Publication Reference
Passard, A., Attal, N., Benadhira, R., Brasseur, L., Saba, G., Sichere, P., … & Bouhassira, D. (2007). Effects of unilateral repetitive transcranial magnetic stimulation of the motor cortex on chronic widespread pain in fibromyalgia. Brain, 130(10), 2661-2670.
Article Summary*
In this randomized, double-blind, sham-controlled study, participants with persistent (≥6 months) widespread pain resulting from fibromyalgia received either 10Hz rTMS (n = 15) or sham (n = 15) over the left M1. All participants were on stable pain medication one month prior to the start of the study and throughout its duration. Individuals with any other cause of pain (e.g. rheumatic disease) or a primary psychiatric condition (e.g. major depression) were excluded from the study. Ten daily sessions of rTMS or sham were given over two weeks, with follow-up on days 15, 30, and 60.
Compared to sham, daily average pain scores from participant diaries were significantly lower in the active rTMS group from day 5 to day 15. Similarly, pain intensity was significantly lower on day 15 in the active rTMS group compared to the sham group. In agreement, the subjective percentage of pain relief was also significantly greater in the active rTMS group up to day 30. At day 15 pressure pain thresholds were significantly higher in the active rTMS group compared to the sham group at the contralateral epicondyle (upper limb area) and trochanter (lower limb area) pressure points. This correlated moderately with the decrease in pain intensity, but not persistently, suggesting different pain pathways may be modulated by rTMS. In agreement with this notion, at day 15 both sensory and affective pain scores (McGill Pain Questionnaire) were significantly reduced in the active rTMS group versus the sham group, but only affective pain score reductions persisted until day 30. There was no reduction in measures of anxiety or depression in either group. The moderate effect size of active rTMS was larger than that often reported in trials using antidepressants for fibromyalgia treatment, and the treatment was more tolerable due to a low incidence of only minor side-effects (e.g. transient headache). The authors concluded that rTMS over the M1 may be an effective alternative analgesic treatment in fibromyalgia.
*For original abstract/publication see the link below.