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The Analgesic and Antihyperalgesic Effects of Transcranial Electrostimulation with Combined Direct and Alternating Current in Healthy Volunteers

Nekhendzy, V. MD*; Lemmens, H. J.*; Tingle, M.*; Nekhendzy, M.*; Angst, M. S.*

doi: 10.1213/ANE.0b013e3181e3697e
Analgesia: Research Reports

BACKGROUND: Transcranial electrostimulation (TES) has been reported to produce clinically significant analgesia, but randomized and double-blind studies are lacking. We investigated the analgesic and antihyperalgesic effects of TES in validated human experimental pain models.

METHODS: In 20 healthy male subjects we evaluated the analgesic and antihyperalgesic effects of TES60Hz and TES100Hz to heat and mechanical pain in experimentally induced ultraviolet B skin sunburns and in normal skin. Previous animal studies in our laboratory predicted that TES60Hz would provide significant analgesia, and TES100Hz was a suitable active control. The study was conducted in a double-blind, randomized, 2-way cross-over fashion. TES was administered for 35 minutes. Quantitative sensory testing evaluating heat and mechanical pain thresholds was conducted before TES, during TES, and 45 minutes after TES.

RESULTS: TES (TES60Hz > TES100Hz) evoked rapidly developing, significant thermal and mechanical antihyperalgesic effects in the ultraviolet B lesion, and attenuated thermal pain in unimpaired skin. No long-lasting analgesic and antihyperalgesic effects of a single TES treatment were demonstrated in this study.

CONCLUSIONS: TES produces significant, frequency-dependent antihyperalgesic and analgesic effects in humans. The characteristics of the TES effects indicate a high likelihood of its ability to modulate both peripheral sensitization of nociceptors and central hyperexcitability.

Published ahead of print June 8, 2010

From the *Department of Anesthesia, Stanford University, Stanford, California.

This study was supported by a research grant from the Department of Anesthesia, Stanford University (to V. Nekhendzy).

Address correspondence and reprint requests to Vladimir Nekhendzy, MD, Stanford University Medical Center, Department of Anesthesia, Room H3580, 300 Pasteur Drive, Stanford, CA 94305-5640. Address e-mail to

Accepted April 2, 2010

Published ahead of print June 8, 2010

© 2010 International Anesthesia Research Society