Modulating Brain Rhythms of Pain using Transcranial Alternating Current Stimulation (tACS) – A Sham-controlled Study in Healthy Human Participants.

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Chronic pain is a major health care problem. A better mechanistic understanding and new treatment approaches are urgently needed. In the brain, pain has been associated with neural oscillations at alpha and gamma frequencies, which can be targeted using transcranial alternating current stimulation (tACS). Thus, we investigated the potential of tACS to modulate pain and pain-related autonomic activity in an experimental model of chronic pain in 29 healthy participants. In 6 recording sessions, participants completed a tonic heat pain paradigm and simultaneously received tACS over prefrontal or somatosensory cortices at alpha or gamma frequencies or sham tACS. Concurrently, pain ratings and autonomic responses were collected. Using the present setup, tACS did not modulate pain or autonomic responses. Bayesian statistics confirmed a lack of tACS effects in most conditions. The only exception was alpha tACS over somatosensory cortex where evidence was inconclusive. Taken together, we did not find significant tACS effects on tonic experimental pain in healthy humans. Based on our and previous findings, further studies might apply refined stimulation protocols targeting somatosensory alpha oscillations. TRIAL REGISTRATION: The study protocol was pre-registered at ClinicalTrials.gov (NCT03805854). PERSPECTIVE: Modulating brain oscillations is a promising approach for the treatment of pain. We therefore applied transcranial alternating current stimulation to modulate experimental pain in healthy participants. However, tACS did not modulate pain, autonomic responses or EEG oscillations. These findings help to shape future tACS studies for the treatment of pain.

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Authors: Elisabeth S May, Vanessa D Hohn, Moritz M Nickel, Laura Tiemann, Cristina Gil Ávila, Henrik Heitmann, Paul Sauseng, Markus Ploner