Neuroplastic Effects of Transcranial Direct Current Stimulation on Painful Symptoms Reduction in Chronic Hepatitis C: A Phase ll Randomized, Double Blind, Sham Controlled Trial
Neuroplastic Effects of Transcranial Direct Current Stimulation on Painful Symptoms Reduction in Chronic Hepatitis C: A Phase ll Randomized, Double Blind, Sham Controlled Trial
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DOI：
10.3389/fnins.2015.00498
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发表时间：
2016-01-11
影响因子：
4.3
通讯作者：
Caumo, Wolnei
中科院分区：
文献类型：
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作者：
Brietzke, Aline P.;Rozisky, Joanna R.;Caumo, Wolnei
简介：聚乙二醇干扰素α（Peg-IFN）与其他药物联合使用是慢性丙型肝炎感染（HCV）的标准治疗方法，与严重的疼痛症状有关。本研究的目的是评估经颅直流电刺激（tDCS）在控制与聚乙二醇干扰素副作用相关的疼痛症状方面的疗效。材料和方法：在这个II期双盲试验中，28名HCV受试者随机接受连续5天的活性tDCS（n = 14）或假手术（n = 14）在连续5天的初级运动皮层区域使用2 mA的阳极刺激20 min。主要结果是视觉模拟评分（VAS）疼痛和脑源性神经营养因子（BDNF）血清水平。次要结果是压力疼痛阈值（PPT），慢性疼痛的巴西概况：屏幕（B-PCP：S），和药物镇痛剂的使用。结果：tDCS降低VAS评分（P < 0.003），平均疼痛下降56%（P < 0.001）。此外，tDCS能够提高BDNF水平（p < 0.01）。治疗组平均增加37.48%。最后，tDCS提高了PPT（p < 0.001），减少了B-PCP：S评分和镇痛剂使用（p < 0.05）。结论：5次tDCS治疗可有效减轻接受Peg-IFN治疗的HCV患者的疼痛症状。这些发现支持tDCS作为一种有前途的治疗工具的功效，以改善与使用Peg-IFN相关的副作用的耐受性。未来需要进行更大规模的研究（III期和IV期试验），以确认tDCS在此类疾病中的治疗效果的临床应用。
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.