The correlation of laboratory tests and Sympathetic Skin Response parameters by using artificial neural networks in fibromyalgia patients

Fibromyalgia syndrome (FMS) is a chronic musculoskeletal disease which causes dysfunction of the autonomic nervous system. Sympathetic Skin Response (SSR) is a part of electrical impedance of body which is affected by the autonomic nervous system dysfunctions. In this study, values obtained from the results of the patients diagnosed with fibromyalgia syndrome, and healthy subjects blood samples in the laboratory conditions are recorded in Suleyman Demirel University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation. SSR measurements are recorded from patients and healthy controls. Values of latency time, maximum amplitude and elapsed time between two stimulus parameters are obtained from recorded sympathetic skin response data by using Matlab software. The relationship between SSR parameters and laboratory tests is investigated by using artificial neural networks. As a result SSR seems to be a valid parameter in the classification of FMS.

Fibromyalgia symptoms are reduced by low-dose naltrexone: a pilot study

OBJECTIVE

Fibromyalgia is a chronic pain disorder that is characterized by diffuse musculoskeletal pain and sensitivity to mechanical stimulation. In this pilot clinical trial, we tested the effectiveness of low-dose naltrexone in treating the symptoms of fibromyalgia.

DESIGN

Participants completed a single-blind, crossover trial with the following time line: baseline (2 weeks), placebo (2 weeks), drug (8 weeks), and washout (2 weeks).

PATIENTS

Ten women meeting criteria for fibromyalgia and not taking an opioid medication.

INTERVENTIONS

Naltrexone, in addition to antagonizing opioid receptors on neurons, also inhibits microglia activity in the central nervous system. At low doses (4.5 mg), naltrexone may inhibit the activity of microglia and reverse central and peripheral inflammation.

OUTCOME MEASURES

Participants completed reports of symptom severity everyday, using a handheld computer. In addition, participants visited the lab every 2 weeks for tests of mechanical, heat, and cold pain sensitivity.

RESULTS

Low-dose naltrexone reduced fibromyalgia symptoms in the entire cohort, with a greater than 30% reduction of symptoms over placebo. In addition, laboratory visits showed that mechanical and heat pain thresholds were improved by the drug. Side effects (including insomnia and vivid dreams) were rare, and described as minor and transient. Baseline erythrocyte sedimentation rate predicted over 80% of the variance in drug response. Individuals with higher sedimentation rates (indicating general inflammatory processes) had the greatest reduction of symptoms in response to low-dose naltrexone.

CONCLUSIONS

We conclude that low-dose naltrexone may be an effective, highly tolerable, and inexpensive treatment for fibromyalgia.