Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.63231/2595-0118.20250036-en
Brazilian Journal of Pain
Original Article

Effect of transcranial direct current stimulation on pain and mood in end-stage renal disease patients: a randomized clinical trial

Efeito da estimulação transcraniana por corrente contínua na dor e humor de pacientes renais em estágio terminal: ensaio clínico randomizado

Carla Daniele Ferreira Dantas; Artur Quintiliano; Edson Silva-Filho; Gianna Mastroianni Kirsztajn; Clecio Gabriel de Sousa; Rodrigo Pegado

http://dx.doi.org/10.63231/2595-0118.20250036-en BrJP, vol.8, e20250036, 2025
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Abstract

BACKGROUND AND OBJECTIVES: Chronic kidney disease (CKD) is a significant public health concern. Patients affected by chronic kidney problems often experience symptoms, such as pain and mood disorders, while awaiting a transplant. Nonpharmacological interventions with no collateral effects are necessary for managing the symptoms. The objective of this study was to assess the effects of transcranial direct current stimulation (tDCS) on pain, anxiety, and depression in patients affected by CKD.

METHODS: This is a single-center, double-blinded, parallel, randomized sham-controlled clinical trial. The interventions consisted of ten non-consecutive sessions of anodal tDCS over the left dorsolateral prefrontal cortex and the cathode over the contralateral supraorbital region. Each session lasted 20 min with an intensity of 2 mA. This clinical trial included patients with CKD who experienced chronic pain and had been undergoing hemodialysis for more than three months. There were four assessments: at baseline, after the first and last intervention, and seven days after the last intervention (follow-up).

RESULTS: There was a significant interaction between group and time regarding pain (p=0.0005; partial η2 = 0.362) and a significant time interaction (p = 0.0005, partial η2 = 0.659) with significant differences between groups at day 10 (p= 0.004; partial η2 = 0.37) and follow-up (p= 0.03; partial η2 = 0.22). Additionally, there was a significant difference between groups for anxiety (p<0.02, partial η2= 0.258).

CONCLUSION: After ten sessions of tDCS, patients affected by chronic kidney disease showed a reduction in pain, anxiety, and depression

Keywords

Chronic pain; Hemodialysis; Neuromodulation; Noninvasive brain stimulation; Quality of life

Resumo

JUSTIFICATIVA E OBJETIVOS: A doença renal crônica (DRC) é uma preocupação significativa de saúde pública. Pacientes com problemas renais crônicos frequentemente apresentam sintomas como dor e transtornos do humor enquanto aguardam um transplante. Intervenções não farmacológicas, sem efeitos adversos, são necessárias para o manejo desses sintomas. O objetivo deste estudo foi avaliar os efeitos da estimulação transcraniana por corrente contínua (ETCC) na dor, ansiedade e depressão em pacientes com DRC.

MÉTODOS: Trata-se de um ensaio clínico randomizado, controlado por placebo, paralelo, duplo-cego e conduzido em um único centro. As intervenções consistiram em 10 sessões não consecutivas de ETCC anódica sobre o córtex pré-frontal dorsolateral esquerdo, com o cátodo posicionado sobre a região supraorbital contralateral. Cada sessão teve duração de 20 minutos, com intensidade de 2 mA. O ensaio clínico incluiu pacientes com DRC que apresentavam dor crônica e estavam em hemodiálise há mais de três meses. Foram realizadas quatro avaliações: na linha de base, após a primeira e última intervenção e sete dias após a última intervenção (follow-up).

RESULTADOS: Houve interação significativa entre grupo e tempo em relação à dor (p=0,0005; η2 parcial=0,362) e interação significativa com o tempo (p=0,0005; η2 parcial=0,659), com diferenças significativas entre os grupos no dia 10 (p=0,004; η2 parcial=0,37) e no follow-up (p=0,03; η2 parcial=0,22). Além disso, foi observada diferença significativa entre os grupos quanto à ansiedade.

CONCLUSÃO: Após 10 sessões de ETCC, pacientes com DRC apresentaram diminuição de dor, ansiedade e depressão.

Palavras-chave

Dor crônica; Estimulação cerebral não invasiva; Hemodiálise; Neuromodulação; Qualidade de vida

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Submitted date:
03/10/2025

Accepted date:
05/09/2025

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