Efficacy of neuromodulation on the treatment of fibromyalgia: A network meta-analysis

Ying-Chih Cheng; Wen-Yin Chen; Min-I Su; Yu-Kang Tu; Chih-Chiang Chiu; Wei-Lieh Huang

doi:10.1016/j.genhosppsych.2024.01.007

Efficacy of neuromodulation on the treatment of fibromyalgia: A network meta-analysis

Gen Hosp Psychiatry. 2024 Mar-Apr:87:103-123. doi: 10.1016/j.genhosppsych.2024.01.007. Epub 2024 Jan 26.

Authors

Ying-Chih Cheng¹, Wen-Yin Chen², Min-I Su³, Yu-Kang Tu⁴, Chih-Chiang Chiu⁵, Wei-Lieh Huang⁶

Affiliations

¹ Department of Psychiatry, China Medical University Hsinchu Hospital, China Medical University, Hsinchu, Taiwan; Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Research Center of Big Data and Meta-analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
² Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Songde branch, Taipei, Taiwan; School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
³ Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; Division of Cardiology, Department of Internal Medicine, Taitung MacKay Memorial Hospital, Taitung, Taiwan; Graduate Institute of Business Administration, College of Management, National Dong Hwa University, Hualien, Taiwan.
⁴ Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan.
⁵ Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Songde branch, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
⁶ Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan; Cerebellar Research Center, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan. Electronic address: Y03046@ms1.ylh.gov.tw.

PMID: 38382420
DOI: 10.1016/j.genhosppsych.2024.01.007

Abstract

Objective: Several types of neuromodulation have been investigated for the treatment of fibromyalgia, but they show varied efficacy on pain, functioning, comorbid depression and comorbid anxiety. Whether some types of neuromodulation or some factors are associated with a better response also awaits clarification.

Methods: We conducted a systematic review and network meta-analysis of randomized controlled trials to evaluate the efficacy of neuromodulation in patients with fibromyalgia. We searched PubMed, EMBASE, the Cochrane Central Register of Controlled Trials and PsycINFO before March 2022. We employed a frequentist random-effects network meta-analysis.

Results: Forty trials involving 1541 participants were included. Compared with sham control interventions, several types of transcranial direct current stimulation (tDCS), transcranial random noise stimulation (tRNS), and high-frequency repetitive transcranial magnetic stimulation (rTMS) were associated with significant reduction of pain, depression, anxiety, and improvement in functioning. Many significantly effective treatment options involve stimulation of the primary motor cortex or dorsolateral prefrontal cortex.

Conclusion: We concluded that several types of rTMS, tDCS and tRNS may have the potential to be applied for clinical purposes.

Keywords: Fibromyalgia; Network meta-analysis; Neuromodulation; Repetitive transcranial magnetic stimulation; Transcranial direct current stimulation.

Publication types

Systematic Review
Meta-Analysis
Review

MeSH terms

Fibromyalgia* / therapy
Humans
Network Meta-Analysis
Pain
Transcranial Direct Current Stimulation*
Transcranial Magnetic Stimulation
Treatment Outcome