Effects of Hypnotic Analgesia and Transcranial Direct Current Stimulation on Pain Tolerance and Corticospinal Excitability in Individuals with Fibromyalgia : A Cross-Over Randomized Clinical Trial
Objective: We compare the effect of HAS, a-tDCS on the left dorsolateral prefrontal cortex (l-DLPFC), and rest-testing on pain measures [(cold pressor test (CPT) (primary outcome) and heat pain threshold]. We also compare their effects on the motor evoked potential (MEP) (primary outcome), short int...
| Authors: | , , , , , , , |
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| Format: | article |
| Status: | Published version |
| Publication Date: | 2023 |
| Country: | Brasil |
| Institution: | Universidade Federal do Rio Grande do Sul (UFRGS) |
| Repository: | Repositório Institucional da UFRGS |
| Language: | English |
| OAI Identifier: | oai:www.lume.ufrgs.br:10183/283841 |
| Online Access: | http://hdl.handle.net/10183/283841 |
| Access Level: | Open access |
| Keyword: | Estimulação transcraniana por corrente contínua Hipnose Hipnose anestésica Dor crônica Fibromialgia Limiar da dor Medição da dor tDCS Hypnosis Hypnotic analgesia Chronic pain Fibromyalgia Pain threshold Cold pressor test CPM-test |
| Summary: | Objective: We compare the effect of HAS, a-tDCS on the left dorsolateral prefrontal cortex (l-DLPFC), and rest-testing on pain measures [(cold pressor test (CPT) (primary outcome) and heat pain threshold]. We also compare their effects on the motor evoked potential (MEP) (primary outcome), short intracortical inhibition (SICI), intracortical facilitation (ICF), and cortical silent period (CSP). Methods: This randomized, blind, crossover trial included 18 women with fibromyalgia, aged from 18 to 65 years old. They received at random and in a crossover order a-tDCS over the l-DLPFC (2mA), HAS, or a rest-testing. Results: HAS compared to a-tDCS increased the pain tolerance with a moderate effect size (ES) [Cohen’s f=− 0.78; (CI 95%; − 1.48 to − 0.12)]. While compared to rest-testing, HAS increased the CPT with a large ES [Cohen’s f=− 0.87; (CI 95%; − 1.84 to − 0.09)]. The a-tDCS compared to HAS increased the MEP amplitude with large ES [Cohen’s f=− 1.73 (CI 95%; − 2.17 to − 0.17)]. Likewise, its ES compared to rest-testing in the MEP size was large [Cohen’s f=− 1.03; (CI 95%; − 2.06 to − 0.08)]. Conclusion: These findings revealed that HAS affects contra-regulating mechanisms involved in perception and pain tolerance, while the a-tDCS increased the excitability of the corticospinal pathways. They give a subsidy to investigate their effect as approaches to counter regulate the maladaptive neuroplasticity involved in fibromyalgia. |
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