Characterizing fibromyalgia flares: a prospective observational study.

Introduction: Although most patients with fibromyalgia describe periods of exacerbation of their symptomatology, there are very few studies describing its characteristics. Material and methods: We recruited a total of 124 patients from our outpatient clinics who agreed to a follow-up of at least 6 months. All of them were asked to note and describe whether they had had any worsening of their symptoms during that time. Results: Sixty-nine patients (75%) reported at least one flare, with a mean of 2 flares per patient. The mean duration of flares was 11 weeks. The most frequent triggers were: continuous stress (56%), intense stress (39%), physical overexertion (37%) and climatic changes (36%). The most common actions taken by patients were rest and medication. Conclusions: Two-thirds of fibromyalgia patients experienced flares within 6 months. The symptoms and measures taken are similar to those patients usually take when they notice a worsening of symptoms.

Modification of Alpha Brain Oscillatory Activity in Fibromyalgia After Very Low Intensity Transcranial Magnetic Stimulation.

BACKGROUND: Fibromyalgia (FM) is a chronic disease, with no effective treatments for this disorder. The origin is suspected to be a misprocessing of signals in the central nervous system. One of the experimental treatments is very low intensity transcranial magnetic stimulation (LITMS) used to perform central neuromodulation. OBJECTIVES: The main objective was to characterize the differences in oscillatory brain processing before and after LITMS in FM and compare the results with healthy controls. STUDY DESIGN: This is an interventional study with control group, which shows how the treatment with LITMS could modify brain oscillatory activity and be useful for the improvement of symptoms in FM patients. METHODS: Thirty-three women with FM and 14 healthy controls are studied using magnetoencephalography recording, and mechanical stimuli are applied before and after treatment with transcranial magnetic stimulation. Changes in different brain areas and a specific brain frequency are studied, and the results are analyzed within and between patients, before and after treatment. RESULTS: In the FM group, an increase in alpha brain oscillatory activity was observed mainly in the dorsolateral prefrontal cortex (DLPFS), and more pronounced in the left hemisphere (P = 0.03). In addition, there was a significant improvement in the FM impact questionnaire in the patients (P < 0.01). When comparing patients with controls, it is observed that the differences in alpha frequency in this brain area disappear between groups. LIMITATIONS: Age difference between patients and controls. Replicating the long-term results. CONCLUSIONS: This treatment improves the patients' symptomatology, and also produces statistical changes in alpha brain activity in the DLPFS. Furthermore, a normalization was observed in this frequency and in this area, similar to that of the controls.

Improvement of digestive symptoms in fibromyalgia patients following a diet modification according to histamine release test - an observational study.

Introduction: There is growing interest in the relationship between fibromyalgia and processes related to food, such as food intolerances. In fact, different associations have been described between the control of dietary habits and the improvement of the different symptoms of fibromyalgia. Material and methods: We collected the results of applying a specific test of histamine release related to the diet of patients with fibromyalgia, and evaluated the changes in terms of the symptoms usually described by the patients. A total of 84 patients who met the established criteria were recruited; 40 of them underwent the exclusion diet for a period of 6 months, while the remaining ones continued with their usual dietary habits. All patients were instructed not to modify any other parameter during the study, such as medication, exercise, or other complementary treatments. The parameters studied were as follows: the Fibromyalgia Impact Questionnaire (FIQ), the Gastrointestinal Symptoms Rating Scale (GSRS), the pain Visual Analogue Scale (VAS), as well as the patients' body weight was controlled. Results: There was a significant improvement (p < 0.05) in the group of patients who underwent the exclusion diet in assesment by GSRS and in total in total body weight. There were no differences compared to the rest of the patients in terms of VAS and FIQ. Conclusions: Diet modification in patients with fibromyalgia by specific histamine relase test improves certain clinical parameters related to the symptoms of the digestive sphere, compared to the control group. Our work opens a possible way of non-pharmacological treatment to improve some symptoms of this very prevalent disease.

Modification in Pittsburgh Sleep Quality Index after low intensity transcranial magnetic stimulation in patients with fibromyalgia.

