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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
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