Pain exerts a tremendous cost in healthy care, rehabilitation and lost productivity. It is is associated with a wide range of diseases and their social consequences is a public health problem. With the progress of neuroscience and studies on the plasticity of the central nervous system, it has been provided a better understanding of the neurobiological mechanisms of pain. The neurohormone Melatonin stands by having systemic and diverse mechanisms of action, both in physiological and pathological situations, with modulating effects on the process of nociceptive signaling and neurochemical mechanisms such as serotonergic, opioidergic and GABAergic, exerting anti-inflammatory action, analgesic activity among others. The advent of neuromodulation techniques such as transcranial direct current stimulation (tDCS), which promote changes in neuronal activity and signaling to be effective in conditions of chronic pain by attenuating changes in cortical excitability. There is clinical evidence of the analgesic effect of Melatonin and tDCS alone. Thus, considering the potential for each isolated intervention and the lack of knowledge of their combined effect, the authors propose the present study to investigate the effect of this combination on the heat-pain detection threshold and the neuroplasticity in the healthy subjects.
The methods are according to the CONSORT guidelines. Heat pain threshold and tolerance : Quantitative Sensory Testing (QST) will be used on a computer Peltier-based device thermode. Conditioned Pain Modulation (CPM)-task: Immerssing the non-dominant hand cold water for 1 minute. Serum Brain Derived Neurotrophic Factor (BDNF). Transcranial Magnetic Stimulation (TMS) assessment: motor threshold, motor evoked potential, Short intracortical inhibition and intracortical facilitation. Statistical analyses: Descriptive statistics, Linear and multiple regression analysis, performed with SPSS version18.0.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
QUADRUPLE
Enrollment
50
Hospital de Clinicas de Porto Alegre
Porto Alegre, Rio Grande do Sul, Brazil
RECRUITINGChange from baseline in heat-pain threshold with pain score
Heat-threshold by Pettier-based device on the contralateral hand assessment pain score (VAS)
Time frame: Baseline, one week
Change from baseline Brain-Derived neurotrophic factor (BDNF)
Time frame: Baseline, one week
Change from Baseline from Catastrophizing Scale
Time frame: Baseline, one week
Change from baseline Inventory of state-trait anxiety Scale
Time frame: Baseline, one week
Change from baseline Inventory of Coping
Time frame: Baseline, one week
Change from baseline of cortical excitability
Transcranial Magnetic Stimulation (TMS) assessment motor threshold, motor-evoked potentials, silent period, intracortical inhibition and facilitation
Time frame: Baseline, one week
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