OBJECTIVES: Fibromyalgia is a disease of unknown origin in which sleep involvement is very prevalent, and one of the main symptoms, even as prevalent as pain. In fact, one condition has been linked to the other, and the two may feedback on each other. We investigated what happens if by applying low-field magnetic stimulation in patients with fibromyalgia, it could improve sleep variables, and if this would be related to an improvement in the pain of the patients. METHODS: We compared the results of a group of female patients with fibromyalgia, who underwent treatment for 6 weeks, with another group of patients with similar characteristics, who were not treated. The results were also compared with a group of healthy women, who served as a second control group. The Pittsburgh sleep scale was used as a sleep scale and a global clinical scale was used to assess general state. RESULTS: A significant improvement was observed in the different items of the sleep scale applied, from the four weeks of treatment, being even more evident at the end of treatment at six weeks. A total of 82% of patients improved at the end of treatment. There was a correlation of this improvement with the overall pain situation of the patients. In addition, there was a trend towards equal sleep outcomes between treated patients and healthy subjects. CONCLUSIONS: Treatment with low intensity magnetic stimulation could improve the sleep of fibromyalgia patients, as well as their overall clinical situation, and both processes could be interrelated.

30 Hz, Could It Be Part of a Window Frequency for Cellular Response?

Many exogenous and endogenous risk factors have been proposed as precursors of brain tumors, including the exposure to non-ionizing electromagnetic fields. Nevertheless, there is still a debate among the scientific community about the hazard of the effects produced by non-ionizing radiation (NIR) because conflicting results have been found (number of articles reviewed >50). For that reason, to provide new evidence on the possible effects produced by exposure to NIR, we performed different studies with several combinations of extremely low frequencies, times, and field intensities in tumoral and non-tumoral cells. The results of our studies showed that cell viability was frequency dependent in glioblastoma cells. In fact, our results revealed that a frequency of 30 Hz-or even other frequencies close to 30 Hz-could constitute a window frequency determinant of the cellular response in tumoral and non-tumoral cells.

What is the radiation before 5G? A correlation study between measurements in situ and in real time and epidemiological indicators in Vallecas, Madrid.

BACKGROUND: Exposure of the general population to electromagnetic radiation emitted by mobile phone base stations is one of the greater concerns of residents affected by the proximity of these structures due to the possible relationship between radiated levels and health indicators. OBJECTIVES: This study aimed to find a possible relationship between some health indicators and electromagnetic radiation measurements. METHODS: A total of 268 surveys, own design, were completed by residents of a Madrid neighborhood surrounded by nine telephone antennas, and 105 measurements of electromagnetic radiation were taken with a spectrum analyzer and an isotropic antenna, in situ and in real - time, both outside and inside the houses. RESULTS: It was shown statistically significant p - values in headaches presence (p = 0.010), nightmares (p = 0.001), headache intensity (p < 0.001), dizziness frequency (p = 0.011), instability episodes frequency (p = 0.026), number of hours that one person sleeps per day (p < 0.001) and three of nine parameters studied from tiredness. Concerning cancer, there are 5.6% of cancer cases in the study population, a percentage 10 times higher than that of the total Spanish population. DISCUSSION: People who are exposed to higher radiation values present more severe headaches, dizziness and nightmares. Moreover, they sleep fewer hours.

CT2A Cell Viability Modulated by Electromagnetic Fields at Extremely Low Frequency under No Thermal Effects.

The effects produced by electromagnetic fields (EMFs) on human beings at extremely low frequencies (ELFs) have being investigated in the past years, across in vitro studies, using different cell lines. Nevertheless, the effects produced on cells are not clarified, and the cellular mechanisms and cell-signaling processes involved are still unknown. This situation has resulted in a division among the scientific community about the adequacy of the recommended level of exposure. In this sense, we consider that it is necessary to develop long-term exposure studies and check if the recommended levels of EMFs are under thermal effects. Hence, we exposed CT2A cells to different EMFs at different ELFs at short and long times. Our results showed frequency dependence in CT2A exposed during 24 h to a small EMF of 30 µT equal to those originated by the Earth and frequency dependence after the exposure during seven days to an EMF of 100 µT at different ELFs. Particularly, our results showed a remarkable cell viability decrease of CT2A cells exposed to EMFs of 30 Hz. Nevertheless, after analyzing the thermal effects in terms of HSP90 expression, we did not find thermal damages related to the differences in cell viability, so other crucial cellular mechanism should be involved.

