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FibromyalgiaNCT04316702

Hyperbaric Oxygen Therapy Compared to Pharmaceutical in Fibromyalgia With Emotional Trauma

A study testing Hyperbaric oxygen therapy (HBOT) treatment and Cymbalta / Lyrica - Drug treatment in people with Fibromyalgia and Emotional Trauma, run by Assaf-Harofeh Medical Center at 1 site in Israel.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The investigators have previously studied the efficacy of hyperbaric oxygen therapy (HBOT) as a treatment for Fibromyalgia syndrome (FMS) in a prospective, active control, crossover clinical trial. Read more about this study

Who is it for?
Ages 18 to 50 years, women only
Conditions the study is for
Fibromyalgia, Emotional Trauma
What is being tested?
Hyperbaric oxygen therapy (HBOT) treatment and Cymbalta / Lyrica - Drug treatment
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
48 participants
Where
1 siteIsrael
Study dates
1 Mar 2020to 30 Nov 2023
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 50 years
  • Women only
  • No healthy volunteers
  • Adult

Who may be able to join

  • FM diagnosis based on the widespread pain index (WPI) and the Symptom Severity Score (SSS).
  • Score at the trauma questionnaire indicating low, moderate or severe trauma in one of the criteria specified in the questionnaire.
  • Ability to provide informed consent
  • Age>18

Who cannot join

  • Presence of systemic inflammatory disorders including inflammatory rheumatological and autoimmune disorders.
  • History of traumatic brain injury (TBI)
  • Other FM etiologies
  • Currently or previously treated with Duloxetine (Cymbalta) or Pregabalin (Lyrica)
  • Contraindications to both Lyrica and Cymbalta
  • Major psychiatric disorder (such as major depression, schizophrenia, bi-polar disorder)
Show all 17Show fewer
  • Previous suicidal attempt/s
  • Does not take part in psychotherapy on a weekly basis (minimum)
  • Previous HBOT for any other reason prior to their inclusion
  • Chest pathology (including active asthma)
  • Inner ear disease
  • Claustrophobia
  • Inability to perform awake brain MRI test
  • Chronic renal failure (eGFR< 60 ml/min)
  • Previous neurological conditions (eg. Epilepsy, neuromuscular diseases, metabolic diseases, etc.); Brain tumors; Skull base fractures; Active malignancy; s/p neurosurgery
  • Active Smoking
  • Pregnancy or not committing to not getting pregnant during the study period

Trial locations and contacts

1 site in 1 country.

Israel1 site
  • hyperbaric center Asaf harofe medical center

    Rishon LeZiyyon

Other trials in Israel

About this study

Official title: Hyperbaric Oxygen Therapy vs. Pharmaceutical Therapy in Patients Suffering From Fibromyalgia That Was Induced by Emotional Trauma: Prospective, Randomized, Two Active Arms Clinical Trial

The investigators have previously studied the efficacy of hyperbaric oxygen therapy (HBOT) as a treatment for Fibromyalgia syndrome (FMS) in a prospective, active control, crossover clinical trial. The results demonstrated significant amelioration of all FMS symptoms, with significant improvement in life quality; furthermore, the investigators were able to demonstrate significant neuroplasticity on SPECT imaging, with a decrease of the hyperactivity in posterior regions and elevation of the reduced activity in frontal areas.

In this study, the investigators intend to both repeat and expand the investigator's previous findings, treating FMS patients with history of emotional trauma with HBOT, while performing an extensive of evaluation both before and after treatment.

In the current study, the investigators plan to compare HBOT to current standard of care of FMS (pharmacological and non - pharmacological).

Read the detailed description

The study will include 60 fibromyalgia patients in whom emotional trauma, such as childhood abuse, could be considered as the trigger for FMS. Each participant will be examined at the time of recruitment and a diagnosis of FMS will be verified, based on the updated 2016 diagnostic criteria. In the current study the investigators will recruit patients not currently being treated with the target medications (Lyrica or Cymbalta).

Patients will undergo randomization upon recruitment to one of the two study groups. One group will proceed to a course of HBOT treatment while the second group will commence with standard treatment for FMS, as outlined in the Israeli guidelines for the diagnosis and treatment of FMS .

HBOT protocol: a total of 60 daily hyperbaric oxygen treatment sessions will be administrated 5 days per week. 60 sessions will include exposure of 90 minutes to 100% at 2 Absolute atmospheres (ATA), with 5 minutes air breaks every 20 minutes.

Pharmaceutical protocol: patients will be offered pharmacological treatment with one of the two medications currently licensed for the treatment of FMS in Israel, i.e. Cymbalta and Lyrica. Treatment with Lyrica will start at a dose of 75 mg twice a day, at morning and at bedtime, while treatment with Cymbalta will start at a dose of 30 mg a day (in the morning). After a period of 2 weeks, patients will be evaluated and dose will be adjusted as necessary and tolerated, up to the maximum dosage recommended for FM. Patients may also be switched from one medication to the other according to clinical judgment of the physician.

