title: C2 area neurostimulation: a surgical treatment for fibromyalgia.
abstract: BACKGROUND
  Fibromyalgia (FM), a disorder characterized by diffuse pain, fatigue, and a variety of other symptoms, is thought to derive from dysfunction of the central nervous system. Neuromodulation is a technique to treat pain from a variety of causes, including disorders of the central nervous system (CNS). Occipital nerve stimulation is a neuromodulation technique currently under study to treat various migraine headache disorders. This study examines a technique of neurostimulation that appears to affect the pain and symptoms of FM.
  
  
  OBJECTIVE
  To evaluate the effect of a new technique of peripheral neurostimulation of the C2 scalp area on pain, fatigue, depression, and quality of life in FM patients.
  
  
  METHODS
  In total, 12 patients (nine females and three males; mean age 48 years) who met criteria for FM, and with comorbid headache disorder, were trialed and implanted with this C2 area stimulation technique. Outcome was prospectively studied with standard evaluation tools at baseline, 3 and 6 months post implant.
  
  
  RESULTS
  Visual Analog Scale (VAS) pain levels for FM-related pain decreased significantly at 6 months, and pain-drawing total area and number of areas colored in also decreased dramatically. Chronic fatigue and depression as assessed by the Beck Depression Inventory and Fatigue Impact Scale were markedly improved. Overall quality of life as assessed by the Health Survey Short Form 36 (SF-36) was markedly improved. There were no infectious or technical complications.
  
  
  CONCLUSIONS
  C2 area scalp stimulation may diminish pain and related symptoms in patients with FM.
authors.affiliation: Pain Management Division, Department of Anesthesiology, Griffin Hospital, Derby, Connecticut 06418, USA. mthimineur@aol.com
authors.forename: Mark
authors.initials: M
authors.lastname: Thimineur
authors.forename: Dirk
authors.initials: D
authors.lastname: De Ridder
mesh_terms: D000328:Adult; D000339:Affect; D003391:Cranial Nerves / Q000502:physiology*; D003863:Depression / Q000209:etiology / Q000523:psychology; D004599:Electric Stimulation Therapy; D004567:Electrodes, Implanted; D005221:Fatigue / Q000209:etiology; D005260:Female; D005356:Fibromyalgia / Q000150:complications / Q000523:psychology / Q000628:therapy*; D006261:Headache / Q000209:etiology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012535:Scalp; D016896:Treatment Outcome