• Guillermo García-Barajas, Diego Serrano-Muñoz, Julio Gómez-Soriano, Juan Avendaño-Coy, Josue Fernández-Carnero, Megía GarcíaAlvaroABiomechanical and Technical Aids Unit, Hospital Nacional de Parapléjicos, SESCAM, Toledo, Spain., Antonio Segura-Fragosa, and Julian Taylor.
• Sensorimotor Function Group, Hospital Nacional de Parapléjicos, SESCAM, Toledo, Spain.
• Pain Med. 2021 Dec 11; 22 (12): 2908-2917.

ObjectiveThe aim of this study was to assess whether anodal DCS applied to the suboccipital (SO) target area could potentiate antinociception assessed primarily with conditioned pain modulation of tonic thermal test stimuli.DesignRandomized double-blinded control trial.SettingRehabilitation hospital.SubjectsHealthy participants.MethodsForty healthy participants were randomized to receive either SO-DCS or M1-DCS. The 20-minute 1.5 mA anodal or sham DCS intervention were applied to each participant in randomized order during two test sessions. The primary outcome measure included heterotopic cold-pressor conditioned pain modulation (CPM) of tonic heat pain. Secondary measures included pressure pain threshold and tonic thermal pain intensity.ResultsHeterotopic CPM of tonic heat pain intensity was unaffected by either SO-DCS or active M1, including the secondary measures of pressure pain threshold and tonic thermal pain intensity. Although low-power non-significant interactions were identified for DCS intervention (active versus sham) and time (before and after), a significant within-group inhibition of tonic cold pain was identified following SO-DCS (P = .011, mean [SD]: -0.76 ± 0.88 points) and M1-DCS (P < .002: -0.84 ± 0.82 points), without a significant change following sham DCS.ConclusionsAlthough heterotopic CPM was not facilitated with either SO-DCS or M1-DCS, a general significant inhibition of tonic cold pain intensity was demonstrated following both interventions. The general effects of active DCS compared to sham on tonic cold pain-irrespective of the M1 or SO target-need to be confirmed using standard quantitative sensory testing.© The Author(s) 2021. Published by Oxford University Press on behalf of the American Academy of Pain Medicine.All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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