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Case Reports
. 2020 Apr 5:12:243-251.
doi: 10.2147/IJWH.S226501. eCollection 2020.

Modulating Anxiety and Functional Capacity with Anodal tDCS Over the Left Dorsolateral Prefrontal Cortex in Primary Dysmenorrhea

Larissa Ramalho Dantas Varella Dutra  1 , Rodrigo Pegado  2 , Luana Karyne Silva  2 , Hégila da Silva Dantas  2 , Hialison Andrade Câmara  2 , Edson Meneses Silva-Filho  2 , Grasiéla Nascimento Correia  2 , Maria Thereza Albuquerque Barbosa Cabral Micussi  1
Affiliations
Case Reports

Modulating Anxiety and Functional Capacity with Anodal tDCS Over the Left Dorsolateral Prefrontal Cortex in Primary Dysmenorrhea

Larissa Ramalho Dantas Varella Dutra et al. Int J Womens Health. .

Abstract

Background: Primary dysmenorrhea is a common and often debilitating condition affecting 40-90% of menstruating women. This condition reduces functionality, quality of life, and social activities. Transcranial direct current stimulation (tDCS) has been used in many chronic pain syndromes, with evidence of improved pain, functionality, and mood in women with primary dysmenorrhea. The objective of this study was to determine whether tDCS could offer clinical benefits on pain, anxiety, affectivity, and functionality in women with primary dysmenorrhea.

Methods: This parallel, sham, randomized, double-blind trial was conducted with 26 women randomized into sham tDCS and active tDCS. Anodal tDCS was applied for 5 consecutive days over F3 corresponding to the left dorsolateral prefrontal cortex (DLPFC) and the cathode electrode over Fp2 for 20 min with an intensity of 2 mA. A numeric rating scale (NRS) was used to assess pain, anxiety, positive and negative affect, and submaximal aerobic performance during two consecutive menstrual cycles.

Results: No significant interaction was found between intervention and time on the NRS [F(2,44) = 1.358, p = 0.26], and a significant main effect of time [F(2,44) = 4.446, p = 0.01] was found. The active group showed a significant reduction in anxiety (p = 0.03) with a mean difference of 5.12 (95% CI 0.79 to 11.05). No significant differences in positive and negative affect were found (p = 0.95 and p = 0.15, respectively). Submaximal aerobic performance was significantly greater in the active group [F(2,21) = 5.591, p = 0.02], with a mean difference of 70.87 (95% CI 8.53 to 133.21).

Conclusion: Anodal tDCS over the DLPFC seems to be an effective therapeutic approach for improving anxiety and functionality in women with primary dysmenorrhea.

Keywords: anxiety; functional capacity; menstrual cycle; non-invasive brain stimulation; pain.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
CONSORT flowchart for the study.
Figure 2
Figure 2
Research protocol. Notes: ƚOutcome evaluated on first, second, and third days of menstruation. *All outcomes evaluated only on the first day of menstruation.
Figure 3
Figure 3
(A, B) Mean changes in numeric rating scale (NRS) assessed for 3 consecutive days before treatment (baseline) and after intervention. *Significant difference in active tDCS when comparing day 1 to day 3. Percentages describes the difference between day 1 and day 3 in each group. (C, D) No significant changes in positive and negative affect were found. (E) Anxiety showed a significant difference between day 1 and day 3 in active tDCS. (F) Six-Minute Walk Test (6MWT) indicates statistically significant differences between groups of intervention** and in intragroup analysis for active tDCS*.
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