Abstract:Objective: To evaluate the effectiveness of transcranial direct current stimulation on pain in fibromyalgia patients.
Data source: Pubmed.
Study eligibility criteria: Articles published in English language between 2005 to January 2018.
Participants: Studies should include fibromyalgia patients.
Interventions: Application of tDCS in the treatment group.
Outcome measure: Pain intensity using visual analogue scale and numeric rating scale.
Synthesis: Percentage of difference (% diff) was calculated by pre and post value/pre value x 100.
Results: 14 articles with 437 patients; 320 females and 127 males were included. Pain intensity measured by visual analogue scale and numeric rating scale were used as an outcome measure. Application of anodal tDCS over primary motor cortex (M1), DLPFC and C2 nerve dermatome, resulted in significant decrease in pain, whereas cathodal stimulation resulted in no significant decrease in pain intensity. Application of tDCS over primary motor cortex(M1) resulted in significant reduction in pain scores as compared to stimulation over DLPFC area with a mean difference of 1.05(95% CI 0.82 to 1.28).
Conclusion: The application of anodal tDCS over primary motor cortex (M1) can be the choice of stimulation for reducing pain in fibromyalgia patients. However, effectiveness of tDCS over other areas of stimulation must be explored so that a precise site for better management of pain in fibromyalgia patients can be recommended.
Implications: Anodal tDCS over primary motor cortex can be a preferred site for stimulation for reducing pain in fibromyalgia patients.
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