Low-frequency Repetitive Transcranial Magnetic Stimulation Improves Cognition and Psychiatric Function in Fibromyalgia: Study

A recent clinical trial Brain Sciences journal explored the efficacy of repetitive transcranial magnetic stimulation (rTMS) in addressing multiple domains of fibromyalgia-related symptoms. This study focused on evaluating the impact of low-frequency rTMS on psychiatric and cognitive disorders in fibromyalgia patients.

This trial included a total of 42 patients diagnosed with fibromyalgia (FM) who were randomly assigned to receive either active or sham rTMS treatments. Over the course of 20 sessions, the participants in the active group were administered 1 Hz rTMS at 120% of their resting motor threshold by delivering a total of 1200 pulses per session to the right dorsolateral prefrontal cortex (DLPFC). The sham group underwent identical procedures without the active stimulation.

The assessments were conducted at three intervals; the baseline, post-treatment and three months post-treatment. The evaluation tools included the Fibromyalgia Impact Questionnaire (FIQ), Hamilton Depression and Anxiety Rating Scales (HDRS and HARS), Montreal Cognitive Assessment (MoCA), Rey Auditory Verbal Learning Test (RAVLT), Tower of London test (TOL) and the Trail Making and Digit Span Tests. These comprehensive evaluations measured the influence of rTMS on both psychiatric and cognitive functions in FM patients.

The findings revealed that both the active and sham groups expressed improvement across most rating scales at the one-month and three-month follow-ups. However, the active rTMS group demonstrated significantly greater improvements when compared to the sham group. There was a significant correlation between the FIQ scores and cognitive rating scales with the RAVLT and TOL tests. These tests are designed to measure verbal memory and executive function, respectively.

The results suggest that 20 sessions of low-frequency rTMS over the right DLPFC can lead to substantial improvements in FIQ scores by targeting psychiatric and cognitive symptoms in medicated FM patients. The observed changes in RAVLT and TOL performance were strongly linked to the improvements in FIQ results which suggests the beneficial impact of rTMS on cognitive functions impaired by fibromyalgia.

This study contributes to the growing body of research on rTMS by highlighting its potential as a therapeutic option for managing fibromyalgia symptoms. Further investigation is imperative to fully understand the mechanisms and long-term effects for the better management strategies for patients with this chronic condition.

Source:

Badr, M. Y., Ahmed, G. K., Amer, R. A., Aref, H. M., Salem, R. M., Elmokadem, H. A., & Khedr, E. M. (2024). Impact of Repetitive Transcranial Magnetic Stimulation on Cognitive and Psychiatric Dysfunction in Patients with Fibromyalgia: A Double-Blinded, Randomized Clinical Trial. In Brain Sciences (Vol. 14, Issue 5, p. 416). MDPI AG. https://doi.org/10.3390/brainsci14050416