Does Multisession Cathodal Transcranial Direct Current Stimulation of the Left Dorsolateral Prefrontal Cortex Prime the Effects of Cognitive Behavioral Therapy on Fear of Pain, Fear of Movement, and Disability in Patients with Nonspecific Low Back Pain? A Randomized Clinical Trial Study

Ehsani, Fatemeh; Hafez Yousefi, Mohaddeseh Sadat; Jafarzadeh, Abbas; Zoghi, Maryam; Jaberzadeh, Shapour

doi:10.3390/brainsci13101381

Open AccessArticle

Does Multisession Cathodal Transcranial Direct Current Stimulation of the Left Dorsolateral Prefrontal Cortex Prime the Effects of Cognitive Behavioral Therapy on Fear of Pain, Fear of Movement, and Disability in Patients with Nonspecific Low Back Pain? A Randomized Clinical Trial Study

by

Fatemeh Ehsani

¹,

Mohaddeseh Sadat Hafez Yousefi

^1,2,*

,

Abbas Jafarzadeh

¹,

Maryam Zoghi

³ and

Shapour Jaberzadeh

⁴

¹

Neuromuscular Rehabilitation Research Centre, Semnan University of Medical Sciences, Semnan 3514799442, Iran

²

Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran 5166614711, Iran

³

Discipline of Physiotherapy, Institute of Health and Wellbeing, Federation University Victoria, Ballarat, VIC 3350, Australia

⁴

Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3800, Australia

^*

Author to whom correspondence should be addressed.

Brain Sci. 2023, 13(10), 1381; https://doi.org/10.3390/brainsci13101381

Submission received: 22 August 2023 / Revised: 21 September 2023 / Accepted: 25 September 2023 / Published: 28 September 2023

(This article belongs to the Special Issue Application of Transcranial Direct Current Stimulation Based Methods in Neurological Diseases: New Advances and Perspectives)

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Abstract

Many studies have shown that low back pain (LBP) is associated with psychosomatic symptoms which may lead to brain changes. This study aimed to investigate the effect of the concurrent application of cognitive behavioral therapy (CBT) and transcranial direct electrical stimulation (tDCS) over the left dorsolateral prefrontal cortex (DLPFC) on fear of pain, fear of movement, and disability in patients with nonspecific LBP. This study was performed on 45 LBP patients (23 women, 22 men; mean age 33.00 ± 1.77 years) in three groups: experimental (2 mA cathodal tDCS (c-tDCS)), sham (c-tDCS turned off after 30 s), and control (only received CBT). In all groups, CBT was conducted for 20 min per session, with two sessions per week for four weeks. Fear of pain, fear of movement, and disability were evaluated using questionnaires at baseline, immediately after, and one month after completion of interventions. Results indicated that all three different types of intervention could significantly reduce fear and disability immediately after intervention (p > 0.05). However, improvement in the experimental group was significantly higher than in the other groups immediately after and at the one-month follow-up after interventions (p < 0.05). DLPFC c-tDCS can prime the immediate effects of CBT and also the lasting effects on the reduction in the fear of pain, fear of movement, and disability in LBP patients.

Keywords: low back pain; cognition; transcranial direct electrical stimulation; left dorsolateral prefrontal cortex; fear; disability

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MDPI and ACS Style

Ehsani, F.; Hafez Yousefi, M.S.; Jafarzadeh, A.; Zoghi, M.; Jaberzadeh, S. Does Multisession Cathodal Transcranial Direct Current Stimulation of the Left Dorsolateral Prefrontal Cortex Prime the Effects of Cognitive Behavioral Therapy on Fear of Pain, Fear of Movement, and Disability in Patients with Nonspecific Low Back Pain? A Randomized Clinical Trial Study. Brain Sci. 2023, 13, 1381. https://doi.org/10.3390/brainsci13101381

AMA Style

Ehsani F, Hafez Yousefi MS, Jafarzadeh A, Zoghi M, Jaberzadeh S. Does Multisession Cathodal Transcranial Direct Current Stimulation of the Left Dorsolateral Prefrontal Cortex Prime the Effects of Cognitive Behavioral Therapy on Fear of Pain, Fear of Movement, and Disability in Patients with Nonspecific Low Back Pain? A Randomized Clinical Trial Study. Brain Sciences. 2023; 13(10):1381. https://doi.org/10.3390/brainsci13101381

Chicago/Turabian Style

Ehsani, Fatemeh, Mohaddeseh Sadat Hafez Yousefi, Abbas Jafarzadeh, Maryam Zoghi, and Shapour Jaberzadeh. 2023. "Does Multisession Cathodal Transcranial Direct Current Stimulation of the Left Dorsolateral Prefrontal Cortex Prime the Effects of Cognitive Behavioral Therapy on Fear of Pain, Fear of Movement, and Disability in Patients with Nonspecific Low Back Pain? A Randomized Clinical Trial Study" Brain Sciences 13, no. 10: 1381. https://doi.org/10.3390/brainsci13101381

APA Style

Ehsani, F., Hafez Yousefi, M. S., Jafarzadeh, A., Zoghi, M., & Jaberzadeh, S. (2023). Does Multisession Cathodal Transcranial Direct Current Stimulation of the Left Dorsolateral Prefrontal Cortex Prime the Effects of Cognitive Behavioral Therapy on Fear of Pain, Fear of Movement, and Disability in Patients with Nonspecific Low Back Pain? A Randomized Clinical Trial Study. Brain Sciences, 13(10), 1381. https://doi.org/10.3390/brainsci13101381

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Does Multisession Cathodal Transcranial Direct Current Stimulation of the Left Dorsolateral Prefrontal Cortex Prime the Effects of Cognitive Behavioral Therapy on Fear of Pain, Fear of Movement, and Disability in Patients with Nonspecific Low Back Pain? A Randomized Clinical Trial Study

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