Review Article

The Application of tDCS to Treat Pain and Psychocognitive Symptoms in Cancer Patients: A Scoping Review

Table 3

Results of included studies.

First author, yearProcedureOutcomesMeasuresMain results

Gao et al., 2022 [47]tDCS for 30 min, once daily for 4 weeksAnxiety;
depression
SAS;
SDS
Anxiety and depression:
After treatment, tDCS group achieved a reduction in anxiety and depression

Gaynor et al., 2020 [45]Four study visits over 4 consecutive days (2 days of tDCS stimulation and 2 days of sham stimulation)Attention;
self-report measure of difficulty with memory, attention, concentration, language, and thinking abilities;
measure of difficulties with attention and concentration related to difficulty filtering irrelevant sensory information;
patients’ experience with tDCS;
adverse events related to tDCS
CPT;
PAOFI;
SGI;
tDCS patient experience questionnaire; brunoni adverse events questionnaire
Self-reported cognitive difficulties:
A nominal decrease in self-reported cognitive problems:
mean PAOFI score pre-tDCS (97.71 ± 25.54) vs. after tDCS (93.93 ± 21.90) sessions
Marginally significant change in SGI scores from pre-tDCS (M = 62.14 ± 30.49) vs. after tDCS (M = 56.43 ± 29.22)
Attention:
Better sustained attention in tDCS group vs. sham,

Knotkova et al., 2014 [42]T0: five sessions of tDCS on 5 consecutive days
T1: 2 weeks after tDCS completion
Executive functioning; memory (nonverbal); attention; global cognitive scoreGo/No-Go test, stroop interference test and catch game; immediate recognition and delayed recognition tests; score across the three cognitive domainsImprovements in all cognitive functions except attention.
Global cognitive score:
pre-tDCS: 88.7
after tDCS: 108.6
after 2 weeks: 103.9
Memory:
pre-tDCS: 79.4
after tDCS: 114.9
after 2 weeks: 111.9
Executive functions:
pre-tDCS: 89.5
after tDCS: 108.2
after 2 weeks: 101.3
Attention:
pre-tDCS: 97.2
post-tDCS: 102.8
post 2 weeks: 98.5

Nguyen et al., 2016 [39]T0: One tDCS stimulation (20 min) for 5 consecutive daysPain; depression and anxiety; analgesic and coanalgesic consumption in chronic painVAS;
HAD;
MQS
Pain:
Prestimulation: VAS score varying between 6 and 8/10 with at least four very painful peaks per day
poststimulation: by the second day of treatment, VAS fluctuating between 2 and 3/10 with only 1–2 painful peaks per day
Drug treatment:
Pre-stimulation: 36 MQS score
Post-stimulation: 15 MQS score
Depression
Prestimulation: 14/21 HAD score poststimulation: 6/21 HAD score
Stamenkovic et al., 2020 [46]tDCS group received stimulation for 20 min on 5 consecutive days after thoracotomy vs. sham group
T1: immediately before the thoracotomy
T2: immediately after the thoracotomy
T3–T6: every 1 hr for 4 hr
Т7–Т31: every 6 hr for 5 days
Pain;
depression; anxiety; morphine dose
VAS;
BDI;
PRO survey (questions on pain intensity, time with severe pain; pain interference, patient satisfaction)
Morphine dose:
Cumulative morphine dose administered during the first 120 hr after surgery was lower by 31.25% (Cohen’s d = 0.42) in the tDCS group ()
Pain:
On postoperative day 5, VAS pain score with cough was significantly lower in the tDCS group ()
Pain intensity, time with severe pain, pain interference:
Pain interference with cough (PROs) was 80% lower (), and not identify any other differences existed between groups with regard to PRO
Anxiety, depression, mood:
There was no significant difference between group

