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Article

Medial Prefrontal Transcranial Direct Current Stimulation Aimed to Improve Affective and Attentional Modulation of Pain in Chronic Low Back Pain Patients

Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, 9220 Aalborg East, Denmark
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Author to whom correspondence should be addressed.
Academic Editors: Björn Gerdle and Andrea D. Furlan
J. Clin. Med. 2021, 10(4), 889; https://doi.org/10.3390/jcm10040889
Received: 13 January 2021 / Revised: 9 February 2021 / Accepted: 18 February 2021 / Published: 22 February 2021
(This article belongs to the Special Issue Improved Rehabilitation for Patients with Chronic Pain)
Chronic low back pain (CLBP) is often without clear underlying pathology. Affective disturbance and dysfunctional pain mechanisms, commonly observed in populations with CLBP, have, therefore, been suggested as potential contributors to CLBP development and maintenance. However, little consensus exists on how these features interact and if they can be targeted using non-invasive brain stimulation. In this pilot trial, 12 participants completed two phases (Active or Sham) of high-definition transcranial direct current stimulation (HD-tDCS) to the medial prefrontal cortex, applied for 20 min on three consecutive days. Clinical pain ratings, questionnaires, and sensitivity to painful cuff pressure were completed at baseline, then 4 trials of conditioned pain modulation (CPM; alone, with distraction using a Flanker task, with positive affect induction, and with negative affect induction using an image slideshow) were performed prior to HD-tDCS on Day 1 and Day 4 (24 h post-HD-tDCS). At baseline, attentional and affective manipulations were effective in inducing the desired state (p < 0.001) but did not significantly change the magnitude of CPM-effect. Active HD-tDCS was unable to significantly alter the magnitude of the shift in valence and arousal due to affective manipulations, nor did it alter the magnitude of CPM under any basal, attentional, or affective manipulation trial significantly on Day 4 compared to sham. The CPM-effect was greater across all manipulations on Day 1 than Day 4 (p < 0.02) but also showed poor reliability across days. Future work is needed to expand upon these findings and better understand how and if HD-tDCS can be used to enhance attentional and affective effects on pain modulation. View Full-Text
Keywords: high-definition transcranial direct current stimulation; conditioned pain modulation; low back pain; affect induction; distraction high-definition transcranial direct current stimulation; conditioned pain modulation; low back pain; affect induction; distraction
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MDPI and ACS Style

McPhee, M.E.; Graven-Nielsen, T. Medial Prefrontal Transcranial Direct Current Stimulation Aimed to Improve Affective and Attentional Modulation of Pain in Chronic Low Back Pain Patients. J. Clin. Med. 2021, 10, 889. https://doi.org/10.3390/jcm10040889

AMA Style

McPhee ME, Graven-Nielsen T. Medial Prefrontal Transcranial Direct Current Stimulation Aimed to Improve Affective and Attentional Modulation of Pain in Chronic Low Back Pain Patients. Journal of Clinical Medicine. 2021; 10(4):889. https://doi.org/10.3390/jcm10040889

Chicago/Turabian Style

McPhee, Megan E., and Thomas Graven-Nielsen. 2021. "Medial Prefrontal Transcranial Direct Current Stimulation Aimed to Improve Affective and Attentional Modulation of Pain in Chronic Low Back Pain Patients" Journal of Clinical Medicine 10, no. 4: 889. https://doi.org/10.3390/jcm10040889

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