Phantom Limb Pain Clinical Trial
Official title:
Does Transcranial Direct Current Stimulation (tDCS) Improve the Effect of Mirror Therapy? A Double-blind Randomized Controlled Study in Patients With Phantom Limb Pain.
In this study we will examine assess if treatment with transcranial Direct Current Stimulation (tDCS) improve the analgesic effects of mirror therapy for patients with phantom pain of lower extremity. The study will include 3 arms: only mirror therapy, mirror therapy + sham tDCS, and mirror therapy + active tDCS.
Phantom pain following amputation is difficult to treat, resulting in many patients who
suffer. One of the mechanisms suspected to contribute to phantom pain is abnormal plasticity
and reorganization of the cortex.
Mirror therapy is a behavioral technique that proven useful for the treatment of phantom
pain, yet the analgesic effects are unfortunately moderate and not long lasting. The assumed
underlying mechanism of mirror therapy treatment is the induction of neuronal plasticity in
the opposite direction than the abnormal reorganization of the cortex (due to the
amputation), and by that relive pain.
tDCS is a non-invasive technique that allow the administration of low currents directly to
the scalp. The currents affect the cortex, and result in changes to the membrane potential of
neurons in the stimulated area. This in turn affects the tendency of those neurons to
generate action potentials.
It was hypothesize that combination of mirror therapy and tDCS treatment could result in
additive effects. According to this hypothesis, the effects of the mirror therapy could be
enhanced by the tDCS treatment. The aim of the current study is to investigate this
hypothesis.
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