Title: The Effectivity of Anodal tDCS Over Somatosensory Cortex in Reducing Central Pain Sensitization in Chronic Daily Headache
e-poster Number: INSIM123
Category: Pain
Author Name: Amanda Tiksnadi
Institute: Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Co-Author Name: Dyah Tunjungsari, Eka Candra Sasmita Putri, Ahmad Faried
Abstract :
Objective: We present a case of chronic daily headache who showed greatest respond after facilitatory
anodal transcranial direct current stimulation (tDCS) over somatosensory cortex.
Background: Central sensitization amplifies the neural signaling within the CNS and elicits pain
hypersensitivity in chronic pain. It predicts poor treatment outcomes. Facilitation (anodal tDCS) of
primary motor (M1) and/or dorsolateral prefrontal cortex (DLPFC) has been well-known to be effective
in chronic pain management, in contrast to inhibition (cathodal tDCS) of somatosensory cortex (S1).
Methods: A 24-year-old female presented with a 6-year history of refractory and chronic headaches
after a motorcycle accident. The headaches worsened over the last 2 years after a traumatic
psychological event. A completed 12-week course of tDCS was conducted for 20 minutes at 1 mA, 2
times/week, with a series of excitation and inhibition combinations on DLPFC, S1, and M1. Clinical
evaluation was conducted at the end of each protocol by weeks 2, 8, and 12.
Results: anodal tDCS over DLPFC, M1, and S1 led to decrease in VAS and frequency of acute attacks, a
prolonged headache-free period, and an increase of work daily living. Cathodal tDCS over S1 seemed
showed no response. The best result was found in the combination of anodal tDCS over left DLPFC with
anodal tDCS over left S1.
Conclusions: tDCS neuromodulation on DLPFC, S1, and M1 seems effective in reducing central pain
sensitization in chronic pain. Excitation produced by anodal tDCS on the somatosensory cortex is
superior to the M1 or DLPFC for the alleviation of chronic headaches.
Keywords: tDCS, chronic headache
