Single-subject design reveals improved cortisol and heart variability outcomes in a fibromyalgia patient through exercise and tDCS.
Objective. To analyze and describe the effects of physical exercise combined with transcranial direct current stimulation (tDCS), applied over the left dorsolateral prefrontal cortex (DLPFC) at an intensity of 2mA, on serotonin levels, salivary cortisol, and clinical characteristics of a participant with fibromyalgia. Method. A single-subject design was conducted with an "A-B-C" protocol divided into six weeks. Protocol "A" consisted of two weeks of aerobic exercise for 30 minutes; protocol "B" included two weeks of aerobic exercise for 30 minutes combined with active tDCS during the first 20 minutes; and protocol "C" consisted of two weeks of aerobic exercise for 30 minutes combined with sham tDCS. The participant was assessed at the beginning and end of each protocol using the COMPASS 21 scale, heart rate variability, and salivary cortisol levels. Results. Protocol B showed better outcomes in autonomic nervous system modulation and salivary cortisol levels. Conclusion. The physical exercise protocol resulted in clinical differences in cortisol levels and autonomic nervous system modulation.
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Vasques et al. (2025) studied this question.
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