Investigation into the Effectiveness of Combining Transcranial Direct Current Stimulation and Transcutaneous Electrical Nerve Stimulation as Treatment Options for Poststroke Shoulder Pain by Utilizing Functional Near-Infrared Spectroscopy

Yu Li,1 Zhi-Peng Yan,1 Nan-Nan Zhang,1 Jun Ni,1,2 Zhi-Yong Wang1 1Department of Rehabilitation Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, People’s Republic of China; 2Department of Rehabilitation Medicine, th...

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Main Authors: Li Y, Yan ZP, Zhang NN, Ni J, Wang ZY
Format: Article
Language:English
Published: Dove Medical Press 2023-11-01
Series:Therapeutics and Clinical Risk Management
Subjects:
Online Access:https://www.dovepress.com/investigation-into-the-effectiveness-of-combining-transcranial-direct--peer-reviewed-fulltext-article-TCRM
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author Li Y
Yan ZP
Zhang NN
Ni J
Wang ZY
author_facet Li Y
Yan ZP
Zhang NN
Ni J
Wang ZY
author_sort Li Y
collection DOAJ
description Yu Li,1 Zhi-Peng Yan,1 Nan-Nan Zhang,1 Jun Ni,1,2 Zhi-Yong Wang1 1Department of Rehabilitation Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, People’s Republic of China; 2Department of Rehabilitation Medicine, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, People’s Republic of ChinaCorrespondence: Zhi-Yong Wang, Department of Rehabilitation Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital of Fujian Medical University, 999 Huashan Road, Fuzhou, 350212, People’s Republic of China, Tel +86-13635298857, Email fjykdxwzy@163.comObjective: The aim of this study is to explore the therapeutic effects of transcranial direct current stimulation (tDCS) and transcutaneous electrical nerve stimulation (TENS) on post stroke shoulder pain (PSSP).Methods: We enrolled 13 individuals in this study who underwent three different treatments in a random sequence: active tDCS+active TENS, active tDCS+sham TENS, and sham tDCS+active TENS. Each treatment was administered once, with a 3-day washout period between interventions. A blinded rater assessed the visual analog scale (VAS) scores, fNIRS readings, and sensory and pain tolerance thresholds of the participants before and after the stimulation.Results: All three treatment methods can significantly alleviate PSSP (p< 0.05). Compared with using tDCS alone, tDCS+TENS can significantly improve pain, with a statistically significant difference (p< 0.05). In the 2KHz PTT task, the three treatment methods showed significant differences (p< 0.05) in the mean oxygenated hemoglobin (HbO) levels in the false premotor cortex (PMC)/auxiliary motor area (SMA) before and after intervention.Conclusion: The combination of tDCS+TENS can increase the pain-relieving impact on PSSP when compared to using tDCS alone. TENS may contribute an additional effect on the inhibitory systems influenced by tDCS that help reduce pain.Clinical Registration Number: Registration website: https://www.chictr.org.cn. Registration date: 2022-02-25. Registration number: ChiCTR2200056970.Keywords: functional near-infrared spectroscopy, pain tolerance threshold, post-stroke shoulder pain, transcranial direct current stimulation, transcutaneous electrical nerve stimulation
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spelling doaj.art-9694cbd481e64d4c959242e4deebb9dc2023-11-09T17:11:20ZengDove Medical PressTherapeutics and Clinical Risk Management1178-203X2023-11-01Volume 1987588788059Investigation into the Effectiveness of Combining Transcranial Direct Current Stimulation and Transcutaneous Electrical Nerve Stimulation as Treatment Options for Poststroke Shoulder Pain by Utilizing Functional Near-Infrared SpectroscopyLi YYan ZPZhang NNNi JWang ZYYu Li,1 Zhi-Peng Yan,1 Nan-Nan Zhang,1 Jun Ni,1,2 Zhi-Yong Wang1 1Department of Rehabilitation Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, People’s Republic of China; 2Department of Rehabilitation Medicine, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, People’s Republic of ChinaCorrespondence: Zhi-Yong Wang, Department of Rehabilitation Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital of Fujian Medical University, 999 Huashan Road, Fuzhou, 350212, People’s Republic of China, Tel +86-13635298857, Email fjykdxwzy@163.comObjective: The aim of this