Functionality of patients with fibromyalgia after the association of low-dose naltrexone (LDN) and transcranial direct current stimulation (tDCS)

Maiara Cristina de Cesaro 1, Mariane Schäffer Castro 2, Rodrigo Hernandes Paludo 2, Maiara de Oliveira Salbego 2, Felipe Fregni 3, Liciane Fernandes Medeiros 1, Andressa de Souza 1

  1. Programa de Pós-Graduação em Saúde e Desenvolvimento Humano da Universidade La Salle, Canoas/RS
  2. Discente da Universidade La Salle, Canoas/RS
  3. Neuromodulation Center and Center for Clinical Research Learning. Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Boston/MA

OBJECTIVE: Evaluate the effect of the association of low doses of naltrexone (LDN) and transcranial direct current electrical stimulation (tDCS) on the quality of life of patients with fibromyalgia (FM).

METHODS: This is a randomized clinical trial in which 86 women aged between 18 and 65 years and diagnosed with FM were included. Patients were randomized between LDN + tDCS (n = 21), LDN + Sham-tDCS (n = 22), Placebo + tDCS (n = 22) or Placebo + Sham-tDCS (n = 21), receiving 21 days of medication and 5 days of association. Patients underwent the following procedures: sociodemographic questionnaire and Fibromyalgia Impact Questionnaire (FIQ), subdivided into function, overall impact and symptoms. The data were analyzed using the SPSS 20.0 program, using Friedman's test followed by Wilcoxon's Post-Hoc (significance when P <0.05).

RESULTS: There was no significant difference between groups in the baseline data (age, BMI, education), demonstrating to be a homogeneous sample. The LDN + tDCS group showed a significant difference when comparing the fourth assessment with the first in the function domain (P = 0.005), when comparing the eighth assessment with the first, significant differences were found in the total impact and symptoms (P = 0.004 and P < 0.001, respectively). The other groups showed a significant difference only in the symptoms domain, when the eighth assessment was compared with the first (P = 0.003 for all).

CONCLUSIONS: through this study it was possible to conclude that the association of LDN and tDCS is efficient in improving the impact of the syndrome on patients.

KEYWORDS: Fibromyalgia, low-dose naltrexone, transcranial direct current stimulation