High Definition Transcranial Direct Current Stimulation Motor Cortex Versus Insula
Condition: Pain
Study type: Interventional

Summary: 
      Brain stimulation is a technique that can alter cortical function and thus be suitable for
      treating pain. This is especially when pain is chronic and associated with functional and
      even structural reorganization of the central nervous system. The idea of using invasive and
      noninvasive brain stimulation for pain relief is not new. Studies from the 1950s have
      investigated the brain stimulation for therapeutic use. Direct implantation of electrodes on
      the cerebral cortex has been carried out by Tsubokawa and colleagues in Japan. Although
      reported to be effective, it is invasive and involves the implantation of a foreign body into
      the cranium. Recent advancements in the techniques of non-invasive brain stimulation have
      improved and have measurable modulatory effects making this an attractive alternative for
      treating pain
    

Detailed description: 
      Repetitive transcranial magnetic stimulation and transcranial direct current stimulation are
      currently the two main methods of non-invasive brain stimulation under investigation.
      Stimulation of the primary motor cortex has been reported to relieve neuropathic,
      musculoskeletal, visceral pain as well as headaches and migraine. Other parameters of
      stimulation have shown encouraging results. For example, stimulation of the secondary
      somatosensory cortex was also reported to relieve chronic visceral pain. However, there are
      numerous unanswered questions regarding these techniques.

      This research project is an attempt to answer some of these questions:

        1. Which pain conditions can be alleviated by non-invasive brain stimulation?

        2. What are the best parameters for stimulation-

             1. method: transcranial direct current stimulation or repetitive transcranial magnetic
                stimulation transcranial or Alternating Current Stimulation

             2. High-Definition transcranial direct current stimulation or conventional
                transcranial direct current stimulation?

             3. which area to stimulate? Primary motor cortex, insula?

        3. Will other forms of treatment such as pharmacotherapy, peripheral nerve stimulation or
           multi-disciplinary pain management enhance the effectiveness of non-invasive brain
           stimulation
    

Intervention name(s): HD tDCS active motor cortex; HD tDCS active insula cortex; HD tDCS sham motor cortex; Capsaicin cream
Intervention type(s): Device; Device; Device; Other
Intervention description(s): the intervention will be 10 participants will be subjected to 1.5-gram of Capsaicin cream 0.075 concentration for 30 min then participants will be subjected to active stimulation targeting motor cortex area with the high-definition transcranial direct current stimulation device with current intensity 2 milliampere for 20 min; the intervention will be 10 participants will be subjected to 1.5 gram of Capsaicin cream 0.075 concentration for 30 min then participants will be subjected to active stimulation targeting Insular cortex area with the high-definition transcranial direct current stimulation device, with current intensity 2milliampere for 20 min; the intervention 10 participants will be subjected to1.5 gram of Capsaicin cream 0.075% concentration for 30 min then participants will be subjected to sham stimulation targeting motor cortex area using the high-definition transcranial direct current stimulation device by starting stimulation for 30 seconds then stop stimulation for 20 min; Capsaicin cream
Intervention MeSH terms: Capsaicin
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Treatment