Hyperbaric oxygen therapy improves outcomes in adults with fibromyalgia after TBI

Key takeaways:

• Significant improvements were noted in pain measures, quality of life and social and emotional function.
• Brain imaging also showed increased activity in frontal and parietal regions.

Hyperbaric oxygen therapy improved pain symptoms, quality of life and social and emotional function in adults with fibromyalgia after traumatic brain injury compared with pharmacologic intervention, according to research in PLOS One.

“Current treatment for [fibromyalgia syndrome] relies on multidisciplinary interventions, with only a modest role for pharmacological agents,” Jacob N. Ablin, MD, professor and director of internal medicine at Tel Aviv Sourasky Medical Center, and colleagues wrote. “Notably, even with optimal implementation of such methods, which are not universally accessible, success rates remain modest, and [fibromyalgia syndrome] continues to constitute an unmet need.”

To investigate the use of hyperbaric oxygen therapy (HBOT) for TBI-related fibromyalgia, researchers conducted a prospective, randomized controlled trial at Shamir Medical Center in Israel and included 64 adults with fibromyalgia syndrome and a history of TBI.

Participants were randomized to receive either 60 daily sessions, five times per week, of HBOT, which included breathing 100% oxygen by mask at 2 absolute atmospheres for 90 minutes, or pharmacological intervention (pregabalin 75 mg/day at bedtime or duloxetine 30 mg/day in the morning) for 3 months.

The primary outcome of interest was subjective pain intensity on the visual analogue scale, and secondary endpoints included results from questionnaires on quality of life and fibromyalgia- and psychological-related symptoms, assessments of pain threshold and conditioned pain modulation, and Tc-99m-ECD SPECT brain imaging.

Researchers reported a significant group-by-time interaction in pain intensity in the HBOT group (n = 29) compared with the medication group (n = 29), with a large net effect size (d = –0.95) in pain intensity reduction after HBOT compared with medication.

Significant improvements also were noted in fibromyalgia-related symptoms, quality of life, psychological symptoms and pain tolerance as a result of HBOT.

In addition, of the 17 HBOT and 25 medication group participants who completed all SPECT evaluations, there was significant group-by-time interactions between HBOT and medication groups, specifically in the left frontal and the right temporal cortex.

“We found that HBOT induced significant improvements in all [fibromyalgia syndrome] pain measures, quality of life, emotional and social function,” Ablin and colleagues wrote.