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经颅直流电刺激对纤维肌痛女性患者初级运动皮层的影响:一项随机、三盲临床试验。

Effects of Anodal Transcranial Direct Current Stimulation on the Primary Motor Cortex in Women With Fibromyalgia: A Randomized, Triple-Blind Clinical Trial.

机构信息

Department of Physiotherapy, Grande Dourados University Center, Dourados, Brazil.

Department of Physiotherapy, Grande Dourados University Center, Dourados, Brazil.

出版信息

Neuromodulation. 2023 Jun;26(4):767-777. doi: 10.1016/j.neurom.2022.11.007. Epub 2023 Jan 25.

Abstract

OBJECTIVES

The aim of this study was to analyze the effects of ten sessions of active transcranial direct current stimulation transcranial direct current stimulation (tDCS) (2 mA) with 13:20:13 stimulation at M1 in women with fibromyalgia (FM). To the best of our knowledge, this is the first article that uses this protocol in patients with FM. The main hypothesis is that the protocol would be effective in decreasing pain and that the results would last for up to 90 days.

MATERIALS AND METHODS

This study was a randomized clinical trial with 35 women with FM divided into two groups, active tDCS group and sham tDCS group. A conventional tDCS device was used to deliver 2 mA for 13 minutes, with a 20-minute break followed by a further 13 minutes of stimulation for ten sessions. The anodal stimulus was in the left primary motor cortex M1 region. The primary outcome was a change in the visual analog scale and the Survey of Pain Attitudes pain score at the end of treatment, after 30 days, and 90 days after the end of treatment. Secondary outcomes included changes in the Fibromyalgia Impact Questionnaire, Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, World Health Organization's Quality of Life Questionnaire, and Fatigue Assessment Scale. The Research Ethics Committee of the Centro Universitário da Grande Dourados under registration number Certificado de Apresentação de Apreciação Ética approved this research: 36444920.5.0000.5159. The study was registered in The Brazilian Registry of Clinical Trials with the identifier RBR-8wc8rjq.

RESULTS

The active tDCS group showed improvement in pain after ten sessions (p < 0.001), after 30 days (p < 0.01), and after 90 days (p < 0.001) compared with sham tDCS. In addition, improvement in quality of life (QoL) and fatigue was observed in the active tDCS group.

CONCLUSION

The results of this study suggest that active tDCS with an intensity of 2 mA for ten sessions was effective in decreasing pain and fatigue and improving QoL in patients with FM.

摘要

目的

本研究旨在分析 10 次经颅直流电刺激(tDCS)(2 mA)对患有纤维肌痛(FM)的女性 M1 区刺激的影响。据我们所知,这是第一篇使用该方案治疗 FM 患者的文章。主要假设是该方案在减轻疼痛方面有效,并且结果可持续长达 90 天。

材料和方法

这是一项随机临床试验,纳入 35 名 FM 女性患者,分为真刺激 tDCS 组和假刺激 tDCS 组。使用常规 tDCS 设备输送 2 mA 电流 13 分钟,中间休息 20 分钟,然后再刺激 13 分钟,共 10 个疗程。阳极刺激位于左侧初级运动皮层 M1 区。主要结局是治疗结束时、治疗结束后 30 天和 90 天时视觉模拟量表(VAS)和疼痛态度调查疼痛评分的变化。次要结局包括纤维肌痛影响问卷、汉密尔顿焦虑量表、汉密尔顿抑郁量表、世界卫生组织生活质量问卷和疲劳评估量表的变化。该研究得到了 Centro Universitário da Grande Dourados 大学伦理委员会的批准(注册号:Certificado de Apresentação de Apreciação Ética 36444920.5.0000.5159)。该研究在巴西临床试验注册处注册,注册号为 RBR-8wc8rjq。

结果

与假刺激 tDCS 组相比,真刺激 tDCS 组在 10 个疗程后(p<0.001)、30 天后(p<0.01)和 90 天后(p<0.001)疼痛均有改善。此外,真刺激 tDCS 组的生活质量(QoL)和疲劳也有改善。

结论

本研究结果表明,10 次 2 mA 强度的真刺激 tDCS 可有效减轻 FM 患者的疼痛和疲劳,改善 QoL。

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