Unravelling the Epigenetic Mechanisms of Exercise-induced Pain in Chronic Widespread Pain: DNA Methylation Regulation of the Brain-derived Neurotrophic Factor Expression and Its Modulation by Transcranial Direct Current Stimulation
Many people with chronic widespread pain (CWP) feel more pain and fatigue after exercise. This makes it hard to stay active. Unfortunately, the investigators do not fully understand why this happens and how to prevent it. The primary goal of this study is to explore the underlying genetic and epigenetic mechanisms of BDNF gene in response to exercise, and investigate if transcranial direct current stimulation (tDCS) during exercise works to improve worsening symptoms response to exercise in people with CWP. The investigators designed a randomized crossover study and will enroll 60 patients with CWP and 60 healthy controls. Participants will undergo 2 interventions in random order: 1) exercise + active tDCS, and 2) exercise + sham tDCS. Participants will visit the hospital twice with at least one week in between the visits.
⁃ Patients
⁃ Participants in the patient group must meet all of the following criteria:
• Diagnosis of chronic widespread pain (CWP) or fibromyalgia;
• Age between 18 and 70 years old;
• Body mass index (BMI) ≤ 35;
• Widespread Pain Index (WPI) assessment: the WPI questionnaire (0-19 points) will be used to record the number and distribution of painful body sites. Participants will be classified as having CWP if pain is reported on both sides of the body, above and below the waist, and in the axial skeleton, with pain symptoms lasting ≥ 3 months;
• Stable medication use for at least 1 month prior to study entry.
⁃ Healthy control group
⁃ Participants in the healthy control group must meet all of the following criteria:
• Age between 18 and 70 years old;
• Body mass index (BMI) ≤ 35;
• No chronic conditions, such as chronic pain and diabetes.