Article of the Month by David Burke

While the main symptom of osteoarthritis (OA) is peripheral pain, central sensitization mechanisms are also implicated.  Transcranial direct current stimulation (tDCS) has been found to be effective for the management of chronic pain including that from OA.  Convergent evidence suggests that brain drive neurotrophic factor (BDNF) is a critical determinate of these effects.  This study further explored this relationship.

Subjects were adults, ages 50-70 years of age with symptomatic knee osteoarthritis.  Randomized to receive either active or sham T DCS (2 mA intensity) for 20 minutes on 5 consecutive days. The anode was placed at C3/C4 contralateral to the affected knee. The cathode was placed over the supraorbital (SO) contralateral to the anode (M1-SO montage). The sham condition used the same configuration.  Blood draws at baseline and on day 5 were completed to assess levels of BDNF.

Adjusted for baseline values. , higher levels of log–BDNF were found in the sham tDCS group than in the active tDCS group.  Elevated levels of BDNF were correlated with higher scores on the Numeric Rating Scale for Pain.

Suchting, R et al., Changes in Brain Drive Neurotrophic Factor From Active and Sham Transcranial Direct Current Stimulation in Older Adults With Knee Osteoarthritis. Clin J Pain 2021, December; 37(12):898–903.