Abstract
Despite promising preliminary results of transcranial direct current stimulation (tDCS) treatment in patients with fibromyalgia (FM), several issues need to be addressed, including its limited efficacy, low response rate, and poor tolerability. We investigated the efficacy and safety of tDCS as an add-on treatment for chronic pain in Korean patients with FM. This study enrolled 46 patients who were refractory to pain medications from May 2016 to February 2017. A conventional tDCS device was used to supply 2 mA of current for 20 min on five consecutive days. The primary end-point was a change in visual analogue scale (VAS) pain score at the end of treatment; secondary end-points included changes in Fibromyalgia Impact Questionnaire (FIQ), Brief Pain Inventory (BPI), Brief Fatigue Inventory (BFI), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and Medical Outcomes Study Sleep Scale (MOS-SS) scores. After tDCS, 46 patients showed clinical improvements in VAS pain scores on days 6, 13, and 36 compared with day 0 (p < 0.001). Improvement in FIQ was seen on day 13. The BDI decreased significantly on days 6 and 36, and BFI improved significantly on days 6 and 13. There were no significant improvements in STAI-I, STAI-II, and MOS-SS scores after tDCS. No serious adverse events were observed. Our results suggest that tDCS can result in significant pain relief in FM patients and may be an effective add-on treatment.
Highlights
Despite promising preliminary results of transcranial direct current stimulation treatment in patients with fibromyalgia (FM), several issues need to be addressed, including its limited efficacy, low response rate, and poor tolerability
Secondary efficacy outcomes included revised Fibromyalgia Impact Questionnaire (FIQ), Brief Pain Inventory (BPI), Beck Depression Inventory (BDI), Brief Fatigue Inventory (BFI), State-Trait Anxiety Inventory (STAI), and Medical Outcomes Study Sleep Scale (MOS-SS): We evaluated changes in parameters from baseline to 1 day after treatment, 1 week after treatment, and 1 month after treatment
The pain visual analogue scale (VAS) score decreased significantly on day 6, which was maintained on day 13 (− 2.891; 95% CI − 3.373 to − 2.409; p < 0.001) and day 36 (− 1.391; 95% CI − 1.959 to − 0.823; p < 0.001)
Summary
Despite promising preliminary results of transcranial direct current stimulation (tDCS) treatment in patients with fibromyalgia (FM), several issues need to be addressed, including its limited efficacy, low response rate, and poor tolerability. We investigated the efficacy and safety of tDCS as an add-on treatment for chronic pain in Korean patients with FM. After tDCS, 46 patients showed clinical improvements in VAS pain scores on days 6, 13, and 36 compared with day 0 (p < 0.001). Among the brain stimulation techniques, transcranial direct current stimulation (tDCS) is a novel treatment in FM patients with chronic pain. In addition to its efficacy toward pain intensity, little is known about the effect of tDCS on associated symptoms, such as fatigue and depression. Because the effect sizes for pharmacological treatment are generally small, it is necessary to investigate whether tDCS is effective in patients who are refractory to pain medication. We explored the efficacy, tolerability, and safety of tDCS treatment as an add-on treatment for chronic widespread pain in a large number of Korean patients with FM
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