Effect of Anodal Transcranial Direct Current Stimulation on the Intensity of Post-dural Puncture Headache: Results of Two Randomized Sham Controlled Trials
Abstract Introduction Post-dural puncture headache (PDPH) is a common complication of diagnostic lumbar puncture (LP), often leading to extended hospitalization and additional medication use. Clinical studies have shown that anodal transcranial direct current stimulation (a-tDCS) is effective agains...
Saved in:
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Adis, Springer Healthcare
2025-04-01
|
| Series: | Neurology and Therapy |
| Subjects: | |
| Online Access: | https://doi.org/10.1007/s40120-025-00734-w |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850269131242209280 |
|---|---|
| author | Bledar Gjikolaj Mario Stampanoni Bassi Antonio Bruno Valeria De Ioanni Ettore Dolcetti Sheila Peter Giovanni Galifi Antonella Conte Luana Gilio Diego Centonze Fabio Buttari |
| author_facet | Bledar Gjikolaj Mario Stampanoni Bassi Antonio Bruno Valeria De Ioanni Ettore Dolcetti Sheila Peter Giovanni Galifi Antonella Conte Luana Gilio Diego Centonze Fabio Buttari |
| author_sort | Bledar Gjikolaj |
| collection | DOAJ |
| description | Abstract Introduction Post-dural puncture headache (PDPH) is a common complication of diagnostic lumbar puncture (LP), often leading to extended hospitalization and additional medication use. Clinical studies have shown that anodal transcranial direct current stimulation (a-tDCS) is effective against migraine, and thus we decided to assess whether a-tDCS was also effective in treating and preventing PDPH. Methods In two independent, randomized, monocentric controlled trials (RCTs), we enrolled 97 hospitalized participants who underwent LP for diagnostic purposes. Patients were randomized to receive either active a-tDCS or sham tDCS over the dominant primary motor cortex (M1) in a therapeutic tDCS (Th-tDCS) or preventive tDCS (Pr-tDCS) study. In the two trials, the primary outcome was the severity of PDPH measured using the Visual Analogue Scale (VAS) for pain. Secondary outcomes included the Brief Pain Inventory (BPI) to evaluate other pain-related symptoms associated with LP. Results In the Th-tDCS study, significant differences between groups were observed after tDCS in the VAS (F = 17.011, p < 0.001), as well as in BPI intensity (F = 17.006, p < 0.001) and BPI interference (F = 14.730, p < 0.001). Moreover, in the Pr-tDCS study, VAS analysis showed a significant time × group interaction (F = 6.918, p = 0.002). Significant differences were also observed in BPI intensity (F = 17.866, p < 0.001) and BPI interference (F = 15.520, p < 0.001). Conclusions Our findings suggest that a-tDCS may effectively prevent and treat PDPH and alleviate other pain-related symptoms associated with LP. Encouraging results have emerged for the use of a-tDCS in patients undergoing LP, in both experimental research designs (Th-tDCS and Pr-tDCS). A non-invasive brain stimulation (NIBS) technique, such as a-tDCS, could have a therapeutic and preventive effect on pain resulting from a LP. Trial Registration ClinicalTrials.gov (ID: NCT06640634) retrospectively registered on October 8, 2024. |
| format | Article |
| id | doaj-art-0b32115782b7457cbb5db0f5afee5c46 |
| institution | OA Journals |
| issn | 2193-8253 2193-6536 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Neurology and Therapy |
| spelling | doaj-art-0b32115782b7457cbb5db0f5afee5c462025-08-20T01:53:15ZengAdis, Springer HealthcareNeurology and Therapy2193-82532193-65362025-04-01143989100610.1007/s40120-025-00734-wEffect of Anodal Transcranial Direct Current Stimulation on the Intensity of Post-dural Puncture Headache: Results of Two Randomized Sham Controlled TrialsBledar Gjikolaj0Mario Stampanoni Bassi1Antonio Bruno2Valeria De Ioanni3Ettore Dolcetti4Sheila Peter5Giovanni Galifi6Antonella Conte7Luana Gilio8Diego Centonze9Fabio Buttari10Department of Systems Medicine, Tor Vergata UniversityUnit of Neurology, IRCCS NeuromedUnit of Neurology, IRCCS NeuromedUnit of Neurology, IRCCS NeuromedUnit of Neurology, IRCCS NeuromedDepartment of Systems Medicine, Tor Vergata UniversityDepartment of Systems Medicine, Tor Vergata UniversityUnit of Neurology, IRCCS NeuromedUnit of Neurology, IRCCS NeuromedDepartment of Systems Medicine, Tor Vergata UniversityDepartment of Systems Medicine, Tor Vergata UniversityAbstract Introduction Post-dural puncture headache (PDPH) is a common complication of diagnostic lumbar puncture (LP), often leading to extended hospitalization and additional medication use. Clinical studies have shown that anodal transcranial direct current stimulation (a-tDCS) is effective against migraine, and thus we decided to assess whether a-tDCS was also effective in treating and preventing PDPH. Methods In two independent, randomized, monocentric controlled trials (RCTs), we enrolled 97 hospitalized participants who underwent LP for diagnostic purposes. Patients were randomized