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Clinical Treatment of Functional Pain Syndromes along the Microbiome-Gut-Brain-Axis: Combined Approach with Neuromodulation-Neurofeedback and Multispecies Probiotic

DOI: 10.4236/wjns.2024.144010, PP. 103-119

Keywords: Functional Pain Syndromes (FPS), Neurofeedback-Neuromodulation, Hypothalamus-Pituitary Axis (HPA), Multispecies Probiotic, Microbiome-Gut-Brain-Axis (M-GBA)

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Abstract:

Functional pain syndromes are very common diseases that negatively impact the quality of life of patients with important socio-economic repercussions. The clinical alterations associated with these pathologies are multiple and have a complex psycho-organic character that moves along the micorobiome-gut-brain-axis. For the present study, 45 patients of both sexes (19 male, 26 female) aged 30 - 59 years were enrolled because of a diagnosis of Functional pain syndromes (FPS) that lasted for more than 6 months. All patients underwent pre-treatment clinical assessments (T0) for anxiety disorder, multidimensional assessment of pain, monitoring of baseline values of Alpha-Theta cerebral rhythm in occipital region and monitoring of salivary cortisol levels. All the patients underwent a clinical treatment combined with central neuromodulation with neurofeedback—Alpha Theta increase protocols (once a week for three months), administration of multispecies probiotic (one dose per day for 3 months) and clinical psychological interviews (once a week for three months). At the end of treatment (T1), patients were re-evaluated. Results show statistically relevant improvements of each feature considered: the Relief from Pain provided by the medication increases on average from 36.6% to 87.3%, the salivary Cortisol level at 11 pm decreases from 6.4 ng/ml to a physiological value of 1.2 ng/ml, and the anxiety rating score is reduced from 28 to 12. Moreover, the 23.9% increase in α-θ relative power shows the positive outcome of the brain autoregulation. This study highlights that the combined approach of Neurofeedback with drugs and multispecies probiotic results in great improvements in the patients’ life.

