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Site-specific effects of transcranial direct current stimulation on sleep and pain in fibromyalgia: a randomized, sham-controlled study.
Pain Pract 2007; 7(4):297-306PP

Abstract

OBJECTIVE

To investigate whether active anodal transcranial direct current stimulation (tDCS) (of dorsolateral prefrontal cortex [DLPFC] and primary motor cortex [M1]) as compared to sham treatment is associated with changes in sleep structure in fibromyalgia.

METHODS

Thirty-two patients were randomized to receive sham stimulation or active tDCS with the anode centered over M1 or DLPFC (2 mA, 20 minutes for five consecutive days). A blinded evaluator rated the clinical symptoms of fibromyalgia. All-night polysomnography was performed before and after five consecutive sessions of tDCS.

RESULTS

Anodal tDCS had an effect on sleep and pain that was specific to the site of stimulation: such as that M1 and DLPFC treatments induced opposite effects on sleep and pain, whereas sham stimulation induced no significant sleep or pain changes. Specifically, whereas M1 treatment increased sleep efficiency (by 11.8%, P = 0.004) and decreased arousals (by 35.0%, P = 0.001), DLPFC stimulation was associated with a decrease in sleep efficiency (by 7.5%, P = 0.02), an increase in rapid eye movement (REM) and sleep latency (by 47.7%, P = 0.0002, and 133.4%, P = 0.02, respectively). In addition, a decrease in REM latency and increase in sleep efficiency were associated with an improvement in fibromyalgia symptoms (as indexed by the Fibromyalgia Impact Questionnaire). Finally, patients with higher body mass index had the worse sleep outcome as indexed by sleep efficiency changes after M1 stimulation.

INTERPRETATION

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.

Authors+Show Affiliations

Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil.No 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
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17986164

Citation

Roizenblatt, Suely, et al. "Site-specific Effects of Transcranial Direct Current Stimulation On Sleep and Pain in Fibromyalgia: a Randomized, Sham-controlled Study." Pain Practice : the Official Journal of World Institute of Pain, vol. 7, no. 4, 2007, pp. 297-306.
Roizenblatt S, Fregni F, Gimenez R, et al. Site-specific effects of transcranial direct current stimulation on sleep and pain in fibromyalgia: a randomized, sham-controlled study. Pain Pract. 2007;7(4):297-306.
Roizenblatt, S., Fregni, F., Gimenez, R., Wetzel, T., Rigonatti, S. P., Tufik, S., ... Valle, A. C. (2007). Site-specific effects of transcranial direct current stimulation on sleep and pain in fibromyalgia: a randomized, sham-controlled study. Pain Practice : the Official Journal of World Institute of Pain, 7(4), pp. 297-306.
Roizenblatt S, et al. Site-specific Effects of Transcranial Direct Current Stimulation On Sleep and Pain in Fibromyalgia: a Randomized, Sham-controlled Study. Pain Pract. 2007;7(4):297-306. PubMed PMID: 17986164.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Site-specific effects of transcranial direct current stimulation on sleep and pain in fibromyalgia: a randomized, sham-controlled study. AU - Roizenblatt,Suely, AU - Fregni,Felipe, AU - Gimenez,Rafaela, AU - Wetzel,Thiago, AU - Rigonatti,Sergio P, AU - Tufik,Sergio, AU - Boggio,Paulo S, AU - Valle,Angela C, Y1 - 2007/11/06/ PY - 2007/11/8/pubmed PY - 2007/12/22/medline PY - 2007/11/8/entrez SP - 297 EP - 306 JF - Pain practice : the official journal of World Institute of Pain JO - Pain Pract VL - 7 IS - 4 N2 - OBJECTIVE: To investigate whether active anodal transcranial direct current stimulation (tDCS) (of dorsolateral prefrontal cortex [DLPFC] and primary motor cortex [M1]) as compared to sham treatment is associated with changes in sleep structure in fibromyalgia. METHODS: Thirty-two patients were randomized to receive sham stimulation or active tDCS with the anode centered over M1 or DLPFC (2 mA, 20 minutes for five consecutive days). A blinded evaluator rated the clinical symptoms of fibromyalgia. All-night polysomnography was performed before and after five consecutive sessions of tDCS. RESULTS: Anodal tDCS had an effect on sleep and pain that was specific to the site of stimulation: such as that M1 and DLPFC treatments induced opposite effects on sleep and pain, whereas sham stimulation induced no significant sleep or pain changes. Specifically, whereas M1 treatment increased sleep efficiency (by 11.8%, P = 0.004) and decreased arousals (by 35.0%, P = 0.001), DLPFC stimulation was associated with a decrease in sleep efficiency (by 7.5%, P = 0.02), an increase in rapid eye movement (REM) and sleep latency (by 47.7%, P = 0.0002, and 133.4%, P = 0.02, respectively). In addition, a decrease in REM latency and increase in sleep efficiency were associated with an improvement in fibromyalgia symptoms (as indexed by the Fibromyalgia Impact Questionnaire). Finally, patients with higher body mass index had the worse sleep outcome as indexed by sleep efficiency changes after M1 stimulation. INTERPRETATION: 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. SN - 1533-2500 UR - https://www.unboundmedicine.com/medline/citation/17986164/Site_specific_effects_of_transcranial_direct_current_stimulation_on_sleep_and_pain_in_fibromyalgia:_a_randomized_sham_controlled_study_ L2 - https://doi.org/10.1111/j.1533-2500.2007.00152.x DB - PRIME DP - Unbound Medicine ER -