Energy Healing Brain Hyper Scanning in Fibromyalgia

1. Overview

Energy medicine or energy healing (EH) is an emerging therapy with significant promise. It is derived from the theory that using the body’s own biological energy a therapeutic effect can be obtained in another individual such as a patient. Preliminary data in chronic pain patients, suggests that EH, delivered by an experienced practitioner, may be able to reduce self-reported pain symptoms within minutes. Effects lasting for weeks to months have also been anecdotally reported. In addition to improvements in pain, reductions in other symptoms including fatigue, sleep, and cognitive dysfunction may also be possible with EH.

EH practitioners may be trained within a specific tradition such as healing touch, reiki, and qigong, or work via novel unique methods. The energy practitioners that will be used for this study have practiced their unique style of EH for years and one has taken his work through a blinded hospital study demonstrating its feasibility and efficacy.[1] This study took place in inpatient units and the emergency department and found both acceptability and demand for energy medicine. Of 50 reports of pain, 38 (76%) showed marked improvement. Of 29 non-pain-related problems, 23 (79%) showed marked improvement.[1]

We propose to study EH delivered by an experienced therapist, for the treatment of fibromyalgia (FM), a chronic pain condition that results from aberrant central nervous system function and neurochemistry. This work will be performed at the University of California, Irvine and comply with the university’s Institutional Review Board ethics.  Participant recruitment will be for 18 months and funding for this study will be in part through DMT Quest, the Subtle Energy Funders Collective, and ResearchHub.  Data will be shared with the public following initial publication of study results.

2. Introduction

Fibromyalgia (FM) is a Common Chronic Pain Syndrome and a Major Public Health Issue.  Fibromyalgia (FM) is the second most common rheumatologic disorder, behind osteoarthritis, with 2 - 4% of the populations of industrialized countries affected.[2-4] Overall, it is estimated that FM costs the American taxpayers over $20 billion a year in lost wages and disability.[5]  In part this burden on the US healthcare system is our lack of understanding of the specific pathophysiology of the disorder. While research suggests that FM is a central non-nociceptive pain syndrome,[6-8] it is uncertain if the observed neurobiological outcomes are causally related to development of FM.  That said, our recent study in children suggests that the development of widespread pain, a hallmark of FM, is preceded by aberrant brain neural function.[9]  The study proposed here may provide much needed information into the pathology of this disorder and how it is treated in a clinical setting.  Moreover our proposed project may synergize with emerging data indicating a generalized disturbance in central nervous system pain processing in this condition.[10,11]

Need for a Neurobiological Model underlying EH for FM.  There is a lack of key information about how EH may work for pain.  One key missing piece in the field is that there are no objective markers that have been identified that actually track with subjective self-reported pain improvements following treatment with EH. This limitation is a key factor that prevents a more general adoption of this therapy by the medical community. An objective marker of chronic pain, that is modulated by EH, that also tracks with self-reported symptom improvement, would be a major advance for the field and also aid the development of a biomedical theory of how this therapy works.  Moreover showing that similar brain activity occurs in an energy healer and the patient during treatment would also link the actions of healing at a distance: a key tenet of EH.  Finally, our proposed neurobiological outcomes may also detect the effects of EH on brain neuroimaging biomarkers that we have previously found to track with clinical pain in FM, thus supporting the mechanisms of EH in chronic pain.

Hypotheses 

Aim 1: Assess the effects of EH as compared to control, on neuroelectrical activity acquired simultaneously from patients with FM and an energy healer (EEG hyperscan) and relate these brain changes to improvements in clinical pain.  Hypothesis 1A: EEG gamma power assessed in FM patients and the healer will be greater during active healing as compared to control. Hypothesis 1B: patient-practitioner brain-to-brain connectivity will be higher during EH as compared to control. Hypothesis 1C: changes in EEG metrics will be correlated with improvements in clinical pain during active EH as compared to control.

Aim 2 (exploratory): Explore the action of EH on brain explosive synchronization, an EEG measure of brain network instability and chronic pain.[19,20]  Hypothesis 2: Brain explosive synchronization metrics (network instability) will decrease in conjunction with chronic pain during EH as compared to control.  

Impact.  If our hypotheses are proven true, 1) critical information will be provided that may help incorporate EH into mainstream clinical care, 2) EH may be shown to reduce pain symptoms in FM, and 3) we may obtain a better understanding of EH and how it might be utilized in future studies of other chronic pain conditions.

3. Methods

Overview. Our overall goal is to understand the role EH plays in modulating neuroimaging markers related to altered neural processing of pain in FM as well as the effects it has on clinical pain, heart rate variability, biophoton emission, and skin temperature. We will study 20 FM patients using brain electroencephalogram (EEG) hyper scanning in both the energy healer and the patient simultaneously.  We will also collect data on clinical pain changes as well as physiological outcomes in the patient and healer such as heart rate, skin temperature, and biophoton emission, secondary outcomes that may be associated with EH.  Data during energy healing periods will be compared to data acquired during rest.  Patients will be blinded as to the timing of these periods (see below). 

