus (CHIKV) is a globally prevalent pathogen, with outbreaks occurring in tropical regions. Chronic pain is the main symptom reported and is associated with decreased mobility and disability. Transcranial direct current stimulation (tDCS) is emerging as a new therapeutic tool for chronic arthralgia.</p></div><div><h3>Objective</h3><p>To evaluate the effectiveness of 10 consecutive sessions of anodal tDCS on pain (primary outcome) in participants with chronic CHIKV arthralgia. Secondary outcomes included functional status, quality of life, and mood.</p></div><div><h3>Methods</h3><p>In this randomized, double-blind, placebo-controlled trial, 30 participants with chronic CHIKV arthralgia were randomly assigned to receive either active (<em>n</em> = 15) or sham (<em>n</em> = 15) tDCS. The active group received 10 consecutive sessions of tDCS over M1 using the C3/Fp2 montage (2 mA for 20 min). Visual analog scale of pain (VAS), health assessment questionnaire (HAQ), short-form 36 health survey (SF-36), pain catastrophizing scale, Hamilton anxiety scale (HAS), timed up and go (TUG) test, lumbar dynamometry, 30-s arm curl and 2-min step test were assessed at baseline, day 10 and at 2 follow-up visits.</p></div><div><h3>Results</h3><p>There was a significant interaction between group and time on pain (<em>p</em> = 0.03; effect size 95 % CI 0.9 (-1.67 to -0.16), with a significant time interaction (<em>p</em> = 0.0001). There was no interaction between time and group for the 2-minute step test (<em>p</em> = 0.18), but the groups differed significantly at day 10 (<em>p</em> = 0.01), first follow-up (<em>p</em> = 0.01) and second follow-up (<em>p</em> = 0.03). HAQ and SF-36 improved but not significantly. There was no significant improvement in mental health, and physical tests.</p></div><div><h3>Conclusion</h3><p>tDCS appears to be a promising intervention for reducing pain in participants with chronic CHIKV arthralgia, although further research is needed to confirm these findings and explore potential long-term benefits.</p></div><div><h3>Trial Registration</h3><p>Brazilian Registry of Clinical Trials (ReBEC): RBR-245rh7.</p></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"67 4","pages":"Article 101826"},"PeriodicalIF":3.9000,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Anodal tDCS over the motor cortex improves pain but not physical function in chronic chikungunya arthritis: Randomized controlled trial\",\"authors\":\"Antônio Felipe Lopes Cavalcante , Joanna Sacha Cunha Brito Holanda , João Octávio Sales Passos , Joyce Maria Pereira de Oliveira , Edgard Morya , Alexandre H. Okano , Marom Bikson , Rodrigo Pegado\",\"doi\":\"10.1016/j.rehab.2024.101826\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Chikungunya virus (CHIKV) is a globally prevalent pathogen, with outbreaks occurring in tropical regions. Chronic pain is the main symptom reported and is associated with decreased mobility and disability. Transcranial direct current stimulation (tDCS) is emerging as a new therapeutic tool for chronic arthralgia.</p></div><div><h3>Objective</h3><p>To evaluate the effectiveness of 10 consecutive sessions of anodal tDCS on pain (primary outcome) in participants with chronic CHIKV arthralgia. Secondary outcomes included functional status, quality of life, and mood.</p></div><div><h3>Methods</h3><p>In this randomized, double-blind, placebo-controlled trial, 30 participants with chronic CHIKV arthralgia were randomly assigned to receive either active (<em>n</em> = 15) or sham (<em>n</em> = 15) tDCS. The active group received 10 consecutive sessions of tDCS over M1 using the C3/Fp2 montage (2 mA for 20 min). Visual analog scale of pain (VAS), health assessment questionnaire (HAQ), short-form 36 health survey (SF-36), pain catastrophizing scale, Hamilton anxiety scale (HAS), timed up and go (TUG) test, lumbar dynamometry, 30-s arm curl and 2-min step test were assessed at baseline, day 10 and at 2 follow-up visits.