Reboot chronic pain with transcranial direct current stimulation (tDCS)

Reboot Pain: Integrating Neuromodulation Into Clinical Care for Military and Veterans With Chronic Pain

This program will try daily, short tDCS sessions alongside Emory's Accelerated Behavioral Health Program to see if it reduces chronic pain in adult service members and veterans.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 100 (estimated)
• Ages: 18 Years to 89 Years
• Sex: All
• Sponsor: Emory University (other)
• Locations: 1 site (Atlanta, Georgia)
• Trial ID: NCT07411859 on ClinicalTrials.gov

What this trial studies

This protocol adds non-drug brain stimulation (tDCS) to standard mental health care in the Emory Healthcare Veterans Program Accelerated Behavioral Health Program (ABHP) to target chronic pain. Adult service members and veterans (ages 18–89) enrolled in ABHP will self-administer roughly 20-minute tDCS sessions daily for two weeks, either in person at Emory's Executive Park Clinic or virtually with support. Pain will be tracked with the PEG scale, daily surveys, questionnaires, and standard clinical interviews, with follow-up assessments at 3, 6, and 12 months. Participants with implanted devices, seizure disorders, certain medications, pregnancy, or new neurologic symptoms are excluded due to safety concerns.

Who should consider this trial

Good fit: Adult service members or veterans (18–89) enrolled in Emory's ABHP who report moderate-to-severe chronic pain (PEG ≥ 4), have an established primary care or pain provider, and have no contraindications are ideal candidates.

Not a fit: People with implanted pacemakers, seizure disorders, current use of excluded medications, new neurologic symptoms, pregnancy, or those not enrolled in Emory's ABHP are unlikely to be eligible or benefit.

Why it matters

Potential benefit: If successful, adding tDCS to behavioral care could lower chronic pain and improve daily function without adding medications.

How similar studies have performed: Prior small trials of tDCS for chronic pain have shown mixed but occasionally promising results, so the approach has some supportive evidence but is not yet definitively proven.

Eligibility criteria

Inclusion Criteria:

* Male or Female, 18-89 years old
* Treated on site for ABHP
* Willing to self-administer tDCS and complete the measures
* PEG pain intensity of 4 or more for most of the day at least 3 days per week
* Have an established PCP (Primary Care Provider) or pain management provider

Exclusion Criteria:

* Implanted pacemaker
* Seizure Disorder
* Pregnancy, if applicable
* Any new onset of the following:

  * Balance Problems
  * Difficulty walking
  * Bladder incontinence
  * Bowel incontinence
  * Numbness
  * Tingling
  * Weakness
* Medical contraindications

  * Current use of sodium channel blockers
  * Lidocaine (OTC/transdermal delivery is ok)
  * Mexiletine
  * Amitriptyline; other tricyclic antidepressants
  * Anti-epileptic medications: phenytoin, carbamazepine, lamotrigine, oxcarbazepine, rufinamide, lacosamide and eslicarbazepine acetate

    * Current use of calcium channel blockers
    * Current use of N-Methyl-D-aspartate receptor antagonists
  * Ketamine
  * Dextromethorphan
  * Felbamate

    * History of brain surgery
    * History of brain tumor
    * History of seizure disorder
    * History of stroke
    * Intracranial metal implantation
* Adults unable to consent
* Individuals who are not yet adults
* Prisoners
* Non-English speaking

Where this trial is running

Atlanta, Georgia

• The Emory Clinic — Atlanta, Georgia, United States (RECRUITING)

Study contacts

• Principal investigator: Sheila Rauch, PhD — Emory University
• Study coordinator: Syreese Fuller

Conditions: Chronic Pain