Quantitative Data for Transcutaneous Electrical Nerve Stimulation and Acupuncture Effectiveness in Treatment of Fibromyalgia Syndrome

M Yüksel,S Ayas,M.T Cabioglu,D Yilmaz,C Cabioglu

doi:10.1016/j.jams.2018.08.079

Abstract

Aim. To evaluate the effects of acupuncture and transcutaneous electric nerve stimulation (TENS) applications on the quantitative electroencephalography (qEEG) changes and to evaluate their therapeutic effects in patients with fibromyalgia syndrome (FMS). The study included 42 patients with FMS and 21 healthy volunteers. The patients were randomly assigned to two groups (n=21 in each) to undergo either TENS or acupuncture application. In both acupuncture and TENS groups, baseline electroencephalography (EEG) recording was performed for 10 min and, then, TENS or acupuncture was performed for 20 min, followed by another 10 min EEG recording. Baseline qEEG findings of FMS patients in the TENS and acupuncture groups were similar. Delta and theta powers over the frontal region of FMS patients were lower than controls. Theta powers of right posterior region were also lower than controls. In the TENS group, after the treatment, an increase was observed in the alpha power of the left anterior region as well as a decrease in pain scores. In the acupuncture group, an increase was determined in the alpha power of the right and left posterior regions as well as a decrease in pain score after the treatment. The power of low- and moderate-frequency waves on resting EEG was decreased in the patients with FMS. Decreased pain and increased inhibitor activity were found on qEEG after TENS and acupuncture applications. In conclusion, both TENS and acupuncture applications seem to be beneficial in FMS patients.

Highlights

Fibromyalgia syndrome (FMS) is a complex chronic pain syndrome accompanied by widespread pain with the presence of tender points, fatigue, sleep disorder, and cognitive disorders
The mean total Pressure pain threshold (PPT) score was significantly lower in the transcutaneous electric nerve stimulation (TENS) group compared to the acupuncture group (80.47±13.36 versus 90.61±12.98, resp.; p
These findings are consistent with previous results obtained by Hargrove et al [16], indicating that FMS patients had a decrease in the absolute power of low-medium-frequency waves, in the frontal region, whereas there was an increase in the relative power of high-frequency waves in the frontal/central regions

Summary

Introduction

Fibromyalgia syndrome (FMS) is a complex chronic pain syndrome accompanied by widespread pain with the presence of tender points, fatigue, sleep disorder, and cognitive disorders. The theories on the pathophysiology of FMS have initially underlined the pathologies of muscular origin, the origin of pain has recently turned toward processing disorders [1]. It has been demonstrated that chronic painful stimuli in FMS patients lead to neuroplasticity and dysfunction in pain pathways in the central nervous system and that the brain gives different responses to pain [2]. Increased sensitivity to visual and auditory stimuli in addition to the presence of pain supports the fact that the underlying problem is pain and/or sensorial. There is a study using functional magnetic resonance imaging in FMS patients which appears to support exaggerated central pain response [3]

Objectives

Methods

Results

Conclusion