Theta-band EEG changes following sequential rTMS and tACS in fibromyalgia: A randomized controlled pilot study

Sequential left primary motor cortex 10-Hz rTMS followed by 10 daily bilateral 10-Hz tACS increased resting-state theta power in 10 adults with fibromyalgia (Time×Group F(1,8)=8.70, p=.018).

• Why it matters: Resting-state EEG effects of combining rTMS and tACS in fibromyalgia are unknown, limiting understanding of how sensorimotor and pain-related networks may change after sequential stimulation.
• What they did: In an exploratory randomized controlled pilot, 5 received active stimulation (1,000 rTMS pulses/session, then 1 mA, 20 min daily tACS) and 5 had no-stimulation control; 6-minute eyes-closed EEG was recorded pre/post and analyzed for delta, theta, alpha, beta power.
• The result: Theta power rose significantly in the active group but not controls, with increased theta in central-centroparietal (p=.004) and posterior (p=.012) regions, while delta, alpha, and beta showed no significant interaction effects.