Elsevier

Brain Stimulation

Volume 2, Issue 2, April 2009, Pages 103-107
Brain Stimulation

Original Research
A preliminary study of transcranial direct current stimulation for the treatment of refractory chronic pelvic pain

https://doi.org/10.1016/j.brs.2008.09.009Get rights and content

Background

The modulatory effects of transcranial direct current stimulation (tDCS) appear beneficial for different chronic pain syndromes; however, it is unclear whether this method can be used to treat refractory chronic pelvic pain.

Objective

The objective of this preliminary study was to determine the efficacy and safety of tDCS for the management of refractory chronic pelvic pain.

Methods

Seven patients with chronic pelvic pain having failed standard medical or surgical therapy underwent a crossover, double-blind sham controlled tDCS treatment protocol consisting of 1 mA applied for 20 minutes on two consecutive days with 2 weeks of follow-up symptom recording. Symptoms were recorded using multiple scoring systems, including visual analog scales for different pains, as well as organ-specific symptom scales. Comparison between active and sham treatment was performed by using paired t tests.

Results

Overall and pelvic pain scores were significantly lower after active compared with sham treatment, as were disability and traumatic stress scores. No patient discontinued the study because of side effects, which were infrequent.

Conclusions

Active tDCS treatment induces a modest pain reduction in refractory chronic pelvic pain patients as compared with sham tDCS treatment. These results can guide the design and implementation of further studies investigating this method of neuromodulation for the treatment of refractory chronic pelvic pain.

Section snippets

Methods and Materials

This is a single-center, phase-II, double-blind, sham-controlled, crossover clinical trial to prospectively investigate the efficacy of tDCS treatment in reducing chronic pelvic pain in a cohort of patients with refractory chronic pelvic pain. Conduct of this study was performed according to an institutional review board-approved investigational protocol at Summa Health System. Seven patients were randomly assigned to receive either active or sham tDCS at the first, 2-day treatment session.

Results

Seven patients with a mean age of 38 years (range: 24-36 years) participated in the study. All patients had a previous history of abuse, gynecologic pain, and IC. All patients were either in natural menopause or undergoing medical or surgical induction of amenorrhea. All but one patient had myofascial pain syndrome in addition to the other pain generators listed. Patients had an average 80 months of pain, had seen an average of four previous physicians, had undergone an average of three

Discussion

In this pilot study, tDCS was well tolerated and moderately effective in decreasing symptom scores from chronic pelvic pain. A regimen of 2 days of treatment, followed by 2 weeks of symptom recording was chosen to decrease the possibility that there would be a lingering effect from the active treatment for those patients randomly assigned to receive that arm first. Although shorter than the usual number of days of active tDCS used in other treatment protocols, this was a pilot study designed to

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