ACUTE EFFECT OF TDCS ON BRAIN ELECTRICAL ACTIVITY IN WOMEN AFFECTED BY PRIMARY DYSMENORRHEA: A RANDOMIZED CLINICAL TRIAL
electroencephalography, chronic pain, neuromodulation, dorsolateral prefrontal cortex, motor cortex.
Primary dysmenorrhea (PD) is a prevalent condition characterized by altered central pain-processing networks and a lack of consistently effective pharmacological treatments. Electroencephalography (EEG) offers a noninvasive approach to detect cortical biomarkers associated with these dysfunctional processes. This study examined the acute effects of transcranial direct current stimulation (tDCS) applied over the primary motor (M1) and dorsolateral prefrontal (DLPFC) cortices on brain electrical activity in women with PD. This single-center, randomized, double-blind, sham-controlled trial involved 40 participants. Active wearable tDCS (2.0 mA for 20 minutes; anodes C3/FC5, cathodes C4/FC6) or sham was applied. Pre- and post-intervention EEG during an emotion recognition task was analyzed using generalized linear mixed models. Compared with sham, active tDCS significantly reduced theta (4–8 Hz) and alpha (8–13 Hz) power across frontal, central, and parietal regions, peaking at electrode P3 for theta (β = −0.2120; p < 0.0001) and alpha (β = −0.2432; p < 0.0001). Right parietal focal power increases were also identified, whereas sham produced limited, inconsistent changes. Overall, a single bilateral M1-DLPFC tDCS session acutely modulated brain oscillations linked to pain processing, highlighting wearable neuromodulation as a promising non-pharmacological strategy and providing a mechanistic rationale for multi-session trials targeting sustained symptom relief.