Being tested
Hyperbaric oxygen therapy (HBOT) treatment, Cymbalta / Lyrica - Drug treatment
Medical subject headings
Fibromyalgia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Hyperbaric oxygen therapy (HBOT) treatmentDevice

    60 daily hyperbaric oxygen treatment sessions will be administrated 5 days per week. Each session will include exposure of 90 minutes to 100% at 2 ATA, with 5 minutes air breaks every 20 minutes

  • Cymbalta / Lyrica - Drug treatmentDrug

    one of the two medications currently licensed for the treatment of FMS in Israel, i.e. Cymbalta and Lyrica. Two medications currently licensed for the treatment of FM in Israel, i.e. Cymbalta and Lyrica. Treatment with Lyrica will start at a dose of 75 mg twice a day, at morning and at bedtime, while treatment with Cymbalta will start at a dose of 30 mg a day (in the morning).

Study groups in NCT04316702
Study groupRoleWhat they receive
Hyperbaric OxygenActive comparator60 daily hyperbaric oxygen treatment sessions will be administrated 5 days per week. Each session will include exposure of 90 minutes to 100% at 2 ATA, with 5 minutes air breaks every 20 minutes
Receives: Device: Hyperbaric oxygen therapy (HBOT) treatment
PharmacotherapyActive comparatorTwo medications currently licensed for the treatment of FM in Israel, i.e. Cymbalta and Lyrica. Treatment with Lyrica will start at a dose of 75 mg twice a day, at morning and at bedtime, while treatment with Cymbalta will start at a dose of 30 mg a day (in the morning). After a period of 2 weeks, patients will be evaluated and dose will be adjusted as necessary and tolerated, up to the maximum dosage recommended for FM. Patients may also be switched from one medication to the other according to clinical judgment of the physician.
Receives: Drug: Cymbalta / Lyrica - Drug treatment

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Fibromyalgia Impact Questionnaire (FIQ) questionnaire

    Fibromyalgia Impact Questionnaire (FIQ) questionnaire score at the end of treatment period (HBOT/pharmaceutical). Score range 0-100, higher score means worse outcome

    Measured: at 3 months

  2. Fibromyalgia Impact Questionnaire (FIQ) questionnaire

    Fibromyalgia Impact Questionnaire (FIQ) questionnaire score at the end of follow up period (HBOT/pharmaceutical). Score range 0-100, higher score means worse outcome

    Measured: at 6 months

Secondary outcomes (24)
  1. Widespread pain index questionnaire

    Fibromyalgia syndrome symptoms questionnaire named:Wide Spread Pain Index (scale 0-19, higher score means worse outcome)

    Measured: at baseline, 3 months, 6 months

  2. Symptoms severity scale questionnaire

    Fibromyalgia syndrome symptoms questionnaire named:Symptom Severity Scale (SSS) (scale 0-12, higher score means worse outcome)

    Measured: at baseline, 3 months, 6 months

  3. Post traumatic stress disorder (PTSD) symptoms scale (PSS) questionnaire

    a 17-item semi-structured interview that assesses the presence and severity of Diagnostic and Statistical Manual (DSM-IV) PTSD symptoms related to a single identified traumatic event in individuals with a known trauma history. scale 0-51, higher score means worse outcome

    Measured: at baseline, 3 months, 6 months

  4. Medical somatic dissociation questionnaire (MSDQ)

    assess somatic dissociation in the healthcare system setting, Scale 5-130, higher score means worse outcome

    Measured: at baseline, 3 months, 6 months

  5. Recovery promoting relationships scale (RPRS)

    assesses patient-therapist relationships from the patient's perspective.

    Measured: at baseline, 3 months, 6 months

  6. the brief symptom inventory (BSI-18)

    evaluate psychological distress, three sub-scales: depression, anxiety, and somatization. scale of 0-24, higher score means worse outcome.

    Measured: at baseline, 3 months, 6 months

  7. Beck depression inventory (BDI)

    a 21-question multiple choice self-report inventory, designed to measure severity of depression. scale of 0-63, higher score means worse outcome

    Measured: at baseline, 3 months, 6 months

  8. Short form health survey (sf-36)

    Quality of life questionnaire, scale of 0-100, higher score means better outcome

    Measured: at baseline, 3 months, 6 months

  9. patient's global impression of change PGIC questionnaire

    patient's global impression of change questionnaire, scale of 1-7, higher score means better outcome

    Measured: at 3 months, at 6 months

  10. draw a person (DAP) assignment

    self drawing tool, allows the expression of hidden or repressed thoughts and feelings in a relatively rapid and simple way by passing the censorship defensive mechanism

    Measured: at baseline, 3 months, 6 months

  11. Heat pain threshold

    Heat pain threshold is determined as the minimum temperature causing pain. Thermal pain is induced with thermal electrode (thermode). Thermode temperature will initially be set at 32.0°C and gradually increase at a rate of 0.3°C/sec. Participants will be instructed to report when the sensation produced by the thermode changed from heat sensation to pain (heat-pain threshold). This procedure will be conducted three times for every subject and the mean of the trials will be calculated.

