Fighting fibromyalgia a search for effective treatment

Jan 18, 2002

Dr. Jeff Hargrove has learned first-hand it's not what you know, but who you know, that can change your life.

Dr. Jeff Hargrove has learned first-hand it's not what you know, but who you know, that can change your life. Hargrove, assistant professor of Mechanical Engineering at Kettering University, found his life's passion when a close friend was diagnosed in 1996 with fibromyalgia, a neurochemical disease that causes full body diffuse pain, cognitive dysfunction and chronic fatigue.

Her plight prompted him to study the disease and it "became my life's passion," he said. That passion has led him to work with specialists in Washington, D.C., and Atlanta to develop a diagnostic tool and viable course of treatment for fibromyalgia and myofascial pain patients, and spearhead collaboration with McLaren Regional Medical Center, in Flint, to host a clinical trial for the treatment. As part of the collaboration, Hargrove has been accepted as adjunct faculty in the School of Medicine at Michigan State University.

The trial, only the second such trial in the country, will be a double-blind, placebo-controlled clinical trial to study the effects of cranial neurostimulation on fibromyalgia patients, including the effect on myofascial trigger points relating to muscle pain symptoms. Funding for the trial will be provided by the McLaren Foundation and Kettering University.

Hargrove, Dr. Susan Smith and Dr. Sunil Nagpal, directors of the Internal Medicine residency program at McLaren, are currently seeking fibromyalgia patients for the trial. "We are looking for 160 people between the ages of 18 and 62, who have been diagnosed as having fibromyalgia using the American College of Rheumatology (ACR) 1990 criteria," said Hargrove.

The ACR 1990 criteria uses 18 prescribed tender points on the body to indicate excessive pain caused by fibromyalgia. "A patient must have 11 of 18 tender points to be diagnosed with fibromyalgia," Hargrove said. Participants must be able to receive 22 treatments at McLaren over a period of about 11 weeks. Interested persons can call 810-762-9791 for more information or to apply to be included in the trial.

Fibromyalgia affects 4 percent of the general population and women nine times more frequently than men. Causes are generally unknown, although several pathological factors have been identified in research. "Current treatments provide only a degree of relief and are generally ineffective over the long-term," he said.

"One of the biggest challenges is that the research suggests no single pathology may be responsible for fibromyalgia," Hargrove said, "a lot of conditions have similar symptoms." Because fibromyalgia has a complex pathology with no visible symptoms, patients are often told "it's all in your head," said Hargrove. Recent research is beginning to allow medical professionals to make differential diagnoses.

"The research indicates that fibromaylgia starts as a neurochemical process," said Hargrove, "one common thread among patients is some sort of initiating event, such as a head injury, acute trauma or severe viral infection. We believe this causes the brain to modify its function in a away that causes failure to regulate neurochemicals that control pain perception. As a result of this, there is an excess of neurochemicals that tell the brain there is something injuring the body, and too little of the neurochemicals that counteract this."

The clinical trial at McLaren will deliver neurostimulation to fibromyalgia patients who have abnormal EEG patterns using a device developed at Kettering by Hargrove and Ted Stokes, lecturer in Mechanical Engineering. The device maps brain waves of patients and generates the neurostimulation treatments in an effort to normalize EEG patterns and correct the neurochemical malfunction.

Hargrove's long-term goal is to develop a research and clinical treatment center in cooperation with Kettering University and McLaren Regional Medical Center that will offer patients effective clinical therapy. "I believe this type of therapy will offer benefits for a lot of neurological problems," Hargrove said.

For more information on the upcoming trial and ongoing research,go to: www.kettering.edu/acad/biomed/FM-research.htm

Written by Dawn Hibbard
(810) 762-9865
dhibbard@kettering.edu


Social and Economic Impact of Fibromyalgia
  • estimated 4% of the general population affected
  • estimated cost of healthcare per patient = $2,274 per year, reflecting a patient tendency to constantly search for effective treatment
  • total cost of healthcare $12-15 billion per year
  • affects women 9 times more frequently than men
  • effect of many socio-economic factors (e.g. family impact, work productivity reduction) cannot be quantified, but clearly a significant impact world-wide

 


Collaborations
  • Dr. David G. Simons - internationally recognized expert on muscle tissue anatomical features responsible for painful conditions, author of several books on muscle pain syndromes including the seminal "Myofascial Pain and Dysfunction: The Trigger Point Manual" (Vols. 1 and 2).
  • Dr. Mary Lee Esty - pioneering researcher on the use of low-intensity neurofeedback in treating a number of brain-related illnesses and conditions, including the neurobehavioral outcomes of traumatic brain injury and post-traumatic fibromyalgia.
  • Dr. Susan Smith and Dr. Sunil Nagpal - Internal Medicine Residency Program directors at McLaren RMC and medical faculty at Michigan State Universitiy, both direct collaborators with Dr. Hargrove for the clinical trials noted above at McLaren RMC.