Fibromyalgia Pain and Depression: An Update on the Role of Repetitive Transcranial Magnetic Stimulation.

Fibromyalgia is a musculoskeletal pain of different parts of the body, which is also associated with fatigue, lack of sleep, cognition deficits, family history, gender bias, and other disorders such as osteoarthritis and rheumatoid arthritis. It is generally initiated after trauma, surgery, infection, or stress. Fibromyalgia often coexists with several other conditions or disorders such as temporomandibular joint disorders, bowel and bladder syndrome, anxiety, depression, headaches, and interstitial cystitis. While there is no permanent cure for fibromyalgia, some interventions are available with multiple side effects. rTMS (repetitive transcranial magnetic stimulation), a noninvasive management strategy is used widely for various pain-related etiologies including fibromyalgia in both the laboratory and clinical settings. In this Review, we discuss the role and mechanism of action of rTMS in fibromyalgia patients and on associated comorbidities including anxiety, pain, depression, neurotransmitter alterations, sleep disorders, and overall quality of life of the patients suffering from this chronic problem. We also provide an update on the rTMS application in the clinical trials of fibromyalgia patients and prospective management therapy for multiple problems that these patients suffer.

Reduced parasympathetic tone in newly diagnosed essential hypertension.

AIM: The aim of the study was to compare heart rate variability (HRV) of newly diagnosed essential hypertensive subjects with controls. METHODS: The study was conducted on 120 hypertensive subjects and 120 controls. RESULTS: The time-domain measures, standard deviation of all RR intervals (SDNN), the square root of the mean of the sum of the squares of differences between adjacent RR intervals (RMSSD), and percentage of consecutive RR intervals that differ by more than 50ms (pNN50) which reflect parasympathetic activity were significantly less in hypertensive subjects. In frequency-domain measures, high frequency [HF (ms(2))] and [HF (nu)], which reflects parasympathetic activity, was significantly less in hypertensive subjects while LF (nu) and LF/HF (%), which reflect sympathetic activity, were comparable between the groups. CONCLUSION: These findings suggest that HRV is reduced in subjects with newly diagnosed essential hypertension and the parasympathetic dysregulation is present in the early stage of essential hypertension.