Hu et al., 2016 [34]Prestudy visit: EEG + full questionnaire packet
1 week of CRT: full questionnaire packet
2 week of CRT: five tDCS stimulation daily + EEG + questionnaires 3 week of CRT: five tDCS stimulation daily + EEG + questionnaires 4 weeks of CRT: three tDCS stimulation daily + questionnaires 5 weeks of CRT: three tDCS stimulation daily + questionnaires 6 week of CRT: two tDCS stimulation daily + questionnaires 7 weeks of CRT: two tDCS stimulation daily + EEG + full questionnaire Packet 1 week follow-up: EEG + full questionnaires packet
1 month follow-up: EEG + full questionnaires packet
Pain;
weight loss; and graded
dysphagia between the tDCS stimulus cohort and control cohort
VAS;
PANAS
Pain:
After tDCS: VAS reduced in every week (average decrease range: 0.19–0.57) and PANAS scores decreased (positive decrease range: −0.25–6.5, negative decrease range: 0.5–3.5)

Kamal et al., 2022 [43]Before chemotherapy
T0: measurements before tDCS
one session of tDCS stimulation (20 min) or sham treatment

After chemotherapy
T1, T2, T3: measurements every 24 hr for 72 hr after cessation of chemotherapy
Patients’ nausea;
pain, malaise, and sense of well-being
Cumulative index of nausea, VAS-N, episodes of vomiting; ESASPain:
No significant difference in tDCS group vs. sham group.
Malaise:
tDCS showed a reduction in ESAS malaise score ()
Sense of well-being:
tDCS group improves sense of well-being score () over 3 days vs. the sham group

Ibrahim et al., 2018 [44]tDCS for 10 consecutive days (30 min)
T0: baseline
T1: after first tDCS
T2: after fifth tDCS
T3: after 10th tDCS
T4: after 1 month from last tDCS.
Pain;
depression
VDS;
VAS;
HAM-D
Pain:
Pain reduction in tDCS group after T3 (VAS, ; VDS, ) and T4 (VAS, , VDS, ).
Depression:
Depression reduction in tDCS group after T3 () and T4 ()

Mirski et al., 2015 [40]20 sessions of individually tailored anodal
tDCs + neurofeedback twice a week
DepressionBDIDepression:
Before surgery: no depression (BDI score: 10)
1 month after surgery: mild depression (BDI score: 20)
6 months after surgery: severe depression (BDI score: 32)
tDCS stimulation on depressive symptoms:
After tDCS + neurofeedback: no depression (BDI score: 6)
After 6 months of follow-up: no depression (BDI score: 7)

Silva et al., 2007 [41]Sham and active tDCS in a randomized orderPain;
mood; anxiety; memory; attention; and cognitive functions
Numeric scales for pain, mood, and anxiety;
MMSE, stroop test, forward and backward digit span; questionnaire for adverse effects
Pain, mood, anxiety:
Sham group: no changes
tDCS group: pain reduction from 4 to 0; no changes in mood and anxiety after tDCS.
Cognitive effects:
Sham group:
MMSE and digit span forward: no changes
Digit span backward: increase from 2 to 3 (row scores)
Stroop colors performance execution time decreased
tDCS group:
MMSE and digit span forward and backward: no changes
Stroop colors execution time decreased from 23.06 to 20.56 s (row scores)

Notes. tDCS = transcranial direct current stimulation; SAS = self-rating anxiety scale; SDS = self-rating depression scale; CPT = Conners’ continuous performance test; PAOFI = patient assessment of own functioning inventory; SGI = sensory gating inventory; VAS = visual analogue scale; HAD = Hamilton anxiety and depression scale; MQS = medication quantification scale; BDI = beck depression inventor; VAS-N = visual analog scale for nausea; ESAS = Edmonton symptoms assessment scale; VDS = verbal descriptor scale; HAM-D = Hamilton rating scale for depression; MMSE = mini-mental state examination; CRT = chemoradiotherapy; PANAS = McGill and positive and negative affect schedule.