{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T12:52:40Z","timestamp":1789131160653,"version":"build-2803163510"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2019,9,10]],"date-time":"2019-09-10T00:00:00Z","timestamp":1568073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>The aim of this trial was to investigate the effects of five consecutive sessions of anodal transcranial direct current stimulation (tDCS) over the motor cortex (M1) on pain, mood, and physical performance in patients with primary dysmenorrhea (PDM).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>This is a double-blind randomized controlled trial.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Subjects<\/jats:title>\n                  <jats:p>Twenty-two participants with PDM according to the No. 345-PDM Consensus Guideline were included.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Eleven active treatment and 11 sham stimulation patients received five applications over a one-week period. The primary outcome measures were pain evaluated by numeric rating scale (NRS) and McGill Questionnaire score. Secondary outcomes measures were responses to the Positive and Negative Affect Schedule (PANAS), Hamilton Anxiety Scale (HAM-A), grip strength, and six-minute walk test (6MWT). Baseline data were performed during the first menstrual cycle, and during the second menstrual cycle, participants were conducted to tDCS treatment, and postintervention data were collected.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The intervention provided significant improvements on NRS in active tDCS, shown as an interaction between group intervention vs pre\/postintervention vs days of menstrual cycle (Wald x2 = 10.54, P = 0.005), main effect of days of menstrual cycle (Wald x2 = 25.42, P &amp;lt; 0.001), and pre\/postintervention (Wald x2 = 6.97, P = 0.008). McGill showed an interaction effect between pre\/postintervention and group of stimulation (Wald x2 = 18.45, P = 0.001), with a large reduction in active tDCS (P &amp;lt; 0.001, d\u2009=\u20090.75). Psychological and functional outcomes did not differ between groups or pre\/postintervention.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>tDCS could provide pain relief in subjects with PDM. These results provide some preliminary evidence for the potential role of tDCS as a contributor to the management of symptoms of PDM.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/pm\/pnz202","type":"journal-article","created":{"date-parts":[[2019,7,12]],"date-time":"2019-07-12T19:10:09Z","timestamp":1562958609000},"page":"3615-3623","source":"Crossref","is-referenced-by-count":17,"title":["Effects of Transcranial Direct Current Stimulation for Treatment of Primary Dysmenorrhea: Preliminary Results of a Randomized Sham-Controlled Trial"],"prefix":"10.1093","volume":"21","author":[{"given":"Rodrigo","family":"Pegado","sequence":"first","affiliation":[{"name":"Faculty of Health Science of Trairi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luana Karyne","family":"Silva","sequence":"additional","affiliation":[{"name":"Faculty of Health Science of Trairi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e9gila","family":"da Silva Dantas","sequence":"additional","affiliation":[{"name":"Faculty of Health Science of Trairi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hialison","family":"Andrade C\u00e2mara","sequence":"additional","affiliation":[{"name":"Faculty of Health Science of Trairi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karime","family":"Andrade Mescouto","sequence":"additional","affiliation":[{"name":"Faculty of Health Science of Trairi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edson Meneses","family":"Silva-Filho","sequence":"additional","affiliation":[{"name":"Faculty of Health Science of Trairi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johnnatas Mikael","family":"Lopes","sequence":"additional","affiliation":[{"name":"FACEX University Center, Nassau University Center, Rio Grande do Norte, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Thereza Albuquerque Barbosa Cabral","family":"Micussi","sequence":"additional","affiliation":[{"name":"Health Science Center, Federal University of Rio Grande do Norte, Rio Grande do Norte, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grasi\u00e9la Nascimento","family":"Correia","sequence":"additional","affiliation":[{"name":"Faculty of Health Science of Trairi"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,9,10]]},"reference":[{"key":"2020122823503981500_pnz202-B1","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1002\/ejp.556","article-title":"Self-report pain and symptom measures for primary dysmenorrhoea: A critical review","volume":"19","author":"Chen","year":"2015","journal-title":"Eur J