Category Archives: Neurology

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Fibromyalgia: drug treatment in vain?

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Journal Watch okt 2020
Evidence is insufficient to support most treatments for fibromyalgia, according to a meta-analysis in JAMA Internal Medicine.

Researchers examined data from over 220 randomized trials among nearly 30,000 people with fibromyalgia. High-quality evidence suggested a statistically significant benefit for cognitive behavioral therapy for improving pain in the short term. High-quality evidence also favored antidepressants and central nervous system depressants for improving pain in the medium term, antidepressants for improving quality of life (QOL) in the short term, and antidepressants and central nervous system depressants for improving QOL in the medium term.

However, none of these outcomes met the researchers’ criteria for a clinically important benefit. In addition, high- or moderate-quality evidence did not support any treatment for pain or QOL in the long term.

The researchers conclude, “Clinicians should be aware that current evidence for most of the available therapies for the management of fibromyalgia is limited to small trials of low methodological quality.”

Fibromyalgia, treatment with hyperbaric oxygen

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People with post traumatic brain damage and fibromyalgia who were treated in pressure chamber had much lesser symptoms of muscle pains.A change in brain activity could also be demonstrated.

A possible explanation is that the pressure induces neuroplasticity that repairs deranged function. Quality of life in people who have had stroke has even been seen.

The hypothesis was that the treatment would correct the abnormal brain activity that is seen in fibromyalgia a disease that causes muscle pain in many parts of the body.

Total freedom from symptoms
For two months patients with fibromyalgi got treatment in a pressure chamber and and all patients but three had lesser pain. A change in activity in certain areas of the brain that are connected to pain impulses could also be seen.

“We have seen that where fibromyalgia has been caused by traumatic brain injury a total regress of symptoms was seen that kept after the treatment. If the reason for the fibromyalgi was another for example an infection a follow up treatment is probably necessary said the doctor Shai Efrati chief for Sago, center for hyberbaric medicine and research in Israel and one of the authors of the study in a press release from Rice University in Texas.

48 women with fibromyalgia took part in the prospective clinical study. All got treatment in pressure chamber at 2 athmospheric pressure for 90 minutes 5 days a week for 2 months. For study og brain activity a SPECT was used.

As the study was small the scientists point out that more studies need to be done to verify the results.