Efficacy of Home-Based Transcranial Direct Current Stimulation on Experimental Pain Sensitivity in Older Adults with Knee Osteoarthritis: A Randomized, Sham-Controlled Clinical Trial

Abstract

Although transcranial direct current stimulation (tDCS) is encouraging regarding clinical pain intensity for individuals with knee osteoarthritis, very few studies have explored its impact on experimental pain sensitivity, which may hinder our understanding of underlying therapeutic mechanisms. The purpose of this study was to assess the efficacy of 15 home-based tDCS sessions on experimental pain sensitivity and explore its relationships with clinical pain intensity. We randomly assigned 120 participants to active tDCS (n = 60) and sham tDCS (n = 60). Quantitative sensory testing (QST) was used, including heat pain threshold and tolerance, pressure pain threshold, and conditioned pain modulation. Patients in the active tDCS group exhibited reduced experimental pain sensitivity as reflected by all QST measures at the end of treatment. Furthermore, correlations were observed between changes in clinical pain intensity and experimental pain sensitivity. These findings warrant further studies on tDCS and experimental pain sensitivity in patients with knee osteoarthritis and exploring the magnitude and sustainability of effects on a longer term.

Keywords

• knee osteoarthritis
• pain
• quantitative sensory testing
• conditioned pain modulation
• transcranial direct current stimulation