Motor cortex repetitive transcranial magnetic stimulation in fibromyalgia: a multicentre randomised controlled trial
Abstract
BACKGROUND: Despite affecting 2-4% of the population worldwide, fibromyalgia often remains refractory to treatment. Here we report the first international randomised double-blind, sham-controlled trial developed to assess the efficacy of repetitive transcranial magnetic stimulation (rTMS) as an add-on therapy for fibromyalgia. METHODS: , or sham stimulation. This included 10 induction sessions over 2 weeks, followed by weekly maintenance (6 weeks), and fortnightly extended maintenance (8 weeks). Primary outcome was ≥50% pain reduction at week 8 compared with baseline. Secondary outcomes included pain interference, mood, global impression of change, and Fibromyalgia Impact Questionnaire (FIQ) scores at weeks 8 and 16. RESULTS: We randomised 101 women (mean age 48 [range 25-83] yr) into active (n=52) or sham (n=49) arms. Bayesian analysis revealed a 99.4% probability of ≥50% pain reduction at week 8 in the active group vs sham (odds ratio [OR] 3.04; 95% credible interval [95% CrI] 1.26-8.06), with a number needed to treat of 4.54. Frequentist analysis confirmed that relative pain reduction was higher in the active than in the sham group (40.4% vs 18.4%, P=0.028). At week 16, this probability reduced to 34.2% (OR 0.815; 95% CrI 0.313-2.1), but the likelihood of FIQ score reduction was 79.1%. The intervention appeared safe. CONCLUSIONS: Add-on M1-repetitive transcranial magnetic stimulation reduced pain intensity up to 8 weeks in women with fibromyalgia. Although analgesic effects waned, functional improvements remained during extended maintenance at week 16.
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BibTeX
@article{silva2026motor,
title = {{Motor cortex repetitive transcranial magnetic stimulation in fibromyalgia: a multicentre randomised controlled trial}},
author = {Valquíria A. Silva and Abrahão F. Baptista and Alessandra S. Fonseca and Adriana M. Carneiro and André R. Brunoni and Paulo.E.M. Carrilho and Catarina C. Lins and Gabriel T. Kubota and Ana Mércia B.L. Fernandes and Jorge.D.S. Lapa and Lucas M. dos Santos and Ivo Sasso and Katia Monte-Silva and Frédérique Poindessous-Jazat and Nobuhiko Mori and Kenji Miki and Adriana Baltar and Clarice Tanaka and Manoel J. Teixeira and Koichi Hosomi and Didier Bouhassira and Nadine Attal and Daniel Ciampi de Andrade},
journal = {British Journal of Anaesthesia},
year = {2026},
month = nov,
doi = {10.1016/j.bja.2024.12.045},
url = {https://hal.science/hal-05851900v1},
note = {CC BY},
}
RIS
TY - JOUR
TI - Motor cortex repetitive transcranial magnetic stimulation in fibromyalgia: a multicentre randomised controlled trial
AU - Valquíria A. Silva
AU - Abrahão F. Baptista
AU - Alessandra S. Fonseca
AU - Adriana M. Carneiro
AU - André R. Brunoni
AU - Paulo.E.M. Carrilho
AU - Catarina C. Lins
AU - Gabriel T. Kubota
AU - Ana Mércia B.L. Fernandes
AU - Jorge.D.S. Lapa
AU - Lucas M. dos Santos
AU - Ivo Sasso
AU - Katia Monte-Silva
AU - Frédérique Poindessous-Jazat
AU - Nobuhiko Mori
AU - Kenji Miki
AU - Adriana Baltar
AU - Clarice Tanaka
AU - Manoel J. Teixeira
AU - Koichi Hosomi
AU - Didier Bouhassira
AU - Nadine Attal
AU - Daniel Ciampi de Andrade
PY - 2026
DA - 2026/11/04
JO - British Journal of Anaesthesia
DO - 10.1016/j.bja.2024.12.045
UR - https://hal.science/hal-05851900v1
AB - BACKGROUND: Despite affecting 2-4% of the population worldwide, fibromyalgia often remains refractory to treatment. Here we report the first international randomised double-blind, sham-controlled trial developed to assess the efficacy of repetitive transcranial magnetic stimulation (rTMS) as an add-on therapy for fibromyalgia. METHODS: , or sham stimulation. This included 10 induction sessions over 2 weeks, followed by weekly maintenance (6 weeks), and fortnightly extended maintenance (8 weeks). Primary outcome was ≥50% pain reduction at week 8 compared with baseline. Secondary outcomes included pain interference, mood, global impression of change, and Fibromyalgia Impact Questionnaire (FIQ) scores at weeks 8 and 16. RESULTS: We randomised 101 women (mean age 48 [range 25-83] yr) into active (n=52) or sham (n=49) arms. Bayesian analysis revealed a 99.4% probability of ≥50% pain reduction at week 8 in the active group vs sham (odds ratio [OR] 3.04; 95% credible interval [95% CrI] 1.26-8.06), with a number needed to treat of 4.54. Frequentist analysis confirmed that relative pain reduction was higher in the active than in the sham group (40.4% vs 18.4%, P=0.028). At week 16, this probability reduced to 34.2% (OR 0.815; 95% CrI 0.313-2.1), but the likelihood of FIQ score reduction was 79.1%. The intervention appeared safe. CONCLUSIONS: Add-on M1-repetitive transcranial magnetic stimulation reduced pain intensity up to 8 weeks in women with fibromyalgia. Although analgesic effects waned, functional improvements remained during extended maintenance at week 16.
SN - 0007-0912
SN - 1471-6771
ER -