Transcranial direct current stimulation alleviates the pain severity in people suffering from knee osteoarthritis: a systematic review and meta-analysis

Abstract. Considerable research has shown the benefits of transcranial direct current stimulation (tDCS) for the alleviation of pain associated with knee osteoarthritis (KOA). Still, a large variance in study protocols and observations across publications exists. We here thus completed a systematic...

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Main Authors: Tian Dai, Meng Liu, Dapeng Bao, Brad Manor, Junhong Zhou
Format: Article
Language:English
Published: Wolters Kluwer 2025-02-01
Series:PAIN Reports
Online Access:http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001215
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author Tian Dai
Meng Liu
Dapeng Bao
Brad Manor
Junhong Zhou
author_facet Tian Dai
Meng Liu
Dapeng Bao
Brad Manor
Junhong Zhou
author_sort Tian Dai
collection DOAJ
description Abstract. Considerable research has shown the benefits of transcranial direct current stimulation (tDCS) for the alleviation of pain associated with knee osteoarthritis (KOA). Still, a large variance in study protocols and observations across publications exists. We here thus completed a systematic review and meta-analysis to comprehensively and quantitatively characterize the effects of tDCS on KOA-related pain. A search strategy based on the Population, Intervention, Comparison, Outcome, and Study design (PICOS) principle was used to obtain the publications in 7 databases. Studies exploring the effects of tDCS on KOA-related pain were screened, and eligible studies were included. Ten studies of 518 participants using Visual Analogue Scale or Numeric Rating Scale to assess pain were included in the systematic review, and 9 of them were included in meta-analysis. The quality of these studies was good. Compared to control, tDCS induced significant short-term improvements in KOA-related pain with medium heterogeneity (standardized mean difference [SMD] = −0.91, 95% confidence interval [−1.24, −0.58], P < 0.001, I2 = 61%). Subgroup analyses showed that both home-based (SMD = −1.32, 95% CI [−1.65, −0.99], P < 0.001, I2 = 0%) and laboratory-based intervention (SMD = −0.66, 95% CI [−0.99, −0.33], P < 0.001, I2 = 40%) with at least 5 sessions per week (SMD = −1.02, 95% CI [−1.41, −0.64], P < 0.001, I2 = 65%) and/or with a total number of at least 10 sessions (SMD = −1.12, 95% CI [−1.51, −0.74], P < 0.001, I2 = 59%) can induce maximum benefits for the alleviation of KOA-related pain. The results here showed that tDCS is of great promise to alleviate KOA-related pain. Still, future studies with more rigorous design are needed to confirm the observations from this work, which can ultimately help the determination of appropriate intervention protocol that can maximize such benefits.
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spelling doaj-art-448a8a1e143f426c85ee5f43897fcbf22025-08-20T02:40:30ZengWolters KluwerPAIN Reports2471-25312025-02-01101e121510.1097/PR9.0000000000001215PR90000000000001215Transcranial direct current stimulation alleviates the pain severity in people suffering from knee osteoarthritis: a systematic review and meta-analysisTian Dai0Meng Liu1Dapeng Bao2Brad Manor3Junhong Zhou4a China Institute of Sport and Health Science, Beijing Sport University, Beijing, Chinac Sports Coaching College, Beijing Sport University, Beijing, Chinaa China Institute of Sport and Health Science, Beijing Sport University, Beijing, Chinaf Hebrew SeniorLife Hinda and Arthur Marcus Institute for Aging Research, Harvard Medical School, Boston, MA, USAf Hebrew SeniorLife Hinda and Arthur Marcus Institute for Aging Research, Harvard Medical School, Boston, MA, USAAbstract. Considerable research has shown the benefits of transcranial direct current stimulation (tDCS) for the alleviation of pain associated with knee osteoarthritis (KOA). Still, a large variance in study protocols and observations across publications exists. We here thus completed a systematic review and meta-analysis to comprehensively and quantitatively characterize the effects of tDCS on KOA-related pain. A search strategy based on the Population, Intervention, Comparison, Outcome, and Study design (PICOS) principle was used to obtain the publications in 7 databases. Studies exploring the effects of tDCS on KOA-related pain were screened, and eligible studies were included. Ten studies of 518 participants using Visual Analogue Scale or Numeric Rating Scale to assess pain were included in the systematic review, and 9 of them were included in meta-analysis. The quality of these studies was good. Compared to control, tDCS induced significant short-term improvements in KOA-related pain with medium heterogeneity (standardized mean difference [SMD] = −0.91, 95% confidence interval [−1.24, −0.58], P < 0.001, I2 = 61%). Subgroup analyses showed that both home-based (SMD = −1.32, 95% CI [−1.65, −0.99], P < 0.001, I2 = 0%) and laboratory-based intervention (SMD = −0.66, 95% CI [−0.99, −0.33], P < 0.001, I2 = 40%) with at least 5 sessions per week (SMD = −1.02, 95% CI [−1.41, −0.64], P < 0.001, I2 = 65%) and/or with a total number of at least 10 sessions (SMD = −1.12, 95% CI [−1.51, −0.74], P < 0.001, I2 = 59%) can induce maximum benefits for the alleviation of KOA-related pain. The results here showed that tDCS is of great promise to alleviate KOA-related pain. Still, future studies with more rigorous design are needed to confirm the observations from this work, which can ultimately help the determination of appropriate intervention protocol that can maximize such benefits.http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001215
spellingShingle Tian Dai
Meng Liu
Dapeng Bao
Brad Manor
Junhong Zhou
Transcranial direct current stimulation alleviates the pain severity in people suffering from knee osteoarthritis: a systematic review and meta-analysis
PAIN Reports
title Transcranial direct current stimulation alleviates the pain severity in people suffering from knee osteoarthritis: a systematic review and meta-analysis
title_full Transcranial direct current stimulation alleviates the pain severity in people suffering from knee osteoarthritis: a systematic review and meta-analysis
title_fullStr Transcranial direct current stimulation alleviates the pain severity in people suffering from knee osteoarthritis: a systematic review and meta-analysis
title_full_unstemmed Transcranial direct current stimulation alleviates the pain severity in people suffering from knee osteoarthritis: a systematic review and meta-analysis
title_short Transcranial direct current stimulation alleviates the pain severity in people suffering from knee osteoarthritis: a systematic review and meta-analysis
title_sort transcranial direct current stimulation alleviates the pain severity in people suffering from knee osteoarthritis a systematic review and meta analysis
url http://journals.lww.com/painrpts/fulltext/10.1097/PR9.0000000000001215
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