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EEG-Driven Stimulation in Fibromyalgia Patients

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By Source: Fibromyalgia Frontiers • • June 6, 1998

A report on the presentations given by Mary Lee Esty, Ph.D.,
& Theodora Quinn, B.C.I.A.C., at FMAGW on June 6, 1998

[Reprinted from Fibromyalgia Frontiers, Vol. 6, #4, July/August 1998]

If you have fibromyalgia syndrome (FMS) and have ever confided to a friend or family member that your brain seemed to be stuck in "low gear" and you just couldn't "think straight", you might have been close to the truth. New research from Calgary, Canada, suggests that in fibromyalgia patients the most powerful electrical activity in the brain is in the slowest brain waves .1 The condition is known as "EEG slowing". Why this occurs is not yet known, however, it is possible that trauma or severe viral illness (the triggers commonly associated with fibromyalgia syndrome) are at least partially responsible for altering the biochemistry of the brain which in turn produces the many symptoms that FMS patients know so well. The powerful, slow brain waves also seem to prevent FMS patients from maintaining the effects of rehabilitative treatments over the long-term.2 Mary Lee Esty, Ph.D., President of the Neurotherapy Center of Washington (DC) and of Myosymmetries Washington, sums it up this way:

As long as the brain is stuck in that condition where the slowest waves have more power in them than the rest of the spectrum, the symptoms will continue. You cannot get rid of them. People will try and try and try, but the control room up there is set at one speed, and it is almost impossible to change it.3

Dr. Esty and Theodora Quinn, B.C.I.A.C. (Clinical Director of Myosymmetries Washington) recently joined patients and medical professionals at FMAGW's June 6, 1998, Saturday Series to discuss the theory behind the newly published study by Calgary researchers Stuart Donaldson, Ph.D.; Gabriella Sella, M.D., M.P.H., M.Sc.; and Horst Mueller, Ph.D. which used a procedure called "EEG-Driven Stimulation (EDS)--also known as the Flexyx Neurotherapy System (FNS) or EEG Neurotherapy--along with several follow-up treatment modalities, in an attempt to "reset" the brains of FMS patients and restore normal functioning. Dr. Esty, who has had a great deal of experience with EDS in the treatment of traumatic brain injuries, attention deficit disorder, migraines, panic disorder, post-traumatic stress disorder, fibromyalgia and chronic fatigue syndromes, as well as several other conditions, worked closely with the Calgary research team.

Some Background on EEG-Driven Stimulation
EDS was first pioneered by Len Ochs, F.N.S., of Walnut Creek, CA, as part of a NIH study involving learning disabled children. Through his collaboration with Esty and Ochs, Calgary researcher Dr. Stuart Donaldson, already highly experienced in EEG technology and the study of musculoskeletal problems, was able to apply EDS technology to fibromyalgia research. Using a type of brain mapping called QEEG (quantitative electroencephalogram), Donaldson soon discovered a signature spike unique to the brain waves of FMS patients. Of particular interest was the fact that no such spike appeared in the mappings of patients with myofascial pain syndrome, a condition frequently confused with fibromyalgia. Also, by using the QEEG, a patient's brain wave pattern could be assessed and different brainwaves' intensities and locations identified. "EEG slowing" shows up in the brain map (the delta and theta waves of the brain are the slowest).

The good news is that both Dr. Esty (at Myosymmetries Washington) and Dr. Donaldson (at Myosymmetries Calgary) have reported success treating fibromyalgia syndrome using EEG-Driven Stimulation. Dr. Esty describes the usual EDS treatment protocol this way. A patient first has a QEEG map made through the scalp to document electrical activity emanating from 21 sites around the brain. The QEEG is used to create a schematic picture of the brain which is then colorized to show the relative functioning of different brain sites. The patient is then asked to sit in a comfortable chair with eyes closed and to put on a special pair of dark glasses. A sensor is placed on the head; a clip is attached to one ear; and a ground is secured to one hand. The sensor transmits data concerning the areas of strongest brain wave activity through a processor to a computer. A rhythmic stimulus (a non-light emitting diode) is then sent through the glasses into the eyes and brain to essentially draw power from the slowest brain waves up to faster waves. The brain should then be more flexible and shift as needed in response to stimuli.4

