Evidence for the improvement of fatigue in fibromyalgia: A 4‐week left dorsolateral prefrontal cortex repetitive transcranial magnetic stimulation randomized‐controlled trial

Fitzgibbon, Bernadette M.; Hoy, Kate Elizabeth; Knox, Laura; Guymer, EK; Littlejohn, Geoffrey; Elliot, David; Wambeek, LE; McQueen, Susan; Elford, KA; Lee, Stuart; Enticott, Peter G.; Fitzgerald, Paul B.

doi:10.1002/ejp.1213

Cited by 50 publications

(42 citation statements)

References 57 publications

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“…Fitzgibbon et al . recently noted the significant improvement of fatigue and the greater chance in reducing pain intensity in active than sham rTMS targeting the left DLPFC .…”

Section: Discussionmentioning

confidence: 97%

“…39,40 Fitzgibbon et al recently noted the significant improvement of fatigue and the greater chance in reducing pain intensity in active than sham rTMS targeting the left DLPFC. 29 Another recent meta-analysis showed that rTMS for fibromyalgia patients trended toward reducing pain intensity but did not alter depressive symptoms. 41 That meta-analysis consisted of only one study using stimulation at the DLPFC and four studies using stimulation at the M1 area.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, in real world scenarios, fibromyalgia patients often also struggle with depression, which has been shown to respond to rTMS treatment . Nevertheless, very few studies have investigated prefrontal rTMS for fibromyalgia as defined by the modified 2010 ACR criteria . And there is a dearth of data on the connection between the change in depression and pain after left prefrontal rTMS in those patients.…”

mentioning

confidence: 99%

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Analgesic effects of repetitive transcranial magnetic stimulation on modified 2010 criteria‐diagnosed fibromyalgia: Pilot study

Cheng

Wang

et al. 2019

Psychiatry Clin Neurosci

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Aim Fibromyalgia is often comorbid with depression, and less than half those patients achieve satisfactory improvement after adequate pharmacological intervention. The investigation of repetitive transcranial magnetic stimulation (rTMS) at left dorsolateral prefrontal cortex for modified‐2010 American College of Rheumatology (ACR) fibromyalgia and major depressive disorder (MDD) is still in its infancy. Methods In this double‐blind, randomized, sham‐control study, subjects diagnosed with ACR‐2010 fibromyalgia and DSM‐IV‐TR MDD were recruited and received either active or sham interventions for 2 weeks. Hamilton Depression Rating Scale (HDRS) and the 10‐cm visual analogue pain scale were evaluated at baseline, week 1, and week 2. Multivariable generalized estimating equations analysis was performed for the association between depression and pain scores at each checkpoint. Results Twenty subjects were recruited. There was a significant difference over the 2 weeks between the rTMS and sham stimulation groups (P = 0.029), but subgroup analyses were further performed due to significant interaction of group and HDRS on pain outcomes (P = 0.020). The active group had significant improvement in pain at week 2 compared with week 1 (P = 0.021), but the control group did not have any improvement in pain (P = 0.585). Of the mild–moderate depression patients, the pain score in the active group was significantly lower than in the sham group at week 1 (P = 0.001) and at week 2 (P < 0.001). For the severe depression group, there was significantly lower pain over the 2 weeks in the active group (P = 0.045) but the sham group had significantly relapsing pain at week 2 (P < 0.001). Conclusion Left prefrontal rTMS has an analgesic effect in modified‐ACR 2010‐defined fibromyalgia and MDD patients. Further investigation is required, however, in order to determine how to regulate the different rTMS treatment protocols according to individual baseline depression severity in patients with MDD and fibromyalgia.

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“…Fitzgibbon et al . recently noted the significant improvement of fatigue and the greater chance in reducing pain intensity in active than sham rTMS targeting the left DLPFC .…”

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Analgesic effects of repetitive transcranial magnetic stimulation on modified 2010 criteria‐diagnosed fibromyalgia: Pilot study

Cheng

Wang

et al. 2019

Psychiatry Clin Neurosci

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“…Changes in pain ratings do not permit inferring which of the sensory, cognitive, or affective dimensions of pain was preferentially modulated by tDCS. Accumulating evidence suggests that the beneficial effects of noninvasive cortical stimulation may derive from activity changes in high-order brain areas [3,4,10], and that analgesic effects may emerge as secondary to the modulation of emotion-related neural networks distant from the stimulated point [34]. In accordance with this, a strict somatotopic relation between the painful region and the cortical motor area stimulated may not be mandatory [22].…”

