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Repetitive transcranial magnetic stimulation of the prefrontal cortex for fibromyalgia syndrome: a randomised controlled trial with 6-months follow up.
Adv Rheumatol. 2020 Jun 29; 60(1):34.AR

Abstract

OBJECTIVES

Fibromyalgia Syndrome (FMS), is a chronic pain disorder with poorly understood pathophysiology. In recent years, repetitive transcranial magnetic stimulation (rTMS) has been recommended for pain relief in various chronic pain disorders. The objective of the present research was to study the effect of low frequency rTMS over the right dorsolateral prefrontal cortex (DLPFC) on pain status in FMS.

METHODS

Ninety diagnosed cases of FMS were randomized into Sham-rTMS and Real-rTMS groups. Real rTMS (1 Hz/1200 pulses/8 trains/90% resting motor threshold) was delivered over the right DLPFC for 5 consecutive days/week for 4 weeks. Pain was assessed by subjective and objective methods along with oxidative stress markers. Patients were followed up for 6 months (post-rTMS;15 days, 3 months and 6 months).

RESULTS

In Real-rTMS group, average pain ratings and associated symptoms showed significant improvement post rTMS. The beneficial effects of rTMS lasted up to 6 months in the follow-up phase. In Sham-rTMS group, no significant change in pain ratings was observed.

CONCLUSION

Right DLPFC rTMS can significantly reduce pain and associated symptoms of FMS probably through targeting spinal pain circuits and top-down pain modulation .

TRIAL REGISTRATION

Ref No: CTRI/2013/12/004228.

Authors+Show Affiliations

Department of Physiology, AIIMS, New Delhi, 110029, India. Department of Zoology, Govt. College for Girls, Sec-14, Gurugram, Haryana, 122001, India.Department of Physiology, AIIMS, New Delhi, 110029, India.Department of Rheumatology, All India Institute of Medical Sciences, AIIMS, New Delhi, 110029, India.Department of Physiology, AIIMS, New Delhi, 110029, India. renuaiims28@gmail.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32600394

Citation

Tanwar, Suman, et al. "Repetitive Transcranial Magnetic Stimulation of the Prefrontal Cortex for Fibromyalgia Syndrome: a Randomised Controlled Trial With 6-months Follow Up." Advances in Rheumatology (London, England), vol. 60, no. 1, 2020, p. 34.
Tanwar S, Mattoo B, Kumar U, et al. Repetitive transcranial magnetic stimulation of the prefrontal cortex for fibromyalgia syndrome: a randomised controlled trial with 6-months follow up. Adv Rheumatol. 2020;60(1):34.
Tanwar, S., Mattoo, B., Kumar, U., & Bhatia, R. (2020). Repetitive transcranial magnetic stimulation of the prefrontal cortex for fibromyalgia syndrome: a randomised controlled trial with 6-months follow up. Advances in Rheumatology (London, England), 60(1), 34. https://doi.org/10.1186/s42358-020-00135-7
Tanwar S, et al. Repetitive Transcranial Magnetic Stimulation of the Prefrontal Cortex for Fibromyalgia Syndrome: a Randomised Controlled Trial With 6-months Follow Up. Adv Rheumatol. 2020 Jun 29;60(1):34. PubMed PMID: 32600394.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Repetitive transcranial magnetic stimulation of the prefrontal cortex for fibromyalgia syndrome: a randomised controlled trial with 6-months follow up. AU - Tanwar,Suman, AU - Mattoo,Bhawna, AU - Kumar,Uma, AU - Bhatia,Renu, Y1 - 2020/06/29/ PY - 2020/02/10/received PY - 2020/05/28/accepted PY - 2020/7/1/entrez KW - Chronic pain KW - Dorsolateral prefrontal cortex KW - Neuromodulation KW - Nociceptive flexion reflex KW - Non-invasive therapy KW - Oxidative stress SP - 34 EP - 34 JF - Advances in rheumatology (London, England) JO - Adv Rheumatol VL - 60 IS - 1 N2 - OBJECTIVES: Fibromyalgia Syndrome (FMS), is a chronic pain disorder with poorly understood pathophysiology. In recent years, repetitive transcranial magnetic stimulation (rTMS) has been recommended for pain relief in various chronic pain disorders. The objective of the present research was to study the effect of low frequency rTMS over the right dorsolateral prefrontal cortex (DLPFC) on pain status in FMS. METHODS: Ninety diagnosed cases of FMS were randomized into Sham-rTMS and Real-rTMS groups. Real rTMS (1 Hz/1200 pulses/8 trains/90% resting motor threshold) was delivered over the right DLPFC for 5 consecutive days/week for 4 weeks. Pain was assessed by subjective and objective methods along with oxidative stress markers. Patients were followed up for 6 months (post-rTMS;15 days, 3 months and 6 months). RESULTS: In Real-rTMS group, average pain ratings and associated symptoms showed significant improvement post rTMS. The beneficial effects of rTMS lasted up to 6 months in the follow-up phase. In Sham-rTMS group, no significant change in pain ratings was observed. CONCLUSION: Right DLPFC rTMS can significantly reduce pain and associated symptoms of FMS probably through targeting spinal pain circuits and top-down pain modulation . TRIAL REGISTRATION: Ref No: CTRI/2013/12/004228. SN - 2523-3106 UR - https://www.unboundmedicine.com/medline/citation/32600394/Repetitive_transcranial_magnetic_stimulation_of_the_prefrontal_cortex_for_fibromyalgia_syndrome:_a_randomised_controlled_trial_with_6-months_follow_up DB - PRIME DP - Unbound Medicine ER -
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