Background Fibromyalgia Syndrome (FM) is a persistent and debilitating disorder estimated to impair the quality of life of 2%–4% of the population. FM is an important representative example of central nervous system sensitisation and is associated with abnormal brain activity. The syndrome is still elusive and refractory. Hyperbaric oxygen therapy (HBOT) can rectify abnormal brain function underlying the symptoms of FM patients. Increasing oxygen concentration by HBOT may change the brain metabolism and glial function to rectify the FM-associated brain abnormal activity.1
Objectives To evaluate the effect of HBOT on clinical symptoms in FM resistant to the usual pharmacological treatment
Methods Thirty female patients, aged 21–67 years and diagnosed with FM at least 2 years earlier, and resistant to any pharmacological treatment were assigned to be added on with HBOT. The treated group patients were evaluated at baseline and after 10 and 20 HBOT sessions. Evaluations consisted of physical examination, including tender point count, extensive evaluation of quality of life. Study endpoints included assessments of pain (VAS), the FACIT Fatigue Scale which is a short, 13-item, that measures an individual’s level of fatigue during their usual daily activities over the past week. A validated Italian version of the Fibromyalgia Impact Questionnaire (FIQ-R) was used to evaluate the level of functional impairment as weel as the FAS index which is a short and easy to complete self-administered index combining a set of questions relating to non-articular pain, fatigue and the quality of sleep that provides a single composite measure of disease activity ranging from 0 to 10. The HBOT protocol comprised 20 sessions, 3 days/week, 90 min, 100% oxygen at 2.5 ATA.
Results The effect of the hyperbaric oxygen treatment on the clinical symptoms are summarised in table 1. HBOT treatments of treated group led to statistically significant improvements in the mean scores of pain and fatigue (FACIT) after 10 and 20 HBOT sessions (mean change of pain after 20 sessions −1.76±2.5, p<0.001) (mean change of fatigue after 20 sessions 5.93±2.10, p<0.001)The FIQ-R score significantly improved following HBOT in the treated group (mean change after 20 sessions −12.89±17.04, p=0.001). The FAS score showed a positive trend after 10 sessions and a significant improvement after 20 sessions (mean change −2.02±3.14, p=0.006).
Conclusions These preliminary data show that HBOT may determine a significant clinical improvement in patients affected by FM and resistant to the common pharmacological treatment. However, further studies of large numbers of patients are required in order to confirm this preliminary finding and modify treatment strategies accordingly.
Reference  Barilaro G, et al. Isr Med Assoc J. 2017;19:429–34.
Disclosure of Interest None declared
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