Effects of needle acupuncture application on oxidative stress mechanisms, pain and quality of life in fibromyalgia

Introduction and Aim: It is assumed that oxidative stress and oxidant/antioxidant balance play a role in the etiology of fibromyalgia syndrome (FMS). Acupuncture therapy has been shown to have antioxidant effects. In this study, it was aimed to determine the relationship between needle acupuncture application with serum thiol/disulfide balance, ischemia modified albumin, intracellular oxidized, reduced, total glutathione levels and clinical parameters such as pain, depression and quality of life in patients with FMS. Materials and Method: In this study, 52 female patients between the ages of 18-55 who applied to the Ankara City Hospital Physical Medicine and Rehabilitation outpatient clinic between 06/2019-01/2020 and were diagnosed with FMS according to the 2016 ACR FMS criteria and did not accept drug treatment and 26 healthy female volunteers (44.2 ± 6.8 years) were included. The patients were divided into two groups as needle (45.2 ± 8.0 years) and sham (45.8 ± 7.1 years) acupuncture groups. Clinical parameters of the patients were evaluated with Visual Analogue Scale (VAS), Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory (BDI), Short Form-Quality of Life Assessment Scale (SF-36), and Fatigue Severity Scale (FSS) before treatment, at the end of treatment, and at 1 month after treatment. Serum thiol/disulfide balance, ischemia modified albumin, intracellular oxidized, reduced and total glutathione levels were evaluated in the patient and control groups before treatment and 1 month after treatment. Results: Statistically significant improvements were found in the VAS, FIQ, FSS, BDI, SF-36 scores of the patients in the needle group compared to the sham group at the end of treatment and at the first month after treatment (p<0.05). Before treatment intracellular oxidized, reduced, total glutathione levels and serum thiol/disulfide balance were found to be higher in the oxidant direction in FMS patients compared to the control group (p<0.05). In the needle group, there was a significant increase in antioxidant direction in intracellular oxidized, reduced and total glutathione levels in the first month after treatment compared to before treatment (p<0.05). When the percentage changes of the clinical parameters and oxidative stress markers of the needle and sham groups before and after the treatment was compared, the changes in the needle group was found to be significantly higher (p<0.05). Conclusions: To our knowledge, this study is the first study evaluating oxidative stress levels with intracellular oxidized, reduced and total glutathione levels in patients with FMS compared to the control group examine the relationship between oxidative stress and acupuncture applications in FMS. These results suggest that intracellular oxidized, reduced and total glutathione levels may be among the biomarkers that can be used to evaluate oxidative stress in patients with FMS. In addition, it is thought that needle acupuncture applications may create a difference in the oxidative balance in patients with FMS. Keywords: fibromyalgia syndrome, acupuncture, oxidative stress, oxidized-reduced glutathione, thiol/disulfide balance