Ginzarly Mouzayan, Khairy Sherif, Wang Zemer, Qureshi Umair, Zaitoun Raghda, Efrati Shai
The Brain and Performance Center, JLT, Dubai, United Arab Emirates.
Radiology, The Brain and Performance Center, JLT, Dubai, United Arab Emirates.
J Med Case Rep. 2025 Aug 5;19(1):386. doi: 10.1186/s13256-025-05453-2.
BACKGROUND: Fibromyalgia syndrome is a chronic pain disorder characterized by central sensitization and neuroinflammation. Conventional treatments primarily focus on symptom management but often fail to address the underlying dysfunction. Hyperbaric oxygen therapy has emerged as a promising approach that promotes neuroplasticity and may provide symptom relief. CASE PRESENTATION: We present the case of a 62-year-old North African female patient with treatment-resistant fibromyalgia and a history of childhood trauma who underwent 60 hyperbaric oxygen therapy sessions over 12 weeks (90 min at 2.0 atmospheres absolute). Baseline and posttreatment assessments included clinical evaluations (Fibromyalgia Impact Questionnaire Revised, widespread pain index, and symptom severity scale), neurocognitive testing, magnetic resonance imaging-diffusion tensor imaging, single-photon emission computed tomography imaging, and functional mobility tests. Following hyperbaric oxygen therapy, the patient reported substantial pain reduction (Fibromyalgia Impact Questionnaire Revised score decreased from 60.5 to 44; Fibromyalgia Diagnostic Criteria Questionnaire score decreased from 16 to 12). Computerized cognitive assessments revealed a 10% improvement in global cognitive function and a 26.9% increase in attention. Medication use was also reduced, with the discontinuation of pregabalin (Lyrica) and a 50% reduction in duloxetine (Cymbalta) dosage. Additionally, physical function improved, with walking speed increasing from 3.2 to 4.5 km/h and notable gains in balance and coordination. Corresponding to the clinical improvements, the brain imaging demonstrated increased perfusion on single-photon emission computed tomography and enhanced white matter integrity on magnetic resonance imaging-diffusion tensor imaging. CONCLUSION: Hyperbaric oxygen therapy promotes neuroplasticity, resulting in significant clinical improvements in fibromyalgia syndrome, including pain reduction, enhanced cognitive function, and improved physical mobility. These findings highlight the potential of hyperbaric oxygen therapy as a therapeutic strategy targeting the core pathophysiology of fibromyalgia syndrome rather than solely managing symptoms.
背景：纤维肌痛综合征是一种以中枢敏化和神经炎症为特征的慢性疼痛疾病。传统治疗主要侧重于症状管理，但往往无法解决潜在的功能障碍。高压氧治疗已成为一种有前景的方法，可促进神经可塑性并可能缓解症状。 病例介绍：我们报告了一例62岁的北非女性患者，患有难治性纤维肌痛且有童年创伤史，在12周内接受了60次高压氧治疗（在2.0绝对大气压下90分钟）。基线和治疗后评估包括临床评估（修订的纤维肌痛影响问卷、广泛疼痛指数和症状严重程度量表）、神经认知测试、磁共振成像 - 扩散张量成像、单光子发射计算机断层扫描成像和功能活动测试。高压氧治疗后，患者报告疼痛显著减轻（修订的纤维肌痛影响问卷评分从60.5降至44；纤维肌痛诊断标准问卷评分从16降至12）。计算机化认知评估显示整体认知功能改善10%，注意力提高26.9%。药物使用也减少，停用了普瑞巴林（乐瑞卡），度洛西汀（欣百达）剂量减少50%。此外，身体功能改善，步行速度从3.2公里/小时提高到4.5公里/小时，平衡和协调能力有显著提高。与临床改善相对应，脑成像显示单光子发射计算机断层扫描灌注增加，磁共振成像 - 扩散张量成像显示白质完整性增强。 结论：高压氧治疗可促进神经可塑性，在纤维肌痛综合征中产生显著的临床改善，包括疼痛减轻、认知功能增强和身体活动能力改善。这些发现突出了高压氧治疗作为一种针对纤维肌痛综合征核心病理生理学而非仅管理症状的治疗策略的潜力。
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