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

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.

Effects of inescapable versus escapable social stress in Syrian hamsters: the importance of stressor duration versus escapability.

Social avoidance is a common characteristic of many clinical psychopathologies and is often triggered by social stress. Our lab uses Syrian hamsters to model stress-induced social avoidance, and we have previously established that both inescapable and escapable social defeat result in increased social avoidance when compared with no-defeat controls. Our previous work suggested, however, that social avoidance was significantly greater after inescapable defeat. The goal of this study was to determine if this difference in behavior after the two types of defeat was due to experimental differences in the controllability (i.e., escapability) of the defeat or simply to differences in the overall duration of the defeat. In Experiment 1, we used a yoked design to hold constant the duration of defeat between escapable and inescapable defeat conditions. This design resulted in only a very brief social defeat, yet when comparing defeated animals with no-defeat controls, a significant increase in social avoidance was still observed. In Experiment 2, we also used the yoked design, but the escape task was made more difficult to ensure a longer defeat experience. Again, we observed no effect of controllability. Together, these data suggest that the ability to escape a social stressor does not reduce the impact of the stressful experience. These results emphasize that social stressors need not be prolonged or uncontrollable to produce marked effects on subsequent behavior.