References

[1]  Bourke, J.H., Langford, R.M. and White, P.D. (2015) The Common Link between Functional Somatic Syndromes May Be Central Sensitisation. Journal of Psychosomatic Research, 78, 228-236.
https://doi.org/10.1016/j.jpsychores.2015.01.003
[2]  Fantoni, F., Salvetti, G., Manfredini, D. and Bosco, M. (2007) Current Concepts on the Functional Somatic Syndromes and Temporomandibular Disorders. Stomatologia, 9, 3-9.
[3]  Dell, M.L. and Campo, J.V. (2011) Somatoform Disorders in Children and Adolescents. Psychiatric Clinics of North America, 34, 643-660.
https://doi.org/10.1016/j.psc.2011.05.012
[4]  Nimnuan, C., Rabe-Hesketh, S., Wessely, S. and Hotopf, M. (2001) How Many Functional Somatic Syndromes? Journal of Psychosomatic Research, 51, 549-557.
https://doi.org/10.1016/s0022-3999(01)00224-0
[5]  Rief, W. and Isaac, M. (2014) The Future of Somatoform Disorders: Somatic Symptom Disorder, Bodily Distress Disorder or Functional Syndromes? Current Opinion in Psychiatry, 27, 315-319.
https://doi.org/10.1097/yco.0000000000000089
[6]  Schechter, N.L. (2014) Functional Pain: Time for a New Name. JAMA Pediatrics, 168, 693-694.
https://doi.org/10.1001/jamapediatrics.2014.530
[7]  American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.
https://doi.org/10.1176/appi.books.9780890425596
[8]  Castelletti, M., Berné, E., Castagnoli, E.D.C., Montagna, A. and Tonon, G. (2024) Galvanic Skin Response—Extinction Biofeedback Training for Psychogenic Abdominal Pain: A Validation Protocol. Journal of Biosciences and Medicines, 12, 190-201.
https://doi.org/10.4236/jbm.2024.125015
[9]  Simons, L., Basch, M., Chow, E., Logan, D. and Schechter, N. (2015) Perspectives on the Clinical Significance of Functional Pain Syndromes in Children. Journal of Pain Research, 8, 675-686.
https://doi.org/10.2147/jpr.s55586
[10]  Rief, W. and Barsky, A.J. (2005) Psychobiological Perspectives on Somatoform Disorders. Psychoneuroendocrinology, 30, 996-1002.
https://doi.org/10.1016/j.psyneuen.2005.03.018
[11]  Knezevic, E., Nenic, K., Milanovic, V. and Knezevic, N.N. (2023) The Role of Cortisol in Chronic Stress, Neurodegenerative Diseases, and Psychological Disorders. Cells, 12, Article 2726.
https://doi.org/10.3390/cells12232726
[12]  Begum, N., Taylor, J.R., Brown, C., Rajan, J., Keevil, B., Pye, E., et al. (2021) Morning and Evening Salivary Cortisol Levels in Patients with Chronic Widespread Pain and Those at High Risk. European Journal of Pain, 26, 197-206.
https://doi.org/10.1002/ejp.1854
[13]  Zefferino, R., Di Gioia, S. and Conese, M. (2020) Molecular Links between Endocrine, Nervous and Immune System during Chronic Stress. Brain and Behavior, 11, e01960.
https://doi.org/10.1002/brb3.1960
[14]  Cohen, S.P., Vase, L. and Hooten, W.M. (2021) Chronic Pain: An Update on Burden, Best Practices, and New Advances. The Lancet, 397, 2082-2097.
https://doi.org/10.1016/s0140-6736(21)00393-7
[15]  Mercer Lindsay, N., Chen, C., Gilam, G., Mackey, S. and Scherrer, G. (2021) Brain Circuits for Pain and Its Treatment. Science Translational Medicine, 13, eabj7360.
https://doi.org/10.1126/scitranslmed.abj7360
[16]  Kohrt, B.A., Griffith, J.L. and Patel, V. (2018) Chronic Pain and Mental Health: Integrated Solutions for Global Problems. Pain, 159, S85-S90.
https://doi.org/10.1097/j.pain.0000000000001296
[17]  Dale, R. and Stacey, B. (2016) Multimodal Treatment of Chronic Pain. Medical Clinics of North America, 100, 55-64.
https://doi.org/10.1016/j.mcna.2015.08.012
[18]  Moisset, X., Lanteri-Minet, M. and Fontaine, D. (2019) Neurostimulation Methods in the Treatment of Chronic Pain. Journal of Neural Transmission, 127, 673-686.
https://doi.org/10.1007/s00702-019-02092-y
[19]  Roy, R., de la Vega, R., Jensen, M.P. and Miró, J. (2020) Neurofeedback for Pain Management: A Systematic Review. Frontiers in Neuroscience, 14, Article 671.
https://doi.org/10.3389/fnins.2020.00671
[20]  Hernández-Calderón, P., Wiedemann, L. and Benítez-Páez, A. (2022) The Microbiota Composition Drives Personalized Nutrition: Gut Microbes as Predictive Biomarkers for the Success of Weight Loss Diets. Frontiers in Nutrition, 9, Article 1006747.
https://doi.org/10.3389/fnut.2022.1006747
[21]  Gebrayel, P., Nicco, C., Al Khodor, S., Bilinski, J., Caselli, E., Comelli, E.M., et al. (2022) Microbiota medicine: towards clinical revolution. Journal of Translational Medicine, 20, Article No. 111.
https://doi.org/10.1186/s12967-022-03296-9
[22]  Hou, K., et al. (2022) Microbiota in Health and Diseases. Signal Transduction and Targeted Therapy, 7, Article No. 135.
[23]  Schlundt, J. (2012) Health and Nutritional Properties of Probiotics in Food including Powder Milk with Live Lactic Acid Bacteria. Report of a Joint FAO/WHO Expert Consultation on Evaluation of Health and Nutritional Properties of Probiotics in Food Including Powder Milk with Live Lactic Acid Bacteria. FAO/WHO.
[24]  Maftei, N., Raileanu, C.R., Balta, A.A., Ambrose, L., Boev, M., Marin, D.B., et al. (2024) The Potential Impact of Probiotics on Human Health: An Update on Their Health-Promoting Properties. Microorganisms, 12, Article 234.
https://doi.org/10.3390/microorganisms12020234
