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Cardiac-Gated Neuromodulation Increased Baroreflex Sensitivity and Reduced Pain Sensitivity in Female Fibromyalgia
Kati Thieme1, Kathrin Jung1, Marc G Mathys1
1Department of Medical Psychology, Philipps-University Marburg, 35037 Marburg, Germany.
Journal of Clinical Medicine
|October 27, 2022
Summary
This study shows that cardiac-synchronized electrical stimulation can improve baroreflex sensitivity (BRS) and reduce pain in fibromyalgia patients. This novel approach may offer a new way to manage chronic pain by targeting intrinsic pain regulatory systems.
Area of Science:
- Neuroscience
- Pain Management
- Cardiovascular Physiology
Background:
- Chronic pain, particularly fibromyalgia (FM), is linked to dysfunctional dorsal medial nucleus tractus solitarii (dmNTS) reflex arcs.
- This dysfunction leads to diminished baroreflex sensitivity (BRS), potentially due to a conditioned response affecting pain perception.
Purpose of the Study:
- To investigate if cardiac-synchronized electrical stimuli can reset BRS and reestablish pain inhibition in fibromyalgia patients.
- To test a novel neuromodulation approach for programming pain inhibition.
Main Methods:
- 32 fibromyalgia (FM) patients and 30 healthy controls (NC) received cardiac-gated peripheral electrical stimuli (experimental protocol and two control conditions).
- Measurements included baroreflex sensitivity (BRS), heart-rate variability (HRV), pain threshold, pain tolerance, and clinical pain intensity.
- Stimuli were non-painful and painful electrical stimuli synchronized to the cardiac cycle.
Main Results:
- Fibromyalgia patients showed a 41% increase in BRS during the experimental protocol.
- Pain thresholds and HRV significantly increased in FM patients during stimulation (P < 0.001).
- Clinical pain intensity in FM patients decreased by 35.52% during the experimental protocol compared to controls (P < 0.001).
Conclusions:
- Cardiac-gated electrical stimulation effectively improved BRS and reduced pain in fibromyalgia patients.
- Baroreceptor training, through BRS-mediated effects, may be a viable strategy for managing FM pain by influencing pain regulatory and autonomic systems.
