More than 90 percent of those diagnosed with the syndrome are women, said Eshel Ben-Jacob, a lead author of the proof-of-concept study who developed the analytical method used to show the association between patients’ improvement and changes in their brains.
He is an adjunct professor of biosciences at Rice University, a senior investigator at Rice’s Center for Theoretical Biological Physics and a professor of physics and member of the Sagol School of Neuroscience at Tel Aviv University. Fibromyalgia is a chronic pain syndrome that can be accompanied by and perhaps is related to other physical and mental conditions that include fatigue, cognitive impairment, irritable bowel syndrome, and sleep disturbance.
Effect of gender on body disorders
“Most people have never heard of fibromyalgia,” he says. “And many who have, including some medical doctors, don’t admit that this is a real disorder. I learned from my MD friends that this is not the only case in which disorders that target mainly women raise skepticism in the medical community as to whether they’re real or not.
However, these days there are increasing efforts to understand the effect of gender on body disorders.” Needless to say, fibromyalgia can severely disrupt daily life, work and relationships, especially since anxiety and depression are close companions of the disorder. To make matters worse, medical science hasn’t been able to offer much in the way of effective treatment, until now.
Hyperbaric oxygen therapy (HBO)
Hyperbaric oxygen therapy (HBO) is a recognized treatment for deep-sea divers experiencing decompression sickness (The Bends); for carbon monoxide poisoning; and for some soft-tissue wounds. The technique involves breathing oxygen via a mask in a pressurised single- or multi-person hyperbaric chamber.
In the UK today, many MS national therapy centres have hyperbaric chambers because of the anecdotal evidence that HBO can help the symptoms of MS. These centres often welcome patients with other diseases too, and many people with ME have taken up this opportunity to try HBO at very reasonable cost.
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Hyperbaric oxygen chambers
Hyperbaric oxygen chambers that expose patients to pure oxygen at higher-than-atmospheric pressures are commonly used to treat patients with embolisms, burns, carbon monoxide poisoning and decompression sickness (known to divers as “the bends”), among many other conditions.
One effect of exposure is to push more oxygen into a patient’s bloodstream, which delivers it to the brain. Efrati’s earlier trials found HBOT induces neuroplasticity that leads to repair of chronically impaired brain functions and improved quality of life for post-stroke and mild traumatic brain injury patients, even years after the initial injury. The women who finished the treatment experienced drastic improvement in their condition.
“The intake of the drugs eased the pain but did not reverse the condition,” said Dr. Efrati. “But hyperbaric oxygen treatments did reverse the condition.” But does HBO really help reduce the symptoms of ME/CFS? In 2006, Action for ME’s Interaction magazine published an overview of members’ experiences of various ‘oxygen therapies’, including HBO. Some found HBO helpful for alleviating certain symptoms, such as brain fog or concentration, but others reported no lasting improvement.
As regards scientific research, there have been only two smallish experimental studies on ME/CFS patients; one reported unspectacular, mostly non-significant results when HBO was given daily for one week (Van hoof 2003), while the other (an uncontrolled trial) reported that HBO given daily for three weeks decreased symptom severity and increased quality of life (Akarsu 2013) . So, there is as yet no convincing evidence (anecdotal or experimental) that HBO can benefit most people with ME/CFS.
Experimental studies
Fibromyalgia is typically treated with a combination of therapies, including drugs, lifestyle changes and cognitive behavioral therapy. The new study included 48 women who had been diagnosed with fibromyalgia at least two years earlier. Half underwent 40 hyperbaric oxygen therapy treatments over two months.
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The treatments were given five times a week. They lasted 90 minutes each session. During the treatment, patients breathed 100 percent oxygen pressurized to twice the normal air pressure. The therapy is thought to increase oxygen flow to body tissues, improving healing.
The brain pathology responsible for the syndrome
“The results are of significant importance,” Dr. Efrati said. “Hyperbaric oxygen treatments are designed to address the actual cause of fibromyalgia the brain pathology responsible for the syndrome. It means that brain repair, including neuronal regeneration, is possible even for chronic, long-lasting pain syndromes, and we can and should aim for that in any future treatment development.”
Follow-up sessions
Some patients will likely require follow-up sessions, Efrati says. “The abnormalities in brain regions responsible for the chronic pain sensation in fibromyalgia patients can be triggered by different events. Accordingly, the longterm response may be different.
Reduction in the number of fibromyalgia ‘tender points’
Overall, HBO led to significant reduction in the number of fibromyalgia ‘tender points’, and in the tenderness of these points. There were also improvements in physical functioning and quality of life. But the most intriguing finding came from SPECT imaging of the brain, which indicated that HBO ‘rectified’ the functioning of certain brain areas believed to be abnormal in fibromyalgia.
Activity in the posterior brain region (which is responsible for pain processing, and may be hyperactive in fibromyalgia) was reduced by HBO. By contrast, activity in the frontal areas of the brain (which are responsible for inhibiting pain and may be hypo-active in fibromyalgia) was increased by HBO. Also, there was intriguing evidence that the ‘normalization’ of brain activity in these areas coincided with improvements in symptoms.
Periodic maintenance therapy
The researchers did find some discrepancies among patients with different fibromyalgia catalysts. When fibromyalgia was triggered by a traumatic brain injury, for example, they witnessed a complete resolution without any need for further treatment. But when the trigger was attributed to other causes, such as fever-related diseases, patients required periodic maintenance therapy.
Also Read: Fibromyalgia Diet: What to eat and what not to eat
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Reference:
- Oxygen Chamber Therapy May Ease Fibromyalgia By Maureen Salamon via Web MD
- Shai Efrati, M.D., director, research and development unit, and director, Sagol Center for Hyperbaric Medicine and Research, Assaf-Harofeh Medical Center, Tel Aviv, Israel; Michelle Dang, M.D., anesthesiologist and pain management specialist, Houston Methodist Hospital, Houston, Texas; June 2015, PLOS ONE
