title: Noninvasive transcranial direct current stimulation (tDCS) for the treatment of orofacial pain.
abstract: OBJECTIVE
  tDCS is a promising method for the treatment of chronic pain. Electrode placement locations must be chosen in accordance with the density and the time course of the current in order to prevent pathological changes in the underlying tissue. In order to reduce current spatial variability, more electrodes of the same polarity are placed in a circle around the second electrode of the opposite polarity. The applied current produced the greatest changes directly beneath the electrodes: the cathode reduces the excitability of cortical neurons, while the anode has the opposite effect.
  
  
  METHODS
  Based on inclusion criteria, 10 patients with chronic orofacial pain, secondary trigeminal neuralgia after oral surgery, were enrolled and underwent both anode and cathode stimulation. Before the first session we measured pain intensity on a numeric pain rating scale and tactile and thermal stimulation were used to assess somatosensory status. tDCS was applied for five consecutive days. At the end of tDCS application, somatosensory status was assessed again.
  
  
  RESULTS
  From our results we can conclude that the application of tDCS improves the perception of some types of pain. When we increase our sample size, we would expect confirmation not only on our positive results, but also some additional findings for explaining the pathophysiology of orofacial pain. These pathophysiological findings and explanations are very important for the application of tDCS in the treatment of orofacial pain and also for other types of neuropathic pain.
authors.affiliation: Department of Anaesthesiology, Resuscitation, and Intensive Care, 1st Faculty of Medicine and General Faculty Hospital, Charles University, Prague, Czech Republic.
authors.forename: Jitka
authors.initials: J
authors.lastname: Fricova
authors.affiliation: Department of Normal, Pathological and Clinical Physiology, 3rd Faculty of Medicine, Charles University, Prague, Czech Republic.
authors.forename: Katerina
authors.initials: K
authors.lastname: Englerova
authors.affiliation: Department of Normal, Pathological and Clinical Physiology, 3rd Faculty of Medicine, Charles University, Prague, Czech Republic.
authors.forename: Richard
authors.initials: R
authors.lastname: Rokyta
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000628:therapy*; D004566:Electrodes; D019054:Evoked Potentials, Motor / Q000502:physiology*; D005157:Facial Pain / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000502:physiology*; D009437:Neuralgia / Q000503:physiopathology / Q000628:therapy; D065908:Transcranial Direct Current Stimulation / Q000379:methods; D055815:Young Adult