New Neuromodulation Techniques to Treat Fibromyalgia

Fibromyalgia and some chronic diseases are characterized by significantly altering the daily lives of sufferers. Sufferers experience an increased risk of poor mental and physical health-related quality of life, which may depend on multiple factors, including their perception of health, trust in physicians and the health care system, and compliance with treatment that is often ineffective or incomplete in its effect.

Treatment of these patients is mostly based on drugs that act centrally and peripherally on the pain pathways. Often times, if managed by expert pain units, patients achieve significant relief that allows them to continue with their activities of daily living but often side effects that can diminish medication compliance and trust in physicians.

There are several groups around the world currently investigating more direct ways to influence the brain and the way it processes and interprets sensory information. One of the most promising types of techniques is non-invasive neuromodulation.

What is tDCS?

tDCS is a technique used to modulate the brain plasticity of neural centers responsible for pain perception, or in some cases, mood regulation.

This technique, which stands for “Transcranial Direct Current Stimulation”, has been successfully investigated for more than 15 years in world-renowned research centers. So far it has been used for the treatment of multiple neurological diseases due to its ability to modulate the way in which neurons interconnect, i.e. it modifies brain plasticity to normalize brain function.

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Is it a safe technique?

Dr. Romero, a specialist in Neurology, is one of the specialists accredited to perform the TDCS technique. The doctor explains that the technique is absolutely safe, since very low intensity currents from a portable battery are administered to a specific part of the patient’s head using two electrodes. To date, no significant adverse effects have been reported in the world’s scientific literature.

The technique is approved by the European community to be performed by a neurologist in a hospital setting for the treatment of fibromyalgia, neuropathic pain and depression. At the moment there are no studies that support the use of this therapy in other pathologies with relevant effects.

Our research group is currently working so that in the future it can be used in patients with stroke and Parkinson’s disease.

What type of patients is this therapy aimed at?

This therapy is usually administered as an alternative or adjuvant treatment to pharmacological treatment in patients in whom medication has not been effective. As there are no chemical agents involved that affect the whole organism, the therapy can be used as a complementary therapy without the risk of dangerous drug interactions.

It is also safe to perform the treatment during lactation and it is an ideal alternative in those patients with intolerance or significant adverse reactions to pharmacological treatment.

Who is eligible for this therapy?

Not all patients are candidates for this therapy, nor is the number of sessions or location of the electrodes the same for each patient. This therapy is highly personalized, so patients are evaluated in a first visit by the Neurology specialist, who prescribes the treatment and his team performs neuropsychological evaluations before, during and after its application to verify the effect of the therapy.

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In the case of pain patients, those with neuropathic or central pain characteristics, such as stroke, multiple sclerosis or spinal cord or radicular lesions, are those who benefit most from the therapy. On the other hand, no effects have been demonstrated in episodes of pain produced by peripheral lesions. For this reason, an initial neurological evaluation is essential to determine if the therapy is indicated in each case.

How long does the treatment last?

Once the patient meets all the inclusion and exclusion criteria, the start of therapy and number of sessions is proposed. Usually 10 to 15 stimulation sessions of 20 to 30 minutes each are administered. During the therapy the patient can continue taking any usual treatment since the therapy has no interactions.

How effective is the treatment?

According to recent meta-analyses of patients undergoing tDCS treatment for fibromyalgia symptoms and chronic pain, about 80% have improved pain by reducing their consumption of analgesics.

In case of applying this technique for the treatment of mood symptoms, 58% of patients have a significant improvement even though most patients continue with some type of pharmacological treatment or tDCS sessions to prevent the reoccurrence of symptoms.