Efficacy of anodal transcranial direct current stimulation (tDCS) for the treatment of fibromyalgia: results of a randomized, sham-controlled longitudinal clinical trial.
Efficacy of anodal transcranial direct current stimulation (tDCS) for the treatment of fibromyalgia: results of a randomized, sham-controlled longitudinal clinical trial.
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发表时间：
2009
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通讯作者：
A. Valle;S. Roizenblatt;S. Botte;S. Zaghi;M. Riberto;S. Tufik;P. Boggio;F. Fregni
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作者：
A. Valle;S. Roizenblatt;S. Botte;S. Zaghi;M. Riberto;S. Tufik;P. Boggio;F. Fregni
纤维肌痛是一种中枢性疼痛疾病，有神经解剖学和神经生理学改变的证据。以前的研究与非侵入性脑刺激技术-经颅直流电刺激（tDCS）和重复经颅磁刺激（rTMS）-已经表明，这些方法与纤维肌痛相关的疼痛和睡眠功能障碍的显着缓解。在这里，我们试图确定一个更长的治疗方案，包括10个疗程的2 mA，20分钟tDCS的左侧初级运动（M1）或背外侧前额叶皮层（DLPFC）是否可以提供额外的，更持久的临床效益，在管理疼痛的纤维肌痛。方法：41名患有慢性难治性纤维肌痛的女性患者随机接受10次每日M1、DLPFC或假tDCS治疗。研究结果：我们的研究结果表明，M1和DLPFC刺激在治疗方案结束时均显示疼痛评分（VAS）和生活质量（FIQ）改善，但在治疗结束后30天和60天评估时，只有M1刺激导致长期临床获益。结论：这项研究证明了治疗期持续时间的重要性，表明每日10次tDCS治疗比仅5次治疗的结果更持久。此外，这项研究支持了一项类似设计的rTMS试验的结果，因为两者都能诱导同样持久的疼痛减轻。
Fibromyalgia has been recognized as a central pain disorder with evidence of neuroanatomic and neurophysiologic alterations. Previous studies with techniques of noninvasive brain stimulation--transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS)--have shown that these methods are associated with a significant alleviation of fibromyalgia-associated pain and sleep dysfunction. Here we sought to determine whether a longer treatment protocol involving 10 sessions of 2 mA, 20 min tDCS of the left primary motor (M1) or dorsolateral prefrontal cortex (DLPFC) could offer additional, more long-lasting clinical benefits in the management of pain from fibromyalgia. METHODS: Forty-one women with chronic, medically refractory fibromyalgia were randomized to receive 10 daily sessions of M1, DLPFC, or sham tDCS. RESULTS: Our results show that M1 and DLPFC stimulation both display improvements in pain scores (VAS) and quality of life (FIQ) at the end of the treatment protocol, but only M1 stimulation resulted in long-lasting clinical benefits as assessed at 30 and 60 days after the end of treatment. CONCLUSIONS: This study demonstrates the importance of the duration of the treatment period, suggesting that 10 daily sessions of tDCS result in more long lasting outcomes than only five sessions. Furthermore, this study supports the findings of a similarly designed rTMS trial as both induce pain reductions that are equally long-lasting.