Impact of Bifrontal Home-Based Transcranial Direct Current Stimulation in Pain Catastrophizing and Disability due to Pain in Fibromyalgia: A Randomized, Double-Blind Sham-Controlled Study
Impact of Bifrontal Home-Based Transcranial Direct Current Stimulation in Pain Catastrophizing and Disability due to Pain in Fibromyalgia: A Randomized, Double-Blind Sham-Controlled Study
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DOI：
10.1016/j.jpain.2021.11.002
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发表时间：
2022-04-02
期刊：
影响因子：
4
通讯作者：
Fregni, Felipe
中科院分区：
文献类型：
--
作者：
Caumo, Wolnei;Alves, Rael Lopes;Fregni, Felipe
这项随机、双盲试验检验了20次家庭阳极（a）-经颅直流电刺激（tDCS）（2 mA持续20分钟）双额叶，左侧背外侧前额叶皮质（I-DLPFC）上有anodel将优于假手术-（s）-tDCS，以降低疼痛灾难性量表评分和慢性疼痛特征评估的疼痛相关残疾：筛选（主要结局）。次要结果为抑郁症状、睡眠质量、热痛阈值、热痛耐受性和血清脑源性神经营养因子（BDNF）。48名患有纤维肌痛的女性，30至65岁，随机分为2：1组[a-tDCS（n = 32）或s-tDCS（n = 16）]。事后分析显示，a-tDCS使疼痛灾难性量表总分降低了51.38%，而s-tDCS为26.96%，a-tDCS使慢性疼痛特征：筛选总分降低了31.43%，而s-tDCS为19.15%。a-tDCS改善了抑郁症状，睡眠质量并提高了热痛耐受性。血清BDNF中的δ值（治疗结束后的平均值减去治疗前）与疼痛灾难化中的a-tDCS效应相反地相关。相比之下，在治疗结束时，a-tDCS对减少与疼痛相关的残疾的影响与血清BDNF的减少和抑郁症状，睡眠质量和疼痛灾难性症状的改善呈正相关。观点：基于家庭的双额叶tDCS与a-tDCS对I-DLPFC的影响与以下结果中的中等效应大小（ES）相关：1）减少反刍和放大疼痛灾难化。2)改善因纤维肌痛症状导致的日常活动障碍。总的来说，这些发现支持DLPFC上自我应用基于家庭的tDCS改善纤维肌痛症状的可行性。(C)2022年美国疼痛研究协会，Inc.
This randomized, double-blind trial tested the hypothesis that 20 sessions of home-based anodal(a)-transcranial direct current stimulation (tDCS) (2mA for 20 minutes) bifrontal, with anodel on the left dorsolateral prefrontal cortex (I-DLPFC) would be better than sham-(s)-tDCS to reduce scores on Pain Catastrophizing Scale and disability-related to pain assessed by the Profile of Chronic Pain: Screen (primary outcomes). Secondary outcomes were depressive symptoms, sleep quality, heat pain threshold , heat pain tolerance , and serum brain-derived-neurotrophic-factor (BDNF). Forty-eight women with fibromyalgia, 30 to 65 years-old were randomized into 2:1 groups [a-tDCS (n = 32) ors-tDCS (n = 16)]. Post hoc analysis revealed that a-tDCS reduced the Pain Catastrophizing Scale total scores by 51.38% compared to 26.96% in s-tDCS, and a-tDCS reduced Profile of Chronic Pain: Screen total scores by 31.43% compared to 19.15% in s-tDCS. The a-tDCS improved depressive symptoms, sleep quality and increased the heat pain tolerance. The delta-value in the serum BDNF (mean post treatment end minus pretreatment) was conversely correlated with the a-tDCS effect in pain catastrophizing. In contrast, the a-tDCS impact on reducing the disability-related to pain at the treatment end was positively associated with a reduction in the serum BDNF and improvement of depressive symptoms, sleep quality and pain catastrophizing symptoms.Perspective: Home-based bifrontal tDCS with a-tDCS on the I-DLPFC are associated with a moderate effect size (ES) in the following outcomes: 1) Decreased rumination and magnification of pain catastrophizing. 2) Improved the disability for daily activities due to fibromyalgia symptoms. Overall, these findings support the feasibility of self-applied home-based tDCS on DLPFC to improve fibromyalgia symptoms. (C) 2022 by United States Association for the Study of Pain, Inc.