Highlights
- •Remotely-supervised cranial electrical stimulation reduced clinical pain.
- •Remotely-supervised cranial electrical stimulation was feasible.
- •Remotely-supervised cranial electrical stimulation was well tolerated.
Abstract
Cranial electrical stimulation (CES) is a noninvasive brain stimulation technique
that has been shown to improve pain. However, few studies have investigated the potential
benefits associated with remotely supervised CES in older adults with knee osteoarthritis
(OA). The aim of this study was to examine the feasibility and preliminary efficacy
of remotely supervised CES via secure videoconferencing software on clinical pain
severity, experimental pain sensitivity, and pain-related cortical response in older
adults with knee OA. Thirty participants with symptomatic knee OA pain were randomly
assigned to receive 10 daily sessions (60 min each) of remotely supervised CES (n = 15)
or sham CES (n = 15) over two weeks. We measured clinical pain severity via a Numeric
Rating Scale, experimental pain sensitivity (e.g., heat pain sensitivity, pressure
pain sensitivity, and conditioned pain modulation) using quantitative sensory testing,
and pain-related cortical response via functional near-infrared spectroscopy imaging.
We also measured participant satisfaction with treatment using the Client Satisfaction
Questionnaire. Active CES significantly reduced scores on the Numeric Rating Scale
and increased heat pain threshold, pressure pain thresholds, and conditioned pain
modulation. We also found significant changes in pain-related cortical hemodynamic
activity after CES. Participants tolerated CES well without serious adverse effects
and were satisfied with the treatment. Our findings demonstrate promising clinical
efficacy of remotely supervised CES for older adults with knee OA.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Clinical NeuroscienceAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The economic costs of pain in the United States.J Pain. 2012; 13: 715-724
- Osteoarthritis: from palliation to prevention: AOA critical issues.J Bone Joint Surg Am. 2014; 96e130
- Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II.Arthritis Rheumatol. 2008; 58: 26-35
- Epidemiology of osteoarthritis.Rheum Dis Clin North Am. 2013; 39: 1-19
- Current evidence on risk factors for knee osteoarthritis in older adults: a systematic review and meta-analysis.Osteoarthr Cartil. 2015; 23: 507-515
- Knee osteoarthritis has doubled in prevalence since the mid-20th century.Proc Natl Acad Sci USA. 2017; 114: 9332-9336
- Adverse effects of analgesics commonly used by older adults with osteoarthritis: focus on non-opioid and opioid analgesics.Am J Geriatr Pharmacother. 2012; 10: 331-342
- The comparative safety of analgesics in older adults with arthritis.Arch Intern Med. 2010; 170: 1968-1976
- Characteristics of older adults receiving opioids in primary care: treatment duration and outcomes.Pain Med. 2010; 11: 1063-1071
- Psychophysical and functional imaging evidence supporting the presence of central sensitization in a cohort of osteoarthritis patients.Arthritis Rheumatol. 2009; 61: 1226-1234
- The dorsolateral prefrontal network is involved in pain perception in knee osteoarthritis patients.Neurosci Lett. 2014; 581: 109-114
- Functional MRI demonstrates pain perception in hand osteoarthritis has features of central pain processing.J Biomed Graph Comput. 2013; 3
- Brain activity for chronic knee osteoarthritis: dissociating evoked pain from spontaneous pain.Eur J Pain. 2011; 15: e1-e14
- Pain treatment for patients with osteoarthritis and central sensitization.Phys Ther. 2013; 93: 842-851
- Principles of neuromodulation.in: Knotkova H. Rasche D. Textbook of neuromodulation. Springer, New York, NY2012
- Strategies for replacing non-invasive brain stimulation sessions: recommendations for designing neurostimulation clinical trials.Expert Rev Med Devices. 2017; 14: 633-649
