tDCS-Induced Analgesia and Electrical Fields in Pain-Related Neural Networks in Chronic Migraine

  1. Alexandre F. DaSilva DDS, DMedSc†,
  2. Mariana E. Mendonca PT†,
  3. Soroush Zaghi MD,
  4. Mariana Lopes MD,
  5. Marcos Fabio DosSantos DDS, MS,
  6. Egilius L. Spierings MD, PhD,
  7. Zahid Bajwa MD,
  8. Abhishek Datta PhD,
  9. Marom Bikson PhD,
  10. Felipe Fregni MD, PhD*

Article first published online: 18 APR 2012

DOI: 10.1111/j.1526-4610.2012.02141.x

Issue

Headache: The Journal of Head and Face Pain

Headache: The Journal of Head and Face Pain

Volume 52, Issue 8, pages 1283–1295, September 2012

Additional Information

How to Cite

DaSilva, A. F., Mendonca, M. E., Zaghi, S., Lopes, M., DosSantos, M. F., Spierings, E. L., Bajwa, Z., Datta, A., Bikson, M. and Fregni, F. (2012), tDCS-Induced Analgesia and Electrical Fields in Pain-Related Neural Networks in Chronic Migraine. Headache: The Journal of Head and Face Pain, 52: 1283–1295. doi: 10.1111/j.1526-4610.2012.02141.x

Author Information

  1. From the Headache & Orofacial Pain Effort (H.O.P.E.), Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA (A.F. DaSilva and M.F. DosSantos); Laboratory of Neuromodulation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA (M.E. Mendonca, S. Zaghi, A. Datta, and F. Fregni); Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital & Massachusetts General Hospital, Harvard Medical School, Boston, MA (M.E. Mendonca and F. Fregni); Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA (S. Zaghi, M. Lopes, and F. Fregni); Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA (E.L. Spierings); Arnold Pain Center, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA (Z. Bajwa); Department of Biomedical Engineering, The City College of the City University of New York, New York, NY, USA (M. Bikson).

  1. †

    Equally contributing authors.

*F. Fregni, Laboratory of Neuromodulation, 125 Nashua Street #727, Boston, MA 02114, USA, email: fregni.felipe@mgh.harvard.edu

  1. Conflict of interest: The City University of New York has intellectual property on brain stimulation with Marom Bikson and Abhishek Datta as inventors.

  2. †

    Equally contributing authors.

Publication History

  1. Issue published online: 4 SEP 2012
  2. Article first published online: 18 APR 2012
  3. Accepted for publication February 11, 2012.

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Keywords:

  • transcranial direct current stimulation;
  • chronic migraine;
  • motor cortex;
  • neuromodulation;
  • brain stimulation;
  • chronic pain

Objective.— We investigated in a sham-controlled trial the analgesic effects of a 4-week treatment of transcranial direct current stimulation (tDCS) over the primary motor cortex in chronic migraine. In addition, using a high-resolution tDCS computational model, we analyzed the current flow (electric field) through brain regions associated with pain perception and modulation.

Methods.— Thirteen patients with chronic migraine were randomized to receive 10 sessions of active or sham tDCS for 20 minutes with 2 mA over 4 weeks. Data were collected during baseline, treatment and follow-up. For the tDCS computational analysis, we adapted a high-resolution individualized model incorporating accurate segmentation of cortical and subcortical structures of interest.

Results.— There was a significant interaction term (time vs group) for the main outcome (pain intensity) and for the length of migraine episodes (ANOVA, P < .05 for both analyses). Post-hoc analysis showed a significant improvement in the follow-up period for the active tDCS group only. Our computational modeling studies predicted electric current flow in multiple cortical and subcortical regions associated with migraine pathophysiology. Significant electric fields were generated, not only in targeted cortical regions but also in the insula, cingulate cortex, thalamus, and brainstem regions.

Conclusions.— Our findings give preliminary evidence that patients with chronic migraine have a positive, but delayed, response to anodal tDCS of the primary motor cortex. These effects may be related to electrical currents induced in pain-related cortical and subcortical regions.

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