Repetitive Transcranial Magnetic Stimulation in Fibromyalgia: A Systematic Review

Abstract

Introduction: Fibromyalgia is a rheumatologic condition that mainly manifests with chronic and diffuse musculoskeletal pain, as well as neuropsychological symptoms. Recent guidelines point to several treatment modalities, among the main ones: aerobic exercise, pharmacological treatment and cognitive behavioral therapy. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive cerebral cortex neuromodulation technique that has shown positive effects in the control of chronic pain. Objectives: Through a systematic review of the literature, this work aims to determine the efficacy and safety of repetitive transcranial magnetic stimulation for the treatment of fibromyalgia. Methodology: A systematic review of randomized controlled trials published in English or Portuguese was conducted in the PubMed database. The selected studies compared repetitive transcranial magnetic stimulation (rTMS) with placebo, and the outcomes evaluated were related to the effectiveness of this technique compared to the usual ones. Results and discussion: Eight studies were included in this review. There is evidence that repetitive transcranial magnetic stimulation contributes to the improvement of pain and reduction of the social impact caused by fibromyalgia. Conclusion:Findings demonstrate an association between rTMS neuronal stimulation therapy and painful and social outcomes caused by fibromyalgia compared to placebo. However, future studies that mainly evaluate the long-term changes with the use of this therapy will be necessary to better evaluate these associations.