Efficacy of Transcranial Direct Current Stimulation-Enhanced Mindfulness-Based Program for Chronic Pain: a Single-Blind Randomized Sham Controlled Pilot Study

Abstract

Chronic pain impacts approximately 100 million adults in the USA. Mindfulness-based programs (MBPs) are effective behavioral treatments for chronic pain, yet the effects tend to be small. The current study was designed to assess whether transcranial direct current stimulation (tDCS) could enhance learning of mindfulness skills (primary outcome) in an MBP among adults with chronic pain. We also examined whether MBP + tDCS resulted in improvements in pain acceptance, pain coping, and physical health (secondary outcomes). A single blind randomized controlled trial was used to examine the effectiveness of active tDCS (2.0 mA)-enhanced MBP compared to sham tDCS (0.1 mA)-enhanced MBP for adults with chronic pain. Participants (N = 47) were diagnosed with chronic pain and were recruited from the community. Self-report measures of mindfulness, pain, and physical health were completed at baseline and end of treatment. Participants were randomized to active or sham tDCS of the right dorsolateral prefrontal cortex (dlPFC). Participants were blind to tDCS condition and all participants received a group MBP for eight bi-weekly, 2-hour sessions over 4 weeks. There were no main effects of active tDCS on primary or secondary outcomes. Those who received active tDCS as compared with sham tDCS and who attended more treatment sessions, reported significantly higher rates of mindfulness and greater overall physical health after participating in a group MBP. This study advances our knowledge of behavioral interventions for chronic pain by testing a novel combination intervention that may help those struggling with pain.