Evidence map›Paper›PMID 40343412›Full record

ArticleBrain and behavior2025

The Effect of Combining Transcranial Direct Current Stimulation and Pain Neuroscience Education in Patients With Chronic Low Back Pain and High Pain Catastrophizing: An Exploratory Clinical, Cognitive, and fMRI Study.

Cory Alcon, Sarah Margerison, Haley Kirse, Christopher Zoch, Paul Laurienti, David Seminowicz, Sharon Wang-Price

Abstract read
In one paragraph

Article in Brain and behavior, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
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

7 authors.

Cory AlconDepartment of Physical Therapy, High Point University, High Point, North Carolina, USA.ORCID https://orcid.org/0000-0001-7654-4301
Sarah MargerisonDepartment of Neural and Pain Sciences, University of Maryland School of Dentistry, Baltimore, Maryland, USA.
Haley KirseLaboratory for Complex Brain Networks, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
Christopher ZochDepartment of Physical Therapy, High Point University, High Point, North Carolina, USA.
Paul LaurientiLaboratory for Complex Brain Networks, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.ORCID https://orcid.org/0000-0001-8871-9658
David SeminowiczDepartment of Neural and Pain Sciences, University of Maryland School of Dentistry, Baltimore, Maryland, USA.
Sharon Wang-PriceSchool of Physical Therapy, Texas Woman's University-Dallas, Dallas, Texas, USA.

Funding

Woodcock Institute for the Advancement of Neurocognitive Research and Applied Practice
6 · The paper itself

Abstract

objectivesPriming the neural circuitry likely targeted by pain neuroscience education (PNE) using transcranial direct current stimulation (tDCS) may enhance the efficacy of PNE. This exploratory study aimed to examine the effects of combining tDCS and PNE in those with chronic low back pain (CLBP).

methodsSix participants experiencing CLBP completed the study. Assessments for pain catastrophizing, kinesiophobia, pressure pain thresholds (PPT), pain intensity, cognitive function, and resting state and task fMRI were collected before and after the combined tDCS and PNE intervention. Each participant received five 20-min sessions of 2.0 mA tDCS targeting the left dorsolateral prefrontal cortex (DLPFC), followed by a 20-min PNE session.

resultsThe participants had a 58.9% reduction in pain catastrophizing, a 25.9% reduction in kinesiophobia, and an 18.8% improvement in cognitive function (i.e., reduced attentional interference). The MRI results indicated increased gray matter volume within the left DLPFC. Additionally, larger reductions in DLPFC activity at rest were associated with larger reductions in kinesiophobia. Increased modularity within networks responsible for cognitive control and executive functions was evident following the intervention. DISCUSSION: Our clinical and fMRI outcomes shed light on the clinical potential of combining tDCS and PNE, as well as the mechanisms substantiating their effects. We speculate that tDCS alters brain activity and structure, amplifies the effects of PNE, and promotes positive changes in the cognitive-evaluative and sensory-discriminative pain domains investigated. A randomized controlled trial is warranted to determine the effects of tDCS combined with PNE compared with tDCS or PNE alone.

Indexed as

CatastrophizationChronic PainLow Back PainTranscranial Direct Current StimulationAdultCognitionDorsolateral Prefrontal CortexFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedNeurosciencesPain ManagementPrefrontal CortexcognitionfMRIlow back painpain catastrophizingtDCS

Identifiers

PMID40343412
PMCPMC12060226

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Registered trials

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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.