Efeitos da estimulação transcraniana por corrente contínua em variáveis físicas e comportamentais em mulheres com fibromialgia - ensaio clínico controlado randomizado

Abstract

Background:Fibromyalgia (FM) is a syndrome characterized by chronic widespread pain, fatigue, cognitive behavioral impairments, mood disorders and sleep problems. Although the etiology of FM is unknown, it has been recognized as a centralized pain state where the patient’s Central Nervous System (CNS) is hyperactive, phenomenon known by Central Sensitization. Transcranial Direct Current Stimulation (tDCS) is a non-invasive, safe andcost-effective brain stimulation techniquethat modulates cortical excitability and has been showing positive effects in FM patients. However, there is no consensus on which method and exactly location of stimulation is most effective and presents with more significant benefits in this patients population. Objective: The aim of this study is to evaluate whether a 5 consecutive day treatment with active tDCS stimulation results in better outcome for physical and behavior variables when compared to sham, or placebo in women with FM. Methods: This randomized controlled trial had forty-five participants with FM, which were randomized in one of three groups: active tDCS in the primary motor cortex (M1; n=15) and dorsolateral prefrontal cortex (DLPFC; n=15) and sham stimulation (SHAM; n=15). All the data were collected 7 days prior to the begging of the intervention (baseline), on the 5th day of treatment, with 7 and 21 days of follow-up. A constant current of 2 mA intensity was administered during 5 consecutive days for 20min. Results: The results showed there was no statistical significant improvement in pain, pressure pain threshold and tolerance, neither in depression, anxiety, function or affectivity in any of the groups (p> 0.05). Conclusion: The results of this study suggests that tDCS treatment of 5 consecutive days in cortical areas M1 and DLPFC of 2mA intensity for 20min have no significant results in physical or behavior variables in patients with FM with no immediate or sustained effects after treatment.