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ORIGINAL RESEARCH ARTICLE

The effect of high-definition transcranial direct current stimulation on pain in somatic symptom disorder with predominant pain: A randomized single-blind sham-controlled crossover study

Sanjana Kathiravan1 ,  Abhishek Ghosh1 ,  Shubh Mohan Singh1*
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1 Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
JCBP 2024, 2(3), 2002 https://doi.org/10.36922/jcbp.2002
Submitted: 10 October 2023 | Accepted: 9 May 2024 | Published: 16 July 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Somatic symptom disorder with predominant pain (SSD-P) is a commonly encountered disorder, yet treatment options often yield unsatisfactory outcomes. Transcranial direct current stimulation (tDCS) has proven useful in chronic pain conditions and may hold potential for treating somatoform pain. High-definition tDCS (HD-tDCS) offers more precise cortical stimulation than conventional tDCS. However, this modality has not been extensively studied in SSD-P. Consequently, this study aims to assess the effects of a novel HD-tDCS protocol on pain and other associated variables in patients with SSD-P. The Institute Ethics Committee approved the study, which was also registered in the Clinical Trials Registry of India. A single-blind, sham-controlled, crossover study design was employed. Thirty right-handed patients with DSM-5 diagnosis of SSD-P, aged 18 – 60 years and receiving stable treatment, were enrolled through consecutive sampling. After simple randomization, two repeated, short-interval sessions (2 mA, 20 min each) of either active or sham HD-tDCS were administered, followed by a washout period of 7 days and a subsequent crossover. Assessments were conducted at baseline, week 1, and week 2. Participants in active and sham arms were comparable on all baseline parameters. At the end of the 1st week, patients in the active group showed significant improvement in the study variables compared to the sham group. By week 2, all participants, irrespective of being in the active or sham arm, demonstrated a statistically significant difference (Cohen’s d > 0.8) in pain and associated parameters such as depression, anxiety, pain-related interference, burden, and disability (P < 0.01). Transient mild local side effects such as burning, pain, and itching were noted, with no cognitive side effects reported. In conclusion, this novel HD-tDCS protocol is effective in reducing pain in patients with SSD-P, with sustained effects up to 1 week.

Keywords
High definition transcranial direct current stimulation
HD-tDCS
Chronic pain
Somatic symptom disorder
Crossover study
Sham-controlled study
Funding
None.
Conflict of interest
The authors declare that they have no competing interests.
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Journal of Clinical and Basic Psychosomatics, Electronic ISSN: 2972-4414 Published by AccScience Publishing
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