Once the brain has been coaxed into a flexible, new state which allows it to perform its integrative functions in an optimal way, neuro-muscular re-education can begin. Theodora Quinn, who coordinates soft tissue rehabilitation programs at Myosymmetries Washington, described the supplemental treatment protocols designed by Dr. Donaldson. During the time period when brain wave neurotherapy treatments are being applied, a multi-disciplinary team of specially trained clinicians conduct both static and dynamic evaluations of posture and muscle functioning as well as assessments of a client's work and home environments to produce an individualized treatment plan which helps the patient regain the use of deconditioned muscles and develop new awareness of inappropriate postures, work habits, or muscle-guarding.5 Surface Electromyography (sEMG) is one technology frequently used to record abnormal muscle activity in various locations around the body and to identify muscles that are working in-effectively together as a team. Often, micro-exercises are prescribed to re-establish proper muscle function. Trigger point therapy and myofascial release are also commonly performed in careful symmetry with EDS therapy to help restore muscle health.6

The Calgary Study
In a newly published article, "Fibromyalgia: A Retrospective Study of 252 Consecutive Referrals", (Canadian Journal of Clinical Medicine, June 1998), Donaldson et al report on the success of the EEG Neurotherapy treatment protocol (i.e., EEG-Driven Stimulation, sEMG neuromuscular retraining, and physical and massage therapy) on 44 FMS patients from their larger study whose progress had been followed for up to a year. Of the 44, only four patients rated themselves as worse after receiving treatment. Dr. Donaldson notes that these patients had also experienced problems with medication interactions or had other undiagnosed medical problems in addition to fibromyalgia syndrome. The other 40 patients reported improvement. Interestingly, those who indicated slight improvement (n=14) tended to be those whose FMS was thought to be triggered by viral infection. Those who reported being either greatly improved or symptom-free (n=26) tended to have developed fibromyalgia syndrome after a trauma.7

It should be noted that symptom-relief did not come all at once. In all cases, "fibro-fog" (i.e., decreased ability to concentrate, decreased short-term memory, difficulty with multiple tasks) disappeared first, generally within 20 days from the start of treatment. Pain symptoms seemed to change from being generalized to being site-specific and somewhat more intense. Mood and irritability symptoms lessened or resolved in approximately 20 to 30 days, while fatigue decreased after one to two months. Sleep improved in two to three months. During this same period, specific pain decreased, and muscle function and range of motion improved.8 Unfortunately, the study makes no mention of other symptoms commonly associated with FMS such as irritable bowel, gastrointestinal complaints, genito-urinary symptoms, environmental sensitivity, and others. Admittedly, research on EEG-Driven Stimulation is in its infancy, and much more work and observation need to be done. Nevertheless, the new body of work surrounding EDS undoubtedly raises some interesting questions about the effect of physical trauma on the brain and how that effect differs from stresses imposed by viral illness. Also exciting is Dr. Donaldson's identification of a signature spike in the brain waves of FMS patients. If this finding can be corroborated by double-blind, controlled studies, it may mean, at last, that there is an accurate tool for the differential diagnosis of FMS. Unfortunately, there is also a down side to the neurotherapy protocol, at least for the present. Not surprisingly, it is quite expensive and not yet covered by many insurers. However, Dr. Esty and Ms. Quinn promise that they are working hard to educate insurers.

If you would like more information on the work done by Dr. Esty and Ms. Quinn in the Washington, DC, area, please contact:

Myosymmetries Washington
5480 Wisconsin Avenue, Suite 221
Chevy Chase, Maryland 20815
Phone: 301/652-7175
Fax: 301/652-7186

Correspondence may be sent to Dr. Stuart Donaldson at:

10655 Southport Road, SW
Suite 445
Calgary, Alberta
T2W 4Y1 Canada

For reprints of the Donaldson study, contact:

Canadian Journal of
Clinical Medicine
1015 Hooke Road
Edmonton, Alberta
T5A 4K5 Canada
Phone: 403/456-9647
Fax: 403/476-1363.

Donaldson et al, "Fibromyalgia: A Retrospective Study of 252 Consecutive Referrals," Canadian Journal of Clinical Medicine, Volume 5, Number 6, June 1998, pp. 116-127.
Presentation by Mary Lee Esty, PhD, to the Fibromyalgia Association of Greater Washington, Inc., "EEG Neurotherapy: A Promising New Treatment for FMS?", Vienna, VA, June 6, 1998.
Presentation by Theodora Quinn, BCIAC, to the Fibromyalgia Association of Greater Washington, Inc., "EEG Neurotherapy: A Promising New Treatment for FMS?", Vienna, VA, June 6, 1998.
Ibid, Donaldson et al, p. 121.

Ibid, Donaldson et al, p. 121.

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