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<p>This double-blind, sham-controlled randomized clinical trial investigated whether a single session of anodal-(a) transcranial direct current stimulation (tDCS), applied over the primary motor cortex (M1), cerebellum (CB), or both, would reduce pain and increase corticospinal excitability more effectively than sham stimulation (s-tDCS). Ninety-two women with fibromyalgia were randomized to a single session of anodal-(a)-tDCS or sham-(s)-tDCS. Primary outcomes were pain intensity, assessed with the Numerical Pain Scale (NPS), and corticospinal excitability, measured by motor evoked potentials (MEP). Compared to sham, a-tDCS significantly reduced NPS scores (Wald χ<sup>2</sup> = 7.02, df = 1, <i>p</i> &lt; 0.01; d = 0.55, 95% CI 0.08–0.92) and increased MEP amplitude (Wald χ<sup>2</sup> = 8.37, df = 1, <i>p</i> &lt; 0.01; d = 0.48, 95% CI 0.07–0.89). Post-hoc and interaction analyses indicated that these effects were primarily attributable to M1 stimulation, rather than cerebellar or combined protocols. Anodal tDCS also reduced multidimensional pain interference, as measured by the Brief Pain Inventory (BPI), and reduced the cortical silent period (CSP) in a BDNF-dependent manner. These findings provide mechanistic insights rather than clinical efficacy, showing that a single M1 a-tDCS session—compared to sham, cerebellar, or combined protocols—more effectively reduced pain intensity and interference and modulated cortical excitability in a BDNF-dependent manner.</p><p><b>Trial registration</b>: ClinicalTrials.gov. NCT05963321. URL <a href="https://clinicaltrials.gov/study/NCT05963321">https://clinicaltrials.gov/study/NCT05963321</a> (Date of registration 27/07/2023).</p>

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Cortical excitability and analgesic effects of multisite transcranial direct current stimulation targeting the motor cortex and cerebellum in fibromyalgia

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月23日

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  • Daniel Fernando Arias Betancur,
  • Maria da Graça Lopes Tarragó,
  • Bárbara Regina França,
  • Graziele Borges Bueno,
  • Júlia Gomes,
  • Mariana Lentino Coelho,
  • Caroline Leffa Venturini,
  • Iraci L. S. Torres,
  • Felipe Fregni,
  • Hugo Bock,
  • Wolnei Caumo

摘要

This double-blind, sham-controlled randomized clinical trial investigated whether a single session of anodal-(a) transcranial direct current stimulation (tDCS), applied over the primary motor cortex (M1), cerebellum (CB), or both, would reduce pain and increase corticospinal excitability more effectively than sham stimulation (s-tDCS). Ninety-two women with fibromyalgia were randomized to a single session of anodal-(a)-tDCS or sham-(s)-tDCS. Primary outcomes were pain intensity, assessed with the Numerical Pain Scale (NPS), and corticospinal excitability, measured by motor evoked potentials (MEP). Compared to sham, a-tDCS significantly reduced NPS scores (Wald χ2 = 7.02, df = 1, p < 0.01; d = 0.55, 95% CI 0.08–0.92) and increased MEP amplitude (Wald χ2 = 8.37, df = 1, p < 0.01; d = 0.48, 95% CI 0.07–0.89). Post-hoc and interaction analyses indicated that these effects were primarily attributable to M1 stimulation, rather than cerebellar or combined protocols. Anodal tDCS also reduced multidimensional pain interference, as measured by the Brief Pain Inventory (BPI), and reduced the cortical silent period (CSP) in a BDNF-dependent manner. These findings provide mechanistic insights rather than clinical efficacy, showing that a single M1 a-tDCS session—compared to sham, cerebellar, or combined protocols—more effectively reduced pain intensity and interference and modulated cortical excitability in a BDNF-dependent manner.

Trial registration: ClinicalTrials.gov. NCT05963321. URL https://clinicaltrials.gov/study/NCT05963321 (Date of registration 27/07/2023).