Pubblicazioni

Transcranial direct current stimulation in the neuromodulation of pain in fibromyalgia: A case study

L, DalĺAgnol; P, Pascoal-Faria; S, Barros Cecílio; I, Corrêa F

Abstract:

Fibromyalgia is a prevalent chronic pain syndrome that can occur in women with widespread pain, fatigue, muscle stiffness, depression, poor quality of life and anxiety. It might also be associated with exacerbated psychological factors such as somatization, helplessness and catastrophic thinking related to pain. The accurate pathophysiology of this syndrome is not completely known; however, some evidence shows that both peripheral and central sensitization may affect the functioning of descending inhibitory mechanisms and facilitatory pathways. These impairments, in turn, can modify the pain perception and sensory processing in the neurosystem and lead to emotional behavior in a person experiencing pain. We lack effective approaches to the management of long-lasting pain symptoms, and the pain experiences might affect sleep quality, physical functioning and quality of life, which can maintain a continuous cycle and sustain the experience of a chronic condition. Brain neuromodulation therapies such as transcranial direct current stimulation (tDCS) can decrease pain in fibromyalgia. tDCS might induce significant analgesic effects when applied to the primary motor cortex (M1) and also a significant antidepressant effect when applied over the dorsolateral prefrontal cortex (DLPFC), but its benefit for alleviating catastrophic thinking related to pain in fibromyalgia has never been investigated. A decrease in pain might have a considerable impact on the functional physical rehabilitation of patients with fibromyalgia.

Patologie/Applicazioni:

• Terapia del dolore
• Stimolazione elettrica transcranica (TES)

Anno:

2015

Tipo di pubblicazione:

Articolo

Parola chiave:

stimolazione elettrica transcranica; terapia del dolore; fibromialgia; Sham

Testata scientifica:

Annals of Physical and Rehabilitation Medicine

Nota:

I pazienti hanno ricevuto 3 trattamenti (10 sessioni di 20 minuti ciascuna per ciascun trattamento, 30 sessioni totali, con un intervallo di 1 settimana tra un tipo di trattamento e l'altro): (1) tDC attivo (2 mA) sull'area M1, (2) stimolazione tDCS sham e (3) stimolazione TDC attiva (2 mA) sulla DLPFC. I risultati suggeriscono che la stimolazione attiva della M1 e della DLPFC potrebbero ridurre la percezione del dolore e i livelli di ansia. Inoltre è stato riscontrato che la stimolazione della DLPFC sembra avere effetti positivi su idee ansiogene di catastrofismo. Applicando a regime un totale di 10 sessioni giornaliere di TDC per ogni protocollo, non è possibile indagare gli effetti a lungo termine della terapia.

DOI:

doi.org/10.1016/j.rehab.2015.10.002