ANALYSIS OF THE EFFECTIVENESS OF TRANSCRANIAL CONTINUOUS CURRENT ELECTROSTIMULATION IN PATIENTS WITH PRIMARY DISMENORRIAGE: RANDOMIZED AND BLIND CONTROLLED CLINICAL TRIAL
Menstrual Cycle. Pelvic pain. Chronic pain. Electric Stimulation Therapy. Conservative treatment. Physical therapy Modalities.
Introduction: Primary dysmenorrhea is a chronic condition in which the patient presents with uterine pain, like colic, accompanied by menstruation and in the absence of pelvic pathologies. It negatively affects a woman's life in many social, emotional, and physical aspects. To date, drug therapy and thermotherapy have been the most effective means of treating dysmenorrhea, but these have unwanted adverse reactions or a small duration and local effect. Thus, other therapies remain under study. Transcranial direct current therapy (tDCS) has shown good results on pain and function in patients with various chronic pain patients. To date there are no studies of tDCS in patients with primary dysmenorrhea. Objectives: To investigate the effect of TDCs on pain and functionality in patients with primary dysmenorrhea, as well as to analyze the effect of tDCS on the region of dorsolateral prefrontal cortex (tDCSDLPC) emotional symptoms, observe the perception of improvement of patients regarding treatment, evaluate the long-term effect of the intervention, and establish protocol for treatment of primary dysmenorrhea. Methods: This is a randomized, double-blind, controlled clinical trial. The 26 patients with primary dysmenorrhea were randomized into two groups. The tDCSDLPC group received the therapy for 5 consecutive days, while the Sham group performed the same protocol, but the current remains turned off. The tDCS was performed in the region of the dorsolateral prefrontal cortex, with intensity of 0.2mA. The location of the point was done using the 10/20 system, using the "F3 measurement System" program. The participants of the two groups were evaluated in two moments: in the first 24 hours of the initial menstrual cycle (EV1) and in the first 24 hours of the next menstrual cycle, after intervention (EV2). Only the participants in the intervention group underwent a third evaluation on the first day of the next menstrual cycle (EV3). The numerical scale of pain and the McGill pain questionnaire were used to evaluate the pain and the 6-minute walk test was used to evaluate the and functionality. For the secondary outcomes affectivity, anxiety and mesntruaual symptoms were used, respectively, the scale of positive and negative affection, the scale of evaluation of anxiety of Hamilton, the tool of screening of premenstrual symptoms. Patient Global Impression of Change was used to analyze the subjective perception of the treatment. Expected results: At the end of the study, it is expected to elucidate questions about the effects of transcranial electrostimulation by direct current on the pain and functionality of patients with primary dysmenorrhea, as well as its effects on menstrual symptoms, mood and anxiety.