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Transcranial direct current stimulation (tDCS) over the primary motor cortex (M1) will be applied for patient who suffer from neuropathic pain following spinal cord injury The tDCS treatment will be coupled with a video of a man walking (creating a visual illusion) in order to enhance functional ability and reduce pain
Non-invasive cortical brain stimulation is a promising method for treating cases of neuropathic pain in patients with spinal cord injury (SCI). Transcranial direct current stimulation (tDCS) over the primary motor cortex (M1) appears to modulate cortical excitability and can reduce pain levels following SCI, however its effects remaining for short-term and may not be useful for the rehabilitation progress in these patients.
Recent findings suggest that M1 stimulation combined with visual illusion (VI) enhances the reduction in pain which maintain up to 3 month following treatment. The current study aims to reveal whether reduction of neuropathic pain in patients with SCI through tDCS have beneficial effect on functional ability during rehabilitation program.
In the present study the investigators will use anodal stimulation of the M1 via neuroConn DC stimulator. Current intensity of 2mA or sham stimulation will be given during 20 min in parallel to a visual illusion of walking legs (or neutral video for sham stimuli).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| intervention tDCS+VI | Experimental | The anode will be placed over C3-C4 (EEG 10/20 system) to target M1 and the cathode over the contralateral supraorbital area. The stimulation will apply to the hemisphere which contralateral to the more painful hemi body. 2mA will be delivered over 20 min via neuroConn DC stimulator combined with video presenting walking legs. A total of 10 sessions (5 per week) will be administrated at the same manner. |
|
| tDCS Sham+VI Sham | Sham Comparator | The stimulation will be turned on for only short duration (up to 30 sec), the video film will contains graphical illustrations or nature movie without human movement. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| tDCS+VI | Device | 2mA will be delivered over 20min to M1 via neuroConn DC stimulator combined with video presenting walking legs. |
|
| Measure | Description | Time Frame |
|---|---|---|
| change in SCIM 3 (scale) | spinal cord independence measure | up to 7 day before and following the treatment |
| Measure | Description | Time Frame |
|---|---|---|
| change in VAS (Visual Analog Scale) | reported subjective pain scale | up to 7 day before and following the treatment |
| change in BPI (Brief Pain Inventory) | up to 24h before and following the treatment |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Rotem Gur, Ph.D | Contact | 97297709170 | rotemgu@clalit.org.il | |
| Motti Ratmansky, MD | Contact | 97297709102 | mottir@clalit.org.il |
| Name | Affiliation | Role |
|---|---|---|
| Motti Ratmansky, MD | Loewenstein Rehabilitation Center | Principal Investigator |
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| ID | Term |
|---|---|
| D013119 | Spinal Cord Injuries |
| D007088 | Illusions |
| D009437 | Neuralgia |
| ID | Term |
|---|---|
| D013118 | Spinal Cord Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D020196 | Trauma, Nervous System |
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| tDCS Sham+VI Sham | Device | 2mA will be delivered up to 30 sec to M1 via neuroConn DC stimulator combined with video presenting graphical illustration or nature movie for total duration of 20 min. |
|
|
| D014947 | Wounds and Injuries |
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010523 | Peripheral Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
| D010146 | Pain |