Pain
Volume
121, Issue 3 ,
April 2006,
Pages 276-280
doi:10.1016/j.pain.2005.12.025 
Copyright
© 2006 International Association for the Study of Pain Published
by Elsevier B.V.
Clinical note
Electroconvulsive therapy improves severe pain associated with
fibromyalgia
Chie Usuia,
,
, Nagafumi
Doib,
Makiko Nishiokac,
Hiroyuki Komatsua,
Ryoko Yamamotoa,
Taku Ohkuboa,
Takuya Ishizukaa,
Nobuto Shibataa,
Kotaro Hattaa,
Haruhiro Miyazakid,
Kusuki Nishiokae
and Heii Araia
aDepartment of Psychiatry, Juntendo
University School of Medicine, Tokyo, Japan
bDepartment of Neuropsychiatry, Faculty
of Medicine, Tokyo University, Tokyo, Japan
cDepartment of Radiology, Jikei
University School of Medicine, Tokyo, Japan
dDepartment of Anesthesiology, Juntendo
University School of Medicine, Tokyo, Japan
eInstitute of Medical Science, St.
Marianna University School of Medicine, Kawasaki, Japan
Received 29 July 2005; revised 11 December 2005; accepted
19 December 2005. Available online 21 February 2006.
Abstract
The pathophysiology of fibromyalgia remains
unknown. Several reports have recently suggested the novel concept that
fibromyalgia is due to the central nervous system becoming
hyper-responsive to a peripheral stimulus. The effect of
electroconvulsive therapy (ECT) as pain remedication in cases of
fibromyalgia without major depressive disorder was studied in a
prospective trial lasting three months. All of the patients taking part
in the study fulfilled the American College of Rheumatology diagnostic
criteria for fibromyalgia. Technetium-99m ethyl cysteinate dimer single
photon emission computed tomography was used to assess regional
cerebral blood flow (rCBF) before and after a course of ECT. Pain
assessment in the patients was undertaken by use of the visual analog
scale (VAS) and by evaluation of tender points (TPs). Beck’s depression
inventory (BDI) was further used to assess depressive mood change in
the patients. Our study clearly demonstrated that pain was
significantly less severe after ECT, as indicated by the VAS scale for
pain and the evaluation of TPs. A further notable observation was that
thalamic blood flow was also improved. We conclude that a course of ECT
produced notable improvements in both intractable severe pain
associated with fibromyalgia and also in terms of thalamic blood flow.
Keywords: Fibromyalgia; Electroconvulsive therapy;
SPECT; Thalamus
Corresponding
author. Tel./fax: +81 3 5802 1071.
