Transcranial direct current stimulation for fibromyalgia treatment: a systematic review

Fibromyalgia is characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. In this review, Deus-Yela J et al. used a novel non-invasive transcranial direct current stimulation (tDCS) technique and reported the significant reduction in symptoms of fibromyalgia.

Fibromyalgia is a multisymptomatic diffuse chronic musculoskeletal pain syndrome with evidence of central nervous system dysfunction. Accordingly, non-invasive brain stimulation techniques for example transcranial direct current stimulation (tDCS) may be a complementary therapeutic resource to decrease the pain perception.
This review depicts the potential effectiveness of tDCS to reduce pain in fibromyalgia and identify the most effective neurostimulation parameters and delimit its safety.

Systematic review of prospective studies reported in PubMed and Cochrane reviews.

The anodal tDCS of the left primary motor cortex, at 2mA for 20 minutes with 35 cm2 electrodes on five consecutive days, provides better results in reducing pain (14-59%), and improves the sleep quality, with greater accentuation on the fifth day. The clinical improvement lasts up to a minimum of 60 days (11-20% reduction of pain). Adverse effects are well tolerated and few.

The experience with tDCS in fibromyalgia is still limited.But, the anodal tDCS in the left primary motor cortex can be suggested with level B (probable therapeutic efficacy) and appears to act through the modification of the sensorial processing of the pain of thalamic inhibitory circuitry.