It is believed that around 10 million people in the US, and 2 million people in the UK, may suffer from fibromyalgia. It is a disabling syndrome of unknown cause, mainly characterised by widespread musculoskeletal pain and symptoms such as fatigue, stiffness, sleep problems, cognitive dysfunction, and distress. It generates a huge amount of suffering in the population, and a great economic burden for public health.
A combination of exercises, relaxation techniques, and cognitive approaches have previously been recommended for patients, showing positive but limited short term benefits with small effect sizes.
This study was a randomised controlled trial (RCT), with a total of 41 fibromyalgia patients who were randomised into two study arms: the active intervention group using a combination of amygdala and insula retraining and Mindfulness (MAIR), and an active control group engaging in an equivalent amount of time in relaxation techniques (RT), both as add-ons to treatment as usual.
The MAIR group demonstrated significantly greater reductions in functional impairment, anxiety, and depression, as well as significant decreases in pain catastrophising, with large effect sizes. There were also significant improvements in clinical severity and health-related quality of life, again with large effect sizes.
The study also analysed changes in a brain chemical known as brain-derived neurotrophic factor (BDNF). Some studies have found this to be elevated in fibromyalgia, with some authors suggesting its potential implication in worsening pain symptoms, as it plays a key role in a variety of neuroplasticity processes, including pain modulation, pain transduction, nociception, and hyperalgesia.
In the study, there were no changes in the BDNF levels in patients in the control group. However, in the active MAIR group, levels of BDNF were significantly reduced and approached those of pain-free controls, pointing towards a normalising effect of MAIR.
This is the first controlled study of its kind to examine the effects of neuroplasticity programmes on chronic illnesses, and it is hoped that this study will attract further funding for a larger scale trial, and bring hope to millions of sufferers.
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