BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation
Volume 4, Issue 1 , Pages 38-42, January 2011

Reducing procedural pain and discomfort associated with transcranial direct current stimulation

  • James L. McFadden

      Affiliations

    • Brain Stimulation Laboratory, Medical University of South Carolina, Charleston, South Carolina
    • ,
  • Jeff J. Borckardt

      Affiliations

    • Brain Stimulation Laboratory, Medical University of South Carolina, Charleston, South Carolina
    • Corresponding Author InformationCorrespondence to: Jeff Borckardt, MUSC Institute of Psychiatry, 67 President St, PH 518, Charleston, SC 29425.
    • ,
  • Mark S. George

      Affiliations

    • Brain Stimulation Laboratory, Medical University of South Carolina, Charleston, South Carolina
    • Ralph H. Johnson VA Medical Center, Charleston, South Carolina
    • ,
  • William Beam

      Affiliations

    • Brain Stimulation Laboratory, Medical University of South Carolina, Charleston, South Carolina

Received 13 January 2010; received in revised form 14 April 2010; accepted 20 May 2010. published online 18 June 2010.

Background

Transcranial direct current stimulation (tDCS) appears to have modulatory effects on the excitability of cortical brain tissue. Though tDCS as presently applied causes no apparent harm to brain structure or function, a number of uncomfortable sensations can occur beneath the electrodes during stimulation, including tingling, pain, itching, and burning sensations. Therefore, we investigated the effect of topically applied Eutectic mixture of local anesthetics (EMLA) on tDCS-related discomfort.

Methods

Nine healthy adults received both anodal and cathodal 2.0 mA tDCS for 5 minutes over the prefrontal cortex with the skin pretreated for 20 minutes with either EMLA or placebo cream. Participants rated procedural discomfort six times across eight dimensions of sensation.

Results

On average, the mean sensation ratings for EMLA-associated tDCS stimulation were significantly lower than placebo-associated stimulation for every cutaneous sensation evaluated. Cathodal stimulation was associated with higher ratings of “sharpness” and intolerability than anodal stimulation.

Conclusions

Topical EMLA may reduce tDCS-related discomfort.

Keywords: anode, cathode, EMLA, pain reduction, transcranial direct current stimulation, tDCS

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 Mr McFadden was funded through a grant from the Medical University of South Carolina College of Graduate Studies Summer Health Professionals Research Program.

 Dr George was funded through grants from the National Institutes of Health (National Institute of Mental Health, National Institute on Drug Abuse, National Institutes), the Department of Defense and Veterans Administration.

 Dr Borckardt was funded through grants from the National Institutes of Health (National Institute of Neurological Disorders and Stroke, National Institute of Nursing Research) and the Robert Wood Johnson Foundation.

PII: S1935-861X(10)00058-6

doi:10.1016/j.brs.2010.05.002

BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation
Volume 4, Issue 1 , Pages 38-42, January 2011

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