Site‐specific Effects of Transcranial Direct Current Stimulation on Sleep and Pain in Fibromyalgia: A Randomized, Sham‐controlled Study

Roizenblatt, Suely; Fregni, Felipe; Gimenez, Rafaela; Wetzel, Thiago; Rigonatti, Sergio P.; Tufik, Sérgio; Boggio, Paulo S.; Valle, Angela C.

doi:10.1111/j.1533-2500.2007.00152.x

Cited by 129 publications

(126 citation statements)

References 49 publications

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“…In pain treatment, the motor cortex that is proven to be efficacious in chronic pain treatment should be the first cortical target. Extensive literature shows that stimulation of this area with either invasive or noninvasive brain stimulation is associated with pain improvement (23,24). We therefore hypothesized that LF-rTMS of the motor cortex can reduce chronic widespread pain in patients with fibromyalgia, according to knowledge from previous studies.…”

Section: Discussionmentioning

confidence: 99%

Is the Transcranial Magnetic Stimulation an Adjunctive Treatment in Fibromyalgia Patients?

Yağcı¹,

Ağırman²,

Öztürk³

et al. 2014

Turk J Phys Med Rehab

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ÖzetAmaç: Medikal tedaviye dirençli fibromiyalji hastalarında motor korteks alana uygulanan düşük frekanslı tekrarlayıcı transkraniyal manyetik stimülasyonun (tTMS) etkinliğini araştırmak. Gereç ve Yöntemler: Toplam 25 hasta randomize olarak aktif ve plasebo gruplarına ayrılarak çalışmaya alındı. Aktif tTMS grubu için stimülasyon sol primer motor korteks üzerinden motor eşik değerin %90'ı hesaplanarak 1 Hz ve 20 dakika uygulandı. Her seansta 1200 uyarı olmak üzere, iki hafta boyunca toplam 10 seans tedavi uygulandı. Plasebo grup için, parabolik koil 90° açı ile motor kortekse yerleştirildi ve aynı şekilde toplam 10 seans stimülasyon uygulandı. Sonuçlar, ağrı için vizüel analog skalası (VAS), Fibromiyalji Etkinlik Anketi (FIQ) ve Beck Depresyon Skalası (BDS) ile değerlendirildi. Bulgular: Her iki grupta da tedavi sonunda, 1 ve 3. ay sonunda ağrı derecesinde, FIQ ve BDS'de anlamlı iyileşme gözlendi. Ancak, aktif tTMS grubunda iyileşme plasebo gruba göre daha iyiydi. Tedavi sonu FIQ skorlarında aktif grupta, plasebo gruba göre istatistiksel olarak anlamlı iyileşme gözlendi. Diğer değerlendirmelerde gruplar arasında istatistiksel farklılık saptanmadı. Sonuç: Primer motor korteks üzerine düşük doz tTMS uygulamasının uzun süreli takiplerde fibromiyalji hastalarında plaseboya göre anlamlı iyileşme göstermediği görülmüştür. Anahtar Kelimeler: Fibromiyalji, transkraniyal manyetik stimülasyon, ağrı AbstractObjective: To investigate the effectiveness of low-frequency (LF) repetitive transcranial magnetic stimulation (rTMS) to the motor cortex area in fibromyalgia patients who are resistant to medical treatment. Material and Methods: A total of 25 patients were randomly assigned to the study, who were in the active rTMS (n=13) or sham stimulation (n=12) group. For the rTMS group, the main stimulation parameters were 90% of motor threshold for 60 seconds at 1 Hz and a 45-second interval between each train. Ten sessions of low-frequency rTMS, which had a total of 1200 pulses at each session, were applied to the left primary motor cortex area daily over a period of 2 weeks. For the sham group, the same parabolic coil was placed at 90° angles to the motor cortex area, and the patients received 10 sessions of sham stimulation. The outcome parameters were pain intensity, which was measured by visual analog scale (VAS), Fibromyalgia Impact Questionnaire (FIQ), and the Beck Depression Inventory (BDI). Results: A significant improvement in pain intensity, FIQ, and BDI scores was seen at the 10 th day and first and third months in both groups. Although the mean of parameters of the rTMS groups was better than the sham group, the difference did not reach statistical significance, except FIQ scores at the 10 th day in the real rTMS group. Conclusion: Patients with fibromyalgia who enroll in real TMS did not present significant differences in long-term follow-ups with respect to those who enrolled in the sham TMS group.

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Section: Discussionmentioning

confidence: 99%

Is the Transcranial Magnetic Stimulation an Adjunctive Treatment in Fibromyalgia Patients?

