Transcranial direct current stimulation in fibromyalgia: effects on pain
               and quality of life evaluated clinically and by brain perfusion scintigraphy

Jales Junior, Levi Higino; Costa, Maria do Desterro Leiros; Jales Neto, Levi Higino; Ribeiro, João Paulo Moraes; Freitas, Waleska Jessiane Silva do Nascimento; Teixeira, Manoel Jacobsen

doi:10.5935/1806-0013.20150008

Acessibilidade / Reportar erro

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

ORIGINAL ARTICLES • Rev. dor 16 (1) • Jan-Mar 2015 • https://doi.org/10.5935/1806-0013.20150008 copy

Transcranial direct current stimulation in fibromyalgia: effects on pain and quality of life evaluated clinically and by brain perfusion scintigraphy^* * Received from Teaching Hospital Onofre Lopes, Federal University of Rio Grande do Norte, School of Medicine, University of São Paulo, São Paulo, SP, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

BACKGROUND AND OBJECTIVES:

Transcranial Direct Current Stimulation is a neuromodulation method to treat neuropsychiatric and other diseases. This study aimed at evaluating the effect of this technique on pain and quality of life of fibromyalgia patients, in addition to studying brain images by Brain Perfusion Scintigraphy before and after procedures.

METHODS:

Prospective, double-blind, randomized, controlled study with parallel arms evaluated clinically and by CT scan with single photon emission (Brain Spect). Sample was made up of 20 female fibromyalgia patients divided in two groups of 10. Parameters evaluated were quality of life by the pain Visual Analog Scale, Quality of Life Questionnaire SF-36, Fibromyalgia Impact Questionnaire and pain level measurement on tender points with Fischer’s Algiometer. The effective group has received 1.0mA anodal stimulation for 20 minutes in M1 to the left, cathode positioned on the right supraorbital region once a week in a total of 10 consecutive weeks. The Sham group received no electric impulses.

RESULTS:

There has been decrease in the Fibromyalgia Impact Questionnaire (55.36 to 35.42; p=0.0059) and the Visual Analog Scale (6.05 to 3.60; p=0.0316) scores. There has been statistically significant difference (p<0.05) in trigger points measurement in the effective group. For the effective group, there has been also evidence of statistically significant difference in the evaluation of SF-36 (p<0.05) in Functional Capacity, Physical and Emotional Aspects domains, where patients have increased respective indices after treatment. In Brain Spect, for 3 effective group patients, there have been significant changes in images with decreased biparietal hypoperfusion after procedures. No significant Brain Spect image changes were observed in the Sham group.

CONCLUSION:

Transcranial Direct Current Stimulation was effective for therapeutic pain control and has improved quality of life of fibromyalgia patients. Brain Spect has contributed for complementary fibromyalgia evaluation.

Chronic pain; Electric stimulation; Fibromyalgia; Neuromodulation; Scintigraphy

Descriptive statistics	Minimum	Maximum	Median	Mean	Standard deviation
Sham group
Pre-treatment	10.67	84.34	61.93	61.93	24.974
Post-treatment	12.67	85.20	47.65	42.42	28.241
p=0.192
Effective group
Pre-treatment	31.19	76.49	55.53	55.36	14.018
Post-treatment	17.53	60.43	32.26	35.42	12.841
p=0.005

Descriptive statistics	Minimum	Maximum	Median	Mean	Standard deviation
Sham group
Pre-treatment	30.60	78.10	48.85	49.92	14.093
Post-treatment	34.30	80.40	49.90	52.38	14.821
p=0.556
Effective group
Pre-treatment	28.00	59.60	48.30	46.24	10.733
Post-treatment	31.30	74.00	54.45	53.14	14.008
p=0.037

Descriptive statistics	Minimum	Maximum	Median	Mean	Standard deviation
Sham group
Pre-treatment	3.00	10.0	7.50	6.70	2.111
Post-treatment	2.00	9.00	6.00	5.60	2.503
p=0.277
Effective group
Pre-treatment	2.50	9.00	6.00	6.05	2.061
Post-treatment	0.00	6.00	3.50	3.60	1.838
p=0.031

Descriptive statistics	Minimum	Maximum	Median	Mean	Standard deviation
Functional capacity
Pre-treatment	10.00	75.00	20.00	31.00	23.070
Post-treatment	10.00	95.00	32.50	38.00	26.895
p=0.120
Physical aspects
Pre-treatment	0.00	100.00	0.00	22.50	36.228
Post-treatment	0.00	100.00	25.00	47.50	41.583
p=0.123
Pain
Pre-treatment	40.00	90.00	60.00	62.00	13.166
Post-treatment	20.00	80.00	45.00	50.00	23.570
p=0.064
General health status
Pre-treatment	30.00	80.00	62.50	59.00	15.420
Post-treatment	50.00	85.00	62.50	63.50	9.443
p = 0.307
Vitality
Pre-treatment	40.00	65.00	55.00	54.50	6.852
Post-treatment	45.00	80.00	55.00	58.00	10.055
p=0.142
General aspects
Pre-treatment	25.00	75.00	50.00	50.00	15.590
Post-treatment	25.00	75.00	50.00	50.00	16.667
p=1
Emotional aspects
Pre-treatment	0.00	33.33	16.67	16.67	17.566
Post-treatment	0.00	100.00	66.67	60.00	43.886
p=0.033
Mental health
Pre-treatment	36.00	68.00	52.00	51.60	10.741
Post-treatment	36.00	68.00	54.00	54.00	11.963
p=0.399

Descriptive Minimum statistics	Maximum	Median	Mean	Standard deviation
Functional capacity
Pre-treatment 20.00	65.00	50.00	48.00	16.364
Post-treatment 50.00	85.00	70.00	68.50	11.068
p=0.014
Physical aspects
Pre-treatment 0.00	75.00	12.50	17.50	23.717
Post-treatment 0.00	100.00	75.00	75.00	31.180
p=0.008
Pain
Pre-treatment 10.00	90.00	55.00	55.00	22.730
Post-treatment 10.00	70.00	40.00	43.00	18.288
p=0.289
General health status
Pre-treatment 50.00	80.00	60.00	63.50	10.554
Post-treatment 40.00	75.00	55.00	58.00	11.106
p=0.523
Vitality
Pre-treatment 30.00	60.00	45.00	46.50	10.014
Post-treatment 45.00	70.00	52.50	53.50	9.144
p=0.098
General aspects
Pre-treatment 25.00	75.00	50.00	51.25	17.129
Post-treatment 12.50	62.50	50.00	47.50	15.366
p=0.429
Emotional aspects
Pre-treatment 0.00	66.67	16.67	26.67	30.633
Post-treatment 0.00	100.00	100.00	80.00	35.833
p=0.013
Mental health
Pre-treatment 44.00	68.00	54.00	53.60	8.044
Post-treatment 32.00	76.00	60.00	58.40	11.345
p=0.124

Sociedade Brasileira para o Estudo da Dor Av. Conselheiro Rodrigues Alves, 937 cj 2, 04014-012 São Paulo SP Brasil, Tel.: (55 11) 5904 3959, Fax: (55 11) 5904 2881 - São Paulo - SP - Brazil
E-mail: dor@dor.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Correspondence to: Levi Higino Jales Junior, Avenida Hermes da Fonseca, 1078 – Petrópolis, 59034-000 Natal, RN, Brasil. E-mail: ipens@supercabo.com.br