A groundbreaking study suggests that repetitive transcranial magnetic stimulation (rTMS), a brain-stimulation therapy, could potentially provide relief from the non-pain-related symptoms of fibromyalgia, such as emotional distress. This research, recently published in the journal Neurology, opens up new possibilities for enhancing the overall quality of life for individuals coping with this challenging condition.
Fibromyalgia is a chronic ailment characterized by persistent pain and tenderness in various body joints, muscles, and tendons, accompanied by profound fatigue. Beyond these physical symptoms, individuals with fibromyalgia often contend with a range of other distressing issues, including sleep disruptions, irritable bowel syndrome, restless leg syndrome, numbness or tingling sensations in the limbs, and depression, as detailed by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMSD).
In the United States alone, an estimated five million adults grapple with fibromyalgia, with the majority—80 to 90 percent—being women, according to NIAMSD.
At present, the primary treatments for fibromyalgia encompass a combination of prescription and over-the-counter drugs, as well as pain relievers. The findings of this study hold the promise of introducing a fresh approach to alleviating some of the more stubborn symptoms associated with this condition.
Dr. Eric Guedj, the study’s author, remarked in a press release, “rTMS is a way to alter the excitability of the brain. A treatment such as this may provide a safe and noninvasive complement to pain pills in some people.”
While previous research has identified brain-function irregularities in certain fibromyalgia patients, Dr. Guedj pointed out that these affected brain regions are reachable through rTMS. However, earlier studies did not explore rTMS as a potential treatment option.
Guedj stated, “Other colleagues have reported the interest of rTMS in fibromyalgia—two clinical trials to my knowledge. Our study is the first to combine an rTMS clinical trial with a functional brain exploration in order to better understand the mechanisms of action of this therapeutic approach in fibromyalgia.”
Pain vs. Non-Pain Symptoms
Dr. Guedj pointed out, “Previous neuroimaging studies in fibromyalgia patients have indicated alterations in brain processes responsible for regulating both pain and emotions. Our study’s goal was to demonstrate the feasibility of using rTMS to modulate specific brain regions, correct functional brain irregularities, and ameliorate patients’ symptoms.”
To achieve this, Dr. Guedj and his team conducted a 10-week randomized, double-blind, placebo-controlled trial. They enrolled 38 adults who had been grappling with fibromyalgia for over six months. These participants were randomly assigned to receive either rTMS treatment or sham stimulation utilizing a device that closely resembled the actual rTMS device.
Throughout the study, consisting of 14 sessions of either rTMS or sham stimulation, researchers assessed various aspects of the participants’ well-being, including their quality of life, levels of depression and anxiety, and their experience of pain. Assessments were conducted at three intervals: at the beginning of the study, after two weeks, and after 11 weeks. Changes in participants’ quality of life were gauged using a questionnaire, while brain metabolic changes were tracked through PET neuroimaging.
The study revealed that after 11 weeks, high-frequency rTMS applied to the left primary motor cortex of the brain had a positive impact on the quality of life of individuals with fibromyalgia. Interestingly, this treatment did not affect the experience of pain.
According to questionnaire results, participants who received rTMS treatment had an initial average quality-of-life score of 60. Scores on this scale ranged from zero to 100, with lower scores indicating a higher quality of life. After 11 weeks, the average score for those who underwent actual rTMS treatment had decreased by approximately 10 points. In contrast, participants who received sham stimulation had an initial average score of 64, and their average score increased by two points after 11 weeks.
Dr. Guedj concluded, “This study demonstrates that rTMS enhances the quality of life for fibromyalgia patients, particularly those who may be more sensitive to pain or resistant to traditional treatments.” The improvements in quality of life encompassed mood, emotional well-being (including feelings of joy, sadness, anger, and anxiety), social aspects such as work performance, interactions with others, engagement in activities, and pursuit of hobbies and interests.
The Psychological Dimension of Fibromyalgia
This study’s findings illuminate the emotional and social facets of fibromyalgia. According to the Anxiety and Depression Association of America (ADAA), approximately 20 percent of individuals experiencing pain-related symptoms linked to fibromyalgia also grapple with anxiety or depression.
These secondary symptoms, particularly those manifesting as sleep disruptions and cognitive impairment or memory issues, often receive inadequate attention and are not managed as effectively as the more commonly recognized pain symptoms associated with the condition, as highlighted by Dr. Guedj.
To comprehensively address all the manifestations of fibromyalgia, the ADAA recommends seeking the expertise of one healthcare professional for the physical symptoms of the disease and another physician or therapist for any accompanying social or emotional symptoms.
Coping with Fibromyalgia
In addition to collaborating with your healthcare provider or therapist, the NIAMSD recommends integrating the following healthy habits into your daily routine to alleviate symptoms and enhance your overall well-being:
- Maintain proper sleep hygiene by establishing a consistent bedtime and wake-up time, abstaining from caffeine in the afternoon and evening, and using your bed solely for sleep and intimacy.
- Incorporate regular exercise into your routine, even when grappling with pain and fatigue, as physical activity can be challenging.
- Adhere to a nutritious diet to support your health.
- Be open to making adjustments in your work and personal life, such as reducing your working hours or seeking less demanding employment, to align with your unique symptoms and requirements.