</p></div><div><h3>Results</h3><p>There was a significant interaction between group and time on pain (<em>p</em> = 0.03; effect size 95 % CI 0.9 (-1.67 to -0.16), with a significant time interaction (<em>p</em> = 0.0001). There was no interaction between time and group for the 2-minute step test (<em>p</em> = 0.18), but the groups differed significantly at day 10 (<em>p</em> = 0.01), first follow-up (<em>p</em> = 0.01) and second follow-up (<em>p</em> = 0.03). HAQ and SF-36 improved but not significantly. There was no significant improvement in mental health, and physical tests.</p></div><div><h3>Conclusion</h3><p>tDCS appears to be a promising intervention for reducing pain in participants with chronic CHIKV arthralgia, although further research is needed to confirm these findings and explore potential long-term benefits.</p></div><div><h3>Trial Registration</h3><p>Brazilian Registry of Clinical Trials (ReBEC): RBR-245rh7.</p></div>\",\"PeriodicalId\":56030,\"journal\":{\"name\":\"Annals of Physical and Rehabilitation Medicine\",\"volume\":\"67 4\",\"pages\":\"Article 101826\"},\"PeriodicalIF\":3.9000,\"publicationDate\":\"2024-03-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Physical and Rehabilitation Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1877065724000101\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Physical and Rehabilitation Medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1877065724000101","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}
Anodal tDCS over the motor cortex improves pain but not physical function in chronic chikungunya arthritis: Randomized controlled trial
Background
Chikungunya virus (CHIKV) is a globally prevalent pathogen, with outbreaks occurring in tropical regions. Chronic pain is the main symptom reported and is associated with decreased mobility and disability. Transcranial direct current stimulation (tDCS) is emerging as a new therapeutic tool for chronic arthralgia.
Objective
To evaluate the effectiveness of 10 consecutive sessions of anodal tDCS on pain (primary outcome) in participants with chronic CHIKV arthralgia. Secondary outcomes included functional status, quality of life, and mood.
Methods
In this randomized, double-blind, placebo-controlled trial, 30 participants with chronic CHIKV arthralgia were randomly assigned to receive either active (n = 15) or sham (n = 15) tDCS. The active group received 10 consecutive sessions of tDCS over M1 using the C3/Fp2 montage (2 mA for 20 min). Visual analog scale of pain (VAS), health assessment questionnaire (HAQ), short-form 36 health survey (SF-36), pain catastrophizing scale, Hamilton anxiety scale (HAS), timed up and go (TUG) test, lumbar dynamometry, 30-s arm curl and 2-min step test were assessed at baseline, day 10 and at 2 follow-up visits.
Results
There was a significant interaction between group and time on pain (p = 0.03; effect size 95 % CI 0.9 (-1.67 to -0.16), with a significant time interaction (p = 0.0001). There was no interaction between time and group for the 2-minute step test (p = 0.18), but the groups differed significantly at day 10 (p = 0.01), first follow-up (p = 0.01) and second follow-up (p = 0.03). HAQ and SF-36 improved but not significantly. There was no significant improvement in mental health, and physical tests.
Conclusion
tDCS appears to be a promising intervention for reducing pain in participants with chronic CHIKV arthralgia, although further research is needed to confirm these findings and explore potential long-term benefits.
Trial Registration
Brazilian Registry of Clinical Trials (ReBEC): RBR-245rh7.
期刊介绍：
Annals of Physical and Rehabilitation Medicine covers all areas of Rehabilitation and Physical Medicine; such as: methods of evaluation of motor, sensory, cognitive and visceral impairments; acute and chronic musculoskeletal disorders and pain; disabilities in adult and children ; processes of rehabilitation in orthopaedic, rhumatological, neurological, cardiovascular, pulmonary and urological diseases.
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