    Measured: at baseline, 3 months

  12. conditioned pain modulation using Heat test-stimulus (HTS)

    Following heat pain thresholds assessments, the thermode will be applied on the forearm for 120 seconds at constant temperature. The temperature will be individually adapted to induce a mean pain intensity of 50/100, Participant's pain intensity will be evaluated by numeric pain rating scale (NPRS) ranging from 0 (no pain) to 100 (most intense pain tolerable). The 120-second HTS will be done before and during cold water immersion of the contralateral hand in 10 Celsius degrees, using the same thermode temperature to measure conditioned pain modulation (CPM). CPM efficiency will be evaluated by computing the difference in mean pain intensity induced by the pressure stimulus and the Heat test-stimulus (HTS) before and during the Cold water immersion of the opposite hand. Thus, effective pain inhibitory mechanisms are represented by higher (positive) values

    Measured: at baseline, 3 months

  13. Cerebral blood volume

    Cerebral blood volume (in milliliter) will be measured using perfusion MRI protocol Dynamic susceptibility contrast (DSC).

    Measured: at baseline, 3 months

  14. Cerebral blood Flow

    Cerebral blood volume (in milliliter/min) will be measured using perfusion MRI protocol Dynamic susceptibility contrast (DSC).

    Measured: at baseline, 3 months

  15. Fractional anisotropy

    Brain microstructure imaging will evaluate fractional anisotropy (FA , scale 0-1 in each region of interest. The MRI protocol will include diffusion tensor imaging (DTI)

    Measured: at baseline, 3 months

  16. Mean diffusivity

    Brain microstructure imaging will evaluate mean diffusivity (MD, scale 0-1 in each region of interest. The MRI protocol will include diffusion tensor imaging (DTI).

    Measured: at baseline, 3 months

  17. Brain function imaging

    Resting state fMRI(rsfMRI or R-fMRI)- a method of functional brain imaging that can be used to evaluate regional interactions that occur when a subject is not performing an explicit task. This resting brain activity is observed through changes in blood flow in the brain which creates what is referred to as a blood-oxygen-level dependent (BOLD) signal that can be measured using functional Magnetic Resonance Imaging (fMRI).

    Measured: at baseline, 3 months

  18. Metabolic Brain function imaging

    Brain Single photon emission computed tomography (SPECT) will be conducted.

    Measured: at baseline, 3 months

  19. Brain functionality

    FMRI tasks will evaluate brain function during cognitive (working memory task) and emotional tasks (emotion recognition task)

    Measured: at baseline, 3 months

  20. NeuroTrax

    computerized cognitive evaluation battery

    Measured: at baseline, 3 months

  21. CANTAB Cambridge Neuropsychological Test Automated Battery

    computerized cognitive evaluation battery

    Measured: at baseline, 3 months

  22. Physical activity

    The daily physical activity will be objectively tracked by Garmin watch technology. The watch will be also wired during night for measurements of the time asleep, restless and awake, trackers help you understand each night to make the most of each day

    Measured: at baseline, 3 months

  23. Inflammatory cytokines

    Blood Tests will include: IL-1, IL-6, Tumor necrosis factor-alpha, C-reactive protein (CRP).

    Measured: at baseline, 3 months

  24. Endocrine system

    Free cortisol, Adrenocorticotropic hormone (ACTH) in blood tests and a hair sample for cortisol levels

    Measured: at baseline, 3 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Mar 2020
  2. Study start1 Mar 2020
  3. Primary completion30 Nov 2023
  4. Study completion30 Nov 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Model description
randomized controlled trial using conventional pharmacotherapy treatment compared to hyperbaric oxygen therapy
Masking
Double blind
Who is masked
Investigator, Outcomes assessor
Enrolment
48 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04316702
Sponsor's protocol ID
0008-20
Status last verified
Apr 2026
First submitted
3 Mar 2020
Last updated
21 Apr 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Hyperbaric oxygen therapy (HBOT) treatment and Cymbalta / Lyrica - Drug treatment in people with Fibromyalgia and Emotional Trauma, run by Assaf-Harofeh Medical Center at 1 site in Israel.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 17 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 21 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Israel. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Fibromyalgia Impact Questionnaire (FIQ) questionnaire (time frame: at 3 months). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Apr 2026.

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