An implanted device that zaps the nerves at the nape of the neck - shown
effective in treating some people with migraines - may also help ease the ache
of fibromyalgia, an ailment that causes widespread body pain and tenderness.
A Belgian scientist treated small numbers of fibromyalgia patients with
"occipital nerve stimulation", which rouses the occipital nerves just beneath
the skin at the back of the neck using an implanted device. Dr Mark Plazier
found that pain scores dropped for 20 of 25 patients using this device over six
months, and their quality of life improved significantly.
"There are only a few treatment options [for fibromyalgia] right now and the
response to treatment is far from 100%, which implies there are a lot of
patients still looking for help to get a better life. This treatment might be an
excellent option for them," said Plazier, a neurosurgeon at University Hospital
Antwerp. But, "it is difficult to determine the impact of these findings on
fibromyalgia patients, since larger trials are necessary."
Plazier is to present his research this week at a meeting of the
International Neuromodulation Society, in Berlin. Neuromodulation is a group of
therapies that use medical devices to relieve symptoms or restore abilities by
altering nerve system function.
Research presented at scientific conferences has not typically been
peer-reviewed or published and is considered preliminary.
Fibromyalgia is thought to affect about 5 million American adults - most of
them women - according to the US National Institutes of Health. The cause of the
disorder, which can also involve sleep problems, anxiety and depression, is
unknown and it can be difficult to treat.
Plazier also presented a separate study on six fibromyalgia patients using
PET scan images to visualise brain changes from occipital nerve stimulation
treatment. It suggested that the nerve stimulation changes activity in the
limbic system, a brain region that helps determine pain perception.
"In fibromyalgia, we see that there is a hyper vigilance to pain, so patients
are more sensitive to pain and more aware of it," Plazier said. "They also have
high scores on questionnaires concerning catastrophising behaviour, which
implies the high impact of pain on their lives."
"During [occipital nerve] stimulation we see differences in brain activity on
PET scans in regions involved in pain," he added. "This all might suggest that
we are influencing a cerebral system and might even turn it back to 'normal'
Study participants didn't find the nerve-zapping treatment to be painful,
Plazier noted. The occipital nerve stimulation device is implanted during a
brief surgery using general anaesthesia, he said, and postoperative pain is
normal but not extreme.
Dr Patrick Wood, director of the fibromyalgia clinic at Madison River Oaks
Medical Center in Canton, Miss., called the study "interesting and promising"
but said additional research is necessary before treatment with occipital nerve
stimulation - which may cost around $10 000 - could become mainstream for
"It's mostly used in headaches, and even in the headache realm it's still
considered experimental," Wood said. "It would be nice to have expanded data
here that would indicate there's something worth banking on and putting our
hopes on. It's promising, but more work needs to be done before the average
patient can consider it."
The US National Institute of Arthritis and Musculoskeletal and Skin Diseases
has more about fibromyalgia.