Background: Fibromyalgia (FM) affects the population’s physical and mental health and is characterized by changes in brain activity and pain reporting. Objectives: To systematize and discuss the effects of tDCS on pain improvement in patients with FM as well as the “state of the art”. Design and setting: Systematic review with bibliometric. Methods: Articles were searched in the databases: MEDLINE / PubMed, Web of Science, Scopus and Physiotherapy Evidence Database. Randomized clinical trials, published between 1996 and 2021, that used tDCS to treat pain in patients with fibromyalgia were included. Studies that used tDCS associated with another technique (except pharmacological) were excluded. Methodological quality and risk of bias were assessed using the PEDro and Rob 2.0 scale. Software R. was used to perform bibliometrics. Results: Nine articles were included, totaling 306 participants. The main stimulated areas were the primary death cortex (M1) (6 studies) and left dorsalateral prefrontal cortex (CPFDL) (4 studies). Eight studies used the intensity of 2 mA and application for 20 minutes. Both stimulation of M1 and CPFDL showed effects on pain improvement greater than tDCS sham. As for the research institutes, Havard Medical School and the Federal University of Rio Grande do Sul lead the ranking. The author with the greatest impact was Fregni, F. (index h: 12, index g: 17, index m: 0.800, total publications 17, beginning: 2006). Conclusions: tDCS proved to be effective for the treatment of pain in FM. The production of studies is limited.

IntroductionRepetitive Transcranial Magnetic Stimulation (rTMS), through modulation of cortical activity, has become an invaluable tool in experimental and clinical neurosciences. Although this form of noninvasive treatment is considered safer than other means of brain stimulation it has been associated with adverse effects (AE).ObjectiveTo make a brief review, concerning the AE of rTMS, their prevention and management.AimsTo understand and be able to deal with the most common AE associated with rTMS.MethodsA PubMed database search, using as keywords “Transcranial magnetic stimulation”, “Repetitive Transcranial magnetic stimulation”; “adverse effects”; “management” and “guidelines” between the year 1998 and 2015.ResultsAE caused by rTMS are rare. They can be classified into severe (seizures) and mild (syncope, and transient hearing impairment, acute psychiatric changes, headache, local pain, neck pain, toothache, paresthesia and cognitive/neuropsychological changes) and into early and late AE. In order to obviate and avoid them, guidelines have been created; some state that to apply rTMS the technician needs to obtain the patient's informed consent and assess the risks/benefit ratio. To meet these criteria, screening tools have been created, and since then the number of AE has reduced.ConclusionsEven though rTMS is considered safer than other forms of brain stimulation it is still associated with AE. In order to avoid them, screening tools have been created allowing the clinician to assess the risks and benefits of applying this technique.Disclosure of interestThe authors have not supplied their declaration of competing interest.