Article

Even though repetitive transcranial magnetic stimulation (rTMS) has been used for
a decade for the treatment of fibromyalgia, evidence of its effectiveness has not
been definitely presented.
The aim of this study was to investigate whether there
is evidence of rTMS being effective in decreasing the severity of pain among
patients with fibromyalgia. CENTRAL, MEDLINE, EMBASE, CINAHL, SCOPUS, WEB OF
SCIENCE, and relevant references of the identified studies were searched.
Randomized controlled studies on adults with fibromyalgia were included. The
outcome studied was change in pain severity. Methodological quality was assessed
using the scale introduced in the Guidelines for Systematic Reviews in the
Cochrane Collaboration Back Review Group. A random-effects meta-analysis was
carried out with a test for heterogeneity using the I and pooled estimate as a
nonstandardized mean of difference in change in pain severity measures by a
numeric rating scale. The search resulted in 791 records, eight relevant, and
meta-analyses on seven trials. The risk of bias was considered low for seven
studies. Pain severity before and after the last stimulation decreased by -1.2
points on 0-10 numeric rating scale (95% confidence interval: -1.7 to -0.8). Pain
severity before and 1 week to 1 month after the last stimulation decreased by
-0.7 points (95% confidence interval: -1.0 to -0.3). Both pooled results were
below the minimal clinically important difference of 1.5 points. There is
moderate evidence that rTMS is not more effective than sham in reducing the
severity of pain in fibromyalgia patients, questioning the routine recommendation
of this method for fibromyalgia treatment.

Langue : ANGLAIS