The Effect of Repetitive Transcranial Magnetic Stimulation on Fibromyalgia A Randomized Sham-Controlled Trial with 1-Mo Follow-Up

Objectives: The aim of this study was to determine whether low-frequency repetitive transcranial magnetic stimulation (rTMS) applied to the right dorsolateral prefrontal cortex or high-frequency rTMS applied to the left motor cortex could influence pain level or mood status in patients with intractable fibromyalgia. Design: Fifteen women with fibromyalgia were randomized to low-frequency (1 Hz), high-frequency (10 Hz), or sham stimulation. The patients underwent ten consecutive sessions according to rTMS protocol. The number of tender points and the Korean version of the Fibromyalgia Impact Questionnaire were used to assess disease status, a visual analog scale was used to measure level of pain, and the Beck Depression Inventory was used to assess mood status. All subjects were evaluated before, immediately after, and 1 mo after rTMS. Results: In the low-frequency group, the Beck Depression Inventory scores significantly decreased from baseline to 1 mo after rTMS. The visual analog scale and Korean version of the Fibromyalgia Impact Questionnaire scores significantly decreased immediately after rTMS. In the high-frequency group, the visual analog scale and Beck Depression Inventory scores were significantly decreased immediately after rTMS. Conclusions: Low-frequency rTMS may play a role in the long-term treatment of fibromyalgia. Notably, the findings of this study are the first to show that the right dorsolateral prefrontal cortex or the left motor cortex rTMS could have an antidepressive and pain-modulating effect in patients with fibromyalgia.