Using Home-based, Remotely Supervised, Transcranial Direct Current Stimulation for Phantom Limb Pain

From all available treatments, recent studies using transcranial direct current stimulation, tDCS, have reported positive results when combining stimulation of the primary motor cortex, M1, with motor representation techniques. The long-term effects of the combined stimulation resulted in significant, maintained pain reduction after intervention and a follow-up period of three months. Our goal is to provide a visual guideline on how to perform a remote supervised tDCS session, as well as a description of the logistics and challenges of its implementation for treating phantom limb pain, especially in the context of a pragmatic clinical trial.

Another important contribution of this protocol is that most of the insights we are providing here can be translated to other studied population such as Parkinson's disease, traumatic brain injury, and post-stroke rehabilitation. Practical details and guidance on how to implement RS-tDCS for clinical trials on chronic pain are still limited in the literature, and they have the potential to accelerate the clinical application of the safe and effective intervention. And so on, facilitate its combination with the behavioral modalities that can be performed at home.

This trial will provide significant insights in how to use remotely supervised neuromodulation. After this trial, we'll focus on improving the delivery and methodology of home-based devices to increase the reach and the use of neuromodulation techniques in rehabilitation. We think that by addressing these questions, the clinical use of neuromodulation will increase.