Abstract
Background
Fibromyalgia is a complex chronic disorder with few effective treatments currently available. One promising treatment option is repetitive Transcranial Magnetic Stimulation (rTMS), a non-invasive brain stimulation technique that has shown promise in disorders effecting the central nervous system.
Methods
We assessed the efficacy of a course of high-frequency (10Hz) left-hemisphere dorsolateral prefrontal cortex (DLPFC) rTMS in 26 patients (14 active; 12 sham) with a diagnosis of fibromyalgia. Participants underwent a double-blind stimulation protocol of daily (Monday-Friday) rTMS sessions over 4 consecutive weeks (total of 20 sessions; 75 x 4-second 10Hz trains at 120% resting motor threshold). Assessments were conducted at baseline, 4 weeks and at 1 month follow-up.
Results
Using mixed-model analysis we did not identify a group difference for our primary outcome measures. However, we found that patients in the active compared to sham treatment group had significantly greater improvement in the Physical Fatigue (p = .045) and General Fatigue (p = .023) scales of the Multidimensional Fatigue Iventory-20 at the 1 month follow up. In a responder analysis, we also found the active group was significantly more likely (2.84 times) to achieve a minimum 30% improvement in pain intensity ratings. (p = .024).
Conclusions
High-frequency rTMS applied daily for 4 weeks to the left DLPFC induces significant relief from fatigue and a greater chance of clinically meaningful improvement in pain intensity in patients with fibromyalgia. These results suggest DLPFC rTMS may be a relevant therapy for fibromyalgia.
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