The impact of transcranial direct current stimulation over focal musician dystonia

Vila-Nova C 1; Sanches L 2; Parente J 3; Lucena R 1

1 Universidade Federal da Bahia; 2 União Metropolitana de Educação e Cultura (UNIME); 3 Faculdade Bahiana de Medicina

OBJECTIVE: The focal dystonia of the musician is a focal movement disorder that affects a specific part of the body, it can affect an isolated muscle or a small group of fibers and is classified as function lesion. A transcranial direct current stimulation (tDCS) has gained the spotlight in the recent years and a variety of studies used this intervention to investigate a treatment plan for chronic pain. The objective of this study was to determine the impact of anodic tDCS (tDCSA) over the cerebellar cortex on chronic pan in adults with focal dystonia of the musician.

METHODS: It exemplifies a case of a 39-year-old man, focal musician dystonia associated with pain in on the neck and head segment. The brief pain inventory (BPI) was used in a pre and pos tDCSA evaluation. A total of 10 sessions of 20 minutes each was done, one time per day. Anodic electrode was positioned 2cm below the inion and 1 cm to the lateral face of the mastoid processes. Cathodic electrode was positions on right deltoid muscle.

RESULTS: A total value of 78 points was observed on the sum of the scores of the third and the ninth question of the BPI applied right before the tDCSA intervention. A total of 52 points was observed from the same observation right after the intervention. The patient referred total lack of pain on the fourth day of treatment, although it came back on the fifth day. On the day of the botulinum toxin A (TBX-A), considered gold standard for dystonia, 5 points was observed. So, not only did the pain decrease after the intervention it maintained a constant until the TXA-B application.

CONCLUSIONS: Investigation of the affect the tDCSA over the cerebellar cortex on the effects on chronic pain must be done to better understand the effects of neurostimulation over muscle dystonia.

KEYWORDS: focal distonia; pain; transcranial direct current stimulation