Effects of Combined Treatment With tDCS and Cognitive Training in Patients With Fibromyalgia
Condition: Fibromyalgia
MeSH terms: Fibromyalgia; Myofascial Pain Syndromes
Study type: Interventional

Summary: 
      Chronic pain represents an important health problem responsible for decreases in quality of
      life, and is associated with great negative impact in society and economy. In many cases, its
      treatment does not reach therapeutic success causing health professionals and patients
      dissatisfaction. Chronic pain is also associated with somatization, hopelessness and
      catastrophizing thinking. These information processing includes sensorial, emotional and
      cognitive-appraisal thinking, which manifests the working of neural networks at cortical and
      sub-cortical levels. Attention and memory are a central aspect in the processing of pain
      modulation. Like in addictions (e.g. smoking, alcohol), chronic pain may debut with
      displacement in the focus of attention and alterations in the sensorial processing in the
      incentive-motivation tests. Considering that other studies have indicated that experimental
      and clinical pain is capable of modulating cognitive activities such as attention,memory and
      expectation, in this study the investigators will test whether cognitive training, tDCS, or
      the combination of both interventions decrease cognitive deficits associated with
      Fibromyalgia
    

Detailed description: 
      Will be included women aged between 18 and 65 years, chronic pain fibromyalgia according to
      the criteria of the American College of Rheumatology, pain unresponsive to analgesics such as
      paracetamol, acetylsalicylic acid, ibuprofen, Carisoprodol, Zanaflex (Tizanidine) and Codeine
      and give informed consent to participate after initial evaluation. Primary outcome is to
      Evaluate whether the tDCS associated with cognitive retraining technique is able to modulate
      attentional bias in fibromyalgia patients. Secondary outcomes are: compare the effect of
      active tDCS and sham in: Assessed with the Visual Analog Scale for 8 days, Functional
      capacity, Conditional pain modulation (CPM), Maximal Heat Pain tolerance,Catastrophic
      thinking,Serum levels of Brain Derived Neurotrophic Factor (BDNF), Beck Depression Inventory,
      forward and backward digit span( WAIS),Pittsburgh sleep quality and State-Trait Anxiety
      Inventory (STAI) test.
    

Intervention name(s): tDCS-Sham; tDCS-Active; Cognitive training
Intervention type(s): Device; Device; Other
Intervention description(s): Sham tDCS will involve an identical electrode montage, with stimulation ceasing after a 30-second ramp-up period to provide equivalent scalp sensation.; tDCS was delivered using the anode electrode positioned over the left dorsolateral prefrontal cortex (DLPFE) and the cathode electrode at supra orbital right region. The electrodes were placed into a 25-35 cm2 square sponge immersed in saline solution for better current conductivity. Current density used was 2 mA and electrodes attached to the scalp were sustained by rubber band.; . The cognitive training consisted of an online application of a Dual N-Back task .The Training will last for 8 days.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Attention; Memory (short and long-term); Conflict monitoring tasks; Verbal fluency