to receive either active a-tDCS or sham tDCS over the dominant primary motor cortex (M1) in a therapeutic tDCS (Th-tDCS) or preventive tDCS (Pr-tDCS) study. In the two trials, the primary outcome was the severity of PDPH measured using the Visual Analogue Scale (VAS) for pain. Secondary outcomes included the Brief Pain Inventory (BPI) to evaluate other pain-related symptoms associated with LP. Results In the Th-tDCS study, significant differences between groups were observed after tDCS in the VAS (F = 17.011, p < 0.001), as well as in BPI intensity (F = 17.006, p < 0.001) and BPI interference (F = 14.730, p < 0.001). Moreover, in the Pr-tDCS study, VAS analysis showed a significant time × group interaction (F = 6.918, p = 0.002). Significant differences were also observed in BPI intensity (F = 17.866, p < 0.001) and BPI interference (F = 15.520, p < 0.001). Conclusions Our findings suggest that a-tDCS may effectively prevent and treat PDPH and alleviate other pain-related symptoms associated with LP. Encouraging results have emerged for the use of a-tDCS in patients undergoing LP, in both experimental research designs (Th-tDCS and Pr-tDCS). A non-invasive brain stimulation (NIBS) technique, such as a-tDCS, could have a therapeutic and preventive effect on pain resulting from a LP. Trial Registration ClinicalTrials.gov (ID: NCT06640634) retrospectively registered on October 8, 2024.https://doi.org/10.1007/s40120-025-00734-wHeadacheNeuromodulationNon-invasive brain stimulationPost-dural puncture headacheTranscranial direct current stimulation |
| spellingShingle | Bledar Gjikolaj Mario Stampanoni Bassi Antonio Bruno Valeria De Ioanni Ettore Dolcetti Sheila Peter Giovanni Galifi Antonella Conte Luana Gilio Diego Centonze Fabio Buttari Effect of Anodal Transcranial Direct Current Stimulation on the Intensity of Post-dural Puncture Headache: Results of Two Randomized Sham Controlled Trials Neurology and Therapy Headache Neuromodulation Non-invasive brain stimulation Post-dural puncture headache Transcranial direct current stimulation |
| title | Effect of Anodal Transcranial Direct Current Stimulation on the Intensity of Post-dural Puncture Headache: Results of Two Randomized Sham Controlled Trials |
| title_full | Effect of Anodal Transcranial Direct Current Stimulation on the Intensity of Post-dural Puncture Headache: Results of Two Randomized Sham Controlled Trials |
| title_fullStr | Effect of Anodal Transcranial Direct Current Stimulation on the Intensity of Post-dural Puncture Headache: Results of Two Randomized Sham Controlled Trials |
| title_full_unstemmed | Effect of Anodal Transcranial Direct Current Stimulation on the Intensity of Post-dural Puncture Headache: Results of Two Randomized Sham Controlled Trials |
| title_short | Effect of Anodal Transcranial Direct Current Stimulation on the Intensity of Post-dural Puncture Headache: Results of Two Randomized Sham Controlled Trials |
| title_sort | effect of anodal transcranial direct current stimulation on the intensity of post dural puncture headache results of two randomized sham controlled trials |
| topic | Headache Neuromodulation Non-invasive brain stimulation Post-dural puncture headache Transcranial direct current stimulation |
| url | https://doi.org/10.1007/s40120-025-00734-w |
| work_keys_str_mv | AT bledargjikolaj effectofanodaltranscranialdirectcurrentstimulationontheintensityofpostduralpunctureheadacheresultsoftworandomizedshamcontrolledtrials AT mariostampanonibassi effectofanodaltranscranialdirectcurrentstimulationontheintensityofpostduralpunctureheadacheresultsoftworandomizedshamcontrolledtrials AT antoniobruno effectofanodaltranscranialdirectcurrentstimulationontheintensityofpostduralpunctureheadacheresultsoftworandomizedshamcontrolledtrials AT valeriadeioanni effectofanodaltranscranialdirectcurrentstimulationontheintensityofpostduralpunctureheadacheresultsoftworandomizedshamcontrolledtrials AT ettoredolcetti effectofanodaltranscranialdirectcurrentstimulationontheintensityofpostduralpunctureheadacheresultsoftworandomizedshamcontrolledtrials AT sheilapeter effectofanodaltranscranialdirectcurrentstimulationontheintensityofpostduralpunctureheadacheresultsoftworandomizedshamcontrolledtrials AT giovannigalifi effectofanodaltranscranialdirectcurrentstimulationontheintensityofpostduralpunctureheadacheresultsoftworandomizedshamcontrolledtrials AT antonellaconte effectofanodaltranscranialdirectcurrentstimulationontheintensityofpostduralpunctureheadacheresultsoftworandomizedshamcontrolledtrials AT luanagilio effectofanodaltranscranialdirectcurrentstimulationontheintensityofpostduralpunctureheadacheresultsoftworandomizedshamcontrolledtrials AT diegocentonze effectofanodaltranscranialdirectcurrentstimulationontheintensityofpostduralpunctureheadacheresultsoftworandomizedshamcontrolledtrials AT fabiobuttari effectofanodaltranscranialdirectcurrentstimulationontheintensityofpostduralpunctureheadacheresultsoftworandomizedshamcontrolledtrials |