ArticleFrontiers in pain research (Lausanne, Switzerland)2026
Determinants of adherence and safety in fully autonomous home-based transcranial direct current stimulation for fibromyalgia.
Article in Frontiers in pain research (Lausanne, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Autonomous home-based transcranial direct current stimulation (HB-tDCS) is a scalable non-pharmacological intervention for chronic pain, but evidence under fully autonomous use remains limited. Objectives: To identify factors associated with adherence to fully autonomous HB-tDCS; to characterize the incidence, severity, and timing of adverse events under active and sham stimulation; and to examine if patient and clinical factors, including adverse events and clinical response, are associated with variability in adherence and safety outcomes. Design: Secondary pooled analysis of three double blind, sham-controlled randomized clinical trials. Subjects: A total of 234 women with fibromyalgia diagnosed according to the 2016 American College of Rheumatology criteria. Methods: Participants received a standardized autonomous HB-tDCS protocol (≥20 sessions). The primary outcomes were adherence and safety. We examined associations with adherence and adverse events using generalized linear mixed-effects models, adjusted for demographic, clinical, and psychosocial factors. We also explored whether the burden of adverse events explained the link between treatment allocation and adherence. Results: Overall adherence was 82.6% (95% CI, 81.6-83.6). Adherence rates were similar for the active (84.7%, 95% CI, 83.3-86.0) and sham groups (80.5%, 95% CI, 78.9-82.1). Older age ( Conclusions: Autonomous home-based transcranial direct current stimulation was feasible, safe, and highly adhered to in fibromyalgia, with adherence and safety influenced by clinical and psychosocial factors, supporting scalable implementation in chronic pain.
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