Effect of Adjunctive Transcranial Direct Current Stimulation and Cognitive Behavior Therapy on Headache Disability in Episodic Frequent or Chronic Tension-Type Headache A Pilot, Exploratory Study

• Published in: Indian Journal of Pain Vol. 36; no. 3; pp. 140 - 146
• Main Authors: Gupta, Saloni, Goel, Deepak, Garg, Shobit, Tikka, Sai, Mishra, Preeti, Tyagi, Priya
• Format: Journal Article
• Language: English
• Published: Medknow Publications and Media Pvt. Ltd 01.09.2022; Wolters Kluwer Medknow Publications
• Subjects: Behavioral health care; chronic headache; Cognitive therapy; head-on comparison; non-invasive brain stimulation; non-pharmacological; Tension headache
• ISSN: 0970-5333
• DOI: 10.4103/ijpn.ijpn_52_22

Background: Literature suggests that non-pharmacological treatments like non-invasive brain stimulation and cognitive behavioural therapy (CBT) may be used as augments in the management of Tension-Type Headache (TTH). Aims and Objectives: To assess the efficacy of Transcranial Direct Current Stimulation (tDCS) and Cognitive Behavioral Therapy (CBT) compared to treatment as usual (TAU) on headache-related disability and the psychological impact of headache on life of patients suffering from TTH. Materials and Methods: Thirty right-handed TTH patients HDI (headache disability index) > 30 were randomly allocated to group A (tDCS + TAU), group B (CBT + TAU), and group C (TAU). While the primary outcome measure was headache related disability (Headache Disability Index(HDI)), somatic symptoms (Somatic Symptom Severity (SSS-8)), anxiety & depression (Hospital Anxiety and Depression Scale (HADS)) and sleep quality (Pittsburgh Sleep Quality Index (PSQI). Assessments were done at baseline, end of the third and sixth month. Results: We found a statistically significant reduction in HDI (F=12.419, p <0.001), SSS-8 (F=4.587, p=0.010), and HADS-anxiety (F=4.810, p=0.002). tDCS showed better efficacy than CBT, while these two were significantly better than TAU on HDI and SSS-8. On HADS-A also both tDCS and CBT were better than TAU, but showed no significant difference between them. Conclusion: Supplementing non-pharmacological techniques like tDCS and CBT will be effective in reducing headache-related disability and associated psychological symptoms.