Associations between transcranial direct current stimulation session exposure and clinical outcomes in knee osteoarthritis: a cross-sectional analysis exploring the role of pain catastrophizing
Abstract Background Knee osteoarthritis (KOA) is a prevalent musculoskeletal disorder characterized by chronic pain, reduced physical function, and impaired quality of life. Transcranial direct current stimulation (tDCS) has emerged as a promising non-invasive neuromodulatory intervention, yet limit...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-08-01
|
| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-025-06150-y |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849332549592023040 |
|---|---|
| author | Ravi Shankar Reddy Jaya Shanker Tedla Shaker Hassan S. Alshehri Faisal M Alyazedi Suhail Mansour Aljehani Feras Ahmed Alarabi |
| author_facet | Ravi Shankar Reddy Jaya Shanker Tedla Shaker Hassan S. Alshehri Faisal M Alyazedi Suhail Mansour Aljehani Feras Ahmed Alarabi |
| author_sort | Ravi Shankar Reddy |
| collection | DOAJ |
| description | Abstract Background Knee osteoarthritis (KOA) is a prevalent musculoskeletal disorder characterized by chronic pain, reduced physical function, and impaired quality of life. Transcranial direct current stimulation (tDCS) has emerged as a promising non-invasive neuromodulatory intervention, yet limited evidence exists regarding its association with clinical outcomes and the role of psychological mediators in this population. This cross-sectional study investigated the relationship between tDCS parameters (number of sessions, stimulation intensity, and duration) and clinical outcomes—pain, functional disability, and quality of life—in individuals with KOA, and explored whether pain catastrophizing mediates these associations. Methods Sixty-eight participants diagnosed with KOA and treated with tDCS were enrolled. Clinical outcomes were assessed using the Numeric Pain Rating Scale (NPRS), KOOS-Physical Function Shortform (KOOS-PS), and EQ-5D-5 L index. Pain catastrophizing was measured using the Pain Catastrophizing Scale (PCS). Pearson correlations, multiple linear regression, and mediation analysis using the PROCESS macro were performed. A p-value < 0.05 was considered statistically significant. Results The number of tDCS sessions showed significant correlations with reduced pain (r = − 0.42, p = 0.002), improved function (r = 0.39, p = 0.004), and better quality of life (r = 0.44, p = 0.001). Regression analysis showed that the number of tDCS sessions was significantly associated with NPRS (β = − 0.36, p = 0.004), KOOS-PS (β = 0.33, p = 0.005), and EQ-5D-5 L (β = 0.42, p = 0.001). Pain catastrophizing partially mediated these associations, with significant indirect effects observed for all outcomes (p < 0.05). Conclusion Higher tDCS session frequency was correlated with favorable clinical outcomes in KOA, and pain catastrophizing showed statistical evidence of an indirect association, though no causal mediation can be inferred. These findings highlight the importance of considering psychological factors in neuromodulatory treatment planning. |
| format | Article |
| id | doaj-art-9dc48a8c71f4445da6b60ad85c3fe4c7 |
| institution | Kabale University |
| issn | 1749-799X |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj-art-9dc48a8c71f4445da6b60ad85c3fe4c72025-08-20T03:46:11ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-08-0120111110.1186/s13018-025-06150-yAssociations between transcranial direct current stimulation session exposure and clinical outcomes in knee osteoarthritis: a cross-sectional analysis exploring the role of pain catastrophizingRavi Shankar Reddy0Jaya Shanker Tedla1Shaker Hassan S. Alshehri2Faisal M Alyazedi3Suhail Mansour Aljehani4Feras Ahmed Alarabi5Program of Physical Therapy, Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid UniversityProgram of Physical Therapy, Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid UniversityDepartment of Orthopedic Surgery, College of Medicine, King Khalid UniversityPhysical Therapy Department, Prince Sultan Military College of Health SciencesProgram of Physical Therapy, Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid UniversityProgram of Physical Therapy, Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid UniversityAbstract Background Knee osteoarthritis (KOA) is a prevalent musculoskeletal disorder characterized by chronic pain, reduced physical function, and impaired quality of life. Transcranial direct current stimulation (tDCS) has emerged as a promising non-invasive neuromodulatory intervention, yet limited evidence exists regarding its association with clinical outcomes and the role of psychological mediators in this population. This cross-sectional study investigated the relationship between tDCS parameters (number of sessions, stimulation