{
    "abstract": "Post-dural puncture headache (PDPH) is a common complication of diagnostic lumbar puncture (LP), often leading to extended hospitalization and additional medication use. Clinical studies have shown that anodal transcranial direct current stimulation (a-tDCS) is effective against migraine, and thus we decided to assess whether a-tDCS was also effective in treating and preventing PDPH.\nIn two independent, randomized, monocentric controlled trials (RCTs), we enrolled 97 hospitalized participants who underwent LP for diagnostic purposes. Patients were randomized to receive either active a-tDCS or sham tDCS over the dominant primary motor cortex (M1) in a therapeutic tDCS (Th-tDCS) or preventive tDCS (Pr-tDCS) study. In the two trials, the primary outcome was the severity of PDPH measured using the Visual Analogue Scale (VAS) for pain. Secondary outcomes included the Brief Pain Inventory (BPI) to evaluate other pain-related symptoms associated with LP.\nIn the Th-tDCS study, significant differences between groups were observed after tDCS in the VAS (F\u00a0=\u00a017.011, p\u00a0<\u00a00.001), as well as in BPI intensity (F\u00a0=\u00a017.006, p\u00a0<\u00a00.001) and BPI interference (F\u00a0=\u00a014.730, p\u00a0<\u00a00.001). Moreover, in the Pr-tDCS study, VAS analysis showed a significant time\u00a0\u00d7\u00a0group interaction (F\u00a0=\u00a06.918, p\u00a0=\u00a00.002). Significant differences were also observed in BPI intensity (F\u00a0=\u00a017.866, p\u00a0<\u00a00.001) and BPI interference (F\u00a0=\u00a015.520, p\u00a0<\u00a00.001).\nOur findings suggest that a-tDCS may effectively prevent and treat PDPH and alleviate other pain-related symptoms associated with LP. Encouraging results have emerged for the use of a-tDCS in patients undergoing LP, in both experimental research designs (Th-tDCS and Pr-tDCS). A non-invasive brain stimulation (NIBS) technique, such as a-tDCS, could have a therapeutic and preventive effect on pain resulting from a LP.\nClinicalTrials.gov (ID: NCT06640634) retrospectively registered on October 8, 2024.\nA lumbar puncture can frequently lead to a severe headache known as post-dural puncture headache, which may result in prolonged hospital stay and increased use of pharmacological therapy. We have tested a non-invasive brain stimulation technique, called transcranial direct current stimulation, to reduce the intensity and prevent post-dural puncture headache. Transcranial direct current stimulation may prevent and reduce the intensity of post-dural puncture headache.",
    "authors": [
        {
            "affiliation": "Department of Systems Medicine, Tor Vergata University, Rome, Italy.",
            "firstname": "Bledar",
            "initials": "B",
            "lastname": "Gjikolaj"
        },
        {
            "affiliation": "Unit of Neurology, IRCCS Neuromed, Pozzilli, Isernia, Italy.",
            "firstname": "Mario",
            "initials": "M",
            "lastname": "Stampanoni Bassi"
        },
        {
            "affiliation": "Unit of Neurology, IRCCS Neuromed, Pozzilli, Isernia, Italy.",
            "firstname": "Antonio",
            "initials": "A",
            "lastname": "Bruno"
        },
        {
            "affiliation": "Unit of Neurology, IRCCS Neuromed, Pozzilli, Isernia, Italy.",
            "firstname": "Valeria",
            "initials": "V",
            "lastname": "De Ioanni"
        },
        {
            "affiliation": "Unit of Neurology, IRCCS Neuromed, Pozzilli, Isernia, Italy.",
            "firstname": "Ettore",
            "initials": "E",
            "lastname": "Dolcetti"
        },
        {
            "affiliation": "Department of Systems Medicine, Tor Vergata University, Rome, Italy.",
            "firstname": "Sheila",
            "initials": "S",
            "lastname": "Peter"
        },
        {
            "affiliation": "Department of Systems Medicine, Tor Vergata University, Rome, Italy.\nUnit of Neurology, IRCCS Neuromed, Pozzilli, Isernia, Italy.",
            "firstname": "Giovanni",
            "initials": "G",
            "lastname": "Galifi"
        },
        {
            "affiliation": "Unit of Neurology, IRCCS Neuromed, Pozzilli, Isernia, Italy.\nDepartment of Human Neurosciences, Sapienza University, Rome, Italy.",
            "firstname": "Antonella",
            "initials": "A",
            "lastname": "Conte"
        },
        {
            "affiliation": "Unit of Neurology, IRCCS Neuromed, Pozzilli, Isernia, Italy.\nFaculty of Psychology, Uninettuno Telematic International University, Rome, Italy.",
            "firstname": "Luana",
            "initials": "L",
            "lastname": "Gilio"
        },
        {
            "affiliation": "Department of Systems Medicine, Tor Vergata University, Rome, Italy. centonze@uniroma2.it.\nUnit of Neurology, IRCCS Neuromed, Pozzilli, Isernia, Italy. centonze@uniroma2.it.",
            "firstname": "Diego",
            "initials": "D",
            "lastname": "Centonze"
        },
        {
            "affiliation": "Department of Systems Medicine, Tor Vergata University, Rome, Italy.\nUnit of Neurology, IRCCS Neuromed, Pozzilli, Isernia, Italy.",
            "firstname": "Fabio",
            "initials": "F",
            "lastname": "Buttari"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2025. The Author(s).\n\u00a9 2025. The Author(s).",
    "doi": "10.1007/s40120-025-00734-w",
    "journal": "Neurology and therapy",
    "keywords": [
        "Headache",
        "Neuromodulation",
        "Non-invasive brain stimulation",
        "Post-dural puncture headache",
        "Transcranial direct current stimulation"
    ],
    "methods": null,
    "publication_date": "2025-04-22",
    "pubmed_id": "40261600",
    "results": "In the Th-tDCS study, significant differences between groups were observed after tDCS in the VAS (F\u00a0=\u00a017.011, p\u00a0<\u00a00.001), as well as in BPI intensity (F\u00a0=\u00a017.006, p\u00a0<\u00a00.001) and BPI interference (F\u00a0=\u00a014.730, p\u00a0<\u00a00.001). Moreover, in the Pr-tDCS study, VAS analysis showed a significant time\u00a0\u00d7\u00a0group interaction (F\u00a0=\u00a06.918, p\u00a0=\u00a00.002). Significant differences were also observed in BPI intensity (F\u00a0=\u00a017.866, p\u00a0<\u00a00.001) and BPI interference (F\u00a0=\u00a015.520, p\u00a0<\u00a00.001).",
    "title": "Effect of Anodal Transcranial Direct Current Stimulation on the Intensity of Post-dural Puncture Headache: Results of Two Randomized Sham Controlled Trials.",
    "xml": "<Element 'PubmedArticle' at 0x78850499d530>"
}