• Tim Hagenacker, Vera Bude, Steffen Naegel, Dagny Holle, Zaza Katsarava, Hans-Christoph Diener, and Mark Obermann.
• Department of Neurology, University Hospital Essen, Hufelandstr, 55, 45147 Essen, Germany. mark.obermann@uni-due.de.
• J Headache Pain. 2014 Nov 25; 15: 78.

BackgroundTranscranial direct current stimulation (tDCS) of the primary motor cortex has been shown to modulate pain and trigeminal nociceptive processing.MethodsTen patients with classical trigeminal neuralgia (TN) were stimulated daily for 20 minutes over two weeks using anodal (1 mA) or sham tDCS over the primary motor cortex (M1) in a randomized double-blind cross-over design. Primary outcome variable was pain intensity on a verbal rating scale (VRS 0-10). VRS and attack frequency were assessed for one month before, during and after tDCS. The impact on trigeminal pain processing was assessed with pain-related evoked potentials (PREP) and the nociceptive blink reflex (nBR) following electrical stimulation on both sides of the forehead before and after tDCS.ResultsAnodal tDCS reduced pain intensity significantly after two weeks of treatment. The attack frequency reduction was not significant. PREP showed an increased N2 latency and decreased peak-to-peak amplitude after anodal tDCS. No severe adverse events were reported.ConclusionAnodal tDCS over two weeks ameliorates intensity of pain in TN. It may become a valuable treatment option for patients unresponsive to conventional treatment.

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