intensity, and duration) and clinical outcomes—pain, functional disability, and quality of life—in individuals with KOA, and explored whether pain catastrophizing mediates these associations. Methods Sixty-eight participants diagnosed with KOA and treated with tDCS were enrolled. Clinical outcomes were assessed using the Numeric Pain Rating Scale (NPRS), KOOS-Physical Function Shortform (KOOS-PS), and EQ-5D-5 L index. Pain catastrophizing was measured using the Pain Catastrophizing Scale (PCS). Pearson correlations, multiple linear regression, and mediation analysis using the PROCESS macro were performed. A p-value < 0.05 was considered statistically significant. Results The number of tDCS sessions showed significant correlations with reduced pain (r = − 0.42, p = 0.002), improved function (r = 0.39, p = 0.004), and better quality of life (r = 0.44, p = 0.001). Regression analysis showed that the number of tDCS sessions was significantly associated with NPRS (β = − 0.36, p = 0.004), KOOS-PS (β = 0.33, p = 0.005), and EQ-5D-5 L (β = 0.42, p = 0.001). Pain catastrophizing partially mediated these associations, with significant indirect effects observed for all outcomes (p < 0.05). Conclusion Higher tDCS session frequency was correlated with favorable clinical outcomes in KOA, and pain catastrophizing showed statistical evidence of an indirect association, though no causal mediation can be inferred. These findings highlight the importance of considering psychological factors in neuromodulatory treatment planning.https://doi.org/10.1186/s13018-025-06150-yKnee osteoarthritisTranscranial direct current stimulationPain catastrophizingPhysical functionQuality of lifeMediation analysis |
| spellingShingle | Ravi Shankar Reddy Jaya Shanker Tedla Shaker Hassan S. Alshehri Faisal M Alyazedi Suhail Mansour Aljehani Feras Ahmed Alarabi Associations between transcranial direct current stimulation session exposure and clinical outcomes in knee osteoarthritis: a cross-sectional analysis exploring the role of pain catastrophizing Journal of Orthopaedic Surgery and Research Knee osteoarthritis Transcranial direct current stimulation Pain catastrophizing Physical function Quality of life Mediation analysis |
| title | Associations between transcranial direct current stimulation session exposure and clinical outcomes in knee osteoarthritis: a cross-sectional analysis exploring the role of pain catastrophizing |
| title_full | Associations between transcranial direct current stimulation session exposure and clinical outcomes in knee osteoarthritis: a cross-sectional analysis exploring the role of pain catastrophizing |
| title_fullStr | Associations between transcranial direct current stimulation session exposure and clinical outcomes in knee osteoarthritis: a cross-sectional analysis exploring the role of pain catastrophizing |
| title_full_unstemmed | Associations between transcranial direct current stimulation session exposure and clinical outcomes in knee osteoarthritis: a cross-sectional analysis exploring the role of pain catastrophizing |
| title_short | Associations between transcranial direct current stimulation session exposure and clinical outcomes in knee osteoarthritis: a cross-sectional analysis exploring the role of pain catastrophizing |
| title_sort | associations between transcranial direct current stimulation session exposure and clinical outcomes in knee osteoarthritis a cross sectional analysis exploring the role of pain catastrophizing |
| topic | Knee osteoarthritis Transcranial direct current stimulation Pain catastrophizing Physical function Quality of life Mediation analysis |
| url | https://doi.org/10.1186/s13018-025-06150-y |
| work_keys_str_mv | AT ravishankarreddy associationsbetweentranscranialdirectcurrentstimulationsessionexposureandclinicaloutcomesinkneeosteoarthritisacrosssectionalanalysisexploringtheroleofpaincatastrophizing AT jayashankertedla associationsbetweentranscranialdirectcurrentstimulationsessionexposureandclinicaloutcomesinkneeosteoarthritisacrosssectionalanalysisexploringtheroleofpaincatastrophizing AT shakerhassansalshehri associationsbetweentranscranialdirectcurrentstimulationsessionexposureandclinicaloutcomesinkneeosteoarthritisacrosssectionalanalysisexploringtheroleofpaincatastrophizing AT faisalmalyazedi associationsbetweentranscranialdirectcurrentstimulationsessionexposureandclinicaloutcomesinkneeosteoarthritisacrosssectionalanalysisexploringtheroleofpaincatastrophizing AT suhailmansouraljehani associationsbetweentranscranialdirectcurrentstimulationsessionexposureandclinicaloutcomesinkneeosteoarthritisacrosssectionalanalysisexploringtheroleofpaincatastrophizing AT ferasahmedalarabi associationsbetweentranscranialdirectcurrentstimulationsessionexposureandclinicaloutcomesinkneeosteoarthritisacrosssectionalanalysisexploringtheroleofpaincatastrophizing |