Augmentation of EMDR with multifocal transcranial current stimulation (MtCS) in the treatment of fibromyalgia: study protocol of a double-blind randomized controlled exploratory and pragmatic trial.

BACKGROUND: Fibromyalgia (FM) is a generalized, widespread chronic pain disorder affecting 2.7% of the general population. In recent years, different studies have observed a strong association between FM and psychological trauma. Therefore, a trauma-focused psychotherapy, such as eye movement desensitization and reprocessing (EMDR), combined with a non-invasive brain stimulation technique, such as multifocal transcranial current stimulation (MtCS), could be an innovative adjunctive treatment option. This double-blind randomized controlled trial (RCT) analyzes if EMDR therapy is effective in the reduction of pain symptoms in FM patients and if its potential is boosted with the addition of MtCS. METHODS: Forty-five patients with FM and a history of traumatic events will be randomly allocated to Waiting List, EMDR + active-MtCS, or EMDR + sham-MtCS. Therapists and patients will be kept blind to MtCS conditions, and raters will be kept blind to both EMDR and MtCS. All patients will be evaluated at baseline, post-treatment, and follow-up at 6 months after post-treatment. Evaluations will assess the following variables: sociodemographic data, pain, psychological trauma, sleep disturbance, anxiety and affective symptoms, and wellbeing. DISCUSSION: This study will provide evidence of whether EMDR therapy is effective in reducing pain symptoms in FM patients, and whether the effect of EMDR can be enhanced by MtCS. TRIAL REGISTRATION: ClinicalTrials.gov NCT04084795 . Registered on 2 August 2019.

Nuevas aproximaciones terapéuticas en el tratamiento de la heminegligencia: la estimulación magnética transcraneal / New therapeutic approaches in the treatment of neglect: transcranial magnetic stimulation

Objetivo. Analizar la eficacia de la estimulación magnética transcraneal (EMT) como estrategia terapéutica en la rehabilitaciónde la heminegligencia. Desarrollo. Los beneficios terapéuticos de la EMT en diferentes trastornos neurológicos, como la epilepsia, la enfermedad de Parkinson, los accidentes cerebrovasculares o las demencias, son cada vez más evidentes. En el caso de la heminegligencia, durante muchos años la investigación clínica ha tratado de desarrollar nuevas y efectivas estrategias de rehabilitación, siendo en la actualidad la EMT repetitiva una herramienta importante en este sentido. Los efectos positivos de lasestrategias terapéuticas basadas en técnicas de estimulación cerebral no invasiva encontrados por diferentes investigadores hacen que sea necesario tener en cuenta la EMT, al menos como intervención terapéutica adyuvante a las estrategias convencionales.Conclusiones. Aunque la evidencia para considerar la EMT como una nueva estrategia terapéutica es aún escasa, dado que las aplicaciones terapéuticas de la EMT constituyen un reciente objeto de estudio, los hallazgos encontrados hastaahora son alentadores. Es necesario un mayor número de investigaciones para conocer con exactitud el potencial de laEMT en la rehabilitación de la heminegligencia, en particular, y de las alteraciones neurológicas, en general (AU)

Aim. To highlight the effectiveness of transcranial magnetic stimulation (TMS) as therapeutic tool in rehabilitation of neglect. Development. The therapeutic benefits of TMS in different neurological disorders, such as epilepsy, Parkinson’s disease,stroke or dementias, are increasingly evident. For many years clinical research has been conducted to develop new andeffective rehabilitation strategies for neglect, being repetitive transcranial stimulation an important tool in this regard.The positive outcomes of treatment of neglect based on noninvasive brain stimulation have been demonstrated by severalresearchers. So, TMS should be, at least, considered as a therapeutic intervention adjuvant to conventional approaches.Conclusions. Although the evidence for considering TMS as a new therapeutic tool is still scarce, as therapeutic applications of TMS are a subject of recent study, the findings so far are encouraging. Further research is essential to know the real TMS potential in the rehabilitation of neglect in particular, and of neurological diseases in general (AU)

Intracranial self-stimulation facilitates a spatial learning and memory task in the Morris water maze.

Learning and memory improvement by post-training intracranial self-stimulation has been observed mostly in implicit tasks, such as active avoidance, which are acquired with multiple trials and originate rigid behavioral responses, in rats. Here we wanted to know whether post-training self-stimulation is also able to facilitate a spatial task which requires a flexible behavioral response in the Morris water maze. Three experiments were run with Wistar rats. In each of them subjects were given at least five acquisition sessions, one daily, consisting of 2-min trials. Starting from a random variable position, rats had to swim in a pool until they located a hidden platform with a cue located on its opposite site. Each daily session was followed by an immediate treatment of intracranial self-stimulation. Control subjects did not receive the self-stimulation treatment but were instead placed in the self-stimulation box for 45 min after each training session. In the three successive experiments, independent groups of rats were given five, three and one trial per session, respectively. Temporal latencies and trajectories to locate the platform were measured for each subject. Three days after the last acquisition session, the animals were placed again in the pool for 60 s but without the platform and the time spent in each quadrant and the swim trajectories were registered for each subject. A strong and consistent improvement of performance was observed in the self-stimulated rats when they were given only one trial per session, i.e. when learning was more difficult. These findings agree with our previous data showing the capacity of post-training self-stimulation to improve memory especially in rats with little training or low conditioning levels, and clearly prove that post-training self-stimulation can also improve spatial learning and memory.