磁刺激
纤维肌痛
焦虑
随机对照试验
荟萃分析
医学
严格标准化平均差
萧条(经济学)
生活质量(医疗保健)
物理疗法
物理医学与康复
刺激
心理学
内科学
精神科
护理部
经济
宏观经济学
作者
Ezekiel Y J Toh,Jarret S P Ng,Roger S. McIntyre,Bach Xuan Tran,Roger Ho,Cyrus S.H. Ho,Wing Tam
标识
DOI:10.1097/psy.0000000000001062
摘要
Meta-analysis was performed to evaluate the effectiveness of repetitive transcranial magnetic stimulation (rTMS) in fibromyalgia on the domains of pain, depression, anxiety and quality of life.Publications were searched with the keywords "repetitive transcranial magnetic stimulation" and "fibromyalgia" for randomized controlled trials that compare rTMS with sham stimulation for treating pain, depression, anxiety, and quality of life. Trials available until April 2021 were searched through PubMed, Scopus, Web of Science, and Cochrane Controlled Trials Register. The postintervention scores after 4 weeks for pain, depression, anxiety, and quality of life were extracted to compare the effects of rTMS and sham. Subgroup analysis was conducted based on the stimulation site.From 265 screened articles, 11 eligible randomized controlled trials involving 303 patients were included. The results show that rTMS is more effective than sham stimulation in improving pain (standardized mean difference [SMD] = -0.35; 95% confidence interval [CI] = -0.62 to -0.08; p = .01) and quality of life (SMD = -0.51; 95% CI = -0.78 to -0.23; p = .0003). It is not more effective than sham stimulation for depression, and anxiety. After sensitivity analysis, subgroup analysis revealed that primary motor cortex stimulation was more effective than sham for improving pain (SMD = -0.57; 95% CI = -0.91 to -0.23; p = <0.01). Neither dorsolateral prefrontal cortex nor primary motor cortex stimulation was more effective than sham in improving depression and anxiety.rTMS is more effective than sham in improving pain and quality of life, but it does not demonstrate reduction in depression or anxiety.
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