COMPARISON OF THE EFFECTS OF NERVUS VAGUS STIMULATION, TENS, AND BACKUP STIMULATION DEVICE ON THE AUTONOMIC NERVOUS SYSTEM AND PAIN IN FIBROMYALGIA PATIENTS

Abstract

Purpose: This study aimed to compare the acute effects of vagus nerve stimulation (VNS), transcutaneous electrical nerve stimulation (TENS), and the backup stimulation device (Backup) on pain, sympathetic, and parasympathetic nervous system functions in fibromyalgia patients. Methods: Thirty fibromyalgia patients (aged 20-45) from a hospital in Bursa were randomly assigned to three groups: VNS, TENS, and Backup stimulation device. Each group received a 30-minute session once weekly for five sessions. Pain was assessed using the visual analog scale (VAS), and sympathetic and parasympathetic functions were measured with the Elite heart rate variability device. Parameters included heart rate, root mean square of successive differences, proportion of NN50 divided by total RR intervals, low-frequency/high-frequency (LF/HF) power, and LF/HF ratio. Results: No significant post-intervention changes were found in autonomic parameters across groups (p>0.05). However, all groups showed a significant reduction in VAS scores (p<0.05), indicating effective pain relief. Heart rate significantly decreased only in the Backup group (p<0.05), suggesting a shift toward parasympathetic dominance. Between-group analysis revealed significant differences in VAS scores between the TENS and VNS groups, and the VNS and Backup groups (p<0.05), indicating variability in pain response. Conclusion: TENS, VNS, and Backup stimulation devices effectively reduce pain in fibromyalgia patients. The heart rate reduction in the Backup group suggests a potential effect on autonomic regulation, which may offer a beneficial approach for managing fibromyalgia symptoms. Although autonomic parameters showed no significant changes overall, further research is needed to understand the long-term effects and clinical relevance of these treatments.

Keywords

• Autonomic nervous system
• Fibromyalgia
• Nervus vagus stimulation
• Pain

FİBROMİYALJİ HASTALARINDA NERVUS VAGUS STİMÜLASYONU, TENS VE BACKUP CİHAZ UYARIMININ OTONOM SİNİR SİSTEMİ VE AĞRI ÜZERİNDEKİ ETKİLERİNİN KARŞILAŞTIRILMASI

Abstract

Amaç: Bu çalışmanın amacı, vagus siniri stimülasyonu (VNS), deriden elektriksel sinir stimülasyonu (TENS) ve yedek stimülasyon cihazı (Backup) uygulamalarının fibromiyalji hastalarında ağrı, sempatik ve parasempatik sinir sistemi fonksiyonları üzerindeki akut etkilerini karşılaştırmaktır. Yöntem: Bursa’daki bir hastaneden 20-45 yaş arasındaki 30 fibromiyalji hastası rastgele üç gruba ayrıldı: VNS, TENS ve Backup. Her grup, haftada bir 30 dakikalık seans olmak üzere beş seans aldı. Ağrı, görsel analog skala (VAS) ile değerlendirildi, sempatik ve parasempatik fonksiyonlar ise Elite kalp hızı değişkenliği cihazı ile ölçüldü. Parametreler arasında kalp atım hızı, ardışık farkların karelerinin ortalaması, NN50’nin toplam RR aralıklarına oranı, düşük frekans/yüksek frekans (DF/YF) gücü ile DF/YF oranı yer aldı. Bulgular: Gruplar arasında otonom parametrelerde müdahale sonrası anlamlı bir değişiklik gözlemlenmedi (p>0,05). Ancak, tüm gruplar VAS skorlarında anlamlı bir azalma gösterdi (p<0,05), bu da etkin bir ağrı hafiflemesi sağlandığını göstermektedir. Kalp atım hızı yalnızca Backup grubunda anlamlı şekilde azaldı (p<0,05), bu da parasempatik baskınlığa doğru bir kayma olduğunu düşündürmektedir. Gruplar arası analiz, TENS ve VNS grupları ile VNS ve yedek grupları arasında VAS skorlarında anlamlı farklar buldu (p<0,05), bu da ağrı yanıtındaki farklılıkları vurgulamaktadır. Sonuç: TENS, VNS ve Backup’ları fibromiyalji hastalarında ağrıyı etkili bir şekilde azaltmaktadır. Yedek grupdaki kalp atım hızı azalması, otonom düzenleme üzerinde potansiyel bir etkisi olduğunu ve fibromiyalji semptomlarının yönetimi için faydalı bir yaklaşım sunabileceğini göstermektedir. Otonom parametrelerde genel olarak anlamlı bir değişiklik gözlemlenmemiş olsa da, bu bulgular bu tedavi yöntemlerinin uzun dönem etkileri ve klinik önemi hakkında daha fazla araştırma yapılması gerektiğini vurgulamaktadır.

Keywords

• Otonom sinir sistemi
• Fibromiyalji
• Nervus vagus uyarımı
• Ağrı

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