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5. Self-administered transcranial direct current stimulation treatment of knee osteoarthritis alters pain-related fNIRS connectivity networks

Author

Montero-Hernandez, Samuel, Pollonini, Luca, Park, Lindsey, Martorella, Geraldine, Miao, Hongyu, Mathis, Kenneth B., Ahn, Hyochol, Montero-Hernandez, Samuel, Pollonini, Luca, Park, Lindsey, Martorella, Geraldine, Miao, Hongyu, Mathis, Kenneth B., and Ahn, Hyochol

Abstract

Epub 2023 Mar 31, Significance: Knee osteoarthritis (OA) is a disease that causes chronic pain in the elderly population. Currently, OA is mainly treated pharmacologically with analgesics, although research has shown that neuromodulation via transcranial direct current stimulation (tDCS) may be beneficial in reducing pain in clinical settings. However, no studies have reported the effects of home-based self-administered tDCS on functional brain networks in older adults with knee OA. Aim: We used functional near-infrared spectroscopy (fNIRS) to investigate the functional connectivity effects of tDCS on underlying pain processing mechanisms at the central nervous level in older adults with knee OA. Approach: Pain-related brain connectivity networks were extracted using fNIRS at baseline and for three consecutive weeks of treatment from 120 subjects randomly assigned to two groups undergoing active tDCS and sham tDCS. Results: Our results showed that the tDCS intervention significantly modulated pain-related connectivity correlation only in the group receiving active treatment. We also found that only the active treatment group showed a significantly reduced number and strength of functional connections evoked during nociception in the prefrontal cortex, primary motor (M1), and primary somatosensory (S1) cortices. To our knowledge, this is the first study in which the effect of tDCS on pain-related connectivity networks is investigated using fNIRS. Conclusions: fNIRS-based functional connectivity can be effectively used to investigate neural circuits of pain at the cortical level in association with nonpharmacological, self-administered tDCS treatment.

Published
2023

12. List of contributors

Author

Antelis, Javier M., Avalos, Omar, Barrón-Estrada, María Lucía, Cano Ortiz, Sergio D., Cruz-Martínez, Claudia, Cuervo-Soto, Bibiana, Delijorge, Jonathan, Durand Rivera, Juan Alfredo, Escalante, Hugo Jair, Filigrana-de-la-Cruz, María A., Fuentes-Aguilar, Rita Q., Gálvez, Jorge, Garcia-Gonzalez, Alejandro, García-Salinas, Jesús S., Harmony, Thalía, Hernández-Del-Toro, Tonatiuh, Herrera-Vega, Javier, Hinojosa-Rodríguez, Manuel, López-Monroy, A. Pastor, Mandujano Valdes, Mario, Martínez González, Claudia Lizbeth, Martínez Ortiz, Efraín José, Martínez-Santiago, Fernando, Mendoza-Montoya, Omar, Moctezuma, Luis A., Molinas, Marta, Mónica Carlier, María E., Montejo-Ráez, Arturo, Montero-Hernández, Samuel A., Morales, Eduardo F., Moreno Escobar, Jesús Jaime, Orihuela-Espina, Felipe, Pérez-Espinosa, Humberto, Reyes-Galaviz, Orion F., Reyes-García, Carlos A., Rojas-Cisneros, Michelle, Rosales-Pérez, Alejandro, Sossa, Humberto, Torres-García, Alejandro A., Villaseñor-Pineda, Luis, Virgilio-G., Carlos D., Wario, Fernando, and Zatarain-Cabada, Ramón

Published
2022
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14. Subjective and Objective Pain Assessment in Persons with Alzheimer’s Disease and Related Dementias: Comparisons Among Self-Report of Pain, Observer-Rated Pain Assessment, and Functional Near-Infrared Spectroscopy

Author

Park, Juyoung, Montero-Hernandez, Samuel, Huff, Allison J., Park, Lindsey, Lin, Lifeng, and Ahn, Hyochol

Abstract

Pain assessment in older adults with Alzheimer’s disease and related dementias (ADRD) is challenging due to memory and judgment impairment and limited ability to report pain verbally. There is growing interest in neuroimaging technology to measure pain at the neural level, such as functional near-infrared spectroscopy (fNIRS), for monitoring cerebral hemodynamic changes. The purpose of this study was to determine whether fNIRS is a reliable objective pain measure for older adults with early-stage ADRD. We compared clinical pain scores from two subjective pain measures—self-report (Numerical Rating Scale [NRS]) and caregiver’s observational report (Mobilization-Observation-Behavior-Intensity-Dementia-2 [MOBID-2])—and objective pain-related cortical response (fNIRS). In 40 older adults (mean 73 years [SD= 7.87], 90% White, 72.5% women) with early-stage ADRD, there was a significantly moderate to strong positive correlation between (a) self-reports and caregiver observations (r =.605, p <.05), (b) NRS and fNIRS measures for channels covering left frontal superior medial (r=.552, p<.05) and right frontal superior orbital (r=.553, p<.05) areas, and (c) MOBID-2 and fNIRS covering right frontal superior orbital (r=.568, p<.05) and frontal middle right region, r=.496, p<.05. Results indicated that fNIRS can be used as a supplement to subjective pain measures for older adults with early-stage ADRD in healthcare settings. Research is needed to test validity of fNIRS as complementary to subjective measures of pain assessment for early-stage ADRD. This trial was registered at www.clinicaltrials.gov (NCT04457973). Funded by National Institutes of Health (R15NR018050).

Published
2024
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