Pain"},{"issue":"5","key":"2020122823503981500_pnz202-B2","first-page":"341","article-title":"Diagnosis and initial management of dysmenorrhea","volume":"89","author":"Osayande","year":"2014","journal-title":"Am Fam Physician"},{"issue":"1","key":"2020122823503981500_pnz202-B3","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.jphys.2013.12.003","article-title":"Some physiotherapy treatments may relieve menstrual pain in women with primary dysmenorrhea: A systematic review","volume":"60","author":"Kannan","year":"2014","journal-title":"J Physiother"},{"issue":"3","key":"2020122823503981500_pnz202-B4","first-page":"233","article-title":"Dysmenorrhea in adolescents and young adults: A review in different countries","volume":"87","author":"De Sanctis","year":"2017","journal-title":"Acta Biomed"},{"key":"2020122823503981500_pnz202-B5","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1002\/ejp.639","article-title":"High prevalence of incidental brain findings in primary dysmenorrhoea","volume":"19","author":"Li","year":"2015","journal-title":"Eur J Pain"},{"issue":"1","key":"2020122823503981500_pnz202-B6","doi-asserted-by":"crossref","first-page":"24543.","DOI":"10.1038\/srep24543","article-title":"Dynamic changes of functional pain connectome in women with primary dysmenorrhea","volume":"6","author":"Wu","year":"2016","journal-title":"Sci Rep"},{"key":"2020122823503981500_pnz202-B7","first-page":"383","article-title":"Dysmenorrhea in adolescents and young adults: Prevalence, related factors and limitations in daily living","volume":"24","author":"Rodrigues","year":"2011","journal-title":"Acta M\u00e9d Port"},{"issue":"1","key":"2020122823503981500_pnz202-B8","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.clinph.2016.10.087","article-title":"Evidence-based guidelines on the therapeutic use of transcranial direct current stimulation (tDCS)","volume":"128","author":"Lefaucheur","year":"2017","journal-title":"Clin Neurophysiol"},{"issue":"18","key":"2020122823503981500_pnz202-B9","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1136\/bjsports-2012-091658","article-title":"Brain stimulation modulates the autonomic nervous system, rating of perceived exertion and performance during maximal exercise","volume":"49","author":"Okano","year":"2015","journal-title":"Br J Sports Med"},{"key":"2020122823503981500_pnz202-B10","doi-asserted-by":"crossref","DOI":"10.1098\/rsta.2015.0187","article-title":"The heart side of brain neuromodulation","author":"Rossi","year":"2016","journal-title":"Philos Trans R Soc A"},{"issue":"1","key":"2020122823503981500_pnz202-B11","doi-asserted-by":"crossref","first-page":"88","DOI":"10.5498\/wjp.v5.i1.88","article-title":"Transcranial direct current stimulation in psychiatric disorders","volume":"5","author":"Tortella","year":"2015","journal-title":"World J Psychiatry"},{"issue":"6","key":"2020122823503981500_pnz202-B12","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/j.neucli.2016.10.002","article-title":"A comprehensive database of published tDCS clinical trials (2005\u20132016)","volume":"46","author":"Lefaucheur","year":"2016","journal-title":"Neurophysiol Clin"},{"issue":"5","key":"2020122823503981500_pnz202-B13","doi-asserted-by":"crossref","first-page":"e0123873","DOI":"10.1371\/journal.pone.0123873","article-title":"A meta-analysis of site-specific effects of cathodal transcranial direct current stimulation on sensory perception and pain","volume":"10","author":"Vaseghi","year":"2015","journal-title":"PLoS One"},{"issue":"3","key":"2020122823503981500_pnz202-B14","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1016\/j.mehy.2014.06.007","article-title":"Role of the primary motor cortex in the maintenance and treatment of pain in fibromyalgia","volume":"83","author":"Castillo Saavedra","year":"2014","journal-title":"Med Hypotheses"},{"issue":"5","key":"2020122823503981500_pnz202-B15","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1097\/AJP.0b013e31823853e3","article-title":"Transcranial direct current stimulation for the reduction of clinical and experimentally induced pain: A systematic review and meta-analysis","volume":"28","author":"Luedtke","year":"2012","journal-title":"Clin J Pain"},{"issue":"3","key":"2020122823503981500_pnz202-B16","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.brs.2011.03.002","article-title":"Clinical research with transcranial direct current stimulation (tDCS): Challenges and future directions","volume":"5","author":"Brunoni","year":"2012","journal-title":"Brain Stimul"},{"issue":"4","key":"2020122823503981500_pnz202-B17","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1016\/j.clinph.2005.12.003","article-title":"Transcranial DC stimulation (tDCS): A tool for double-blind sham-controlled clinical studies in brain