Nighttime sensorial stimulation system improves fibromyalgia symptoms

24/07/2019

Sleeping well and getting a good night's rest alliviates the symptoms of those suffering from fibromyalgia. However, the question is how to get them to rest in the first place? A group of researchers led by members of the Magnetic Resonance Unit of the Radiology Services and doctors in rheumatology at the Hospital del Mar, and researchers from the Department of Clinical Psychology and Health of the Universitat Autònoma de Barcelona for the first time have analysed the effects of using a mattress with gentle tactile vibrations on fibromyalgia patients and have achieved to reduce fatigue and pain, as well as improve their quality of life. The study was published in the journal Arthritis Research & Therapy and included the involvement of the Universitat Politècnica de Catalunya.

Patients with fibromyalgia suffer an imbalance in their brain between the sensitivity impulses related to pain, which are exacerbated, and the somatosensory impulses which are diminished. This problem can be repaired partially by applying a gentle stimulation at night, as demonstrated in the study. To do so, researchers developed a special matress model. A normal matress with a motor incorporated which transmits a gentle vibration to all parts of the body. One of the authors of the study, Dr Joan Deus of the Magnetic Resonance Research Unit at the Hospital del Mar and lecturer of the Department of Clinical Psychology and Health at the UAB, explains that they chose this strategy in order to “strengthen and facilitate patients' willingness to stick to the treatment. Everyone must sleep, therefore you make it easier for them to use the mattress every day. You just need to press a button and the vibration can start”.

Vibration vs Placebo

The 63 patients participating in the study were divided into two groups. The first began by trying the mattress with the gentle vibration. The second group was told that they would be administered an inexistent system of magnetic waves (placebo). Both groups tried out the mattresses during 3 weeks (21 days) and rested another two weeks (15 days). Then, the first group tried the false magnetic system and the second group tried the vibrations system. The objective of the design was to verify the real effects of a gentle sensorial vibration at night on the main symptoms suffered by fibromyalgia patients.

The sensorial vibration was generated through six small motors, symmetrically distributed along the matress, which transmitted a gentle vibration during three hours (2 hours at night and 1 hour in the early morning) with a variable frequency of 2 to 90 Hz, much below the maximums recommended by the World Health Organisation (WHO). With ths vibration, researchers aimed to determine whether there was an improvement in the four clinical parametres described by patients and which define fibromyalgia: pain, fatigue, sleep quality and cognitive alterations. Dr Deus points out that “these individuals have alterations at the sensory processing level, they do not correctly process sensitivity impulses. The brains somatosensory cortex, in charge of processing sensory vibration stimulation, is hypoactive in patients and therefore the activity is reduced. And a profound vibration can stimulate propioception, an information with goes directly to this area of the brain”. Therefore, acting on this allows reestablishing, improving and normalising the balance between sensititvity impulses. 

The results revealed a 25% improvement in fatigue with regard to the beginning of the study or baseline, double the percentage achieved with the placebo alone. In terms of pain there was an 18% improvement. Researchers also registered a significant improvement in sleep quality, while cognitive alterations varied less when compared to the intitial situation and the placebo group. With this data, the authors of the study believe that "this general body stimulation 'charges' a person's batteries”.

One of the most outstanding aspects is that the group which began first with the vibration and then went on to the placebo treatment noticed improvements starting on the fifth day of treatment, which lasted at least 5 weeks, much longer than the patients who began with the false magnetic wave treatment.

Improvement of Symptoms, But No Cure

Joan Deus highlights that the vibration “is not a treatment that can cure fibromyalgia, but it does improve the symptoms which severely invalidate patients. We only improve the symptoms in a way in which the patient can have a better quality of life”. Through magnetic resonance imaging, scientists will now study whether the treatment has produced changes in the functional connectivity of the brain of participants and, in a third phase, they will look for the clinical variables and functional neuroimaging indicators which could influence positively on the vibration.

They will also research whether this technique is applicable to other pathologies causing sleep disorders. “Not only have we been able to find an active principle which can improve some of the main symptoms of the disorder, but we also opened a new line of research to study other possible effects”, says the main author of the study.

Fibromyalgia

The WHO classifies fibromyalgia as a chronic disease which significantly affects the health and quality of life of people suffering from it. It is characterised by pain, fatigue and sleep disorders, occasionally accompanied by irritable bowel syndrome, a hyperactive bladder, teeth grinding, and other symptoms. Fibromyalgia causes a generalised chronic pain in the musculoskeletal system and forms part of the rheumatic disorders causing pain in soft tissues. The exact events leading to its onset is unknown, although it is thought to be caused by an alteration in the pain control processes of the central nervous system, as a central sensititvity syndrome.

In Spain, it affects approximately 2.4% of the adult population aged 20 and over. In Catalonia, some 160,000 people are estimated to be suffering from fibromyalgia. It is seen more frequently in women than in men (6 to 8 times more) and commonly appears in people aged 35 to 55.

Original article

Pujol J*, Ramos-López D, Blanco-Hinojo L, Pujol G, Ortiz H, Martínez-Vilavella G, Blanch J, Monfort J, Deus J. Testing the effects of gentle vibrotactile stimulation on symptom relief in fibromyalgia. Arthritis Res Ther 2019; 21: 148.