Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20220020
Brazilian Journal of Pain
Original Article

Does anodal transcranial direct current stimulation over left motor cortex show body side pain-related difference in fibromyalgia?

A estimulação transcraniana por corrente contínua anódica sobre o córtex motor esquerdo apresenta diferença na dor entre os hemicorpos na fibromialgia?

Monayane Grazielly Leite Matias; Antônio Felipe Lopes Cavalcante; Karime Andrade Mescouto; Edson Meneses Silva Filho; Abrahão Fontes Baptista; Alexandre Hideki Okano; Rodrigo Pegado

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Abstract

BACKGROUND AND OBJECTIVES: Fibromyalgia (FM) is a chronic widespread musculoskeletal pain resulting in central sensitization of nociceptive signaling. Transcranial direct current stimulation (tDCS) over the left motor cortex (M1) is a non-invasive neuromodulation technique indicated for a broad range of chronic pain disorders, including FM. Studies suggest that left and right M1 (contralateral and ipsilateral hemisphere of tDCS stimulation) are modulated. But it is necessary to clarify the differences in clinical pain perception comparing the right and left side of the body. This study aimed to evaluate the pain-related difference between right-left side of the body after five sessions of anodal tDCS in women with FM.

METHODS: A double-blinded, parallel, randomized, sham-controlled trial with 30 women with FM was performed. Five sessions of anodal C3 and cathodal supraorbital (Fp2) tDCS were conducted (2 mA for 20 min). Pain, impact of FM and anxiety were evaluated. No statistically significant three-way interaction between time, stimulation type and body side were found.

RESULTS: Active-tDCS showed significant improvement in pain, but impact of FM and anxiety did not show significant improvement.

CONCLUSION: Five sessions of anodal tDCS over the left M1 improves pain in women with FM, however there was no difference between right-left body sides.

Keywords

Chronic pain, Fibromyalgia, Motor cortex, Noninvasive brain stimulation, Transcranial direct current stimulation

Resumo

JUSTIFICATIVA E OBJETIVOS: A fibromialgia (FM) é uma dor musculoesquelética crônica generalizada que resulta na sensibilização central da sinalização nociceptiva. A estimulação transcraniana de corrente contínua (eTCC) sobre o córtex motor esquerdo (M1) é uma técnica de neuromodulação não invasiva indicada para uma ampla gama de distúrbios de dor crônica, incluindo a FM. Estudos sugerem a modulação do M1 esquerdo e direito (hemisfério contralateral e ipsilateral da eTCC). Mas é necessário esclarecer as diferenças na percepção clínica da dor comparando os lados direito e esquerdo do corpo. Este estudo teve como objetivo avaliar a diferença relacionada à dor entre o lado direito e esquerdo do corpo após cinco sessões de eTCC anodal em mulheres com FM.

MÉTODOS: Foi realizado um estudo duplo-cego, paralelo, randomizado e controlado por sham com 30 mulheres com FM. Foram realizadas cinco sessões de eTCC anodais C3 e supraorbitais catodais (Fp2) (2 mA por 20 min). Foram avaliados a dor, o impacto da FM e a ansiedade. Não foi encontrada nenhuma interação de três vias estatisticamente significativa entre tempo, tipo de estimulação e lado do corpo.

RESULTADOS: A eTCC-Ativa mostrou uma melhora significativa na dor, mas o impacto da FM e da ansiedade não mostrou uma melhora significativa.

CONCLUSÃO: Cinco sessões de eTCC anodal sobre o M1 esquerdo melhoram a dor nas mulheres com FM, entretanto não houve diferença entre os lados direito e esquerdo do corpo.

Palavras-chave

Córtex motor, Dor crônica. Estimulação transcraniana por corrente contínua, Fibromialgia, Síndrome de fadiga crônica

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Submitted date:
11/27/2021

Accepted date:
04/11/2022

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