Brief report: Excitatory and inhibitory brain metabolites as targets of motor cortex transcranial direct current stimulation therapy and predictors of its efficacy in fibromyalgia

Bradley R. Foerster, Thiago D. Nascimento, Misty DeBoer, Marycatherine A. Bender, Indie C. Rice, Dennis Q. Truong, Marom Bikson, Daniel J. Clauw, Jon Kar Zubieta, Richard E. Harris, Alexandre F. DaSilva

Research output: Contribution to journalArticle

Abstract

Objective. Transcranial direct current stimulation (tDCS) has been shown to improve pain symptoms in fibromyalgia (FM), a central pain syndrome whose underlying mechanisms are not well understood. This study was undertaken to explore the neurochemical action of tDCS in the brain of patients with FM, using proton magnetic resonance spectroscopy (1H-MRS). Methods. Twelve patients with FM underwent sham tDCS over the left motor cortex (anode placement) and contralateral supraorbital cortex (cathode placement) for 5 consecutive days, followed by a 7-day washout period and then active tDCS for 5 consecutive days. Clinical pain assessment and 1H-MRS testing were performed at baseline, the week following the sham tDCS trial, and the week following the active tDCS trial. Results. Clinical pain scores decreased significantly between the baseline and active tDCS time points (P = 0.04). Levels of glutamate + glutamine (Glx) in the anterior cingulate were significantly lower at the post-active tDCS assessment compared with the post-sham tDCS assessment (P = 0.013), and the decrease in Glx levels in the thalami between these time points approached significance (P = 0.056). From baseline to the post-sham tDCS assessment, levels of N-acetylaspartate (NAA) in the posterior insula increased significantly (P = 0.015). There was a trend toward increased levels of γ-aminobutyric acid (GABA) in the anterior insula after active tDCS, compared with baseline (P = 0.064). Baseline anterior cingulate Glx levels correlated significantly with changes in pain score, both for the time period from baseline to sham tDCS (β1 = 1.31, P < 0.001) and for the time period from baseline to active tDCS (β1= 1.87, P < 0.001). Conclusion. The present findings suggest that GABA, Glx, and NAA play an important role in the pathophysiology of FM and its modulation by tDCS.

Original languageEnglish (US)
Pages (from-to)576-581
Number of pages6
JournalArthritis and Rheumatology
Volume67
Issue number2
DOIs
StatePublished - Feb 1 2015

Fingerprint

Fibromyalgia
Motor Cortex
Brain
Therapeutics
Pain
Gyrus Cinguli
Transcranial Direct Current Stimulation
gamma-Aminobutyric Acid
Electrodes
Aminobutyrates
Pain Measurement
Glutamine
Thalamus
Glutamic Acid

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy
  • Rheumatology
  • Medicine(all)

Cite this

Brief report : Excitatory and inhibitory brain metabolites as targets of motor cortex transcranial direct current stimulation therapy and predictors of its efficacy in fibromyalgia. / Foerster, Bradley R.; Nascimento, Thiago D.; DeBoer, Misty; Bender, Marycatherine A.; Rice, Indie C.; Truong, Dennis Q.; Bikson, Marom; Clauw, Daniel J.; Zubieta, Jon Kar; Harris, Richard E.; DaSilva, Alexandre F.

In: Arthritis and Rheumatology, Vol. 67, No. 2, 01.02.2015, p. 576-581.