study is to explore the therapeutic effects of transcranial direct current stimulation (tDCS) and transcutaneous electrical nerve stimulation (TENS) on post stroke shoulder pain (PSSP).Methods: We enrolled 13 individuals in this study who underwent three different treatments in a random sequence: active tDCS+active TENS, active tDCS+sham TENS, and sham tDCS+active TENS. Each treatment was administered once, with a 3-day washout period between interventions. A blinded rater assessed the visual analog scale (VAS) scores, fNIRS readings, and sensory and pain tolerance thresholds of the participants before and after the stimulation.Results: All three treatment methods can significantly alleviate PSSP (p< 0.05). Compared with using tDCS alone, tDCS+TENS can significantly improve pain, with a statistically significant difference (p< 0.05). In the 2KHz PTT task, the three treatment methods showed significant differences (p< 0.05) in the mean oxygenated hemoglobin (HbO) levels in the false premotor cortex (PMC)/auxiliary motor area (SMA) before and after intervention.Conclusion: The combination of tDCS+TENS can increase the pain-relieving impact on PSSP when compared to using tDCS alone. TENS may contribute an additional effect on the inhibitory systems influenced by tDCS that help reduce pain.Clinical Registration Number: Registration website: https://www.chictr.org.cn. Registration date: 2022-02-25. Registration number: ChiCTR2200056970.Keywords: functional near-infrared spectroscopy, pain tolerance threshold, post-stroke shoulder pain, transcranial direct current stimulation, transcutaneous electrical nerve stimulationhttps://www.dovepress.com/investigation-into-the-effectiveness-of-combining-transcranial-direct--peer-reviewed-fulltext-article-TCRMfunctional near-infrared spectroscopypain tolerance thresholdpost-stroke shoulder paintranscranial direct current stimulationtranscutaneous electrical nerve stimulation
spellingShingle Li Y
Yan ZP
Zhang NN
Ni J
Wang ZY
Investigation into the Effectiveness of Combining Transcranial Direct Current Stimulation and Transcutaneous Electrical Nerve Stimulation as Treatment Options for Poststroke Shoulder Pain by Utilizing Functional Near-Infrared Spectroscopy
Therapeutics and Clinical Risk Management
functional near-infrared spectroscopy
pain tolerance threshold
post-stroke shoulder pain
transcranial direct current stimulation
transcutaneous electrical nerve stimulation
title Investigation into the Effectiveness of Combining Transcranial Direct Current Stimulation and Transcutaneous Electrical Nerve Stimulation as Treatment Options for Poststroke Shoulder Pain by Utilizing Functional Near-Infrared Spectroscopy
title_full Investigation into the Effectiveness of Combining Transcranial Direct Current Stimulation and Transcutaneous Electrical Nerve Stimulation as Treatment Options for Poststroke Shoulder Pain by Utilizing Functional Near-Infrared Spectroscopy
title_fullStr Investigation into the Effectiveness of Combining Transcranial Direct Current Stimulation and Transcutaneous Electrical Nerve Stimulation as Treatment Options for Poststroke Shoulder Pain by Utilizing Functional Near-Infrared Spectroscopy
title_full_unstemmed Investigation into the Effectiveness of Combining Transcranial Direct Current Stimulation and Transcutaneous Electrical Nerve Stimulation as Treatment Options for Poststroke Shoulder Pain by Utilizing Functional Near-Infrared Spectroscopy
title_short Investigation into the Effectiveness of Combining Transcranial Direct Current Stimulation and Transcutaneous Electrical Nerve Stimulation as Treatment Options for Poststroke Shoulder Pain by Utilizing Functional Near-Infrared Spectroscopy
title_sort investigation into the effectiveness of combining transcranial direct current stimulation and transcutaneous electrical nerve stimulation as treatment options for poststroke shoulder pain by utilizing functional near infrared spectroscopy
topic functional near-infrared spectroscopy
pain tolerance threshold
post-stroke shoulder pain
transcranial direct current stimulation
transcutaneous electrical nerve stimulation
url https://www.dovepress.com/investigation-into-the-effectiveness-of-combining-transcranial-direct--peer-reviewed-fulltext-article-TCRM
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