Yağcı¹,

Ağırman²,

Öztürk³

et al. 2014

Turk J Phys Med Rehab

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“…This observation highlights the long-term effects of tDCS in maintaining low level of pain as compared to the sham intervention. As abovementioned, several studies have highlighted the need for repeating the number of tDCS sessions (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) to induce long-lasting and clinically relevant effects. In the present study, even with a limited sample size, we demonstrated that adding a second phase of 10 stimulations sessions can help maintaining the benefits induced by tDCS.…”

Section: Long-lasting Effects Of Tdcsmentioning

confidence: 99%

“…Robust and extensive basic science research has demonstrated the effects of tDCS and many studies have confirmed that the anode increases cortical excitability while the cathode decreases it [8,10,11]. From a clinical perspective, when the anode is placed over the primary motor cortex (M1), it can induce clinically significant pain relief in chronic pain syndromes [7,[12][13][14][15][16]. In a previous study, our group has tested the effects of tDCS in SCI patients suffering from neuropathic pain, showing that 5 sessions of M1 tDCS significantly reduced level of pain after the end of the stimulation sessions but not when reassessed at 2-week follow-up [7].…”

Section: Introductionmentioning

confidence: 99%

Delayed pain decrease following M1 tDCS in spinal cord injury: A randomized controlled clinical trial

Thibaut

Carvalho

Morse

et al. 2017

Neuroscience Letters

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“…Studies were also excluded if they involved the use of unconventional hyperthermia treatments 7 ; if they used electroacupuncture, which is not included in most physical therapy curricula 8 ; if they lacked a control group or another form of intervention to compare to the electrothermal and phototherapy group [9][10][11][12] ; and if they lacked a commonly used technique in physical therapy training and practice [13][14][15] .…”

Section: Methodsmentioning

confidence: 99%

“…This resource acts through neuromodulation, being used by physicians since the 1950's to treat sleep disorders, pain, cognitive deficits, depression, anxiety, among others, and it has been reported as a resource for FMS treatment [13][14][15] . This modality consists of a micro-current that acts at a subliminal level with direct effect on the brain, on the limbic system, on the reticular activating system level and/or the hypothalamus.…”

Section: Tabe 1 Continuationmentioning

confidence: 99%

A utilização dos recursos eletrotermofototerapêuticos no tratamento da síndrome da fibromialgia: uma revisão sistemática

Ricci¹,

Dias²,

Driusso³

2010

Rev. bras. fisioter.

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Objective: To systematically investigate the scientific evidence relating to electrothermal and phototherapeutic methods for the treatment of fibromyalgia syndrome (FMS). Methods: The search for reports on interventions using electrothermal and phototherapy for FMS was carried out in the Pubmed, Medline, Lilacs, Scielo, ISI Web of Knowledge, PEDro and Cochrane Collaboration databases. Randomized controlled clinical trials published over the past 10 years in English, Portuguese and Spanish were selected. The methodological quality of the studies was assessed using the jadad scale. The analysis on the study results was done by means of critical review of the content. Results: Seven studies were reviewed in full, and these identified interventions using laser (n=4), transcutaneous electrical nerve stimulation (TENS; n=1), interferential current (IFC) alone (n=1) and IFC combined with ultrasound (US; n=1). Only two studies showed good methodological quality according to the jadad scale. Most of the studies (n=6) Key words: fibromyalgia; physical therapy methods; electrotherapy; phototherapy. ResumoObjetivo: Sistematizar as evidências científicas sobre os recursos eletrotermofototerapêuticos na síndrome da fibromialgia (SFM).Métodos: A busca de publicações sobre as intervenções por eletrotermofototerapia na SFM foi realizada nas bases de dados Pubmed, Medline, Lilacs, Scielo, ISI Web of Knowledge, PEDro e Colaboração Cochrane. Foram selecionados ensaios clínicos aleatórios e controlados dos últimos dez anos em língua inglesa, portuguesa e espanhola. A qualidade metodológica dos estudos foi avaliada pela Escala de jadad, e a análise dos resultados, por meio de revisão crítica dos conteúdos. Resultados: Sete estudos foram revisados na íntegra, sendo identificadas intervenções com laser (n=4), estimulação elétrica transcutânea (TENS) (n=1), corrente interferencial vetorial (CIV) isolada (n=1) e CIV combinada com o ultrassom (n=1). Apenas dois estudos obtiveram boa qualidade metodológica pela Escala de jadad. A maioria dos estudos (n=6) utilizou os critérios do American College of Rheumatology para o diagnóstico clínico da SFM. A dor foi o sintoma da SFM mais avaliado pelos estudos. O método e o tempo das intervenções variaram amplamente, além da falta de menção de parâmetros na utilização dos recursos eletrotermofototerapêuticos. Houve melhora significativa em todos os estudos quanto à dor. Conclusão: Generalizações dos resultados, reações adversas e doses de tratamento da SFM com eletrotermofototerapia ainda são restritas. Novos estudos são necessários para se estabelecer a efetividade da eletrotermofototerapia na SFM.

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Site‐specific Effects of Transcranial Direct Current Stimulation on Sleep and Pain in Fibromyalgia: A Randomized, Sham‐controlled Study

Abstract: Our findings suggest that one possible mechanism to explain the therapeutic effects of tDCS in fibromyalgia is via sleep modulation that is specific to modulation of primary M1 activity.

Cited by 129 publications

References 49 publications

Is the Transcranial Magnetic Stimulation an Adjunctive Treatment in Fibromyalgia Patients?

Is the Transcranial Magnetic Stimulation an Adjunctive Treatment in Fibromyalgia Patients?

Delayed pain decrease following M1 tDCS in spinal cord injury: A randomized controlled clinical trial

A utilização dos recursos eletrotermofototerapêuticos no tratamento da síndrome da fibromialgia: uma revisão sistemática

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