Hospital Practices and Research

Abstract Background: Knee Osteoarthritis (OA) is a common degenerative joint disease characterized by ongoing pain and reduced physical function.
Objectives: We aimed to systematically review and meta-analyze the clinical trials that evaluated the impact of transcranial Direct Current Stimulation (tDCS) on knee OA pain.
Methods: A comprehensive search was performed on Scopus, Web of Science, PubMed/MEDLINE, EMBASE, ProQuest, CENTRAL via Cochrane, and PEDro from the inception of these databases until May 31, 2023 with no language restrictions. The objective of the search was to find publications that examined the impact of active tDCS compared to sham tDCS or other interventions in individuals with knee OA.
Results: The meta-analysis comprised ten studies including 517 patients with knee OA. Active tDCS resulted in significantly lower pain scores compared to sham tDCS/ Transcutaneous Electrical Nerve Stimulation (TENS) immediately (effect sizes from pre-test–post-test-control design (dppc2) = -0.83, I² = 61.8%), short-term (dppc2 = -0.74, I² = 43.5%), and mid-term (dppc2 = -1.94, I² = 87.8%) follow-ups, but not in the long term (dppc2 = -0.25, I² = 29.6%). However, the certainty of the evidence was assessed as low to very low.  Moreover, function was significantly improved with active tDCS immediately after the last treatment session either by McMaster Universities Osteoarthritis Index (WOMAC) or Knee Injury and Osteoarthritis Outcome Score (KOOS) (dppc2 = -0.38, I² = 6.6% and dppc2 = 0.87, I² = 60.1%, respectively). The certainty of the evidence was very low. No serious adverse effects of tDCS were reported by the majority of studies.
Conclusion: More than half of the included trials had unclear or high risk of bias and there were no patient follow-ups beyond three months. Given the criteria of reduced I² and sufficient number of studies, no potential sources of heterogeneity were identified. Further high-quality randomized clinical trials with extended follow-up periods are required to determine the true effects of tDCS on knee OA.

Abstract Introduction: The motor function is associated with the activity of both the motor and prefrontal cortices. The efficacy of transcranial direct current stimulation (tDCS) over specific brain cortices has been examined in many psychiatric and neurologic disorders. This study aims to report the tDCS effects on two females of advanced age with idiopathic Parkinson’s disease (PD).
Case Presentation: We considered 50-minute sessions of bilateral primary motor cortices and left dorsolateral prefrontal cortex (DLPFC) anodal stimulation using tDCS with passive stretching exercises simultaneously for a total of 20 sessions in 7 weeks. Clinical signs and electroencephalography (EEG) waveform were assessed at distinct times. Both of the two patients showed improved motor function for a short time. EEG changes to some extent concerned clinical states.
Conclusion: It seems that tDCS can be an auxiliary treatment for motor dysfunction in PD; however, further studies must be carried out to prove the claim.