Evidence map›Paper›PMID 30655690›Full record

ArticleJournal of pain research2019

Intramuscular electrical stimulus potentiates motor cortex modulation effects on pain and descending inhibitory systems in knee osteoarthritis: a randomized, factorial, sham-controlled study.

Maria da Graca-Tarragó, Mateus Lech, Letícia Dal Moro Angoleri, Daniela Silva Santos, Alícia Deitos, Aline Patrícia Brietzke, Iraci Ls Torres, Felipe Fregni, Wolnei Caumo

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of pain research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01747070 (Effect of Transcranial Direct Current Stimulation and Electro Acupuncture in Pain, Functional Capability and Cortical Excitability in Patients With Osteoarthritis.), which is not on this map. Cited by 32 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 6 pooled it
3.6field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01747070 nacompletednot on this map

Effect of Transcranial Direct Current Stimulation and Electro Acupuncture in Pain, Functional Capability and Cortical Excitability in Patients With Osteoarthritis.

TypeinterventionalSponsorHospital de Clinicas de Porto AlegreRan2014 to 2016Enrolled60ConditionsOsteoarthritis, Knee, Chronic PainArmstDCS and EAC sham, tDCS sham and EAC sham, tDCS sham and EAC, tDCS and EAC
3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 6 syntheses or guidelines pooled it, 56 citations in OpenAlex.

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  7. Effects of Transcranial Direct Current Stimulation and Individualized Physical Therapy on Pain and Function in Individuals With Chronic Knee Pain: A Pilot Study.Physiotherapy research international : the journal for researchers and clinicians in physical therapy · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 2 countries.

Maria da Graca-TarragóPost-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil, wcaumo@hcpa.edu.br.
Mateus LechLaboratory of Pain and Neuromodulation, HCPA, Porto Alegre, Brazil, wcaumo@hcpa.edu.br.
Letícia Dal Moro AngoleriLaboratory of Pain and Neuromodulation, HCPA, Porto Alegre, Brazil, wcaumo@hcpa.edu.br.
Daniela Silva SantosLaboratory of Pain and Neuromodulation, HCPA, Porto Alegre, Brazil, wcaumo@hcpa.edu.br.
Alícia DeitosPost-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil, wcaumo@hcpa.edu.br.
Aline Patrícia BrietzkePost-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil, wcaumo@hcpa.edu.br.
Iraci Ls TorresPost-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil, wcaumo@hcpa.edu.br.
Felipe FregniDepartment of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA.
Wolnei CaumoPost-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil, wcaumo@hcpa.edu.br.
Universidade Federal do Rio Grande do Sul · BRHospital de Clínicas de Porto Alegre · BRHarvard University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNeuroplastic changes in nociceptive pathways contribute to severity of symptoms in knee osteoarthritis (KOA). A new look at neuroplastic changes management includes modulation of the primary motor cortex by transcranial direct current stimulation (tDCS).

objectivesWe investigated whether tDCS combined with intramuscular electrical stimulation (EIMS) would be more efficacious than a sham (s) intervention (s-tDCS/s-EIMS) or a single active(a)-tDCS/s-EIMS intervention and/or s-tDCS/a-EIMS in the following domains: pain measures (visual analog scale [VAS] score and descending pain modulatory system [DPMS], and outcomes, and analgesic use, disability, and pain pressure threshold (PPT) for secondary outcomes. REGISTRATION: The trial is registered in Clinicaltrials.gov: NCT01747070.

methodsSixty women with KOA, aged 50-75 years old, randomly received five sessions of one of the four interventions (a-tDCS/a-EIMS, s-tDCS/s-EIMS, a-tDCS/s-EIMS, and s-tDCS/a-EIMS). tDCS was applied over the primary motor cortex (M1), for 30 minutes at 2 mA and the EIMS paraspinal of L1-S2.

resultsA generalized estimating equation model revealed the main effect of the a-tDCS/a-EIMS in the VAS pain scores at end treatment compared with the other three groups (

conclusionThis study provides additional evidence regarding additive clinical effects to improve pain measures and descending pain inhibitory controls when the neuromodulation of the primary motor cortex with tDCS is combined with a bottom-up modulation with EIMS in KOA. Also, it improved the ability to walk due to reduced pain and reduced analgesic use.

Indexed as

conditioned pain modulationCPMelectroacupunctureosteoarthritispain pressure thresholdtDCStranscranial direct current stimulation

Identifiers

PMID30655690
PMCPMC6322702
OpenAlexW2907428299

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.