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Dysmenorrhea & tDCS

Dysmenorrhea as a leading cause of pain, presents with lower abdominal pain with or without radiation to the low back, is reported in 40-90% of female adolescents and 10-20% of  young adults. It causes a chronic pain syndrome with long intermittent periods ranging 24-72 hours of suffering, severe and distressing enough that it often requires absence from school or work. Symptoms can include primary reduced motor functionality, as well as reduced quality of life and social activities. Other symptoms can include nausea, backache, fatigue, diarrhea, sleeplessness, and nervousness.

Brain studies have observed differences between females with and without dysmenorrhea. Females with chronic menstrual pain have abnormal function and structural changes in the medial prefrontal cortex, posterior cingulate cortex, and insula. These regions form some of the cognitive and emotional networks that process how we respond to pain. Besides the psychological stress caused by the recurrent and chronic menstrual pain, prevailing anxiety, chronic stress, depression, and loneliness increases dysmenorrhea and menstrual cycle problems.

With medication management lacking efficacy, studies have turned to supporting brain networks to change mood and pain processing with dysmenorrhea. Transcranial direct current stimulation (tDCS) has risen as a unique approach toward treating chronic pain syndromes. By placing a positive electrode and a negative electrode in specific regions of the scalp we can transmit an electrical current through the skull to alter cortical excitability and mental processes that alter pain and mood. tDCS has been demonstrated to be a very safe and once trained an easy therapy that can be applied as needed in the comfort of your own home. tDCS sessions last 20 minutes are easily implemented in a flexible at home therapy that is very safe and convenient.

Improve Overall Function

  • Improves mood
  • Decreases pain
  • Increases physical function

REFERENCE

    1. Larissa Ramalho Dantas Varella Dutra et al; Modulating Anxiety and Functional Capacity with Anodal tDCS Over the Left Dorsolateral Prefrontal Cortex in Primary Dysmenorrhea. Int J Womens Health. 2020; 12: 243–251. Published online 2020 Apr 5. doi: 10.2147/IJWH.S226501. PMID: 32308497. PMCID: PMC7147620
    2. Rodrigo Pegado et al; Effects of Transcranial Direct Current Stimulation for Treatment of Primary Dysmenorrhea: Preliminary Results of a Randomized Sham-Controlled Trial. Pain Med. 2020 Dec 25;21(12):3615-3623. doi: 10.1093/pm/pnz202. PMID: 31498389
    3. Peng Liu et al; Changes of functional connectivity of the anterior cingulate cortex in women with primary dysmenorrhea. Brain Imaging Behav. 2018 Jun;12(3):710-717. doi: 10.1007/s11682-017-9730-y. PMID: 28516336
    4. Ting-Hsuan Wu et al; Dynamic Changes of Functional Pain Connectome in Women with Primary Dysmenorrhea. Sci Rep. 2016 Apr 19:6:24543. doi: 10.1038/srep24543. PMID: 27089970. PMCID: PMC4835697
    5. P Liu et al; Altered regional cortical thickness and subcortical volume in women with primary dysmenorrhoea. Eur J Pain. 2016 Apr;20(4):512-20. doi: 10.1002/ejp.753. Epub 2015 Jul 29. PMID: 26223337.
    6. W C Li et al; High prevalence of incidental brain findings in primary dysmenorrhoea. Eur J Pain. 2015 Sep;19(8):1071-4. doi: 10.1002/ejp.639. Epub 2014 Dec 8. PMID: 25487523

Study: Modulating Anxiety and Functional Capacity with Anodal tDCS Over the Left Dorsolateral Prefrontal Cortex in Primary Dysmenorrhea

Background: Primary dysmenorrhea is a common and often debilitating condition affecting 40– 90% of menstruating women. This condition reduces functionality, quality of life, and social activities. Transcranial direct current stimulation (tDCS) has been used in many chronic pain syndromes, with evidence of improved pain, functionality, and mood in women with primary dysmenorrhea. The objective of this study was to determine whether tDCS could offer clinical benefits on pain, anxiety, affectivity, and functionality in women with primary dysmenorrhea.
Methods: This parallel, sham, randomized, double-blind trial was conducted with 26 women randomized into sham tDCS and active tDCS. Anodal tDCS was applied for 5 consecutive days over F3 corresponding to the left dorsolateral prefrontal cortex (DLPFC) and the cathode electrode over Fp2 for 20 min with an intensity of 2 mA. A numeric rating scale (NRS) was used to assess pain, anxiety, positive and negative affect, and submaximal aerobic performance during two consecutive menstrual cycles.
Results: No significant interaction was found between intervention and time on the NRS [F(2,44) = 1.358, =  0.26], and a significant main effect of time [F(2,44) = 4.446, =  0.01] was found. The active group showed a significant reduction in anxiety (p =  0.03) with a mean difference of 5.12 (95% CI 0.79 to 11.05). No significant differences in positive and negative affect were found (p =  0.95 and =  0.15, respectively). Submaximal aerobic performance was significantly greater in the active group [F(2,21) = 5.591, =  0.02], with a mean difference of 70.87 (95% CI 8.53 to 133.21).
Conclusion: Anodal tDCS over the DLPFC seems to be an effective therapeutic approach for improving anxiety and functionality in women with primary dysmenorrhea.

REFERENCE

  1. Larissa Ramalho Dantas Varella Dutra et al; Modulating Anxiety and Functional Capacity with Anodal tDCS Over the Left Dorsolateral Prefrontal Cortex in Primary Dysmenorrhea. Int J Womens Health. 2020; 12: 243–251. Published online 2020 Apr 5. doi: 10.2147/IJWH.S226501. PMID: 32308497. PMCID: PMC7147620

These statements have not been evaluated or approved by the FDA. All of the statements made on this document are not anecdotal and have been taken directly from clinical data.