title: Patient-conducted anodal transcranial direct current stimulation of the motor cortex alleviates pain in trigeminal neuralgia.
abstract: BACKGROUND
  Transcranial direct current stimulation (tDCS) of the primary motor cortex has been shown to modulate pain and trigeminal nociceptive processing.
  
  
  METHODS
  Ten patients with classical trigeminal neuralgia (TN) were stimulated daily for 20 minutes over two weeks using anodal (1 mA) or sham tDCS over the primary motor cortex (M1) in a randomized double-blind cross-over design. Primary outcome variable was pain intensity on a verbal rating scale (VRS 0-10). VRS and attack frequency were assessed for one month before, during and after tDCS. The impact on trigeminal pain processing was assessed with pain-related evoked potentials (PREP) and the nociceptive blink reflex (nBR) following electrical stimulation on both sides of the forehead before and after tDCS.
  
  
  RESULTS
  Anodal tDCS reduced pain intensity significantly after two weeks of treatment. The attack frequency reduction was not significant. PREP showed an increased N2 latency and decreased peak-to-peak amplitude after anodal tDCS. No severe adverse events were reported.
  
  
  CONCLUSIONS
  Anodal tDCS over two weeks ameliorates intensity of pain in TN. It may become a valuable treatment option for patients unresponsive to conventional treatment.
authors.forename: Tim
authors.initials: T
authors.lastname: Hagenacker
authors.forename: Vera
authors.initials: V
authors.lastname: Bude
authors.forename: Steffen
authors.initials: S
authors.lastname: Naegel
authors.forename: Dagny
authors.initials: D
authors.lastname: Holle
authors.forename: Zaza
authors.initials: Z
authors.lastname: Katsarava
authors.forename: Hans-Christoph
authors.initials: HC
authors.lastname: Diener
authors.affiliation: Department of Neurology, University Hospital Essen, Hufelandstr, 55, 45147 Essen, Germany. mark.obermann@uni-due.de.
authors.forename: Mark
authors.initials: M
authors.lastname: Obermann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001767:Blinking / Q000502:physiology; D004311:Double-Blind Method; D005071:Evoked Potentials / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000503:physiopathology*; D010147:Pain Measurement; D010919:Placebos; D065908:Transcranial Direct Current Stimulation / Q000379:methods*; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000628:therapy*
chemical_list: D010919:Placebos