{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:07:20Z","timestamp":1791389240339,"version":"4.3.3"},"reference-count":60,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2017,4,25]],"date-time":"2017-04-25T00:00:00Z","timestamp":1493078400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2017,8]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n \n Recent evidence suggests that chronic low back pain is associated with plastic changes in the brain that can be modified by neuromodulation strategies. This study investigated the efficacy of transcranial direct current stimulation (\n tDCS<\/jats:styled-content>\n ) combined simultaneously with peripheral electrical stimulation (\n PES<\/jats:styled-content>\n ) for pain relief, disability and global perception in patients with chronic low back pain (\n CLBP<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Ninety\u2010two patients with\n CLBP<\/jats:styled-content>\n were randomized to receive 12 sessions on nonconsecutive days of anodal\n tDCS<\/jats:styled-content>\n (primary motor cortex, M1), 100\u00a0Hz sensory\n PES<\/jats:styled-content>\n (lumbar spine),\n tDCS<\/jats:styled-content>\n \u00a0+\u00a0\n PES<\/jats:styled-content>\n or sham\n tDCS<\/jats:styled-content>\n \u00a0+\u00a0\n PES<\/jats:styled-content>\n . Pain intensity (11\u2010point numerical rating scale), disability and global perception were applied before treatment and four weeks, three months and six months post randomization.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A two points reduction was achieved only by the\n tDCS<\/jats:styled-content>\n \u00a0+\u00a0\n PES<\/jats:styled-content>\n (mean reduction [\n MR<\/jats:styled-content>\n ]\u00a0=\u00a0\u22122.6,\n CI<\/jats:styled-content>\n 95%\u00a0=\u00a0\u22124.4 to \u22120.9) and\n PES<\/jats:styled-content>\n alone (\n MR<\/jats:styled-content>\n \u00a0=\u00a0\u22122.2,\n CI<\/jats:styled-content>\n 95%\u00a0=\u00a0\u22123.9 to \u22120.4) compared with the sham group, but not of\n tDCS<\/jats:styled-content>\n alone (\n MR<\/jats:styled-content>\n \u00a0=\u00a0\u22121.7,\n CI<\/jats:styled-content>\n 95%\u00a0=\u00a0\u22123.4 to \u22120.0). In addition to maintaining the analgesic effect for up to three months,\n tDCS<\/jats:styled-content>\n \u00a0+\u00a0\n PES<\/jats:styled-content>\n had a higher proportion of respondents in different cutoff points. Global perception was improved at four weeks and maintained three months after treatment only with\n tDCS<\/jats:styled-content>\n \u00a0+\u00a0\n PES<\/jats:styled-content>\n . None of the treatments improved disability and the affective aspect of pain consistently with pain reduction.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n The results suggest that\n tDCS<\/jats:styled-content>\n \u00a0+\u00a0\n PES<\/jats:styled-content>\n and\n PES<\/jats:styled-content>\n alone are effective in relieving\n CLBP<\/jats:styled-content>\n in the short term. However, only\n tDCS<\/jats:styled-content>\n \u00a0+\u00a0\n PES<\/jats:styled-content>\n induced a long\u2010lasting analgesic effect.\n tDCS<\/jats:styled-content>\n alone showed no clinical meaningful pain relief.\n <\/jats:p>\n <\/jats:sec>\n \n Significance<\/jats:title>\n \n Transcranial direct current stimulation combined simultaneously with\n PES<\/jats:styled-content>\n leads to a significant and clinical pain relief that can last up to three months in chronic low back pain patients.\n <\/jats:p>\n For this article, a commentary is available at the Wiley Online Library<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/ejp.1037","type":"journal-article","created":{"date-parts":[[2017,4,25]],"date-time":"2017-04-25T01:57:00Z","timestamp":1493085420000},"page":"1132-1143","source":"Crossref","is-referenced-by-count":70,"title":["Treating low back pain with combined cerebral and peripheral electrical stimulation: A randomized, double\u2010blind, factorial clinical trial"],"prefix":"10.1002","volume":"21","author":[{"given":"F.A.","family":"Hazime","sequence":"first","affiliation":[{"name":"Department of Physical Therapy Federal University of Piau\u00ed Parna\u00edba Brazil"},{"name":"Department of Physical Therapy, Speech\u2010Language and Hearing Science and Occupational Therapy of the Medical School University of S\u00e3o Paulo Brazil"},{"name":"Postgraduate Program in Rehabilitation Sciences of the Medical School University of S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.F.","family":"Baptista","sequence":"additional","affiliation":[{"name":"Department of Biomorphology Federal University of Bahia Salvador Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.G.","family":"de Freitas","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy Irmandade Santa Casa de Miseric\u00f3rdia de S\u00e3o Paulo 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School University of S\u00e3o Paulo Brazil"},{"name":"Postgraduate Program in Rehabilitation Sciences of the Medical School University of S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.M.A.","family":"Jo\u00e3o","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Speech\u2010Language and Hearing Science and Occupational Therapy of the Medical School University of S\u00e3o Paulo Brazil"},{"name":"Postgraduate Program in Rehabilitation Sciences of the Medical School University of S\u00e3o Paulo 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