Faculty, Staff and Student Publications

Language

English

Publication Date

11-3-2023

Journal

Military Medicine

DOI

10.1093/milmed/usac200

PMID

35808998

Abstract

Introduction: Chronic pain and posttraumatic stress disorder (PTSD) are prevalent comorbid conditions, particularly in Veterans; however, there are few integrated treatments for chronic pain and PTSD. Instead, interventions are typically implemented separately and may involve addictive opioids. Although there are highly effective, non-pharmacological treatments for PTSD, they are plagued by high dropout, which may be exacerbated by comorbid pain, as these PTSD treatments typically require increased activity. Importantly, a noninvasive pain treatment, tDCS (transcranial direct current stimulation) shows indications of effectiveness and may be integrated with psychological treatments, even when delivered via telehealth. This study examines the feasibility and initial efficacy of integrating home telehealth tDCS with prolonged exposure (PE), an evidence-based PTSD treatment.

Materials and methods: Thirty-nine Veterans were contacted, 31 consented to evaluation, 21 were enrolled, and 16 completed treatment and provided pre- and post-treatment data at one of two Veterans Affairs Medical Centers. Transcranial direct current stimulation sessions corresponded with PE exposure assignments, as there is theoretical reason to believe that tDCS may potentiate extinction learning featured in PE.

Results: Patients evinced significant improvement in both pain interference and PTSD symptoms and a trend toward improvement in depression symptoms. However, a significant change in pain intensity was not observed, likely because of the small sample size.

Discussion: The findings provide initial support for the feasibility of an entirely home-based, integrated treatment for comorbid PTSD and pain.

Keywords

Humans, Stress Disorders, Post-Traumatic, Veterans, Chronic Pain, Transcranial Direct Current Stimulation, Pilot Projects, Treatment Outcome, Implosive Therapy

Comments

Trial registration: ClinicalTrials.gov NCT04236284.

Published Open-Access

yes

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