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Hyperbaric oxygen therapy compared to pharmacological intervention in fibromyalgia patients following traumatic brain injury: A randomized, controlled trial

Ablin, Jacob N., Lang, Erez, Catalogna, Merav, Aloush, Valerie, Hadanny, Amir, Doenyas-Barak, Keren, Finci, Shachar, Polak, Nir, Fishlev, Gregory, Korin, Calanit, Tzidky, Rachel Yehudit, Meir Genuth, Oshra, Efrati, Shai·2023·PLOS ONE
DOI 10.1371/journal.pone.0282406
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Abstract

Fibromyalgia is a chronic pain syndrome with unsatisfactory response to current treatments. Physical trauma, including traumatic brain Injury (TBI) is among the etiological triggers. Hyperbaric Oxygen therapy (HBOT) is an intervention that combines 100% oxygen with elevated atmospheric pressure. HBOT has been applied as a neuro-modulatory treatment in central nervous system–related conditions. The current study investigated the utility of HBOT for TBI–related fibromyalgia. Fibromyalgia patients with a history of TBI were randomized to either HBOT or pharmacological intervention. HBOT protocol comprised 60 daily sessions, breathing 100% oxygen by mask at 2 absolute atmospheres (ATA) for 90 minutes. Pharmacological treatment included Pregabalin or Duloxetine. The primary outcome was subjective pain intensity on visual analogue scale (VAS); Secondary endpoints included questionnaires assessing fibromyalgia symptoms as well as Tc-99m-ECD SPECT brain imaging. Pain threshold and conditioned pain modulation (CPM) were also assessed. Results demonstrated a significant group-by-time interaction in pain intensity post-HBOT compared to the medication group (p = 0.001), with a large net effect size (d = -0.95) in pain intensity reduction following HBOT compared to medications. Fibromyalgia related symptoms and pain questionnaires demonstrated significant improvements induced by HBOT as well as improvements in quality of life and increase in pain thresholds and CPM. SPECT demonstrated significant group-by-time interactions between HBOT and medication groups in the left frontal and the right temporal cortex. In conclusion, HBOT can improve pain symptoms, quality of life, emotional and social function of patients suffering from FMS triggered by TBI. The beneficial clinical effect is correlated with increased brain activity in frontal and parietal regions, associated with executive function and emotional processing.

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Cited by

Metadata

Authors
Ablin, J. N., Lang, E., Catalogna, M., Aloush, V., Hadanny, A., Doenyas-Barak, K., Finci, S., Polak, N., Fishlev, G., Korin, C., Tzidky, R. Y., Meir Genuth, O., & Efrati, S.
ORCID
Venue
PLOS ONE
Publisher
Public Library of Science (PLoS)
Published
2023-03-10
Volume
18
Issue
3
Pages
e0282406
ISSN
1932-6203
DOI
10.1371/journal.pone.0282406
Cited by
30
References
3
Language
en
Licence
creativecommons.org/licenses/by/4.0/ (vor)
Funders
The study was supported by research grant from Marianne & Doron Livnat

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