title: Hyperbaric oxygen therapy can diminish fibromyalgia syndrome--prospective clinical trial.
abstract: BACKGROUND
  Fibromyalgia Syndrome (FMS) is a persistent and debilitating disorder estimated to impair the quality of life of 2-4% of the population, with 9:1 female-to-male incidence ratio. FMS is an important representative example of central nervous system sensitization and is associated with abnormal brain activity. Key symptoms include chronic widespread pain, allodynia and diffuse tenderness, along with fatigue and sleep disturbance. The syndrome is still elusive and refractory. The goal of this study was to evaluate the effect of hyperbaric oxygen therapy (HBOT) on symptoms and brain activity in FMS.
  
  
  RESULTS
  A prospective, active control, crossover clinical trial. Patients were randomly assigned to treated and crossover groups: The treated group patients were evaluated at baseline and after HBOT. Patients in the crossover-control group were evaluated three times: baseline, after a control period of no treatment, and after HBOT. Evaluations consisted of physical examination, including tender point count and pain threshold, extensive evaluation of quality of life, and single photon emission computed tomography (SPECT) imaging for evaluation of brain activity. The HBOT protocol comprised 40 sessions, 5 days/week, 90 minutes, 100% oxygen at 2ATA. Sixty female patients were included, aged 21-67 years and diagnosed with FMS at least 2 years earlier. HBOT in both groups led to significant amelioration of all FMS symptoms, with significant improvement in life quality. Analysis of SPECT imaging revealed rectification of the abnormal brain activity: decrease of the hyperactivity mainly in the posterior region and elevation of the reduced activity mainly in frontal areas. No improvement in any of the parameters was observed following the control period.
  
  
  CONCLUSIONS
  The study provides evidence that HBOT can improve the symptoms and life quality of FMS patients. Moreover, it shows that HBOT can induce neuroplasticity and significantly rectify abnormal brain activity in pain related areas of FMS patients.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT01827683.
authors.affiliation: Research and Development Unit, Assaf Harofeh Medical Center, Zerifin, Israel; The Institute of Hyperbaric Medicine, Assaf Harofeh Medical Center, Zerifin, Israel; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Shai
authors.initials: S
authors.lastname: Efrati
authors.affiliation: Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Nuclear Medicine institute, Assaf Harofeh Medical Center, Zerifin, Israel.
authors.forename: Haim
authors.initials: H
authors.lastname: Golan
authors.affiliation: The Institute of Hyperbaric Medicine, Assaf Harofeh Medical Center, Zerifin, Israel.
authors.forename: Yair
authors.initials: Y
authors.lastname: Bechor
authors.affiliation: School of Social Work, Ashkelon Academic College, Ashkelon, Israel.
authors.forename: Yifat
authors.initials: Y
authors.lastname: Faran
authors.affiliation: School of Social Work, Ashkelon Academic College, Ashkelon, Israel; Social Work Department, Kaplan Medical Center, Rehovot, Israel.
authors.forename: Shir
authors.initials: S
authors.lastname: Daphna-Tekoah
authors.affiliation: School of Physics and Astronomy, The Raymond and Beverly Sackler Faculty of Exact Sciences, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Gal
authors.initials: G
authors.lastname: Sekler
authors.affiliation: The Institute of Hyperbaric Medicine, Assaf Harofeh Medical Center, Zerifin, Israel; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Gregori
authors.initials: G
authors.lastname: Fishlev
authors.affiliation: Institute of Rheumatology, Tel Aviv Sourasky medical center Israel, Tel- Aviv, Israel; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Jacob N
authors.initials: JN
authors.lastname: Ablin
authors.affiliation: The Institute of Hyperbaric Medicine, Assaf Harofeh Medical Center, Zerifin, Israel; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Jacob
authors.initials: J
authors.lastname: Bergan
authors.affiliation: Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Nuclear Medicine institute, Assaf Harofeh Medical Center, Zerifin, Israel.
authors.forename: Olga
authors.initials: O
authors.lastname: Volkov
authors.affiliation: The Institute of Hyperbaric Medicine, Assaf Harofeh Medical Center, Zerifin, Israel; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Mony
authors.initials: M
authors.lastname: Friedman
authors.affiliation: Research and Development Unit, Assaf Harofeh Medical Center, Zerifin, Israel; Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel; School of Physics and Astronomy, The Raymond and Beverly Sackler Faculty of Exact Sciences, Tel-Aviv University, Tel-Aviv, Israel; Center for Theoretical Biological Physics, Rice University, Houston, Texas, United States of America.
authors.forename: Eshel
authors.initials: E
authors.lastname: Ben-Jacob
authors.affiliation: Department of Medicine H, Soroka Medical Center, BGU University of the Negev, Beer Sheva, Israel.
authors.forename: Dan
authors.initials: D
authors.lastname: Buskila
mesh_terms: D001921:Brain / Q000187:drug effects; D018592:Cross-Over Studies; D005356:Fibromyalgia / Q000628:therapy*; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000379:methods; D008875:Middle Aged; D010100:Oxygen / Q000627:therapeutic use*; D011446:Prospective Studies; D011788:Quality of Life; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods
chemical_list: D010100:Oxygen