In addition to targeting cranial nerves in the treatment of pain, cortical regions have also been targeted in the treatment of chronic pain using transcranial electrical stimulation such as with tDCS.  Transcranial direct current stimulation (tDCS) is a non-invasive, painless brain modulation treatment that uses very small direct electrical currents to stimulate specific parts of the brain. A constant, low intensity current is passed through two or more electrodes placed over the head which modulates neuronal activity. There are two types of stimulation with tDCS: anodal and cathodal stimulation. Anodal stimulation generally acts to excite neuronal activity while cathodal stimulation inhibits or reduces neuronal activity.

Several hundred studies suggest it may be a valuable tool for the treatment of cognitive disorders, as well as, neuropsychiatric conditions such as mood disorders and chronic pain.  tDCS appears to have several advantages over other brain stimulation techniques.  It is relatively inexpensive comparted to other neuromodulation interventions such as Deep Brain Stimulation (DBS), non-invasive, painless and safe. It is also easy to administer and the equipment can be made portable for remote administered applications. The most common side effect of tDCS is a slight itching or tingling on the scalp. 

The NeuroMod-PainTM medical device targets a region in the cortex responsible for enhancing gatekeeping functions in the modulation of pain messages on route to cortical awareness of these pain messages.  This form of pain treatment has been cleared in several non-US countries.   The NeuroMod-PainTM neuromodulation device is presently pending approval for clinical use in some of the regions.  Currently, tDCS is not an FDA-approved treatment.

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