Journal
EUROPEAN ARCHIVES OF PSYCHIATRY AND CLINICAL NEUROSCIENCE
Volume 271, Issue 1, Pages 199-210Publisher
SPRINGER HEIDELBERG
DOI: 10.1007/s00406-020-01214-y
Keywords
Pain; Fibrofog; Non-invasive transcranial stimulation; Rehabilitation; Random noise stimulation (RNS)
Categories
Funding
- Universita degli Studi di Padova within CRUI-CARE Agreement
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The study aimed to investigate cortical oscillations in fibromyalgia patients and provide new treatment options. Transcranial alternating current stimulation (tACS) combined with physiotherapy showed promise in reducing pain and cognitive symptoms.
Fibromyalgia syndrome (FMS) is a complex pain disorder, characterized by diffuse pain and cognitive disturbances. Abnormal cortical oscillatory activity may be a promising biomarker, encouraging non-invasive neurostimulation techniques as a treatment. We aimed to modulate abnormal slow cortical oscillations by delivering transcranial alternating current stimulation (tACS) and physiotherapy to reduce pain and cognitive symptoms. This was a double-blinded, randomized, crossover trial conducted between February and September 2018 at the Rehabilitation Unit of a teaching Hospital (NCT03221413). Participants were randomly assigned to tACS or random noise stimulation (RNS), 5 days/week for 2 weeks followed by ad hoc physiotherapy. Clinical and cognitive assessments were performed at T-0 (baseline), T-1 (after stimulation), T-2 (1 month after stimulation). Electroencephalogram (EEG) spectral topographies recorded from 15 participants confirmed slow-rhythm prevalence and provided tACS tailored stimulation parameters and electrode sites. Following tACS, EEG alpha1 ([8-10] Hz) activity increased at T-1 (p = 0.024) compared to RNS, pain symptoms assessed by Visual Analog Scale decreased at T-1 (T-1 vs T(0)p = 0.010), self-reported cognitive skills and neuropsychological scores improved both at T-1 and T-2 (Patient-Reported Outcomes in Cognitive Impairment, T-0-T-2, p = 0.024; Everyday memory questionnaire, T-1 compared to RNS, p = 0.012; Montreal Cognitive Assessment, T-0 vs T-1, p = 0.048 and T-0 vs T-2, p = 0.009; Trail Making Test B T-0-T-2, p = 0.034). Psychopathological scales and other neuropsychological scores (Trail Making Test-A; Total Phonemic Fluency; Hopkins Verbal Learning Test-Revised; Rey-Osterrieth Complex Figure) improved both after tACS and RNS but earlier improvements (T-1) were registered only after tACS. These results support tACS coupled with physiotherapy in treating FMS cognitive symptoms, pain and subclinical psychopathology.
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