title: A multidisciplinary approach to study the effects of balneotherapy and mud-bath therapy treatments on fibromyalgia.
abstract: OBJECTIVE
  To study the effects of both balneotherapy and mud-bath therapy treatments in patients affected by primary fibromyalgia (FM) using rheumatological, psychiatric, biochemical and proteomic approaches.
  
  
  METHODS
  Forty-one FM patients (39 females, 2 males), who fulfilled the American College of Rheumatology criteria received a 2-week thermal therapy programme consisting of therapy once daily for 6 days/week. Twenty-one patients received mud-bath treatment, while the other twenty balneotherapy. Pain, symptoms, and quality of life were assessed. Oxytocin, brain-derived neurotrophic factor (BDNF), ATP and serotonin transporter levels during therapy were assayed. Comparative whole saliva (WS) proteomic analysis was performed using a combination of two-dimensional electrophoresis (2DE) and mass spectrometry techniques.
  
  
  RESULTS
  We observed a reduction in pain, FIQ values and improvement of SF36 in both groups of patients treated with mud-bath or balneotherapy. The improvement of the outcome measures occurred with different timing and duration in the two spa treatments. A significant decrease in BDNF concentrations was observed either after balneotherapy or mud-bath therapy when assayed after twelve weeks, while no significant change in oxytocin levels, ATP levels and serotonin transporter were detected. Significant differences were observed for phosphoglycerate mutase1 (PGAM1) and zinc alpha-2-glycoprotein 1 (AZGP1) protein expression.
  
  
  CONCLUSIONS
  Our results showed that the thermal treatment might have a beneficial effect on the specific symptoms of the disease. In particular, while balneotherapy gives results that in most patients occur after the end of the treatment but which are no longer noticeable after 3 months, the mud-bath treatment gives longer lasting results.
authors.affiliation: Department of Clinical and Experimental Medicine, Rheumatology Division, University of Pisa, Italy. l.bazzichi@gmail.com.
authors.forename: Laura
authors.initials: L
authors.lastname: Bazzichi
authors.forename: Ylenia
authors.initials: Y
authors.lastname: Da Valle
authors.forename: Alessandra
authors.initials: A
authors.lastname: Rossi
authors.forename: Camillo
authors.initials: C
authors.lastname: Giacomelli
authors.forename: Francesca
authors.initials: F
authors.lastname: Sernissi
authors.forename: Gino
authors.initials: G
authors.lastname: Giannaccini
authors.forename: Laura
authors.initials: L
authors.lastname: Betti
authors.forename: Federica
authors.initials: F
authors.lastname: Ciregia
authors.forename: Laura
authors.initials: L
authors.lastname: Giusti
authors.forename: Pietro
authors.initials: P
authors.lastname: Scarpellini
authors.forename: Liliana
authors.initials: L
authors.lastname: Dell'Osso
authors.forename: Donatella
authors.initials: D
authors.lastname: Marazziti
authors.forename: Stefano
authors.initials: S
authors.lastname: Bombardieri
authors.forename: Antonio
authors.initials: A
authors.lastname: Lucacchini
mesh_terms: D000255:Adenosine Triphosphate / Q000097:blood; D054392:Adipokines; D000328:Adult; D000368:Aged; D001494:Baths; D015415:Biomarkers / Q000097:blood; D019208:Brain-Derived Neurotrophic Factor / Q000097:blood; D002352:Carrier Proteins / Q000378:metabolism; D059350:Chronic Pain / Q000628:therapy; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005356:Fibromyalgia / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D006023:Glycoproteins / Q000378:metabolism; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D008900:Mineral Waters / Q000627:therapeutic use*; D009094:Mud Therapy; D010121:Oxytocin / Q000097:blood; D010147:Pain Measurement; D010736:Phosphoglycerate Mutase / Q000378:metabolism; D040901:Proteomics / Q000379:methods; D011788:Quality of Life; D012463:Saliva / Q000378:metabolism; D050486:Serotonin Plasma Membrane Transport Proteins / Q000097:blood; D011795:Surveys and Questionnaires; D013997:Time Factors; D014153:Transaldolase / Q000378:metabolism; D016896:Treatment Outcome; D055815:Young Adult; D000090203:Zn-Alpha-2-Glycoprotein
chemical_list: D000255:Adenosine Triphosphate; D054392:Adipokines; D015415:Biomarkers; D019208:Brain-Derived Neurotrophic Factor; D002352:Carrier Proteins; D006023:Glycoproteins; D008900:Mineral Waters; D010121:Oxytocin; D010736:Phosphoglycerate Mutase; D050486:Serotonin Plasma Membrane Transport Proteins; D014153:Transaldolase; C488891:AZGP1 protein, human; D000090203:Zn-Alpha-2-Glycoprotein; C493230:SLC6A4 protein, human; C579455:BDNF protein, human