[25]  Wang, X., Zhang, P. and Zhang, X. (2021) Probiotics Regulate Gut Microbiota: An Effective Method to Improve Immunity. Molecules, 26, Article 6076.
https://doi.org/10.3390/molecules26196076
[26]  Vlasova, A.N., Kandasamy, S., Chattha, K.S., Rajashekara, G. and Saif, L.J. (2016) Comparison of Probiotic Lactobacilli and Bifidobacteria Effects, Immune Responses and Rotavirus Vaccines and Infection in Different Host Species. Veterinary Immunology and Immunopathology, 172, 72-84.
https://doi.org/10.1016/j.vetimm.2016.01.003
[27]  Ustianowska, K., Ustianowski, Ł., Machaj, F., Gorący, A., Rosik, J., Szostak, B., et al. (2022) The Role of the Human Microbiome in the Pathogenesis of Pain. International Journal of Molecular Sciences, 23, Article 13267.
https://doi.org/10.3390/ijms232113267
[28]  Anand, N., Gorantla, V.R. and Chidambaram, S.B. (2022) The Role of Gut Dysbiosis in the Pathophysiology of Neuropsychiatric Disorders. Cells, 12, Article 54.
https://doi.org/10.3390/cells12010054
[29]  Reiter, A., Bengesser, S.A., Hauschild, A., Birkl-Töglhofer, A., Fellendorf, F.T., Platzer, M., et al. (2020) Interleukin-6 Gene Expression Changes after a 4-Week Intake of a Multispecies Probiotic in Major Depressive Disorder—Preliminary Results of the PROVIT Study. Nutrients, 12, Article 2575.
https://doi.org/10.3390/nu12092575
[30]  Mayer, E.A., Tillisch, K. and Gupta, A. (2015) Gut/brain Axis and the Microbiota. Journal of Clinical Investigation, 125, 926-938.
https://doi.org/10.1172/jci76304
[31]  Liu, L., Wu, Q., Chen, Y., Ren, H., Zhang, Q., Yang, H., et al. (2023) Gut Microbiota in Chronic Pain: Novel Insights into Mechanisms and Promising Therapeutic Strategies. International Immunopharmacology, 115, Article ID: 109685.
https://doi.org/10.1016/j.intimp.2023.109685
[32]  Hamilton, M. (1959) The Assessment of Anxiety States by Rating. British Journal of Medical Psychology, 32, 50-55.
https://doi.org/10.1111/j.2044-8341.1959.tb00467.x
[33]  Caraceni, A., Mendoza, T.R., Mencaglia, E., Baratella, C., Edwards, K., Forjaz, M.J., et al. (1996) A Validation Study of an Italian Version of the Brief Pain Inventory (breve Questionario per La Valutazione Del Dolore). Pain, 65, 87-92.
https://doi.org/10.1016/0304-3959(95)00156-5
[34]  Dengler-Crish, C.M., Bruehl, S. and Walker, L.S. (2011) Increased Wind-Up to Heat Pain in Women with a Childhood History of Functional Abdominal Pain. Pain, 152, 802-808.
https://doi.org/10.1016/j.pain.2010.12.032
[35]  Ehlert, U., Heim, C. and Hellhammer, D.H. (1999) Chronic Pelvic Pain as a Somatoform Disorder. Psychotherapy and Psychosomatics, 68, 87-94.
https://doi.org/10.1159/000012318
[36]  Zajkowska, Z., Gullett, N., Walsh, A., Zonca, V., Pedersen, G.A., Souza, L., et al. (2022) Cortisol and Development of Depression in Adolescence and Young Adulthood—A Systematic Review and Meta-analysis. Psychoneuroendocrinology, 136, Article ID: 105625.
https://doi.org/10.1016/j.psyneuen.2021.105625
[37]  Mezzullo, M., Fanelli, F., Fazzini, A., Gambineri, A., Vicennati, V., Di Dalmazi, G., et al. (2016) Validation of an LC-MS/MS Salivary Assay for Glucocorticoid Status Assessment: Evaluation of the Diurnal Fluctuation of Cortisol and Cortisone and of Their Association within and between Serum and Saliva. The Journal of Steroid Biochemistry and Molecular Biology, 163, 103-112.
https://doi.org/10.1016/j.jsbmb.2016.04.012
[38]  Chou, R., Deyo, R., Friedly, J., Skelly, A., Hashimoto, R., Weimer, M., et al. (2017) Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline. Annals of Internal Medicine, 166, 493-505.
https://doi.org/10.7326/m16-2459
[39]  Eaton, S., Roberts, S. and Turner, B. (2015) Delivering Person Centred Care in Long Term Conditions. BMJ, 350, h181.
https://doi.org/10.1136/bmj.h181
[40]  Williams, A.C.d.C., Eccleston, C. and Morley, S. (2012) Psychological Therapies for the Management of Chronic Pain (Excluding Headache) in Adults. Cochrane Database of Systematic Reviews, No. 11, CD007407.
https://doi.org/10.1002/14651858.cd007407.pub3
[41]  Wong, J.J., Côté, P., Sutton, D.A., Randhawa, K., Yu, H., Varatharajan, S., et al. (2016) Clinical Practice Guidelines for the Noninvasive Management of Low Back Pain: A Systematic Review by the Ontario Protocol for Traffic Injury Management (Optima) Collaboration. European Journal of Pain, 21, 201-216.
https://doi.org/10.1002/ejp.931
[42]  Marzbani, H., Marateb, H. and Mansourian, M. (2016) Methodological Note: Neurofeedback: A Comprehensive Review on System Design, Methodology and Clinical Applications. Basic and Clinical Neuroscience Journal, 7, 143-158.
https://doi.org/10.15412/j.bcn.03070208
[43]  Koryukalova, Yu.I., et al. (2021) Alhpa-Wave Synchronization Observed in Subjects Practicing Relaxation Revealed an Individual Hyper Neural Network in Cognitive Activities. Journal of Psychiatry, 11, 1-7.
[44]  Da Silva, O.M., Bautitz, B., Benedeti, F., Pauly, L. and Rabelo-Silva, E.R. (2016) Chronic Pain and Pharmacotherapy in Chronic Renal Patients on Hemodialysis. Open Journal of Nursing, 6, 741-750.
https://doi.org/10.4236/ojn.2016.69075

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