TITLE:
Transcranial Direct Current Stimulation Combined with Peripheral Neuromuscular Stimulation Improves Quality of Life, Fatigue, and Pain in a Patient with Rheumatoid Arthritis and Refractory Radicular Pain Related to Spinal Stenosis
AUTHORS:
Rafael Giovani Missé, Lucas De Macedo Dos Santos, Clarice Tanaka, Abrahão Fontes Baptista, Samuel Katsuyuki Shinjo
KEYWORDS:
Neuromodulation, Pain, Radiculopathy, Rheumatoid Arthritis, Treatment
JOURNAL NAME:
Open Journal of Rheumatology and Autoimmune Diseases,
Vol.13 No.1,
February
3,
2023
ABSTRACT: Background: Transcranial direct current stimulation (tDCS) has emerged as an
adjuvant noninvasive neuromodulation tool to control fatigue and pain. To date,
no studies have assessed the safety and
efficiency of tDCS in patients with rheumatoid arthritis and with fatigue, poor
quality of life, and refractory radicular pain associated with spinal stenosis. Case Presentation: An
85-year-old woman patient presented with rheumatoid arthritis in
remission, refractory radicular pain-associated spinal stenosis, fatigue, and
impaired quality of life. The patient underwent 16 daily sessions of tDCS
intervention (2 mA, 20 min, positively and negatively charged electrodes were
positioned at C1 and Fp2, respectively), in addition to simultaneous peripheral
neuromuscular electrical stimulation (frequency of 100 Hz and amplitude of 500
μs). After the intervention, neither disease relapse nor clinical intercurrence
occurred. Moreover, there was a significant and sustained improvement in her
health-related quality of life, with a reduction in the level of pain and
chronic fatigue. Conclusion: The present case report shows that tDCS is
safe and may be an adjuvant tool for the treatment of pain and fatigue in
patients with systemic autoimmune disease, as well as for improving quality of
life. Further studies are required to corroborate this case report.