Section: Discussionmentioning

confidence: 99%

At-Home Cortical Stimulation for Neuropathic Pain: a Feasibility Study with Initial Clinical Results

et al. 2019

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The clinical use of noninvasive cortical stimulation procedures is hampered by the limited duration of the analgesic effects and the need to perform stimulation in hospital settings. Here, we tested the feasibility and pilot efficacy of an internet-based system for at-home, long-duration, medically controlled transcranial motor cortex stimulation (H-tDCS), via a double-blinded, shamcontrolled trial in patients with neuropathic pain refractory to standard-of-care drug therapy. Each patient was first trained at hospital, received a stimulation kit, allotted a password-protected Web space, and completed daily tDCS sessions during 5 weeks, via a Bluetooth connection between stimulator and a minilaptop. Each session was validated and internet-controlled by hospital personnel. Daily pain ratings were obtained during 11 consecutive weeks, and afterwards via iterative visits/phone contacts. Twenty full procedures were completed in 12 consecutive patients (500 daily tDCS sessions, including 20% sham). No serious adverse effects were recorded. Superficial burning at electrode position occurred in 2 patients, and nausea/headache in two others, all of whom wished to pursue stimulation. Six out of the 12 patients achieved satisfactory relief on a scale combining pain scores, drug intake, and quality of life. Daily pain reports correlated with such combined assessment, and differentiated responders from nonresponders without overlap. Clinical improvement in responders could last up to 6 months. Five patients asked to repeat the whole procedure when pain resumed again, with comparable results. At-home, long-duration tDCS proved safe and technically feasible, and provided long-lasting relief in 50% of a small sample of patients with drug-resistant neuropathic pain.

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“…Bei chronisch myofaszialem Schmerz zeigt HF-rTMS/M1 eine signifikante Schmerzlinderung um 30 % und eine signifikante Reduktion der Analgetikaeinnahme um 45 % [68], was durch eine zwei-te Studie bestätigt wurde [69]. Bei Fibromyalgie zeigt HF-rTMS/ DLPFC links eine günstige Wirkung auf das Fatigue-Syndrom [70]. In einer anderen Studie wurde wiederum nur über eine analgetische Wirkung von HF-rTMS/DLPFC links, aber nicht über eine Verbesserung der Müdigkeit oder Schlafqualität bei Fibromyalgie berichtet [71].…”

Section: Fibromyalgie Und Andere Chronische Schmerzsyndromeunclassified

Transkranielle Magnetstimulation

Golaszewski¹,

Nardone²

2020

Nervenheilkunde

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ZUSAMMENFASSUNGDie repetitive transkranielle Magnetstimulation ermöglicht eine nicht invasive Modulation der kortikalen Erregbarkeit des Gehirns, welche durch verschiedene Stimulationsparameter erhöht oder verringert werden kann. Die induzierten Veränderungen können vorübergehend oder längerfristig sein. Es können im Gehirn unterschiedliche neuromodulatorische Prozesse hinsichtlich der stimulierten Region und des stimulierten neuronalen Gewebes induziert werden, was die Schmerzwahrnehmung im Gehirn verändern kann. Es werden kontinuierliche Serien von TMS-Pulsen mit niedriger (≤ 1Hz) oder höherer Frequenz (> 1Hz) mit Hemmung oder Fazilitierung der kortikalen Erregbarkeit durch Veränderungen der synaptischen Transmission angewendet, was zu synaptischer Plastizität insbesondere im Bereich der Langzeitpotenzierung (LTP) oder Langzeitdepression (LTD) führt. Hinreichend Evidenz für die Wirksamkeit der rTMS in der Schmerztherapie gibt es insbesondere für chronisch neuropathische Schmerzen zentraler oder peripherer Genese und für die Fibromyalgie.

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Evidence for the improvement of fatigue in fibromyalgia: A 4‐week left dorsolateral prefrontal cortex repetitive transcranial magnetic stimulation randomized‐controlled trial

Cited by 50 publications

References 57 publications

Analgesic effects of repetitive transcranial magnetic stimulation on modified 2010 criteria‐diagnosed fibromyalgia: Pilot study

Analgesic effects of repetitive transcranial magnetic stimulation on modified 2010 criteria‐diagnosed fibromyalgia: Pilot study

At-Home Cortical Stimulation for Neuropathic Pain: a Feasibility Study with Initial Clinical Results

Transkranielle Magnetstimulation

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