stimulation","volume":"117","author":"Gandiga","year":"2006","journal-title":"Clin Neurophysiol"},{"key":"2020122823503981500_pnz202-B18"},{"issue":"2","key":"2020122823503981500_pnz202-B19","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.jpag.2017.09.014","article-title":"Rates of anovulation in adolescents and young adults with moderate to severe primary dysmenorrhea and those without primary dysmenorrhea","volume":"31","author":"Seidman","year":"2018","journal-title":"J Pediatr Adolesc Gynecol"},{"key":"2020122823503981500_pnz202-B20","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.clinbiomech.2016.01.009","article-title":"Spatio-temporal gait disorder and gait fatigue index in a six-minute walk test in women with fibromyalgia","volume":"33","author":"Heredia-Jimenez","year":"2016","journal-title":"Clin Biomech"},{"key":"2020122823503981500_pnz202-B21","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1164\/ajrccm.166.1.at1102","article-title":"ATS statement: Guidelines for the six-minute walk test","volume":"166","year":"2002","journal-title":"Am J Respir Crit Care Med"},{"issue":"11","key":"2020122823503981500_pnz202-B22","doi-asserted-by":"crossref","first-page":"2554","DOI":"10.1016\/j.pain.2013.07.043","article-title":"Transcutaneous electrical nerve stimulation reduces pain, fatigue and hyperalgesia while restoring central inhibition in primary fibromyalgia","volume":"154","author":"Dailey","year":"2013","journal-title":"Pain"},{"issue":"3","key":"2020122823503981500_pnz202-B23","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1177\/0269215512453353","article-title":"An aerobic walking programme versus muscle strengthening programme for chronic low back pain: A randomized controlled trial","volume":"27","author":"Shnayderman","year":"2013","journal-title":"Clin Rehabil"},{"issue":"2","key":"2020122823503981500_pnz202-B24","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1093\/ptj\/66.2.206","article-title":"Test-retest reliability of hand-held dynamometry during a single session of strength assessment","volume":"66","author":"Bohannon","year":"1986","journal-title":"Phys Ther"},{"issue":"2","key":"2020122823503981500_pnz202-B25","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1037\/0022-006X.73.2.212","article-title":"Positive affect as a source of resilience for women in chronic pain","volume":"73","author":"Zautra","year":"2005","journal-title":"J Consult Clin Psychol"},{"key":"2020122823503981500_pnz202-B26","first-page":"219","article-title":"Contribui\u00e7\u00e3o para o estudo da vers\u00e3o portuguesa da Positive and Negative Affect Schedule (PANAS): II\u2013estudo psicom\u00e9trico","volume":"2","author":"Galinha","year":"2005","journal-title":"An\u00e1l Psicol"},{"key":"2020122823503981500_pnz202-B27","first-page":"81","article-title":"Hamilton Anxiety Rating Scale (HAM-A","volume":"61","author":"Hamilton","year":"1959","journal-title":"J Med"},{"issue":"10","key":"2020122823503981500_pnz202-B28","doi-asserted-by":"crossref","first-page":"1706","DOI":"10.1002\/sim.6817","article-title":"Covariance estimators for generalized estimating equations (GEE) in longitudinal analysis with small samples","volume":"35","author":"Wang","year":"2016","journal-title":"Stat Med"},{"issue":"2","key":"2020122823503981500_pnz202-B29","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.brs.2008.09.009","article-title":"A preliminary study of transcranial direct current stimulation for the treatment of refractory chronic pelvic pain","volume":"2","author":"Fenton","year":"2009","journal-title":"Brain Stimul"},{"issue":"6","key":"2020122823503981500_pnz202-B30","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1093\/humupd\/dmv039","article-title":"What we know about primary dysmenorrhea today: A critical review","volume":"21","author":"Iacovides","year":"2015","journal-title":"Hum Reprod Update"},{"issue":"6","key":"2020122823503981500_pnz202-B31","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/j.semarthrit.2007.09.003","article-title":"Central sensitivity syndromes: A new paradigm and group nosology for fibromyalgia and overlapping conditions, and the related issue of disease versus illness","volume":"37","author":"Yunus","year":"2008","journal-title":"Semin Arthritis Rheum"},{"issue":"9","key":"2020122823503981500_pnz202-B32","doi-asserted-by":"crossref","first-page":"1966","DOI":"10.1016\/j.pain.2011.03.029","article-title":"Dysmenorrhoea is associated with central changes in otherwise healthy women","volume":"152","author":"Vincent","year":"2011","journal-title":"Pain"},{"key":"2020122823503981500_pnz202-B33","doi-asserted-by":"crossref","first-page":"147","DOI":"10.3389\/fnins.2016.00147","article-title":"Prefrontal tDCS decreases pain in patients with multiple sclerosis","volume":"10","author":"Ayache","year":"2016","journal-title":"Front