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Dual Treatment in CSA Survivors with Fibromyalgia - Yair Bechor

Brain Body and Mind: Dual Treatment in CSA Survivors who Suffer from Fibromyalgia.  Fibromyalgia Syndrome (FMS) is a persistent debilitating disorder estimated to impair the quality of life of 2–4% of the population.

FMS is an important representative example of central nervous system sensitization, associated with abnormal brain activity, that can be triggered by traumatic brain injury (TBI), nervous system infections (EBV, CMV) and severe persistence emotional stress. The goal of this study was to evaluate the effect of hyperbaric oxygen therapy (HBOT) on symptoms and brain activity in women suffering from FM triggered by childhood sexual abuse (CSA).

Methods: The study included 30 females CSA survivors suffering from FMS, age 26-68 years. Patients were divided into 2 groups: treatment and control. The control group were treated according to the recurrent recommendation for FMS and the control group had 60 sessions of HBOT, 5 days per week, 100% oxygen at 2 ATA, 90 min each with 5 min air breaks every 20 min. All patients had clinical evaluation covering their FMS symptoms, quality of life and functional questioners, brain imaging (brain SPECT, perfusion MRI + DTI) and psychological testing. All tests were performed at baseline and after 3 months of HBOT or control.

Results: HBOT induced significant improvement in clinical evaluated parameters as compared to the control. A significant improvement in tender points evaluation from 11.6±4.8 to 7.9±5.4 (p=0.0002) in the HBOT group, while the control had non-significant change from 11.3±3.9 to 11.5±4.7 (p=0.57).  The Physical Function Assessment was significantly improved from 64.2±32.9 to 34.3±21.0 in the HBOT group and got non-significant worsening from 74.8±12.2 to 77.2±14.4 in the control (p=0.29). Quality of Life questionnaires was also improved from 38.3±23.1 to 58.7±25.7 in the HBOT group (p=0.0001) and had non-significant worsening in the control from 44.4±17.6 to 37.2±18.4 in the control (P=0.009). With regards to brain imaging the metabolism in Brodman areas 37L, 45L, 8L was increased and in Brodman area 25R, 23L, 38L 28R it was reduce.

Conclusions: HBOT can induce neuroplasticity, relive pain, FMS related symptoms and improve quality of life of fibromyalgia patients in whom the syndrome was triggered by CSA. The metabolic brain imaging indicates that CSA related FMS represent a unique group that is different from other types of fibromyalgia and should probably referred differently.

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