Investigation of predictors of pain relief with high-frequency repetitive motor cortex transcranial magnetic stimulation among people with fibromyalgia
Bibliographic record
Abstract
OBJECTIVES: To identify baseline predictors of clinical response to the primary motor cortex high-frequency repetitive transcranial magnetic stimulation (M1 HF-rTMS) in patients with fibromyalgia. MATERIALS AND METHODS: We performed a secondary analysis of 32 women with fibromyalgia from a randomized, double-blind, sham-controlled international multicenter trial registered at clinicaltrials.gov (NCT03658694). Enrolled participants received active or HF-rTMS-over the primary motor cortex (M1). Baseline demographic data, psychological assessments (Hospital Anxiety and Depression Scale, Brief Pain Inventory, Fibromyalgia Impact Questionnaire, Toronto Alexithymia Scale, and Interoception Questionnaire), psychophysical measures (Conditioned Pain Modulation), and structural brain MRI variables were collected and analyzed. Responders were defined as patients who achieved a ≥ 50 % reduction in pain on a numerical rating scale eight weeks after treatment. Associations between baseline variables and response were analyzed using Wilcoxon Rank Sum tests, chi-square tests, and logistic regression where appropriate. RESULTS: At the end of the treatment period, 15 out of 32 participants (47 %) in the active M1 HF-rTMS group and 7 out of 30 (23 %) in the sham group achieved ≥50 % reduction in pain. None of the baseline demographic, clinical, psychological, psychophysical, or neuroimaging variables evaluated were significantly associated with clinical response to M1 HF-rTMS. Although M1 HF-rTMS induced significant antinociceptive effects measured by psychophysical assessments (heat pain threshold), these effects did not predict clinical outcomes. CONCLUSIONS: No clear baseline predictors of response to M1 HF-rTMS were identified in patients with fibromyalgia, emphasizing the heterogeneity and complexity of the disorder. Further research incorporating larger samples and additional biomarkers is necessary to establish individualized prediction strategies for M1 HF-rTMS therapy in fibromyalgia.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".