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Brietzke AP, Rozisky JR, Dussan-Sarria JA, et al. Neuroplastic Effects of Transcranial Direct Current Stimulation on Painful Symptoms Reduction in Chronic Hepatitis C: A Phase II Randomized, Double Blind, Sham Controlled Trial. Front Neurosci. 2016;9:498doi: 10.3389/fnins.2015.00498.
Brietzke, A. P., Rozisky, J. R., Dussan-Sarria, J. A., Deitos, A., Laste, G., Hoppe, P. F., Muller, S., Torres, I. L., Alvares-da-Silva, M. R., de Amorim, R. F., Fregni, F., & Caumo, W. (2015). Neuroplastic Effects of Transcranial Direct Current Stimulation on Painful Symptoms Reduction in Chronic Hepatitis C: A Phase II Randomized, Double Blind, Sham Controlled Trial. Frontiers in neuroscience, 9498. https://doi.org/10.3389/fnins.2015.00498
Brietzke, Aline P, et al. "Neuroplastic Effects of Transcranial Direct Current Stimulation on Painful Symptoms Reduction in Chronic Hepatitis C: A Phase II Randomized, Double Blind, Sham Controlled Trial." Frontiers in neuroscience vol. 9 (2015): 498. doi: https://doi.org/10.3389/fnins.2015.00498
Brietzke AP, Rozisky JR, Dussan-Sarria JA, Deitos A, Laste G, Hoppe PF, Muller S, Torres IL, Alvares-da-Silva MR, de Amorim RF, Fregni F, Caumo W. Neuroplastic Effects of Transcranial Direct Current Stimulation on Painful Symptoms Reduction in Chronic Hepatitis C: A Phase II Randomized, Double Blind, Sham Controlled Trial. Front Neurosci. 2016 Jan 11;9:498. doi: 10.3389/fnins.2015.00498. eCollection 2015. PMID: 26793047; PMCID: PMC4707227.
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Front Neurosci. 2016 Jan 11;9:498. doi: 10.3389/fnins.2015.00498. eCollection 2015.

Neuroplastic Effects of Transcranial Direct Current Stimulation on Painful Symptoms Reduction in Chronic Hepatitis C: A Phase II Randomized, Double Blind, Sham Controlled Trial.

Frontiers in neuroscience

Aline P Brietzke, Joanna R Rozisky, Jairo A Dussan-Sarria, Alicia Deitos, Gabriela Laste, Priscila F T Hoppe, Suzana Muller, Iraci L S Torres, Mário R Alvares-da-Silva, Rivadavio F B de Amorim, Felipe Fregni, Wolnei Caumo

Affiliations

  1. Laboratory of Pain and Neuromodulation, Department of Clinical Research Center, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul Porto Alegre, Brazil.
  2. Department of Internal Medicine (Gastroenterology/Hepatology), Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul Porto Alegre, Brazil.
  3. Laboratory of Neuromodulation and Center for Clinical Research Learning, Physics and Rehabilitation Department, Spaulding Rehabilitation Hospital Boston, MA, USA.

PMID: 26793047 PMCID: PMC4707227 DOI: 10.3389/fnins.2015.00498

Abstract

INTRODUCTION: Pegylated Interferon Alpha (Peg-IFN) in combination with other drugs is the standard treatment for chronic hepatitis C infection (HCV) and is related to severe painful symptoms. The aim of this study was access the efficacy of transcranial direct current stimulation (tDCS) in controlling the painful symptoms related to Peg-IFN side effects.

MATERIALS AND METHODS: In this phase II double-blind trial, twenty eight (n = 28) HCV subjects were randomized to receive either 5 consecutive days of active tDCS (n = 14) or sham (n = 14) during 5 consecutive days with anodal stimulation over the primary motor cortex region using 2 mA for 20 min. The primary outcomes were visual analogue scale (VAS) pain and brain-derived neurotrophic factor (BDNF) serum levels. Secondary outcomes were the pressure-pain threshold (PPT), the Brazilian Profile of Chronic Pain: Screen (B-PCP:S), and drug analgesics use.

RESULTS: tDCS reduced the VAS scores (P < 0.003), with a mean pain drop of 56% (p < 0.001). Furthermore, tDCS was able to enhance BDNF levels (p < 0.01). The mean increase was 37.48% in the active group. Finally, tDCS raised PPT (p < 0.001) and reduced the B-PCP:S scores and analgesic use (p < 0.05).

CONCLUSIONS: Five sessions of tDCS were effective in reducing the painful symptoms in HCV patients undergoing Peg-IFN treatment. These findings support the efficacy of tDCS as a promising therapeutic tool to improve the tolerance of the side effects related to the use of Peg-IFN. Future larger studies (phase III and IV trials) are needed to confirm the clinical use of the therapeutic effects of tDCS in such condition.

TRIAL REGISTRATION: Brazilian Human Health Regulator for Research with the approval number CAAE 07802012.0.0000.5327.

Keywords: Hepatitis C; Hepatitis C virus; PEG-IFN; chronic pain; transcranial direct current stimulation

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