Page 80 - JCBP-2-3
P. 80
Journal of Clinical and
Basic Psychosomatics HD-tDCS on pain in SSD-P
were delivered, we observed sustained effects that lasted Funding
for 1 week. This effectiveness was demonstrated in other
studies, which showed that sustained effects could be None.
observed only with short interval within-session repeated Conflict of interest
tDCS but not with longer intervals (beyond 2 – 3 h) or
31
with the use of higher amplitudes (3 mA). The sustained The authors declare that they have no competing interests.
32
effects are said to be due to stimulation-timing-dependent
plasticity regulation in the cortex. We observed a high Author contributions
33
Cohen’s d of 0.85 for the reduction in pain and other Conceptualization: Shubh Mohan Singh, Abhishek Ghosh
associated variables, indicating that our protocol is Investigation: Sanjana Kathiravan
effective. Writing-original draft: Shubh Mohan Singh, Sanjana
Patients experienced short-lasting side effects of mild- Kathiravan
to-moderate intensity, similar to other studies on tDCS. Writing-review & editing: Shubh Mohan Singh, Sanjana
34
No cognitive or other serious side effects were observed. Kathiravan
The specialized electrodes used in HD-tDCS ensure
precise control of contact conditions, unlike conventional Ethics approval and consent to participate
tDCS, indicating that HD-tDCS is well tolerated. 16 Approval was obtained from the Institute Ethics Committees
Our study offers several significant reference values where this study was conducted (INT/IEC/2020/SPL-481).
for future studies. As mentioned earlier, this study is The study was registered in the Clinical Trials Registry of
among the first to investigate the effects of HD-tDCS on India (CTRI/2020/10/028752). Patients who consented
pain in SSD-P. A simple protocol of two repeat sessions were included after obtaining written informed consent.
of HD-tDCS was administered. A holistic approach, Consent for publication
using standard assessment rating scales, was employed
to evaluate pain and its associated variables. The study The patients gave consent to publish their data in this study.
was feasible, as it was completed within a 1-year period,
and there were no dropouts, thus demonstrating its Availability of data
acceptability. Potential biases due to blinding, allocation, Data used in this work are available from the corresponding
baseline patient characteristics, order effect, or carryover author upon reasonable request.
effect were ruled out.
References
However, the use of a crossover study design, although
recommended for trials of pain treatment, may introduce 1. Raja SN, Carr DB, Cohen M, et al. The revised international
bias. The study’s limitations include a small sample association for the study of pain definition of pain: Concepts,
size, which was further reduced due to the COVID-19 challenges, and compromises. Pain. 2020;161(9):1976-1982.
restrictions and lockdown, and the use of single blinding. doi: 10.1097/j.pain.0000000000001939
5. Conclusion 2. American Psychiatric Association. Diagnostic and Statistical
Manual of Mental Disorders (DSM-5 ). 5 ed. Washington:
th
®
The study demonstrates that two within-session repeated American Psychiatric Publishing; 2013.
HD-tDCS administrations are effective and tolerable for 3. Katz J, Rosenbloom BN, Fashler S. Chronic pain,
reducing pain and other associated variables in SSD- psychopathology, and DSM-5 somatic symptom disorder.
P, with effects sustained for a week. There is a need for Can J Psychiatry. 2015;60(4):160-167.
studies exploring multiple single-session protocols
and comparing them to develop an optimal protocol. doi: 10.1177/070674371506000402
Formulating maintenance protocols that extend 4. Dimsdale JE, Creed F, Escobar J, et al. Somatic symptom
plasticity for longer periods, thereby improving quality disorder: An important change in DSM. J Psychosom Res.
of life, would benefit patients. In addition, more studies 2013;75(3):223-228.
evaluating parameters other than pain are required to doi: 10.1016/j.jpsychores.2013.06.033
obtain a holistic understanding of the effectiveness of
neuromodulation. 5. Henningsen P. Management of somatic symptom disorder.
Dialogues Clin Neurosci. 2018;20(1):23-31.
Acknowledgments doi: 10.31887/DCNS.2018.20.1/phenningsen
None. 6. Kleinstäuber M, Witthöft M, Steffanowski A, Van Marwijk H,
Volume 2 Issue 3 (2024) 7 doi: 10.36922/jcbp.2002

