By: Dr Alex Robber
Fibromyalgia is a chronic disorder
Fibromyalgia is a chronic disorder which causes long-term pain and tenderness throughout the body in the joints, muscles and tendons as well as severe fatigue. According to the National Institute for Arthritis and Musculoskeletal and Skin Diseases (NIAMSD), people with fibromyalgia may also experience a variety of other symptoms including sleep disturbances, irritable bowel syndrome, restless leg syndrome, numbness or tingling in the arms and legs, and depression.
Fibromyalgia is a condition that is poorly understood and possibly includes sensory hypersensitivity to the central nervous system. There are several disease-related genetic, neuroendocrine and environmental anomalies and recent research findings suggest improved sensory perception, and central monoamine and cytokine expression defects in fibromyalgia patients.
Given traditional therapies with antidepressants, anticonvulsants, low-impact aerobic exercise and psychotherapy the morbidity and financial costs associated with fibromyalgia are very high. Non-invasive methods of brain stimulation such as transcranial direct current stimulation, transcranial magnetic stimulation, and electroconvulsive therapy are starting to be investigated as possibilities for fibromyalgia pain treatments. Early studies look promising but need more research.
Potential approaches can include novel combinations of non-invasive brain stimulation, pharmacological augmentation, and behavioral therapies in clinical care.
Transcranial magnetic stimulation
French researchers believe they have been able to enhance some of the patients’ symptoms by using electrical brain stimulation on patients with fibromyalgia. The researchers found in a small study specifically the procedure, called transcranial magnetic stimulation, elevated quality of life and emotional and social well-being among patients suffering from the disease.
This progress is associated with an increase in brain activity that argues for a physical cause of this condition and for the possibility of changes in brain areas to enhance symptoms, “said lead researcher Dr. Eric Guedj of Aix-Marseille University and Marseille’s National Center for Scientific Research. “Previous studies in patients with fibromyalgia have indicated that brain region modification is involved in pain and emotion control,” he said.
The goal of this study was to show that these brain areas can be modulated using transcranial magnetic stimulation to correct brain abnormalities and improve symptoms for patients, Guedj said.
How Electrical Brain Stimulation Works for Pain Relief
Fibromyalgia is as terrible as it is mysterious. Doctors and patients alike struggled with the unknowns behind the condition and there are few treatment options. Thankfully, the mystery that frustrates so many has also contributed to some groundbreaking research in fibromyalgia: a recent study shows that the pain and discomfort arise in the brain, and these symptoms could be reversed with a new electronic solution called electrical brain stimulation.
Benefits of Electrical Brain Stimulation
Pain relief is the obvious goal but there are more important benefits that could be given to fibromyalgia patients by electrical brain stimulation, such as:
- Decrease in fatigue
- Less depression
- Better emotional states
- Increase in sociability
- Better work performance
- Fewer episodes of anger and anxiety
Cognitive dysfunction in fibromyalgia
Patients with fibromyalgia also have cognitive dysfunction that tends to result from a diminished capacity to sustain the endogenous level of brain activity needed to perform a task. This deficiency may be especially evident when attention demands are increased, indicating that fibromyalgia patients have a reduced capacity to process distracting information.
Thus, the combination of impaired sustained attention and decreased processing speed in this patient population will affect cognitive performance. While these findings were made in several studies, the underlying mechanisms behind the cognitive dysfunctions seen in fibromyalgia were not well described.
The Link between Fibromyalgia and Brain Activity
The findings of a recent French study have reinforced the belief that signs of fibromyalgia may be linked to brain problems. More specifically, a new, non-invasive approach has been discovered in the research that could help patients with fibromyalgia live much more comfortably.
The procedure, called transcranial magnetic stimulation, uses an electrode-fitted cap to send targeted electrical charges to specific brain locations that enhance brain metabolism. The metabolic boost will correct abnormalities in the brain’s pain and emotion centers, and in turn reduce painful symptoms.
Such results are significant not only because fibromyalgia is so hard to treat, but also because it has always been thought of as a neurological condition rather than a physical one. Given that there’s evidence of a physical source, more consideration can be paid to more advanced, focused clinical treatment.
Effect of transcranial magnetic stimulation on dorsolateral prefrontal cortex (DLPFC)
Studies have studied the capacity of the dorsolateral prefrontal cortex (DLPFC) to modulate attention in patients with fibromyalgia via transcranial direct current stimulation (tDCS) The method was effective, likely because the DLPFC influences cognitive-executive control and the modulation of the descending pain system. Adriana Ferreira Silva, a graduate student at Rio Grande do Sul Federal University in Brazil, and colleagues published the results of their DLPFC (tDCS) investigation in patients with fibromyalgia and published the results in Scientific Reports online on March 9.
The investigators tested the effects of a single, standardized (tDCS) dose (1 mA anodal stimulation for 20 minutes) coupled with a go / no – go task in modulating indices of warning, orientation, and executive attention. They randomly assigned 20 patients to the sham-active sequence group, and another 20 to the active-sham sequence group. The researchers used the Attentiveness Network Test to assess attention. Although acknowledging that this uniform dose may not be appropriate for all patients, the team states that a single anodal (tDCS) session over the left DLPFC had a modulative impact on the orientation and executive care networks. Nonetheless, they did not see any impact on alertness.
Supplement for your current therapy
Transcranial magnetic stimulation may be an intelligent complement to your current therapy but may not be a suitable replacement. For one thing, the long-term consequences are not yet understood, and it is difficult to really measure the amount of pain relief it provides. In fact, doctors aren’t sure how often it will be appropriate to undergo the procedure to maintain the positive effects.
- Electrical brain Stimulation for Fibromyalgia By Steven Reinberg via Web Md
- SOURCES: Eric Guedj, M.D., Ph.D., Aix-Marseille University and National Center for Scientific Research, Marseille, France; Alan Manevitz, M.D., clinical psychiatrist, Lenox Hill Hospital, New York City; March 26, 2014, Neurology