Exploring the role of transcranial direct current stimulation (tDCS) for the treatment of fibromyalgia: a narrative review
Bibliographic record
Abstract
INTRODUCTION: Fibromyalgia is a chronic pain syndrome characterized by widespread nociplastic pain, fatigue, sleep disturbances, and mood symptoms. Conventional treatments often yield limited benefits, prompting interest in noninvasive brain stimulation techniques such as transcranial direct current stimulation (tDCS). AREAS COVERED: This review synthesizes evidence from 31 randomized controlled trials (RCTs) evaluating the efficacy, safety, and tolerability of tDCS in fibromyalgia. A systematic search of Embase and Medline were conducted without date or language restrictions. Most studies assessed anodal tDCS targeting the primary motor cortex (M1) or dorsolateral prefrontal cortex (DLPFC), with outcomes spanning pain, global symptom burden, psychological symptoms, fatigue, and sleep quality. Ten of 14 sham-controlled trials reported significant pain reductions with M1 stimulation. Seven trials showed improvements in overall symptom severity (FIQ/FIQR), though most did not meet the minimal clinically important difference. Outcomes for fatigue, sleep, and mood were less consistent and often underreported. EXPERT OPINION: While tDCS appears safe and effective for fibromyalgia-related pain, variability in protocols and limited reporting of non-pain outcomes hinder broader conclusions. As an adjunctive therapy, its role may be enhanced through protocol standardization, longer-term follow-up, and combination strategies such as pairing with repetitive transcranial magnetic stimulation (rTMS) to address the full spectrum of fibromyalgia symptoms.
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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 | 0.000 |
| 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 | 0.000 |
| 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".