Neurosci"},{"issue":"10","key":"2020122823503981500_pnz202-B34","doi-asserted-by":"crossref","first-page":"2178","DOI":"10.1016\/j.pain.2013.06.045","article-title":"Longstanding neuropathic pain after spinal cord injury is refractory to transcranial direct current stimulation: A randomized controlled trial","volume":"154","author":"Wrigley","year":"2013","journal-title":"Pain"},{"issue":"10","key":"2020122823503981500_pnz202-B35","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.1111\/ene.13103","article-title":"EAN guidelines on central neurostimulation therapy in chronic pain conditions","volume":"23","author":"Cruccu","year":"2016","journal-title":"Eur J Neurol"},{"issue":"11","key":"2020122823503981500_pnz202-B36","doi-asserted-by":"crossref","first-page":"2311","DOI":"10.1007\/s00421-015-3212-y","article-title":"The effect of transcranial direct current stimulation of the motor cortex on exercise-induced pain","volume":"115","author":"Angius","year":"2015","journal-title":"Eur J Appl Physiol"},{"issue":"5","key":"2020122823503981500_pnz202-B37","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1111\/papr.12202","article-title":"Investigation of central nervous system dysfunction in chronic pelvic pain using magnetic resonance spectroscopy and noninvasive brain stimulation","volume":"15","author":"Simis","year":"2015","journal-title":"Pain Pract"},{"issue":"3","key":"2020122823503981500_pnz202-B38","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1007\/s11682-017-9730-y","article-title":"Changes of functional connectivity of the anterior cingulate cortex in women with primary dysmenorrhea","author":"Liu","year":"2018","journal-title":"Brain Imaging Behav"},{"key":"2020122823503981500_pnz202-B39","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1002\/ejp.753","article-title":"Altered regional cortical thickness and subcortical volume in women with primary dysmenorrhoea","volume":"20","author":"Liu","year":"2016","journal-title":"Eur J Pain"},{"key":"2020122823503981500_pnz202-B40","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.pnpbp.2017.05.021","article-title":"Transcranial direct-current stimulation (tDCS) for bipolar depression: A systematic review and meta-analysis","volume":"78","author":"Dond\u00e9","year":"2017","journal-title":"Prog Neuropsychopharmacol Biol Psychiatry"},{"issue":"10","key":"2020122823503981500_pnz202-B41","doi-asserted-by":"crossref","first-page":"3243","DOI":"10.1007\/s00221-014-4016-8","article-title":"Anodal-tDCS applied during unilateral strength training increases strength and corticospinal excitability in the untrained homologous muscle","volume":"232","author":"Hendy","year":"2014","journal-title":"Exp Brain Res"},{"issue":"3","key":"2020122823503981500_pnz202-B42","first-page":"402","article-title":"Anodal transcranial direct current stimulation (tDCS) increases isometric strength of shoulder rotators muscles in handball players","volume":"12","author":"Hazime","year":"2017","journal-title":"Acta Radiol Ther Phys Biol"},{"key":"2020122823503981500_pnz202-B43","doi-asserted-by":"crossref","first-page":"68.","DOI":"10.3389\/fnhum.2016.00068","article-title":"Transcranial direct current stimulation combined with aerobic exercise to optimize analgesic responses in fibromyalgia: A randomized placebo-controlled clinical trial","volume":"10","author":"Mendonca","year":"2016","journal-title":"Front Hum Neurosci"},{"key":"2020122823503981500_pnz202-B44","first-page":"259","article-title":"Non-invasive brain stimulation approaches to fibromyalgia pain","volume":"2","author":"Short","year":"2009","journal-title":"J Pain Manag"},{"issue":"7","key":"2020122823503981500_pnz202-B45","first-page":"585","article-title":"No. 345-primary dysmenorrhea consensus guideline","volume":"39","author":"Burnett","year":"2017","journal-title":"JOGC"}],"container-title":["Pain Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/painmedicine\/article-pdf\/21\/12\/3615\/35206454\/pnz202.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/painmedicine\/article-pdf\/21\/12\/3615\/35206454\/pnz202.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,12,29]],"date-time":"2020-12-29T04:51:36Z","timestamp":1609217496000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/painmedicine\/article\/21\/12\/3615\/5566353"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,10]]},"references-count":45,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2019,9,10]]},"published-print":{"date-parts":[[2020,12,25]]}},"URL":"https:\/\/doi.org\/10.1093\/pm\/pnz202","relation":{},"ISSN":["1526-2375","1526-4637"],"issn-type":[{"value":"1526-2375","type":"print"},{"value":"1526-4637","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,12]]},"published":{"date-parts":[[2019,9,10]]}}}