Research output: Contribution to journalArticle

Foerster, BR, Nascimento, TD, DeBoer, M, Bender, MA, Rice, IC, Truong, DQ, Bikson, M, Clauw, DJ, Zubieta, JK, Harris, RE & DaSilva, AF 2015, 'Brief report: Excitatory and inhibitory brain metabolites as targets of motor cortex transcranial direct current stimulation therapy and predictors of its efficacy in fibromyalgia', Arthritis and Rheumatology, vol. 67, no. 2, pp. 576-581. https://doi.org/10.1002/art.38945
Foerster, Bradley R. ; Nascimento, Thiago D. ; DeBoer, Misty ; Bender, Marycatherine A. ; Rice, Indie C. ; Truong, Dennis Q. ; Bikson, Marom ; Clauw, Daniel J. ; Zubieta, Jon Kar ; Harris, Richard E. ; DaSilva, Alexandre F. / Brief report : Excitatory and inhibitory brain metabolites as targets of motor cortex transcranial direct current stimulation therapy and predictors of its efficacy in fibromyalgia. In: Arthritis and Rheumatology. 2015 ; Vol. 67, No. 2. pp. 576-581.
@article{27a3f1ab44a54110a73db8f9d3180c2e,
title = "Brief report: Excitatory and inhibitory brain metabolites as targets of motor cortex transcranial direct current stimulation therapy and predictors of its efficacy in fibromyalgia",
abstract = "Objective. Transcranial direct current stimulation (tDCS) has been shown to improve pain symptoms in fibromyalgia (FM), a central pain syndrome whose underlying mechanisms are not well understood. This study was undertaken to explore the neurochemical action of tDCS in the brain of patients with FM, using proton magnetic resonance spectroscopy (1H-MRS). Methods. Twelve patients with FM underwent sham tDCS over the left motor cortex (anode placement) and contralateral supraorbital cortex (cathode placement) for 5 consecutive days, followed by a 7-day washout period and then active tDCS for 5 consecutive days. Clinical pain assessment and 1H-MRS testing were performed at baseline, the week following the sham tDCS trial, and the week following the active tDCS trial. Results. Clinical pain scores decreased significantly between the baseline and active tDCS time points (P = 0.04). Levels of glutamate + glutamine (Glx) in the anterior cingulate were significantly lower at the post-active tDCS assessment compared with the post-sham tDCS assessment (P = 0.013), and the decrease in Glx levels in the thalami between these time points approached significance (P = 0.056). From baseline to the post-sham tDCS assessment, levels of N-acetylaspartate (NAA) in the posterior insula increased significantly (P = 0.015). There was a trend toward increased levels of γ-aminobutyric acid (GABA) in the anterior insula after active tDCS, compared with baseline (P = 0.064). Baseline anterior cingulate Glx levels correlated significantly with changes in pain score, both for the time period from baseline to sham tDCS (β1 = 1.31, P < 0.001) and for the time period from baseline to active tDCS (β1= 1.87, P < 0.001). Conclusion. The present findings suggest that GABA, Glx, and NAA play an important role in the pathophysiology of FM and its modulation by tDCS.",
author = "Foerster, {Bradley R.} and Nascimento, {Thiago D.} and Misty DeBoer and Bender, {Marycatherine A.} and Rice, {Indie C.} and Truong, {Dennis Q.} and Marom Bikson and Clauw, {Daniel J.} and Zubieta, {Jon Kar} and Harris, {Richard E.} and DaSilva, {Alexandre F.}",
year = "2015",
month = "2",
day = "1",
doi = "10.1002/art.38945",
language = "English (US)",
volume = "67",
pages = "576--581",
journal = "Arthritis and Rheumatology",
issn = "2326-5191",
publisher = "John Wiley and Sons Ltd",
number = "2",

}

TY - JOUR

T1 - Brief report

T2 - Excitatory and inhibitory brain metabolites as targets of motor cortex transcranial direct current stimulation therapy and predictors of its efficacy in fibromyalgia

AU - Foerster, Bradley R.

AU - Nascimento, Thiago D.

AU - DeBoer, Misty

AU - Bender, Marycatherine A.

AU - Rice, Indie C.

AU - Truong, Dennis Q.

AU - Bikson, Marom

AU - Clauw, Daniel J.

AU - Zubieta, Jon Kar

AU - Harris, Richard E.

AU - DaSilva, Alexandre F.

