Evidence map›Paper›PMID 40822360›Full record

SynthesisFrontiers in pain research (Lausanne, Switzerland)2025

Clinical, neurophysiological and neurochemical effects of non-invasive electrical brain stimulation in fibromyalgia syndrome-a systematic review and meta-analysis.

Christine Winterholler, Maria Helena Coura, Pedro Montoya

Abstract readSystematic Review
In one paragraph

Synthesis in Frontiers in pain research (Lausanne, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Christine WinterhollerResearch Institute of Health Sciences (IUNICS) & Balearic Islands Health Research Institute Foundation (IdISBa), University of Balearic Islands (UIB), Palma, Spain.
Maria Helena CouraUniversidade Nove de Julho, São Paulo, Brazil.
Pedro MontoyaResearch Institute of Health Sciences (IUNICS) & Balearic Islands Health Research Institute Foundation (IdISBa), University of Balearic Islands (UIB), Palma, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Fibromyalgia syndrome (FMS) is linked to central sensitization and neuroplastic alterations that contribute to chronic pain, fatigue, cognitive, sleep, and affective disturbances. Conventional treatments offer limited benefit. Non-invasive transcranial electrical stimulation (tES), particularly transcranial direct current stimulation (tDCS), may modulate brain function and relieve symptoms, but findings remain inconsistent. Objective: To systematically review and meta-analyze the effects of tES on clinical, neurophysiological, neuropsychological, and neurochemical outcomes in FMS. Methods: Seven databases were searched for studies published between April 2013 and April 2023. Eligible designs included randomized controlled trials, cross-over, one-arm, and case studies involving adult FMS patients. Data extraction followed Cochrane Collaboration guidelines and used RevMan 6.6.0. Results: Anodal tDCS produced short- to mid-term reductions in pain and mood symptoms, especially when applied over M1 or DLPFC. Longer interventions and repeated sessions enhanced effects, though protocol heterogeneity limited comparability. Both subjective (VAS, NRS) and objective (QST) measures confirmed pain reduction. Cognitive improvements were inconsistent, and quality of life effects were limited. Neurophysiological and neurochemical changes suggested possible mechanisms, though findings varied. Study quality was mixed, with small sample sizes and methodological inconsistencies. Meta-analysis revealed statistically significant but small effects on pain (Hedges' Conclusions: Anodal tDCS may offer short-term relief of pain and mood symptoms in FMS, potentially through modulation of cortical excitability and neuroplasticity. However, due to variability in findings and methodological limitations, its clinical relevance remains unclear. Future trials should use standardized protocols, assess long-term effects, and include clinically meaningful outcome measures. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42023412332, PROSPERO CRD42023412332.

Indexed as

chronic painfibromyalgiahome-based tDCStDCStranscranial electrical current stimulation

Identifiers

PMID40822360
PMCPMC12354543

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.