Differential effects of bifrontal and occipital nerve stimulation on pain and fatigue using transcranial direct current stimulation in fibromyalgia patients.
Fibromyalgia is a disorder characterized by widespread musculoskeletal pain frequently accompanied by other symptoms such as fatigue. Moderate improvement from pharmacological and non-pharmacological treatments have proposed non-invasive brain stimulation techniques such as transcranial direct current stimulation (tDCS) to the occipital nerve (more specifically the C2 area) or to the dorsolateral prefrontal cortex (DLPFC) as potential treatments. We aimed to explore the effectiveness of repeated sessions of tDCS (eight sessions) targeting the C2 area and DLPFC in reducing fibromyalgia symptoms, more specifically pain and fatigue. Forty-two fibromyalgia patients received either C2 tDCS, DLPFC tDCS or sham procedure (15 C2 tDCS-11 DLPFC tDCS-16 sham). All groups were treated with eight sessions (two times a week for 4 weeks). Our results show that repeated sessions of C2 tDCS significantly improved pain, but not fatigue, in fibromyalgia patients, whereas repeated sessions of DLPFC tDCS significantly improved pain as well as fatigue. This study shows that eight sessions of tDCS targeting the DLPFC have a more general relief in fibromyalgia patients than when targeting the C2 area, suggesting that stimulating different targets with eight sessions of tDCS can lead to benefits on different symptom dimensions of fibromyalgia.
Center for Brain Health, School of Behavioral and Brain Sciences, The University of Texas at Dallas, 2200 W Mockingbird Lane, Dallas, TX, 75235, USA. wingting.to@utdallas.edu.
Wing Ting
0000-0002-0570-503X
WT
To
Lab for Clinical and Integrative Neuroscience, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, TX, USA.
Evan
E
James
Brai2n Clinic, St Augustinus, Antwerp, Belgium.
Jan
J
Ost
Center for Brain Health, School of Behavioral and Brain Sciences, The University of Texas at Dallas, 2200 W Mockingbird Lane, Dallas, TX, 75235, USA.
John
J
Hart
Section of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
Dirk
D
De Ridder
Lab for Clinical and Integrative Neuroscience, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, TX, USA.
Sven
S
Vanneste
D000328:Adult; D000368:Aged; D005221:Fatigue / Q000209:etiology / Q000517:prevention & control; D005260:Female; D005356:Fibromyalgia / Q000150:complications / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009778:Occipital Lobe / Q000502:physiology*; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D017397:Prefrontal Cortex / Q000502:physiology*; D016037:Single-Blind Method; D065908:Transcranial Direct Current Stimulation / Q000379:methods*; D016896:Treatment Outcome
DLFPC stimulation; Fibromyalgia; Non-invasive; Occipital nerve stimulation; Transcranial direct current stimulation