Slow-frequency rTMS reduces fibromyalgia pain.
OBJECTIVE
Evidence suggests that fibromyalgia (FM) is a centrally mediated pain disorder. Antidepressants, including electroconvulsive therapy, provide some symptomatic relief in FM and other pain disorders. Repetitive transcranial magnetic stimulation (rTMS) is a new antidepressant treatment, which may also be useful in treating chronic pain.


METHODS
As part of a larger study, four women with depression, FM, and borderline personality disorder received 1-Hz rTMS applied to the right dorsolateral prefrontal cortex. Subjects rated pain using an 11-point Likert scale.


RESULTS
Pretreatment pain averaged 8.2 (7-9.5) and reduced to 1.5 (0-3.5) after treatment (P < 0.009). All had improvement in pain, and two had complete resolution of pain. Only one of the four subjects had an antidepressant response.


CONCLUSIONS
These preliminary findings suggest a possible role for rTMS in treating FM.
Sampson
Shirlene M
SM
Department of Psychiatry and Psychology, W11A, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905, USA. sampson.shirlene@mayo.edu
Rome
Jeffrey D
JD
Rummans
Teresa A
TA
D000328:Adult; D002908:Chronic Disease / Q000523:psychology / Q000628:therapy; D003866:Depressive Disorder / Q000150:complications / Q000523:psychology / Q000628:therapy*; D004311:Double-Blind Method; D004599:Electric Stimulation Therapy / Q000379:methods* / Q000639:trends; D005260:Female; D005356:Fibromyalgia / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D010147:Pain Measurement; D017288:Pain Threshold / Q000502:physiology; D010148:Intractable Pain / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D017397:Prefrontal Cortex / Q000503:physiopathology; D050781:Transcranial Magnetic Stimulation / Q000379:methods* / Q000639:trends; D016896:Treatment Outcome