- Effects of residence and race on burden of travel for care: cross sectional analysis of the 2001 US National Household Travel Survey.BMC Health Serv Res. 2007; 7: 40
- How to get older people included in clinical studies.Drugs Aging. 2007; 24: 187-196
- Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association.Arthritis Rheumatol. 1986; 29: 1039-1049
- Sequential treatment assignment with balancing for prognostic factors in the controlled clinical trial.Biometrics. 1975; 31: 103-115
- Bayesian analysis of the effect of transcranial direct current stimulation on experimental pain sensitivity in older adults with knee osteoarthritis: randomized sham-controlled pilot clinical study.J Pain Res. 2018; 11: 2071-2082
- Experimental pain sensitivity differs as a function of clinical pain severity in symptomatic knee osteoarthritis.Osteoarthritis Cartil. 2013; 21: 1243-1252
- Efficacy of combining home-based transcranial direct current stimulation with mindfulness-based meditation for pain in older adults with knee osteoarthritis: a randomized controlled pilot study.J Clin Neurosci. 2019; 70: 140-145
- Prefrontal hemodynamic mapping by functional near-infrared spectroscopy in response to thermal stimulations over three body sites.Neurophotonics. 2016; 3045008
- Specificity of hemodynamic brain responses to painful stimuli: a functional near-infrared spectroscopy study.Sci Rep. 2015; 5: 9469
- Cortical hemodynamic response to contact thermal stimuli in older adults with knee osteoarthritis: a functional near infrared spectroscopy pilot study.J Pain. 2019; 20: S33
- Thermal and mechanical pain sensitization in patients with osteoarthritis of the knee.Physiother Theory Pract. 2019; 35: 139-147
- Safety and feasibility of transcranial direct current stimulation in pediatric hemiparesis: randomized controlled preliminary study.Phys Ther. 2015; 95: 337-349
- Randomized single blind sham controlled trial of adjunctive home-based tDCS after rTMS for Mal De Debarquement Syndrome: safety, efficacy, and participant satisfaction assessment.Brain Stimul. 2016; 9: 537-544
- Assessment of client/patient satisfaction: development of a general scale.Eval Program Plann. 1979; 2: 197-207
- Assessment of patient satisfaction: development and refinement of a service evaluation questionnaire.Eval Program Plann. 1983; 6: 299-313
- Efficacy of transcranial direct current stimulation over primary motor cortex (anode) and contralateral supraorbital area (cathode) on clinical pain severity and mobility performance in persons with knee osteoarthritis: an experimenter- and participant-blinded, randomized, sham-controlled pilot clinical study.Brain Stimul. 2017; 10: 902-909
- System for long-term measurement of cerebral blood and tissue oxygenation on newborn infants by near infra-red transillumination.Med Biol Eng Comput. 1988; 26: 289-294
- Estimation of optical pathlength through tissue from direct time of flight measurement.Phys Med Biol. 1988; 33: 1433-1442
- Autoregressive model based algorithm for correcting motion and serially correlated errors in fNIRS.Biomed Opt Express. 2013; 4: 1366-1379
- The NIRS brain AnalyzIR toolbox.Algorithms. 2018; 11: 73
- Cranial electrical stimulation improves symptoms and functional status in individuals with fibromyalgia.Pain Manage Nurs. 2013; 14: 327-335
- Efficacy of cranial electrotherapy stimulation for neuropathic pain following spinal cord injury: a multi-site randomized controlled trial with a secondary 6-month open-label phase.J Spinal Cord Med. 2011; 34: 285-296
- Cranial electrotherapy stimulation for the management of depression, anxiety, sleep disturbance, and pain in patients with advanced cancer: a preliminary study.J Pain Symptom Manage. 2018; 55: 198-206
- Cranial electrotherapy stimulation for treatment of anxiety, depression, and insomnia.Psychiatr Clin North Am. 2013; 36: 169-176
Article info
Publication history
Published online: May 10, 2020
Accepted:
May 2,
2020
Received:
April 2,
2020
Identification
Copyright
© 2020 Elsevier Ltd. All rights reserved.
