Brain and Pain (BaP) Lab, Departamento de Psicoloxía Clínica y Psicobioloxía, Facultade de Psicoloxia, Universidade de Santiago de Compostela, Campus Vida, 15782, Santiago de Compostela, A Coruña, Spain.
Psychological Neuroscience Lab, Research Center in Psychology, School of Psychology, University of Minho, Braga, Portugal.
Qual Life Res. 2022 Aug;31(8):2519-2534. doi: 10.1007/s11136-022-03106-1. Epub 2022 Mar 1.
Fibromyalgia (FM) is a chronic pain syndrome with a strong impact on quality of life (QoL). Treatment of this condition remains a challenge, due to the scarce evidence for the effectiveness of the therapeutic approaches available. Current attention is focused on transcranial direct current stimulation (tDCS), which has yielded promising results for pain treatment. Rather than focusing only on pain relief, in this study, we aimed to determine how active or sham tDCS (over three cortical targets -the primary motor cortex, the dorsolateral prefrontal cortex and the operculo-insular cortex-) affect QoL in patients with FM.
Using a double-blind, placebo-controlled design, we applied fifteen tDCS sessions of 20' to initial 130 participants (randomized to any of the four treatment groups). We evaluated the QoL (assessed by SF-36) and the symptoms' impact (assessed by FIQ-R) in baseline, after treatment and at 6 months follow-up.
All groups were comparable as regards age, medication pattern and severity of symptoms before the treatment. We found that QoL and symptoms' impact improved in all treatment groups (including the sham) and this improvement lasted for up to 6 months. However, we did not observe any group effect nor group*treatment interaction.
After the intervention, we observed a non-specific effect that may be due to placebo, favoured by the expectations of tDCS efficacy and psychosocial variables inherent to the intervention (daily relationship with therapists and other patients in the clinic). Therefore, active tDCS is not superior to sham stimulation in improving QoL in FM.
纤维肌痛（FM）是一种慢性疼痛综合征，对生活质量（QoL）有很大影响。由于现有治疗方法的疗效证据有限，因此这种疾病的治疗仍然是一个挑战。目前的研究重点是经颅直流电刺激（tDCS），该方法在疼痛治疗方面取得了有希望的结果。在这项研究中，我们的目的不是仅关注疼痛缓解，而是确定主动或假 tDCS（在三个皮质靶点——初级运动皮层、背外侧前额叶皮层和脑岛皮层——上）如何影响 FM 患者的 QoL。
我们采用双盲、安慰剂对照设计，对最初的 130 名参与者（随机分配到四个治疗组中的任何一组）进行了 15 次 20 分钟的 tDCS 治疗。我们在基线、治疗后和 6 个月随访时评估了 QoL（通过 SF-36 评估）和症状的影响（通过 FIQ-R 评估）。
在治疗前，所有组在年龄、药物治疗模式和症状严重程度方面都具有可比性。我们发现，所有治疗组（包括假刺激组）的 QoL 和症状影响都有所改善，这种改善持续了 6 个月。然而，我们没有观察到任何组间效应或组间治疗相互作用。
在干预后，我们观察到一种非特异性效应，可能是由于安慰剂效应，这得益于对 tDCS 疗效的期望以及干预中固有的心理社会变量（与治疗师和其他在诊所的患者的日常关系）。因此，主动 tDCS 在改善 FM 患者的 QoL 方面并不优于假刺激。
