Adding Anodal Transcranial Direct Current Stimulation to Mindfulness Meditation Abolishes Mindfulness-Induced Improvements in Emotion Regulation in Fibromyalgia: A Responder Analysis.
Perianen Ramasawmy, Andrea Antal, Olga L Gamboa Arana, Frank Petzke, Anne Kästner
Clinical Journal of Pain November 1, 2025 DOI: 10.1097/ajp.0000000000001319 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 40 |
| Population | Patients with fibromyalgia |
| Interventions | Mindfulness-based intervention anodal tDCS of the primary motor cortex sham tDCS |
| Duration | 4-week MBI, 10 days of combined intervention, 12-week follow-up |
| Topics | Meditation |
| Keywords | Emotion regulation Fibromyalgia Neuromodulation Responder analysis |
| Key findings | Mindfulness practice improved emotion regulation in fibromyalgia, but adding anodal tDCS of the primary motor cortex abolished this effect. |
Abstract
Mindfulness-based interventions (MBIs) appear to improve emotion regulation (ER) in disorders involving emotional dysregulation like fibromyalgia (FM). Despite the therapeutic potential of transcranial direct current stimulation (tDCS) in FM, its concurrent application with mindfulness meditation (MM) has not yet been explored. Potential synergistic effects may arise from aligning neural mechanisms underlying both interventions. This study evaluated the impact of a 4-week MBI and a combined tDCS and MM intervention on ER, implementing a responder analysis approach for FM patients. Following the MBI, 40 participants with FM were randomly allocated to receive 10 days of 20 minutes MM combined with either anodal tDCS of the primary motor cortex (M1) or sham tDCS. ER was gauged using a composite score integrating 4 self-report questionnaires. We performed assessment at 6 time points (baseline, post-MBI, immediately postcombined intervention, 4 wk, 8 wk, and 12-wk follow-ups). Clinical responders were defined as patients exhibiting a clinically relevant reduction in FM symptom load. Responders to the MBI showed better ER than nonresponders, lasting for 6 weeks. Interestingly, responders to the combined intervention in the sham group reported larger improvements in ER than nonresponders, which was not observed in the anodal tDCS group. No significant interaction between responder status and time was found for responders to either intervention. Our findings evidence that mindfulness practice is able to improve ER in FM. However, the add-on combination of MM with M1-tDCS abolishes this mindfulness-induced effect. Therefore, based on our data, combining MM and M1-tDCS must be reconsidered as a therapeutic intervention targeting ER in FM.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cites 31
- Using Self-Report Assessment Methods to Explore Facets of Mindfulness Assessment January 27, 2006
- The Mindful Brain and Emotion Regulation in Mood Disorders The Canadian Journal of Psychiatry February 1, 2012
- Mindfulness Meditation Training and Executive Control Network Resting State Functional Connectivity: A Randomized Controlled Trial Psychosomatic Medicine March 22, 2017
- Testing the mindfulness-to-meaning theory: Evidence for mindful positive emotion regulation from a reanalysis of longitudinal data. PLoS One December 6, 2017
- Individual participant data systematic review and meta-analysis of randomised controlled trials assessing adult mindfulness-based programmes for mental health promotion in non-clinical settings. Nature Mental Health July 10, 2023
and 26 more in the library