• Cory Alcon, Christopher Zoch, Riley Luetkenhaus, Emily Lyman, Kelli Brizzolara, Hui-Ting Goh, and Sharon Wang-Price.
• Department of Physical Therapy, High Point University, High Point, NC 27268, United States.
• Pain Med. 2025 Feb 1; 26 (2): 909790-97.

ObjectivePriming the neural circuity likely targeted by pain neuroscience education (PNE), using transcranial direct current stimulation (tDCS) may enhance the efficacy of PNE. The aim of this study was to compare the effects of active tDCS + PNE to sham tDCS + PNE on measures of pain, pain behaviors, and cognitive function in participants with chronic low back pain (CLBP) and high pain catastrophizing.Methods20 participants were recruited and randomly allocated into the active tDCS + PNE (n = 10) or sham tDCS + PNE (n = 10) groups. All participants received five sessions of their assigned interventions over a 2-week period. The active tDCS + PNE group received 20 min of 2 mA, anodal current applied to the left dorsolateral prefrontal cortex.ResultsWithin groups, both interventions demonstrated significant improvement in NPRS, PCS, and TSK. The active tDCS + PNE group also demonstrated significant improvement in the SCWT, CTMT2-Inhibitory, and CTMT2-Set Shifting. Between groups, the active tDCS + PNE group showed significantly greater improvement on the PCS, SCWT, and CTMT2-Inhibitory.ConclusionsThe results of this pilot study suggest that active tDCS + PNE appeared to provide greater improvement than sham tDCS + PNE on levels of pain catastrophizing and attentional interference in participants with CLBP and high pain catastrophizing, consistent with both interventions targeting brain regions involved in those processes. Considering the differences between groups, tDCS appears to provide a priming effect on PNE.PerspectiveThis article presents evidence of a priming effect of transcranial direct current stimulation on pain neuroscience education in participants with chronic low back pain and high pain catastrophizing. The findings support that the combination of interventions improves pain behavior and cognitive function greater than pain neuroscience education alone.Clinical Trial RegistryNCT05571215, The Effect of Combining Pain Neuroscience Education and Transcranial Direct Current Stimulation on Pain Catastrophizing, Kinesiophobia, and Pain in Patients With Chronic Low Back Pain, https://classic.clinicaltrials.gov/ct2/show/NCT05571215.© The Author(s) 2024. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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