Usefulness of transcranial direct current stimulation to ease pelvic pain in endometriosis

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Created On: 30/05/2023

Anodal transcranial direct current stimulation (tDCS) for pain relief in endometriosis and chronic pelvic pain (CPP) patients was the focus of phase II randomized controlled clinical trial.

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Key take away

In people with chronic pelvic pain linked to endometriosis, transcranial direct current stimulation is a beneficial pain management approach.

Background

Anodal transcranial direct current stimulation (tDCS) for pain relief in endometriosis and chronic pelvic pain (CPP) patients was the focus of phase II randomized controlled clinical trial.

Method

A total of 36 endometriosis and CPP subjects were recruited. All volunteers had CPP, which was indicated by a visual analog scale (VAS) score of ≥3/10 for ≥3 months during the previous six months. Overall, 18 participants per arm received anodal or placebo tDCS over the main motor cortex for ten days.

The pressure pain threshold (objective pain measure) was the major endpoint ascertained and the secondary endpoints included disease- and pain-associated questionnaires, Von Frey monofilaments, and numerical rating scale score (subjective pain measure). Data was obtained at the start of the study, at the completion of the 10-day stimulation, and at the follow-up session, which was held one week following the completion of tDCS. For the statistical analysis, the analyses of variance and t-tests were used.

Result

In comparison with the placebo arm, the active tDCS arm experienced significantly less pain perception in both pain measurements (numerical rating scale [NRS] score and pressure pain threshold). This proof-of-concept study demonstrated the value of tDCS as a complementary pain treatment for CPP and endometriosis patients.

Additional studies showed that pain reduction (as measured by pressure pain threshold) remained considerably lower one week following the end of stimulation, suggesting potential long-term analgesic benefits.

Conclusion

tDCS is an efficient treatment for endometriosis-linked CPP. The findings are consistent with the idea that CPP is created and sustained in the central nervous system, necessitating the use of multimodal pain management.