Rationale.  Our proposal originates with coupling brain and other physiological outcomes with clinical pain measures incorporated in a treatment trial framework using EH. In addition to evaluating brain response to EH between two individuals simultaneously, we will also investigate the neurocircuitry subserving clinical pain. Neuroimaging markers reflecting FM patients’ clinical pain are crucial to this design, as (a) they conceptually link more closely to important clinical outcome measures, as compared to markers for experimental pain  in hyperalgesia and allodynia, and (b) their differential susceptibility to different forms of therapy may underlie the ultimate mechanisms of action of EH. Recent efforts have been increasingly aimed at developing a neurobiological model for chronic nociplastic pain, and our proposal is innovative in that it adds to this burgeoning field of research.[12,13]

Procedures.  All EH treatments and physiological testing will occur at the Susan Samueli Integrative Health Institute at the University of California at Irvine. Participants with a diagnosis of FM will be consented in person and then undergo a two-week run-in during baseline to washout previous treatment effects and reduce regression to the mean effects. Pain outcome: Change in pain intensity and interference, as measured in a 10cm Visual Analog Scale (our primary outcome; anchored at 0 = “no pain” and 10 = “worst pain imaginable”) will be assessed. We will also include the Brief Pain Inventory [14] and the FM survey criteria [15] as additional secondary pain outcomes.

Heart rate outcomes: Heart rate variability will be assessed with ECG (secondary outcome) for both the FM patient as well as the energy healer simultaneously during treatment and at rest.  To control for placebo effects and confounding factors FM patients will not be facing the healer during treatment.  This will effectively blind the patient from the timing of the EH and rest periods. For each patient, the order of healing and rest will be randomized.  ECG will be performed using a Movesense sensor (https://www.movesense.com/) connected to a mobile device (via Bluetooth) which runs the patented electrocardiomatrix (ECM) software invented by the Borjigin lab at the University of Michigan that converts the 2D ECG data into a 3D ECM image that resembles a heatmap. The ECM image captured on the mobile device can be used as a standalone diagnostic tool for intuitive visualization of user’s cardiac conditions in real-time or post-capture. The captured ECG data can be uploaded to the ECM website (developed by Dr. Xu in the Borjigin lab) for quantitative processing (HRV and other outcomes).

EEG Acquisition and Analysis.  EEG data will be collected from the energy healer and FM participants simultaneously (hyperscan) to measure synchronized brain activity in each dyad (Energy Healer-FM participant). We use a Brain Products EEG system with 32-channel water-based nets (sensors are distributed accordingly to the International 10-20 system). The EEG caps from the FM participant and the healer will be attached to the same EEG amplifier (BrainAmp) ensuring the millisecond-precision alignment required for the inter-brain connectivity analysis. The EEG equipment has been purchased and tested in pilot acquisitions to ensure rigorous data collection. Gamma Power and Hyperscanning: We use in-house developed MATLAB scripts based on validated pipelines for EEG data processing (EEGLAB). First, we will perform standard preprocessing including bandpass filtering (1-30Hz for inter-brain connectivity assessment and 1-100Hz for gamma analysis), re-referencing, and ocular artifact removal (independent component analysis, ICA). Then Phase Locking Value (PLV) and Partial Directed Coherence (PDC) will be used to measure inter-brain connectivity.[16] PLV assesses the magnitude of phase synchrony[17] whereas PDC is a spectral estimate of causal connectivity including intensity and directionality.[18] We will compute PLV and PDC on the EEG time series acquired during resting prior to EH and concurrently with EH. Additionally we will compute Power Spectral Density (PSD) in all standard EEG frequency bands, including Delta, Theta, Alpha, Beta, and Gamma. Brain-to-brain connectivity measures and Gamma power (assessed separately for patients and the healer) will be contrasted between resting and EH time points to assess change associated with the EH treatment in FM patients and the healer.

Galvanic skin resistance, temperature, and biophoton emission.  Finally in addition to ECG and EEG assessment, we will also measure skin temperature, galvanic skin resistance, and single hand biophoton emission during resting period and active EH for both the healer and the FM patient. 

All study procedures will be approved by the University of California, Irvine Institutional Review Board, and all data will be securely stored in locked password protected computers at the University of California, Irvine campus.

General Analysis. Comparisons between healing and rest will be made for all outcomes using a paired t-Test (see above for EEG analysis). Pearson correlations will be made between change scores in brain neuroimaging outcomes, other physiologic outcomes, and changes in pain. Significant p-values are identified at p<0.05 with no correction for multiple comparisons.

Ethics and Data Management. All procedures will be approved by the local University of California, Irvine Institutional Review Board.  All data will be identified with a unique patient identification number, whose linked personal health information will be kept in a locked cabinet behind a locked door in the Susan Samueli Integrative Health Institute building.  Data will be shared with other researchers once the primary analyses are published and all data will be archived for 7 years at the University of California, Irvine after the study is completed

4. Pilot Data (Optional)

This study has no pilot data to present.

