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ISSN: 2167-0846

Journal of Pain & Relief
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Research Article

Transcranial Direct Current Stimulation in Neuropathic Pain

Niran Ngernyam1#, Mark P Jensen2##, Narong Auvichayapat3#, Wiyada Punjaruk1# and Paradee Auvichayapat1#*
#Member of Noninvasive Brain Stimulation Research Group of Thailand
##Consultant to Noninvasive Brain Stimulation Research Group of Thailand
1Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
2Department of Rehabilitation Medicine, University of Washington, Washington, USA
3Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Corresponding Author : Dr. Paradee Auvichayapat, MD
Associate Professor of Physiology
Department of Physiology, Faculty of Medicine
Khon Kaen University, Khon Kaen, Thailand, 40002
E-mail: [email protected]
Received March 23, 2013; Accepted April 19, 2013; Published April 21, 2013
Citation: Ngernyam N, Jensen MP, Auvichayapat N, Punjaruk W, Auvichayapat P (2013) Transcranial Direct Current Stimulation in Neuropathic Pain. J Pain Relief S3:001. doi: 10.4172/2167-0846.S3-001
Copyright: © 2013 Ngernyam N, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Neuropathic pain (NP) is one of the most common problems contributing to suffering and disability worldwide. Unfortunately, NP is also largely refractory to treatments, with a large number of patients continuing to report significant pain even when they are receiving recommended medications and physical therapy. Thus, there remains an urgent need for additional effective treatments. In recent years, nonpharmacologic brain stimulation techniques have emerged as potential therapeutic options. Many of these techniques and procedures – such as transcranial magnetic stimulation, spinal cord stimulation, deep brain stimulation, and motor cortical stimulation – have very limited availability, particularly in developing countries. Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation procedure that has shown promise for effectively treating NP, and also has the potential to be widely available. This review describes tDCS and the tDCS procedures and principles that may be helpful for treating NP. The findings indicate that the analgesic benefits of tDCS can occur both during stimulation and beyond the time of stimulation. The mechanisms of cortical modulation by tDCS may involve various activities in neuronal networks such as increasing glutamine and glutamate under the stimulating electrode, effects on the μ-opioid receptor, and restoration of the defective intracortical inhibition. Additional research is needed to determine (1) the factors that may moderate the efficacy of tDCS, (2) the dose (e.g. number and frequency of treatment sessions) that results in the largest benefits and (3) the long-term effects of tDCS treatment.

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