Article

It is suggested that transcranial direct current stimulation (tDCS)
can produce lasting changes in corticospinal excitability and can potentially be
used for the treatment of neuropathic pain. However, the detailed mechanisms
underlying the effects of tDCS are unknown. OBJECTIVE:
We investigated the
underlying neural mechanisms of tDCS for chronic pain relief using
[(18)F]-fluorodeoxyglucose positron emission tomography ([(18)F]FDG-PET).
METHODS: Sixteen patients with neuropathic pain (mean age 44.1 +/- 8.6 years, 4
females) due to traumatic spinal cord injury received sham or active anodal
stimulation of the motor cortex using tDCS for 10 days (20 minutes, 2 mA, twice a
day). The effect of tDCS on regional cerebral glucose metabolism was evaluated by
[(18)F]FDG-PET before and after tDCS sessions. RESULTS: There was a significant
decrease in the numeric rating scale scores for pain, from 7.6 +/- 0.5 at
baseline to 5.9 +/- 1.8 after active tDCS (P = .016). We found increased
metabolism in the medulla and decreased metabolism in the left dorsolateral
prefrontal cortex after active tDCS treatment compared with the changes induced
by sham tDCS. Additionally, an increase in metabolism after active tDCS was
observed in the subgenual anterior cingulate cortex and insula. CONCLUSION: The
results of this study suggest that anodal stimulation of the motor cortex using
tDCS can modulate emotional and cognitive components of pain and normalize
excessive attention to pain and pain-related information.

Langue : ANGLAIS