Efficiency of Repetitive Transcranial Magnetic Stimulation (rTMS) Sessions After a Successful 3 Week-treatment in Fibromyalgia

In a previous pilot study, a 3 week treatment with rTMS in fibromyalgia subjects induced a 40% improvement of pain feeling. Three months later, the pain level was still significantly reduced in comparison with the beginning of the treatment, but the clinical improvement was less than at the end of the treatment. We thus propose to realize real or sham rTMS sessions at 3 weeks interval during 6 months with subjects presenting a significant clinical improvement after a 3 week-rTMS or sham treatment to evaluate the response maintenance.

Inclusion criteria

• presence of the criteria from the American College of Rheumatology (2010)for fibromyalgia diagnosis,
• painful state for more than six months,
• visual analogic scale evaluation > or = 5,
• age between 18 and 70,
• no modification in therapeutic treatment one month before and during the protocol
• presence of actual or prior antalgic chronic treatment : pregabalin, duloxetine, milnacipran, gabapentin, venlafaxine, laroxyl, grade 1 or 2 antalgic
• residence in Limoges or the periphery, or the ability to come to the hospital for the treatment

Exclusion criteria

• presence of non stabilized psychiatric comorbidity (personality trouble, addiction, suicide attempt, non controlled affective trouble),
• active epilepsy,
• previous cerebral traumatism, or cerebral surgery, intra-cranial hyper tension,
• pacemaker, metallic pieces in the brain, cochlear ocular implant, or any metallic material contra indicating magnetic resonance imaging.
• clozapine, bupropion, methadon, theophyllin, or other non chemical antalgic technic established during the previous month(kinesitherapy, relaxation, hypnosis...),
• pregnancy, or administrative and judiciary protection, absence of health insurance.