The effects of transcranial direct current stimulation with visual illusion in neuropathic pain due to spinal cord injury: An evoked potentials and quantitative thermal testing study
Open accessAbstract
Background: Neuropathic pain (NP) is common in spinal cord injury (SCI) patients. One of its manifestations is a lowering of pain perception threshold in quantitative thermal testing (QTT) in dermatomes rostral to the injury level. Transcranial direct current stimulation (tDCS) combined with visual illusion (VI) improves pain in SCI patients. We studied whether pain relief with tDCS + VI intervention is accompanied by a change in contact heat‐ evoked potentials (CHEPs) or in QTT. Methods: We examined 18 patients with SCI and NP before and after 2 weeks of daily tDCS + VI intervention. Twenty SCI patients without NP and 14 healthy subjects served as controls. We assessed NP intensity using a numerical rating scale (NRS) and determined heat and pain thresholds with thermal probes. CHEPs were recorded to stimuli applied at C4 level, and subjects rated their perception of evoked pain using NRS during CHEPs. Results: Thirteen patients reported a mean decrease of 50% in the NRS for NP after tDCS + VI. Evoked pain perception was significantly higher than in the other two groups, and reduced significantly together with CHEPs amplitude after tDCS + VI with respect to baseline. Pain perception threshold was significantly lower than in the other two groups before tDCS + VI intervention, and increased significantly afterwards. Conclusion: Two weeks of tDCS + VI induced significant changes in CHEPs, evoked pain and heat pain threshold in SCI patients with NP. These neurophysiological tests might be objective biomarkers of treatment effects for NP in patients with SCI.
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In some studies, a mirror was used with a video projection of walking legs; in others, walking stimuli consisted of a video of an actor in first-person view walking along a path; and in another, participants viewed their virtual arms and legs in first person view in a virtual world through a head-mounted display.
“In some studies, a mirror was used with a video projection of walking legs [7, 15–17], in others the walking stimuli consisted of a video of an actor, in first-person view, walking along a path [18, 19] and in the last one participants viewed their virtual arms and legs in first person view in a virtual world through a head-mounted display [20].”
From Virtual walking therapy in neuropathic spinal cord injury pain: a feasibility study (2024) · cites this paper as [16]
Split into 3 atoms — 1 confirmed, 0 partially supported, 2 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
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Experimental — accuracy not yet measuredThird-person perspective has already been described, while first-person perspective was also applied.
“Third-person perspective has already been described [7], [15–17], while first-person perspective was also applied [18–20].”
From Virtual walking therapy in neuropathic spinal cord injury pain: a feasibility study (2024) · cites this paper as [16]
The different studies regarding VW did not discuss therapy adherence.
“The different studies regarding VW did not discuss therapy adherence [7, 15–20].”
From Virtual walking therapy in neuropathic spinal cord injury pain: a feasibility study (2024) · cites this paper as [16]
The Experimental procedure (§2.5; page unavailable) describes a 10-session intervention and reassessment after the last session, while the Results (§3.2; page unavailable) report pain outcomes. Searches for adherence, compliance, attendance, and completed sessions found no passage addressing therapy adherence. These passages do not establish the broader claim that the cited studies did not discuss it. (LLM, conf=0.68)
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- Authors
- Kumru, H., Soler, D., Vidal, J., Navarro, X., Tormos, J. M., Pascual‐Leone, A., & Valls‐Sole, J.
- Affiliations
- Universitat Autònoma de Barcelona (ES)
- Institut Guttmann Hospital de Neurorehabilitació Institut Universitari adscript a la Universitat Autonoma de Barcelona Barcelona Spain
- Hospital Clinic Barcelona Spain
- Corresponding author
- Kumru, H.
- Venue
- European Journal of Pain
- Publisher
- Wiley
- Published
- 2012-05-18
- Volume
- 17
- Issue
- 1
- Pages
- 55-66
- ISSN
- 1090-3801 (ISSN-L)
- 1532-2149
- OpenAlex
- W2119536210
- Cited by
- 83
- References
- 40
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 5 · 2023: 6 · 2022: 7 · 2021: 8 · 2020: 3 · 2019: 6 · 2018: 8 · 2017: 6 · 2016: 7 · 2015: 7 · 2014: 6 · 2013: 5 · 2012: 1
- FWCI
- 3.06
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- RIUCV (Universidad Católica de Valencia San Vicente Martír) (submittedVersion, cc-by-nc-nd)
- Hispana (submittedVersion, cc-by-nc-nd)
- Funders
- Banco Bilbao Vizcaya Argentaria
- Instituto de Salud Carlos III
- Topics
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Keywords
- transcranial direct current stimulation, optical illusions, neuropathic pain, spinal cord injury, contact heat evoked potentials, pain threshold, evoked pain, treatment biomarkers
- MeSH terms
- Adult, Aged, Evoked Potentials, Somatosensory, Female, Habituation, Psychophysiologic, Hot Temperature, Humans, Illusions, Male, Middle Aged, Neuralgia, Photic Stimulation, Sensory Thresholds, Spinal Cord Injuries, Pain Threshold, Transcranial Magnetic Stimulation
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