Effect of transcranial direct current stimulation on pain and mood in end-stage renal disease patients: a randomized clinical trial

ABSTRACT

BACKGROUND AND OBJECTIVES  Chronic kidney disease (CKD) is a significant public health concern. Patients affected by chronic kidney problems often experience symptoms, such as pain and mood disorders, while awaiting a transplant. Nonpharmacological interventions with no collateral effects are necessary for managing the symptoms. The objective of this study was to assess the effects of transcranial direct current stimulation (tDCS) on pain, anxiety, and depression in patients affected by CKD.

METHODS  This is a single-center, double-blinded, parallel, randomized sham-controlled clinical trial. The interventions consisted of ten non-consecutive sessions of anodal tDCS over the left dorsolateral prefrontal cortex and the cathode over the contralateral supraorbital region. Each session lasted 20 min with an intensity of 2 mA. This clinical trial included patients with CKD who experienced chronic pain and had been undergoing hemodialysis for more than three months. There were four assessments: at baseline, after the first and last intervention, and seven days after the last intervention (follow-up).

RESULTS  There was a significant interaction between group and time regarding pain (p=0.0005; partial η² = 0.362) and a significant time interaction (p = 0.0005, partial η² = 0.659) with significant differences between groups at day 10 (p= 0.004; partial η² = 0.37) and follow-up (p= 0.03; partial η² = 0.22). Additionally, there was a significant difference between groups for anxiety (p<0.02, partial η²= 0.258).

CONCLUSION  After ten sessions of tDCS, patients affected by chronic kidney disease showed a reduction in pain, anxiety, and depression.

Keywords:
Chronic pain; Hemodialysis; Neuromodulation; Noninvasive brain stimulation; Quality of life

HIGHLIGHTS

Patients affected by chronic kidney disease often suffer from pain and mood disorders

The study involved ten non-consecutive sessions of anodal transcranial direct current stimulation (tDCS) over the left dorsolateral prefrontal cortex, with each session lasting 20 minutes at 2 mA

tDCS provided significant reductions in pain and anxiety, with notable differences between groups at day 10 and follow-up assessments