5. Budget

The budget for this work is $400,000 in total which includes personnel salaries ($250,000; PI, study coordinator, imaging analyst, EEG consultant, and biostatistician), purchasing of equipment and supplies ($60,000; EEG equipment, supplies, and galvanic skin resistance device), data analysis (80,000; consulting fees for hyper scanning and other analyses), travel ($4,000), and participant recruitment and reimbursement ($6,000).

This work is an extension of previously funded work with an established energy healer. We are extending our scope of investigation in this study into EEG hyper scanning and other modalities.

6. References

1.  Dufresne F, Simmons B, Vlachostergios PJ, Fleischner Z, Joudeh R, Blakeway J, Julliard K. Feasibility of energy medicine in a community teaching hospital: an exploratory case series. J Altern Complement Med. (2015) 21(6),339-49.

2.  Wolfe, F., et al., The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum. (1995) 38(1): p. 19-28.

3.  Jacobsen, S. and S.R. Bredkjaer. The prevalence of fibromyalgia and widespread chronic musculoskeletal pain in the general population. Scand.J.Rheumatol. (1992) 21(5): p. 261-263.

4.  Raspe, H., C. Baumgartner, and F. Wolfe. The prevalence of fibromyalgia in a rural German community: How much difference do different criteria make? Arthritis & Rheumatism. (1993) 36(9 (Supplement)): p. S48.

5.  Wolfe, F., et al. A prospective, longitudinal, multicenter study of service utilization and costs in fibromyalgia. Arthritis Rheum (1997) 40(9): p. 1560-70.

6.  Gracely, R.H., et al. Functional magnetic resonance imaging evidence of augmented pain processing in fibromyalgia. Arthritis Rheum. (2002) 46(5): p. 1333-1343.

7.  Harris, R.E., et al. Decreased central mu-opioid receptor availability in fibromyalgia. J.Neurosci. (2007) 27(37): p. 10000-10006.

8.  Mountz, J.M., et al., Fibromyalgia in women. Abnormalities of regional cerebral blood flow in the thalamus and the caudate nucleus are associated with low pain threshold levels. Arthritis Rheum. (1995) 38(7): p. 926-938. 

9.  Kaplan CM, Schrepf A, Mawla I, Ichesco E, Boehnke KF, Beltz A, Foxen-Craft E, Puglia MP, Tsodikov A, Williams DA, Hassett AL, Clauw DJ, Harte SE, Harris RE. Neurobiological antecedents of multisite pain in children. Pain. (2022) Apr 1;163(4):e596-e603.

10.  Yunus, M.B., Towards a model of pathophysiology of fibromyalgia: aberrant central pain mechanisms with peripheral modulation. J Rheumatol. (1992) 19(6): p. 846-850.

11.  Clauw, D.J. and G.P. Chrousos, Chronic pain and fatigue syndromes: Overlapping clinical and neuroendocrine features and potential pathogenic mechanisms. Neuroimmunomodulation. (1997) 4(3): p. 134-153.

12.  Apkarian, A.V., M.N. Baliki, and P. Y. Geha, Towards a theory of chronic pain. Prog Neurobiol. (2009) 87(2): p. 81-97.

13.  Tracey, I. and M.C. Bushnell, How neuroimaging studies have challenged us to rethink: is chronic pain a disease? The Journal of Pain. (2009) 10(11): p. 1113-20.

14.  Cleeland CS, Ryan KM. Pain assessment: global use of the Brief Pain Inventory.  Ann Acad Med Singap. (1994) Mar;23(2):129-38.

15.  Clauw DJ. Fibromyalgia: a clinical review. JAMA. (2014) 311(15):1547-55.

16.  Kang K, Orlandi S, Leung J, et al. Electroencephalographic interbrain synchronization in children with disabilities, their parents, and neurologic music therapists. Eur J Neurosci. Jul 2023;58(1):2367-2383. doi:10.1111/ejn.16036

17.  Bastos AM, Schoffelen JM. A Tutorial Review of Functional Connectivity Analysis Methods and Their Interpretational Pitfalls. Front Syst Neurosci. 2015;9:175. doi:10.3389/fnsys.2015.00175 

18.  Baccala LA, Sameshima K. Partial directed coherence: a new concept in neural structure determination. Biol Cybern. Jun 2001;84(6):463-74. doi:10.1007/PL00007990

19.  Joo P, Kim M, Kish B, et al. Brain network hypersensitivity underlies pain crises in sickle cell disease. Sci Rep. Mar 27 2024;14(1):7315. doi:10.1038/s41598-024-57473-5

20.  Lee U, Kim M, Lee K, et al. Functional Brain Network Mechanism of Hypersensitivity in Chronic Pain. Sci Rep. Jan 10 2018;8(1):243. doi:10.1038/s41598-017-18657-4