The effect of balneotherapy on brain derived neurotrophic factor and insuline like growth factor-1 levels in fibromyalgia patients

Aim: To observe the effect of balneological treatment on clinical symptoms and changes of serum Brain Derived Neurotrophic Factor (BDNF) and Insulin Like Growth Factor-1 (IGF-1) levels in fibromyalgia patients. Material and Method: 80 women diagnosed fibromyalgia syndrome according to the ACR 2010 diagnostic criteria and under pharmacological treatment were randomly assigned to treatment (40) or control (40) groups. Four patients from the treatment group and five from the control group were dropped out from the study with different reasons after randomization. The patients in the treatment group received 10 hydrotherapy at 36-38°C for 20 minutes a day, and afterwards mud-pack treatment on cervical region at 45°C. Control group did not receive balneological treatment. The evaluations were performed at the beginning, 12th day and 1st and 3rd month by a physician who blinded to study arms. Visual Analog Scale (VAS) for pain (AD-VAS), patient and doctor global evaluations (HGD-VAS and DGD-VAS), revised Fibromyalgia Impact Questionnaire (R-FIQ), Beck Depression Inventory (BDI), health survey Short Form-36 (SF-36) parameters used in clinical evaluation. Brain Derive Neurotrophic Factor and Insulin-Like Growth Factor-1 levels were measured at baseline, 12th day and 3rd month. Results:In the treatment group, statistically significant improvement was observed in AD-VAS, HGD-VAS, DGD-VAS, R-FIQ, BDI and SF-36 parameters. There was a significant decrease in BDNF levels in the treatment group at the third month. There was a significant increase in IGF-1 levels in the treatment group after treatment. Conclusion: Balneological treatment has been shown to improve clinical parameters in FMS, decrease in BDNF level which is shown to correlate positively with severity of certain symptoms and increase IGF-1 level which is shown to correlate negatively with severity of particular symptoms. Key words: Fibromyalgia syndrome, Balneological treatment, Pain, BDNF, IGF-1