Journal Article

Feasibility of Auricular Field Stimulation in Fibromyalgia: Evaluation by Functional Magnetic Resonance Imaging, Randomized Trial

Kalangara, Jerry, Crosson, Bruce, Woodbury, Anna, Napadow, Vitaly, Guo, Ying, Bicknese, Corinne, Cui, Xiangqin, Krishnamurthy, Venkatagiri, Gebre, Melat, Liu, Mofei, Sniecinski, Roman, Lukemire, Joshua

2021

Overview

Abstract Objective To evaluate the feasibility of recruitment, preliminary efficacy, and acceptability of auricular percutaneous electrical nerve field stimulation (PENFS) for the treatment of fibromyalgia in veterans, using neuroimaging as an outcome measure and a biomarker of treatment response. Design Randomized, controlled, single-blind. Setting Government hospital. Subjects Twenty-one veterans with fibromyalgia were randomized to standard therapy (ST) control or ST with auricular PENFS treatment. Methods Participants received weekly visits with a pain practitioner over 4 weeks. The PENFS group received reapplication of PENFS at each weekly visit. Resting-state functional connectivity magnetic resonance imaging (rs-fcMRI) data were collected within 2 weeks prior to initiating treatment and 2 weeks following the final treatment. Analysis of rs-fcMRI used a right posterior insula seed. Pain and function were assessed at baseline and at 2, 6, and 12 weeks post-treatment. Results At 12 weeks post-treatment, there was a nonsignificant trend toward improved pain scores and significant improvements in pain interference with sleep among the PENFS treatment group as compared with the ST controls. Neuroimaging data displayed increased connectivity to areas of the cerebellum and executive control networks in the PENFS group as compared with the ST control group following treatment. Conclusions There was a trend toward improved pain and function among veterans with fibromyalgia in the ST + PENFS group as compared with the ST control group. Pain and functional outcomes correlated with altered rs-fcMRI network connectivity. Neuroimaging results differed between groups, suggesting an alternative underlying mechanism for PENFS analgesia.

• Publisher: Oxford University Press
• Subject: Analgesia / Blindness / Care and treatment / Cerebellum / Chronic pain / Ear / Executive function / Feasibility Studies / Fibromyalgia / Fibromyalgia - diagnostic imaging / Fibromyalgia - therapy / Functional magnetic resonance imaging / General & Selected Populations Section / Health aspects / Humans / Magnetic Resonance Imaging / Medical imaging / Nerves, Cranial / Neural networks / Neural stimulation / Neuroimaging / Pain / Pain management / Pain perception / Single-Blind Method / Sleep / Testing