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Efficacy of Transcranial Direct Current Stimulation on Pain Level and Disability of Patients with Fibromyalgia: A Systematic Review of Randomized Controlled Trials with Parallel-Group Design.
Azarkolah, Anita; Noorbala, Ahmad Ali; Ansari, Sahar; Hallajian, Amir-Homayun; Salehinejad, Mohammad Ali.
Afiliación
  • Azarkolah A; Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran P.O. Box 1416634793, Iran.
  • Noorbala AA; Psychosomatic Medicine Research Center, Tehran University of Medical Sciences, Tehran P.O. Box 1416634793, Iran.
  • Ansari S; Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran P.O. Box 1416634793, Iran.
  • Hallajian AH; Psychosomatic Medicine Research Center, Tehran University of Medical Sciences, Tehran P.O. Box 1416634793, Iran.
  • Salehinejad MA; Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran P.O. Box 1416634793, Iran.
Brain Sci ; 14(1)2023 Dec 25.
Article en En | MEDLINE | ID: mdl-38248241
ABSTRACT
Transcranial direct current stimulation (tDCS) has been increasingly applied in fibromyalgia (FM) to reduce pain and fatigue. While results are promising, observed effects are variable, and there are questions about optimal stimulation parameters such as target region (e.g., motor vs. prefrontal cortices). This systematic review aimed to provide the latest update on published randomized controlled trials with a parallel-group design to examine the specific effects of active tDCS in reducing pain and disability in FM patients. Using the PRISMA approach, a literature search identified 14 randomized controlled trials investigating the effects of tDCS on pain and fatigue in patients with FM. Assessment of biases shows an overall low-to-moderate risk of bias. tDCS was found effective in all included studies conducted in patients with FM, except one study, in which the improving effects of tDCS were due to placebo. We recommended tDCS over the motor and prefrontal cortices as "effective" and "probably effective" respectively, and also safe for reducing pain perception and fatigue in patients with FM, according to evidence-based guidelines. Stimulation polarity was anodal in all studies, and one single-session study also examined cathodal polarity. The stimulation intensity ranged from 1-mA (7.14% of studies) to 1.5-mA (7.14% of studies) and 2-mA (85.7% of studies). In all of the included studies, a significant improvement in at least one outcome variable (pain or fatigue reduction) was observed. Moreover, 92.8% (13 of 14) applied multi-session tDCS protocols in FM treatment and reported significant improvement in their outcome variables. While tDCS is therapeutically effective for FM, titration studies that systematically evaluate different stimulation intensities, durations, and electrode placement are needed.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials / Guideline / Prognostic_studies / Systematic_reviews Idioma: En Revista: Brain Sci Año: 2023 Tipo del documento: Article País de afiliación: Irán Pais de publicación: Suiza

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials / Guideline / Prognostic_studies / Systematic_reviews Idioma: En Revista: Brain Sci Año: 2023 Tipo del documento: Article País de afiliación: Irán Pais de publicación: Suiza