Michel Guinot1,2, Caroline Maindet3, Hasan Hodaj3, Enkelejda Hodaj4, Damien Bachasson2, Sébastien Baillieul1,2, Jean-Luc Cracowski4, Sandrine Launois2. 1. Grenoble Alpes University Hospital, Sports Pathologies medical unit, F-38000, Grenoble, France. 2. INSERM U1042, Grenoble Alpes University, HP2 laboratory, F-38000, Grenoble, France. 3. Grenoble Alpes University Hospital, Center for Pain, F-38000, Grenoble, France. 4. Grenoble Alpes University Hospital, Clinical Research Center, INSERM CIC1406, F-38000, Grenoble, France.
Abstract
OBJECTIVES: Fibromyalgia (FM) is a chronic painful condition partly due to alterations in pain modulation by the central nervous system. Multicomponent therapy (MT) and repetitive transcranial magnetic stimulation (rTMS) had both been reported as pain modulators in FM patients. The aim of this study was to compare the effects of rTMS on pain with a combination of MT and rTMS versus MT. METHODS:Thirty-nine FM patients with pain visual analogue scale (pVAS) ≥ 40mm were randomized to active or sham rTMS (high frequency, primary motor cortex M1) plus 12 weeks of MT (3 sessions per week combining aerobic training, pool based exercises and relaxation). rTMS was started 2 weeks prior MT and maintained until the end of the program (week 14). Assessments were achieved at baseline, at week 14, and 6 months (week 40) after completing the program. The main outcome was the pain reduction, assessed by the weekly mean daily self-reported level of pain. Secondary outcomes were cardiorespiratory fitness (graded maximal exercise test), cardiac autonomic adaptations and fibromyalgia impact (fibromyalgia impact, depression, sleep efficiency and pain catastrophizing scales). RESULTS: The reduction of the weekly mean daily pain did not differ significantly between groups (repeated measures of ANOVA). Two-way ANOVAs showed that pVAS, as well as cardiorespiratory fitness, quality of life, depression and catastrophizing, improved significantly at week 14 and remained stable until week 40. Neither Cardiac autonomic adaptations nor sleep efficiency changed significantly. CONCLUSION:rTMS did not reduce pain in FM patients who followed the MT program.
RCT Entities:
OBJECTIVES:Fibromyalgia (FM) is a chronic painful condition partly due to alterations in pain modulation by the central nervous system. Multicomponent therapy (MT) and repetitive transcranial magnetic stimulation (rTMS) had both been reported as pain modulators in FMpatients. The aim of this study was to compare the effects of rTMS on pain with a combination of MT and rTMS versus MT. METHODS: Thirty-nine FMpatients with pain visual analogue scale (pVAS) ≥ 40mm were randomized to active or sham rTMS (high frequency, primary motor cortex M1) plus 12 weeks of MT (3 sessions per week combining aerobic training, pool based exercises and relaxation). rTMS was started 2 weeks prior MT and maintained until the end of the program (week 14). Assessments were achieved at baseline, at week 14, and 6 months (week 40) after completing the program. The main outcome was the pain reduction, assessed by the weekly mean daily self-reported level of pain. Secondary outcomes were cardiorespiratory fitness (graded maximal exercise test), cardiac autonomic adaptations and fibromyalgia impact (fibromyalgia impact, depression, sleep efficiency and pain catastrophizing scales). RESULTS: The reduction of the weekly mean daily pain did not differ significantly between groups (repeated measures of ANOVA). Two-way ANOVAs showed that pVAS, as well as cardiorespiratory fitness, quality of life, depression and catastrophizing, improved significantly at week 14 and remained stable until week 40. Neither Cardiac autonomic adaptations nor sleep efficiency changed significantly. CONCLUSION: rTMS did not reduce pain in FMpatients who followed the MT program.
Authors: Carolina Climent-Sanz; Anna Marco-Mitjavila; Roland Pastells-Peiró; Fran Valenzuela-Pascual; Joan Blanco-Blanco; Montserrat Gea-Sánchez Journal: Int J Environ Res Public Health Date: 2020-04-26 Impact factor: 3.390
Authors: Jiali He; Yiling Tang; Jingxia Lin; Guy Faulkner; Hector W H Tsang; Sunny H W Chan Journal: BMC Psychiatry Date: 2022-04-19 Impact factor: 4.144