Reduction of pain thresholds in fibromyalgia after very low-intensity magnetic stimulation: a double-blinded, randomized placebo-controlled clinical trial.

BACKGROUND: Exposure to electromagnetic fields has been reported to have analgesic and antinociceptive effects in several organisms. OBJECTIVE: To test the effect of very low-intensity transcranial magnetic stimulation on symptoms associated with fibromyalgia syndrome. METHODS: A double-blinded, placebo-controlled clinical trial was performed in the Sagrado Corazón Hospital, Seville, Spain. Female fibromyalgia patients (22 to 50 years of age) were randomly assigned to either a stimulation group or a sham group. The stimulation group (n=28) was stimulated using 8 Hz pulsed magnetic fields of very low intensity, while the sham group (n=26) underwent the same protocol without stimulation. Pressure pain thresholds before and after stimulation were determined using an algometer during the eight consecutive weekly sessions of the trial. In addition, blood serotonin levels were measured and patients completed questionnaires to monitor symptom evolution. RESULTS: A repeated-measures ANOVA indicated statistically significant improvement in the stimulation group compared with the control group with respect to somatosensory pain thresholds, ability to perform daily activities, perceived chronic pain and sleep quality. While improvement in pain thresholds was apparent after the first stimulation session, improvement in the other three measures occurred after the sixth week. No significant between-group differences were observed in scores of depression, fatigue, severity of headaches or serotonin levels. No adverse side effects were reported in any of the patients. CONCLUSIONS: Very low-intensity magnetic stimulation may represent a safe and effective treatment for chronic pain and other symptoms associated with fibromyalgia.

Increased brain responses during subjectively-matched mechanical pain stimulation in fibromyalgia patients as evidenced by MEG.

OBJECTIVE: The precise pathophysiology of fibromyalgia, a syndrome characterized by chronic widespread pain, remains to be clarified. When subjected to the same amount of stimulation, patients show enhanced brain responses as compared to controls, providing evidence of central pain augmentation in this syndrome. We aimed to characterize brain response differences when stimulation is adjusted to elicit similar subjective levels of pain in both groups. METHODS: Magnetoencephalography (MEG) was used to investigate the brain responses to pressure stimulation applied both above and below the pain threshold in nine patients and nine control subjects. A device was developed to deliver pressure pulses in a quantifiable and precise manner. The amount of pressure was adjusted to produce similar subjective pain in both groups. RESULTS: A between-group comparison of differences between responses evoked by stimulation above and below the pain threshold was performed using cluster-based permutation testing. Increases in signal amplitude in somatosensory, temporal and parietal areas at short latencies, and in prefrontal areas at both short and long latencies, were found to be larger for patients than for control subjects. CONCLUSION: Fibromyalgia patients show enhanced brain responses after reducing the amount of pressure to produce similar subjective levels of pain than to the control subjects. SIGNIFICANCE: The present results suggest that central pain augmentation is present in fibromyalgia, not only when the objective level of stimulation is kept the same as for control subjects, but also when stimulation is adjusted to produce similar levels of pain in patients and controls.

Conflict and cognitive control during sentence comprehension: recruitment of a frontal network during the processing of Spanish object-first sentences.

During sentence processing there is a preference to treat the first noun phrase found as the subject and agent, unless marked the other way. This preference would lead to a conflict in thematic role assignment when the syntactic structure conforms to a non-canonical object-before-subject pattern. Left perisylvian and fronto-parietal brain networks have been found to be engaged by increased computational demands during sentence comprehension, while event-reated brain potentials have been used to study the on-line manifestation of these demands. However, evidence regarding the spatiotemporal organization of brain networks in this domain is scarce. In the current study we used Magnetoencephalography to track spatio-temporally brain activity while Spanish speakers were reading subject- and object-first cleft sentences. Both kinds of sentences remained ambiguous between a subject-first or an object-first interpretation up to the appearance of the second argument. Results show the time-modulation of a frontal network at the disambiguation point of object-first sentences. Moreover, the time windows where these effects took place have been previously related to thematic role integration (300-500 ms) and to sentence reanalysis and resolution of conflicts during processing (beyond 500 ms post-stimulus). These results point to frontal cognitive control as a putative key mechanism which may operate when a revision of the sentence structure and meaning is necessary.