A new Tel Aviv University study finds that fibromyalgia syndrome — a chronic condition characterized by widespread pain, fatigue and cognitive difficulties — may be a consequence of post-traumatic physical and psychological distress associated with childhood sexual abuse. The new study is part of an ongoing collaboration between TAU, the University of Haifa and Assaf Harofeh Medical Center investigating new therapeutic strategies with which to treat survivors of childhood sexual abuse. It was conducted by Prof. Shai Efrati of TAU’s Sackler School of Medicine and Sagol School of Neuroscience and Director of the Sagol Center for Hyperbaric Medicine and Research, at Assaf Harofeh Medical Center. He stated: “We now know that severe emotional stress, such as that caused by sexual abuse, can induce chronic brain injury. These non-healing “brain wounds” may explain certain unremitting long-term physical and psychological disorders like fibromyalgia. Fibromyalgia takes root in the part of the brain responsible for pain interpretation. Using novel brain imaging technologies, we have now, for the first time, identified those brain areas injured by traumatic abuse”.
The research suggests that survivors of childhood sexual abuse who develop fibromyalgia may be effectively treated with hyperbaric oxygen therapy, the application of hyperbaric pressure in conjunction with increased oxygen delivery to oxygen-deprived tissue. Prof. Efrati believe his results serve as an explanation for the often limited results of psychological intervention, which do not provide physiologic repair of the damaged brain tissue. When these brain wounds are treated with hyperbaric oxygen therapy, neuroplasticity can be induced and the related clinical symptoms significantly improved. To prove his hypothesis, over two years, 30 women suffering from fibromyalgia and bearing a history of childhood sexual abuse were randomly assigned to one of two treatment groups: 60 hyperbaric oxygen therapy sessions or psychotherapy. In comparison with simple psychotherapy treatment, after the hyperbaric oxygen therapy sessions, the participants reported a significant improvement in all measures of quality of life, including symptoms of fibromyalgia and post-traumatic stress disorder (PTSD). The clinical findings were accompanied by an improvement in brain functionality, observed in nuclear imaging (SPECT) and novel MRI (MRI-DTI).
Even though some of the areas of the brain have previously been associated with fibromyalgia and PTSD, the study confirmed the roles for thalamus and insula. According to the study, the ability to recall sexual abuse is by no means a prerequisite for effective treatment of fibromyalgia in cases of childhood sexual abuse. Lately, the researchers have witnessed women in the who knew they were sexually harassed and abused but could not recall the details of the attack. This new approach demonstrates that not being able to remember traumatic events is a biological rather than an emotional limitation. There is no efficient agreed upon therapy for fibromyalgia. Pharmacotherapy, aerobic exercises and cognitive behavioral therapies, consist of symptom management. Integrated programs based on these treatments have moderate pain alleviation with limited effectiveness. Hyperbaric oxygen therapy, the application of hyperbaric pressure in conjunction with increased oxygen content, has been shown in several clinical studies to have the capacity to induce neuroplasticity, that leads to repair of persistent impaired brain functions even years after an acute injury. In this study, scientists applied this principle to fibromyalgia.
In the meantime, they are now looking for novel early interventions for childhood sexual abuse survivors. Prof. Rachel Lev-Wiesel explained: “Repeated exposure to traumatic events creates the need to suppress these events. Biologically, that means that the areas of the brain responsible for those memories are actually being shut down in order to cope with reality. This may be the key for the reason why survivors are unable to recall the details or the traumatic event itself. In the future, we hope to be able to diagnose the so-called ‘psychological’ disorders through objective brain imaging”.
The paper can be found published in Frontiers in Psychology journal.
- Edited by Dr. Gianfrancesco Cormaci, PhD, specialist in Clinical Biochemistry.
Hadanny A et al., Efrati S. Front Psychol. 2018 Dec 17; 9:2495.
Efrati S et al., Lev-Wiesel R. Front Psychol. 2018 May 29; 9:848.