Effects of Cortical and Peripheral Electrical Stimulation on Brain Activity in Individuals with Chronic Low Back Pain

Purpose: Neuroscience studies suggest that Chronic Low Back Pain (CLBP) is associated with central sensitization, and maladaptive reorganization of the brain; this introduced a new target for LBP treatment. Studies revealed that cortical and peripheral electrical stimulation can be beneficial in regulating brain neuronal activity. However, there is a scarcity of evidence to support the effects of cortical and peripheral stimulation on brain function in patients with CLBP. This double-blind randomized controlled trial investigated the immediate and short-term effects of cortical and peripheral stimulation applied alone and combined on brain activity, pain, and function in patients with CLBP. Methods: Twenty-seven patients with CLBP were randomly assigned into three intervention groups using covariate adaptive randomization. The intervention groups received 10 sessions of treatment for 5 days/week as follows: 1: Real Transcranial Direct Current Stimulation (tDCS) and real Transcutaneous Electrical Nerve Stimulation (TENS); group 2: Real tDCS and sham TENS; and group 3: Sham tDCS and real TENS. Brian waves activity, pain intensity, functional ability, and pain threshold were assessed before, immediately after the first session of treatment, as well as one day and 1 month after the interventions. Conclusion: The findings of this study provide insight into the effects of cortical and peripheral stimulation applied alone or combined on brain function in patients with CLBP. It also improves our understanding about potential association between CLBP and cortical plasticity.