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The effects of non-invasive brain stimulation (NBS), including repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (TDCS), in treating FM remain inconclusive.
Fibromyalgia is a
chronic widespread pain disorder. The researchers in this study appropriately
explained that both repetitive transcranial magnetic stimulation (rTMS) and
transcranial direct current stimulation (TDCS) has an effective and lasting
impact on significant pain reduction.
The effects of
non-invasive brain stimulation (NBS), including repetitive transcranial
magnetic stimulation (rTMS) and transcranial direct current stimulation (TDCS),
in treating FM remain inconclusive. The aim of this study was to investigate
present evidence of using NBS as an add-on treatment in treating FM.
We conducted a
database search of the Medline, Embase, PsycINFO and Cochrane Library
electronic databases, from inception to July 2015, to analyze randomized
controlled trials of NBS in treating FM. A total of 16 studies were included in
the current meta-analysis.
The pooled mean
effect sizes of the 16 included studies revealed significant favorable effects
of NBS. The weighted mean effect size in reducing pain, depression, fatigue,
sleep disturbance and tender points and improving general health/function were
0.667 (95% CI 0.446, 0.889), 0.322 (95% CI 0.140, 0.504), 0.511 (95% CI 0.247,
0.774), 0.682 (95% CI 0.350, 1.014), 0.867 (95% CI 0.310, 1.425) and 0.473 (95%
CI 0.285, 0.661), respectively. rTMS stimulation yielded a greater effect size
compared with that of TDCS (effect size 0.698 and 0.568, respectively; P <
0.0001). The primary motor cortex (M1) stimulation yielded a subtle greater effect
size in pain reduction compared with that of the dorsolateral prefrontal cortex
(effect size 0.709 and 0.693, respectively; P < 0.0001). No linear
relationships were found between the effect sizes and treatment regimens and
dose. Most of reported adverse effects were minor.
Both rTMS and
TDCS may be feasible and safe modalities for treating FM. The general effects
of rTMS and TDCS are compatible in FM patients. M1 stimulation may be better in
pain reduction and the dorsolateral prefrontal cortex may be better in
depression improvement.
Rheumatology
The effects of add-on non-invasive brain stimulation in fibromyalgia: a meta-analysis and meta-regression of randomized controlled trials
Wen-Hsuan Hou, Tzu-Ya Wang, Jiunn-Horng Kang
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