Alternate sessions of transcranial direct current stimulation (tDCS) reduce chronic pain in women affected by chikungunya. A randomized clinical trial

• Main Authors: Clecio Gabriel De Souza, Rodrigo Pegado, Jardson Costa, Edgard Morya, Abrahão Fontes Baptista, Gozde Unal, Marom Bikson, Alexandre Hideki Okano
• Format: Article
• Language: English
• Published: Elsevier 2021-05-01
• Series: Brain Stimulation
• Subjects: Chikungunya virus; Arthralgia; Chronic pain; Transcranial direct current stimulation
• Online Access: http://www.sciencedirect.com/science/article/pii/S1935861X21000437

Context: Thousands of people worldwide have been infected by the chikungunya virus (CHIKV), and the persistence of joint pain symptoms has been considered the main problem. Neuromodulation techniques such as transcranial direct current stimulation (tDCS) act on brain areas involved in the processing of chronic pain. It was previously demonstrated that tDCS for five consecutive days significantly reduced pain in the chronic phase of chikungunya (CHIK). Objective: To analyze the effect of alternate tDCS sessions on pain and functional capacity in individuals affected by CHIK. Methods: In a randomized clinical trial, 58 women in the chronic phase of CHIK were divided into two groups: active-tDCS (M1-S0, 2 mA, 20 min) and sham-tDCS. The Visual Analogue Scale (VAS) and the Brief Pain Inventory (BPI) were used to assess pain, while the Health Assessment Questionnaire (HAQ) assessed functional capacity. These scales were used before and after six sessions of tDCS in nonconsecutive days on the primary motor cortex, and at follow-up consultation 7 and 15 days after the last session. A repeated measures mixed-model ANOVA was used for comparison between groups (significant p-values < 0.05). Results: A significant pain reduction (Z [3, 171] = 14.303; p < 0.0001) was observed in the tDCS group compared to the sham group; no significant difference in functional capacity was observed (Z [1.57] = 2.797; p = 0.1). Conclusion: Our results suggest that six nonconsecutive sessions of active tDCS on M1 reduce pain in chronic CHIKV arthralgia.