The effects of anodal tDCS on pain reduction in people with knee osteoarthritis: A systematic review and meta-analysis

Thusharika Dissanayaka*, Piumi Nakandala, Kavinda Malwanage, Aron T Hill, Deborah N Ashthree, Melissa M Lane, Nikolaj Travicia, Elizabeth Gamage, Wolfgang Marx, Shapour Jaberzadeh

*Corresponding author for this work

Research output: Contribution to journalReview articleResearchpeer-review

5 Citations (Scopus)
23 Downloads (Pure)


OBJECTIVES: To synthesise the literature on the efficacy of primary motor cortex anodal transcranial direct current stimulation (M1-a-tDCS), as a standalone or priming technique, for pain reduction in people with knee osteoarthritis (KOA).

METHODS: The systematic literature search was conducted in MEDLINE, CINAHL, Embase and CENTRAL according to PRISMA statement.

RESULTS: Fourteen studies involving 740 people with KOA were included. In the meta-analysis, six studies compared a-tDCS alone with sham stimulation, and five studies compared a-tDCS combined with other methods with sham stimulation. We found positive effect of a-tDCS alone on pain in KOA (standard mean difference (SMD) -0.52; 95% CI, -0.78 to -0.25; P=0.001; I2 = 69%). Further, a-tDCS with other treatments showed positive effect (SMD -1.23; 95% CI, -1.59 to -0.88; P<0.001; I2 = 48%) on pain in people with KOA. This evidence showed low certainty due to a high risk of bias and imprecision.

DISCUSSION AND CONCLUSION: A-tDCS could be considered as standalone and an adjunct treatment for pain reduction in people with KOA. Future randomised studies should address quality issues, including small sample size, to enhance the overall certainty of the findings.

SIGNIFICANCE: A-tDCS can be used as a standalone and adjunct treatment for KOA.


Original languageEnglish
Article number102921
Pages (from-to)1-14
Number of pages14
JournalNeurophysiologie Clinique
Issue number6
Publication statusPublished - Dec 2023
Externally publishedYes


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