Home-based electric stimulation beneficial in fibromyalgia patients

In the management of fibromyalgia, multiple-session home-based anodal transcranial direct current stimulation (A-tDCS) on the left dorsolateral prefrontal cortex helps improve disability due to pain, as shown in a study.

A total of 112 women (mean age 49.04 years) with fibromyalgia were randomly assigned to receive either home-based tDCS (2 mA; 20 min daily) (n=56 placebo nonresponders) or sham tDCS (2 mA; 30 s at the start, then 10 min, and then 20 min, with a 20-s ramp-up and ramp-down) (n=56 placebo responders) for 4 weeks. Treatment was combined with exercise and pain neuroscience education via videos and remote supervision following in-person training.

The primary outcome was the change in Multidimensional Pain Interference Index (MPII) at treatment end and 3-month follow-up. MPII was measured by the Brief Pain Inventory, a 7-item scale that assesses the impact of pain on daily activities, emotional well-being, and social interactions.

In the intention-to-treat analysis, MPII decreased by 38.76 percent with A-tDCS and by 16.08 percent with sham tDCS (mean difference [MD], 22.68 percent, 95 percent CI, 12.79–40.00). A significant treatment-by-time interaction favoured A-tDCS across five assessments, with no interaction by placebo response.

Among placebo responders, MPII was reduced by 34.21 percent with A-tDCS and by 18.13 percent with sham tDCS (MD, 24.23 percent, 95 percent CI, 15.80–32.67). Among placebo nonresponders, the corresponding reductions in MPII were 35.49 percent and 25.96 percent (MD, 9.52 percent, 95 percent CI, 2.79–19.78).

Improvement in MPII of at least 50 percent was achieved in 62.5 percent of patients in the A-tDCS group vs 37.5 percent in the sham tDCS group (relative risk, 0.60, 95 percent CI, 0.39–0.91).