Feasibility of remotely-supervised tDCS in a person with neuropathic pain due to spinal cord injury

Abstract

[Excerpt] Nearly 40% of people with spinal cord injury (SCI) report neuropathic pain that is often refractory to medications.1,2 Substantial research has shown that anodal transcranial direct current stimulation (tDCS) over the motor cortex can induce clinically significant pain relief in chronic pain.3–6 However, these clinical trials often require multiple study visits per trial and are associated to poor adherence to the study protocol. For instance, in our recent tDCS study in SCI, only 7 participants from the initial 46 that were enrolled completed the study.7 In fact, despite all attempts to improve adherence, such as flexibility to schedule sessions, free parking and follow-ups by the phone, most participants ended up dropping out from the study. Since many people with SCI have limited mobility, alternatives for home-based care are needed. Here we report the feasibility of supervised home-based tDCS application in a 57-year old woman with tetraplegia and sublesional neuropathic pain secondary to SCI since 2012. At time of enrollment, she self-reported pain as being 9 out of 10 in a visual analogue scale. [...]