Neuromodulation and Its Therapeutic Potentiality in Different Populations
Condition: Fibromyalgia
MeSH terms: Fibromyalgia; Myofascial Pain Syndromes
Study type: Interventional

Summary: 
      One of the big challenges faced by researchers who act in rehabilitation science is the
      capacity to dispose integrative approaches for its utilization in clinical practice. The
      border profile of a physiotherapy researcher is to be in front of applied research
      amplification in experimental integrative approaches, involving the study of behavioral and
      physiological variables.

      The rehabilitation process transcends the systems physiology and encompasses the cognitive
      behavioral feature of being adapted to the environment that surround us. It is now known by
      the scientific rehabilitation community the necessity for evidence based therapies and even
      more, therapeutic innovation. In both conditions, of health and illness, various options to
      use integrative approaches are today available in physiotherapy, including behavioral and
      physiological profiles of the individuals during physical activities, response to stress and
      in the field of chronic pain.

      It is in the clinical routine of numerous rehabilitation centers the treatment of diseases
      that causes pain, being the leading figure in a physiotherapist work process. The innovative
      study of resources that can alter the pain state of this patients becomes primordial for
      routine clinical use, low cost and easy to apply. The therapeutic treatment for pain offered
      by a physiotherapist need new investigative options based in evidences from the association
      between the neuronal, behavioral and physiological responses where the brain is the central
      organ of this regulation. In this context, become increasingly more necessary the
      construction of investigative approaches in the purpose of reaching the clinical practice, in
      a reduced time lapse, once the great volume of information produced globally does not impact
      in short or medium term in new therapeutic recommendations.

      Among the various chronic painful entities, it is presented the fibromyalgia (FM), painful
      diabetic polyneuropathy and primary dysmenorrhea because of its painful pathogenic complexity
      and its limited therapeutic against pain in rehabilitation process. The 3 painful entities
      presents the central nervous system as main participant of neurogenesis and maintenance of
      the painful state.

      It is primordial importance that rehabilitation science improve methods of non invasive brain
      neuromodulation that allows, through excitation or inhibition of specific cortical areas in
      order to produce pain inhibition, providing a simple and low cost treatment to clinical
      routine. Technological advances and non invasive techniques to modulate brain function has
      been developed, among which transcranial direct current stimulation (tDCS) stands out.
      Basically, electrodes are placed in targeted brain regions that you want to stimulate or
      inhibit. Posteriorly, is applied a continuous electric current (0,4 - 2 mA) for a 3-20
      minutes period, in order to modify cortical excitability. The stimulus of the anodic current
      increases cortical excitability whereas the stimulus of the cathodic current has an
      inhibitory effect.

      Few are the research groups that address the issue of fibromyalgia, painful diabetic
      polyneuropathy and primary dysmenorrhea and the application of tDCS as research focus, being
      a border area for rehabilitation science and great potential in clinical use. Preliminary
      studies associates the use of tDCS with the decrease of painful state, however an approach of
      physical function and behavioral results needs greater investigation.

      The purpose of the presented project is to present the tDCS as a new modality in physical
      rehabilitation for the patient with chronic pain of the 3 entities mentioned above. The study
      proposal is to present behavioral, social and physical results of tDCS application in this
      patients, suggesting a better quality of life and functionality of the individual.
    


Intervention name(s): Transcranial Direct Current Stimulation
Intervention type(s): Device
Intervention description(s): Non invasive brain modulation at a 2mA current during 20minutes
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Fibromyalgia; tDCS