Table 1.
Characteristics of included studies
| Study | Type of study | Sample size | Fibromyalgia description | Age (mean ± SD or range) | Gender | Pain intensity (mean ± SD) | Pain tool/scale | Depression score | Anxiety score | Pain catastrophizing score | Type of control/ intervention comparison |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Beement (2014) | RCT/cross-over | 15 | Diagnosed by a Rheumatologist | 53.7 ± 9.9 | 15 F | 47.8 ± 18.8 | Fibromyalgia Impact Questionnaire | N/A | N/A | N/A | Quiet rest |
| Deitos (2018) | Cross-over | 27 | According to the 2010 American College of Rheumatology criteria | FM: 50.5 ± 8.7 HC: 43.7 ± 9.4 |
27 F | 7.1 ± 1.8 – last 24 h 7.9 ± 1.9 – last 7 d |
VAS | Beck Depression Inventory II | State and trait anxiety | Brazilian Portuguese Catastrophi-zing Scale | Healthy subjects |
| Mahla (2011) | RCT | 40 | According to the 2010 American College of Rheumatology criteria | Active rTMS: 51.8 ± 11.6 Sham rTMS: 49.6 ± 10.0 |
40 F | Active rTMS: 6.2 ± 1.4 Sham rTMS: 6.5 ± 1.8 |
Brief pain inventory | 21-item Hospital Anxiety and Depression
Scaleand 13-item short form of the Beck Depression Inventory |
21-item Hospital Anxiety and Depression Scale | Pain Catastrophi-zing Scale | Sham rTMS |
| Mahla (2010) | RCT | 67 | According to the 2010 American College of Rheumatology criteria | 50.8 ± 10.3 | 67 F | Patients being treated with psychotropic drug:
6.2 ± 1.5 Patients without treatment: 5.5 ± 1.3 |
Brief pain inventory | 21-item Hospital Anxiety and Depression Scale
and 13-item short form of the Beck Depression Inventory |
21-item Hospital Anxiety and Depression Scale | Pain Catastrophi-zing Scale | Healthy subjects and treatment with a psychotropic drug |
| Mendonca (2016) | RCT | 45 | Modified criteria from the American College of Rheumatology criteria | 47.4 ± 12.1 | 44 F/1 M | tDCS/AE: 7.3 ± 1.75 AE: 6.8 ± 2.0 tDCS: 7.2 ± 1.27 |
VNS | Beck Depression Inventory | VNS for anxiety | N/A | Sham aerobic exercisend sham tDCS |
| Schwenkreis (2010) | RCT | 62 | According to the 2010 American College of Rheumatology criteria | MD: 41.0 ± 10.4 FM: 48.7 ± 8.4 HC: 37.7 ± 11.5 |
32 F/ 30 M | N/A | N/A | N/A | N/A | N/A | Muscular dystrophy and Healthy control |
| Alventosa (2020) | RCT | 49 | 2016 American College of Rheumatology: generalized pain for at least 3 months and a widespread pain index ⩾ 7 and symptom severity scale ⩾ 5 or a widespread pain index of 4–6 and a symptom severity scale score ⩾ 9] | 53.30 ± 7.86 | 49 F | Physical exercise group (n =
16): 6.13 ± 2.22. Hyperbaric oxigeny therapy (n = 17): 7.35 ± 1.66. Control: 5.63 ± 1.75 |
VAS | N/A | N/A | N/A | Subjects not submitted to the interventions. |
| Carinal (2019) | Cross-sectional | 63 | 2016 American College of Rheumatology: generalized pain for at least 3 mon and a widespread pain index ⩾ 7 and symptom severity scale ⩾ 5 or a widespread pain index of 4–6 and a symptom severity scale score ⩾ 9] | FM: 50.5 ± 8.7 MDD: 45.2 ± 15.9 HC: 43.8 ± 13.0 |
63 F | 6.7 (5.8–8.2) | VAS | Beck Depression Inventory II | State and trait anxiety | Pain Catastrophi-zing Scale | Major depressive
disorder and Healthy controls |
| Caumo (2016) | Cross-sectional | 114 | According to the 2010 American College of Rheumatology criteria | FM: 50.42 ± 8.84 MPS: 46.13 ± 12.10 OA: 64.42 ± 7.81 HS: 32.43 ± 10.81 |
114 F | Last 7 days: FM: 7.94 ± 1.89 MPS: 7.23 ± 2.19 OA: 6.26 ± 2.15 HS: Not availahle Last 24 h: FM: 7.10 ± 1.88 MPS: 6.11 ± 2.59 OA: 5.37 ± 2.47 HS: NA |
VAS | Beck Depression Inventory II | N/A | Pain Catastrophi-zing Scale | Myofascial pain syndrome; Osteoarthritis
and Healthy subjects |
| Clampide (2017) | Cross-sectional | 47 | According to the 2010 American College of Rheumatology criteria. | 54.2 ± 9.9 | 47 F | 22.8 ± 7.2 | VAS | N/A | N/A | N/A | Healthy controls |
| Kaziyama (2020) | Cross-sectional | 43 | According to the 2010 American College of Rheumatology criteria | Symmetrical FM: 49.4 ±
6.2 Asymmetrical FM: 55.0 ± 13.7 |
43 F | Symmetrical FM: 22.7 ±
7.5 Asymmetrical FM: 28.3 ± 3.9 |
BPI VAS | 21-item Hospital Anxiety and Depression Scale | 21-item Hospital Anxiety and Depression Scale | N/A | Symmetrical Fibromyalgia; Asymmetrical fibromyalgia and Health controls |
| Kukseymen (2020) | Cross-sectional | 26 | According to the 2010 American College of Rheumatology criteria | 53 (47 to 58) | 23F/3 M | 5.98 ± 2.01 | VAS | Beck Depression Inventory | VAS for anxiety | N/A | Combined aerobic exercise and tDCS |
| Salerno (2000) | Cross-sectional | 31 | According to the 1990 American College of Rheumatology criteria | FM: 50.07 ± 5.6 RA: 50.04 ± 5.1 |
31 F | N/A | N/A | N/A | N/A | N/A | Healthy controls (age-matched) and Rheumatoid Arthritis |
| Tiwari (2021) | Cross-sectional | 64 | 2016 American College of Rheumatology: generalized pain for at least 3 mons and a widespread pain index) ⩾ 7 and symptom severity scale ⩾ 5 or a widespread pain index of 4–6 and a symptom severity scale score ⩾ 9] | FM: 40.6 ± 8.7; Pain-free controls: 36.5 ± 9.2 |
64 F | N/A | N/A | N/A | N/A | N/A | Pain-free controls |
| Antal (2010) | RCT/cross-over | 23 | Diagnosed by a neurologist at least two years before the start of the study | 28–70 | 6 M/17 F | 7.11±1.2 – Anodal
tDCS; 7.0 ±1.5 – Sham tDCS; 5.8 ±2.2/2.95 ±2.2 – Active and sham tDCS |
VAS | N/A | N/A | N/A | Sham tDCS |
Note: AE: aerobic excercise, BPI: brief pain inventory, F: females, HC: healthy controls, FM: fibromyalgia, M: males, MD: muscular dystrophy, MDD: major depression disorder, MPS: myofascial pain syndrome, N/A: not available or not applied, OA: osteoarthritis, RA: rheumatoid arthritis, RCT: randomized controlled trial, rTMS: repetitive transcranial magnetic stimulation, tDCS: transcranial direct current stimulation, VAS: visual analogue scale, VNS: visual numeric scale, SD: standard deviation.