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A randomized, sham-controlled, proof of principle study of transcranial direct current stimulation for the treatment of pain in fibromyalgia.
Arthritis Rheum 2006; 54(12):3988-98AR

Abstract

OBJECTIVE

Recent evidence suggests that fibromyalgia is a disorder characterized by dysfunctional brain activity. Because transcranial direct current stimulation (tDCS) can modulate brain activity noninvasively and can decrease pain in patients with refractory central pain, we hypothesized that tDCS treatment would result in pain relief in patients with fibromyalgia.

METHODS

Thirty-two patients were randomized to receive sham stimulation or real tDCS with the anode centered over the primary motor cortex (M1) or the dorsolateral prefrontal cortex (DLPFC) (2 mA for 20 minutes on 5 consecutive days). A blinded evaluator rated the patient's pain, using the visual analog scale for pain, the clinician's global impression, the patient's global assessment, and the number of tender points. Other symptoms of fibromyalgia were evaluated using the Fibromyalgia Impact Questionnaire and the Short Form 36 Health Survey. Safety was assessed with a battery of neuropsychological tests. To assess potential confounders, we measured mood and anxiety changes throughout the trial.

RESULTS

Anodal tDCS of the primary motor cortex induced significantly greater pain improvement compared with sham stimulation and stimulation of the DLPFC (P < 0.0001). Although this effect decreased after treatment ended, it was still significant after 3 weeks of followup (P = 0.004). A small positive impact on quality of life was observed among patients who received anodal M1 stimulation. This treatment was associated with a few mild adverse events, but the frequency of these events in the active-treatment groups was similar to that in the sham group. Cognitive changes were similar in all 3 treatment groups.

CONCLUSION

Our findings provide initial evidence of a beneficial effect of tDCS in fibromyalgia, thus encouraging further trials.

Authors+Show Affiliations

Harvard Medical School, Boston, Massachusetts 02215, USA. ffregni@bidmc.harvard.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

17133529

Citation

Fregni, Felipe, et al. "A Randomized, Sham-controlled, Proof of Principle Study of Transcranial Direct Current Stimulation for the Treatment of Pain in Fibromyalgia." Arthritis and Rheumatism, vol. 54, no. 12, 2006, pp. 3988-98.
Fregni F, Gimenes R, Valle AC, et al. A randomized, sham-controlled, proof of principle study of transcranial direct current stimulation for the treatment of pain in fibromyalgia. Arthritis Rheum. 2006;54(12):3988-98.
Fregni, F., Gimenes, R., Valle, A. C., Ferreira, M. J., Rocha, R. R., Natalle, L., ... Boggio, P. S. (2006). A randomized, sham-controlled, proof of principle study of transcranial direct current stimulation for the treatment of pain in fibromyalgia. Arthritis and Rheumatism, 54(12), pp. 3988-98.
Fregni F, et al. A Randomized, Sham-controlled, Proof of Principle Study of Transcranial Direct Current Stimulation for the Treatment of Pain in Fibromyalgia. Arthritis Rheum. 2006;54(12):3988-98. PubMed PMID: 17133529.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A randomized, sham-controlled, proof of principle study of transcranial direct current stimulation for the treatment of pain in fibromyalgia. AU - Fregni,Felipe, AU - Gimenes,Rafaela, AU - Valle,Angela C, AU - Ferreira,Merari J L, AU - Rocha,Renata R, AU - Natalle,Luane, AU - Bravo,Riviane, AU - Rigonatti,Sergio P, AU - Freedman,Steven D, AU - Nitsche,Michael A, AU - Pascual-Leone,Alvaro, AU - Boggio,Paulo S, PY - 2006/11/30/pubmed PY - 2007/2/7/medline PY - 2006/11/30/entrez SP - 3988 EP - 98 JF - Arthritis and rheumatism JO - Arthritis Rheum. VL - 54 IS - 12 N2 - OBJECTIVE: Recent evidence suggests that fibromyalgia is a disorder characterized by dysfunctional brain activity. Because transcranial direct current stimulation (tDCS) can modulate brain activity noninvasively and can decrease pain in patients with refractory central pain, we hypothesized that tDCS treatment would result in pain relief in patients with fibromyalgia. METHODS: Thirty-two patients were randomized to receive sham stimulation or real tDCS with the anode centered over the primary motor cortex (M1) or the dorsolateral prefrontal cortex (DLPFC) (2 mA for 20 minutes on 5 consecutive days). A blinded evaluator rated the patient's pain, using the visual analog scale for pain, the clinician's global impression, the patient's global assessment, and the number of tender points. Other symptoms of fibromyalgia were evaluated using the Fibromyalgia Impact Questionnaire and the Short Form 36 Health Survey. Safety was assessed with a battery of neuropsychological tests. To assess potential confounders, we measured mood and anxiety changes throughout the trial. RESULTS: Anodal tDCS of the primary motor cortex induced significantly greater pain improvement compared with sham stimulation and stimulation of the DLPFC (P < 0.0001). Although this effect decreased after treatment ended, it was still significant after 3 weeks of followup (P = 0.004). A small positive impact on quality of life was observed among patients who received anodal M1 stimulation. This treatment was associated with a few mild adverse events, but the frequency of these events in the active-treatment groups was similar to that in the sham group. Cognitive changes were similar in all 3 treatment groups. CONCLUSION: Our findings provide initial evidence of a beneficial effect of tDCS in fibromyalgia, thus encouraging further trials. SN - 0004-3591 UR - https://www.unboundmedicine.com/medline/citation/17133529/A_randomized_sham_controlled_proof_of_principle_study_of_transcranial_direct_current_stimulation_for_the_treatment_of_pain_in_fibromyalgia_ L2 - https://doi.org/10.1002/art.22195 DB - PRIME DP - Unbound Medicine ER -