Pathologies treatable with transcranial electrical stimulation (tDCS)

There are a large number of pathologies in which the efficacy of treatment by means of brain electrical stimulation has been demonstrated. These are listed below.

Pain, fibrimyalgia and chronic fatigue: approach with transcranial stimulation

The analgesic effects of neuromodulatory therapies have been shown to be effective in patients with different types of pain. Applied in certain areas of the brain related to pain processing, transcranial stimulation can reverse abnormal brain excitability by modifying the level of excitability of a group of brain areas related to pain processing, obtaining longer lasting analgesic effects, improving the reduction of pain and the frequency of episodes, and facilitating the recovery of the person’s functionality.

Following neurological damage, important plastic changes occur not only at the site of injury, but also at the brain level, as the nervous system attempts to reorganize its functional circuits following neurological damage. Cortical reorganization in response to injury is not always beneficial and there is a risk of changing inappropriately and thus perpetuating deficits over time.

Its efficacy has been demonstrated in central and peripheral neuropathic pain (more than half of patients with neuropathic pain do not respond to conventional treatment) and in chronic and acute pain. Transcranial stimulation has also been shown to be effective in the treatment of pain in complex regional pain syndrome (reflex sympathetic dystrophy), reducing by more than half the pain in these patients by modulating the brain areas involved in pain processing. In other types of neuropathic pain, such as trigeminal neuralgia or painful diabetic neuropathy, its effectiveness has also been demonstrated, not only reducing pain but also improving the cognitive symptoms associated with pain.

In patients with migraine, tDCS treatment produces a stabilization of the cortical hyperexcitability known to be present in migraine patients. Most drugs used in migraine prevention act on the predisposition of the cerebral cortex of these patients to respond inappropriately to external environmental factors. Neuromodulation reduces the number, duration and intensity of migraine attacks.

The main benefit of neuromodulatory treatment with tDCS in patients with pain is pain relief. However, improvements are also observed in sleep, mood, performance of daily activities, cognitive abilities and in a lower consumption of pain medication.

On the other hand, fibromyalgia is a disorder that combines widespread pain and mood disturbance as its main symptoms. Neuromodulation treatment with tDCS significantly improves both symptoms by restoring and strengthening the brain’s pain inhibition mechanisms and improving cognitive function, sleep quality and physical activity.

tDCS is a first-line treatment for fibromyalgia due to its efficacy, lack of side effects and the inadequacy of conventional treatments. A recent systematic review of studies on the application of tDCS in the treatment of fibromyalgia and chronic fatigue syndrome recommends that tDCS treatment should be offered to all patients with fibromyalgia and chronic fatigue.

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Transcranial stimulation after stroke: improves motor rehabilitation

In people who have suffered a stroke, tDCS, together with rehabilitation, helps to accelerate the motor recovery of these patients very significantly, making its use essential. Thus, rehabilitation helps to regain lost mobility after a stroke, but it is often a costly and time-consuming process. With transcranial direct current brain stimulation (tDCS) the recovery time is shortened. In addition to motor rehabilitation, neuromodulation is effective in the recovery of cognitive abilities that are also affected in these patients.

Other diseases such as Parkinson’s disease, essential tremor or dystonia benefit from the positive effects of these treatments. Similarly, neuromodulation has been shown to improve motor function in the elderly.

Treatment of sleep disorders with transcranial stimulation

Treatment with transcranial stimulation improves both primary insomnia and secondary insomnia associated with other pathologies, such as in patients with poliomyelitis who, several years after infection, present worsening weakness and fatigue, pain, and sleep disorders. In this sense, treatment with tDCS improves sleep quality, has a sleep stabilizing effect and increases restful sleep. These changes in sleep quality affect physical and psychological states. Improving sleep quality improves perceived vitality, social and emotional functioning and, indirectly, fatigue.

Stress and neuropsychiatric disorders, improvement with transcranial stimulation

On the other hand, stress is a constant feature of everyday life in our society, playing an important role in a large number of chronic disorders. tDCS prevents stress-associated working memory deficits, improves cognitive function and physical and mental fatigue.

Likewise, alterations in cortical excitability balance correlate with deficits in brain functioning characteristic of some psychiatric and neurological disorders. Neuromodulatory treatment significantly reduces clinical symptoms of depression and anxiety, bipolar disorder, addictions, schizophrenia, obsessive-compulsive disorder, etc., and enhances the efficacy of pharmacological treatments.

ADHD, autism or developmental disorders and transcranial stimulation

Numerous neurological and psychiatric diseases in childhood and adolescence present alterations in brain plasticity. Brain plasticity is a physiological characteristic inherent to the central nervous system (CNS), which refers to the ability to learn, remember and forget, as well as to the capacity to reorganize and recover from brain damage.

An improvement in clinical symptoms and cognitive function (attention, inhibitory control, impulsivity, etc.) has been demonstrated in children with different developmental disorders treated with transcranial stimulation such as ADHD, autism, pervasive developmental disorders, epilepsy, etc.