PY - 2015/2/1

Y1 - 2015/2/1

N2 - Objective. Transcranial direct current stimulation (tDCS) has been shown to improve pain symptoms in fibromyalgia (FM), a central pain syndrome whose underlying mechanisms are not well understood. This study was undertaken to explore the neurochemical action of tDCS in the brain of patients with FM, using proton magnetic resonance spectroscopy (1H-MRS). Methods. Twelve patients with FM underwent sham tDCS over the left motor cortex (anode placement) and contralateral supraorbital cortex (cathode placement) for 5 consecutive days, followed by a 7-day washout period and then active tDCS for 5 consecutive days. Clinical pain assessment and 1H-MRS testing were performed at baseline, the week following the sham tDCS trial, and the week following the active tDCS trial. Results. Clinical pain scores decreased significantly between the baseline and active tDCS time points (P = 0.04). Levels of glutamate + glutamine (Glx) in the anterior cingulate were significantly lower at the post-active tDCS assessment compared with the post-sham tDCS assessment (P = 0.013), and the decrease in Glx levels in the thalami between these time points approached significance (P = 0.056). From baseline to the post-sham tDCS assessment, levels of N-acetylaspartate (NAA) in the posterior insula increased significantly (P = 0.015). There was a trend toward increased levels of γ-aminobutyric acid (GABA) in the anterior insula after active tDCS, compared with baseline (P = 0.064). Baseline anterior cingulate Glx levels correlated significantly with changes in pain score, both for the time period from baseline to sham tDCS (β1 = 1.31, P < 0.001) and for the time period from baseline to active tDCS (β1= 1.87, P < 0.001). Conclusion. The present findings suggest that GABA, Glx, and NAA play an important role in the pathophysiology of FM and its modulation by tDCS.

AB - Objective. Transcranial direct current stimulation (tDCS) has been shown to improve pain symptoms in fibromyalgia (FM), a central pain syndrome whose underlying mechanisms are not well understood. This study was undertaken to explore the neurochemical action of tDCS in the brain of patients with FM, using proton magnetic resonance spectroscopy (1H-MRS). Methods. Twelve patients with FM underwent sham tDCS over the left motor cortex (anode placement) and contralateral supraorbital cortex (cathode placement) for 5 consecutive days, followed by a 7-day washout period and then active tDCS for 5 consecutive days. Clinical pain assessment and 1H-MRS testing were performed at baseline, the week following the sham tDCS trial, and the week following the active tDCS trial. Results. Clinical pain scores decreased significantly between the baseline and active tDCS time points (P = 0.04). Levels of glutamate + glutamine (Glx) in the anterior cingulate were significantly lower at the post-active tDCS assessment compared with the post-sham tDCS assessment (P = 0.013), and the decrease in Glx levels in the thalami between these time points approached significance (P = 0.056). From baseline to the post-sham tDCS assessment, levels of N-acetylaspartate (NAA) in the posterior insula increased significantly (P = 0.015). There was a trend toward increased levels of γ-aminobutyric acid (GABA) in the anterior insula after active tDCS, compared with baseline (P = 0.064). Baseline anterior cingulate Glx levels correlated significantly with changes in pain score, both for the time period from baseline to sham tDCS (β1 = 1.31, P < 0.001) and for the time period from baseline to active tDCS (β1= 1.87, P < 0.001). Conclusion. The present findings suggest that GABA, Glx, and NAA play an important role in the pathophysiology of FM and its modulation by tDCS.

UR - http://www.scopus.com/inward/record.url?scp=84922811075&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84922811075&partnerID=8YFLogxK

U2 - 10.1002/art.38945

DO - 10.1002/art.38945

M3 - Article

C2 - 25371383

AN - SCOPUS:84922811075

VL - 67

SP - 576

EP - 581

JO - Arthritis and Rheumatology

JF - Arthritis and Rheumatology

SN - 2326-5191

IS - 2

ER -