{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:07:17Z","timestamp":1772168837309,"version":"3.50.1"},"reference-count":27,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2017,6,15]],"date-time":"2017-06-15T00:00:00Z","timestamp":1497484800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns4:p>\n                    <ns4:bold>Background:<\/ns4:bold>\n                    Fibromyalgia and complex regional pain syndrome (CRPS) are both chronic pain syndromes with pathophysiologic mechanisms related to autonomic nervous system dysregulation and central sensitization.\u00a0 Both syndromes are considered difficult to treat with conventional pain therapies.\n                    <ns4:bold>Case presentations:<\/ns4:bold>\n                    Here we describe a female veteran with fibromyalgia and a male veteran with CRPS, both of whom failed multiple pharmacologic, physical and psychological therapies for pain, but responded to percutaneous electrical neural field stimulation (PENFS) targeted at the auricular branches of the cranial nerves.\n                    <ns4:bold>Discussion:<\/ns4:bold>\n                    While PENFS applied to the body has been previously described for treatment of localized pain, PENFS effects on cranial nerve branches of the ear is not well-known, particularly when used for regional and full-body pain syndromes such as those described here. PENFS of the ear is a minimally-invasive, non-pharmacologic therapy that could lead to improved quality of life and decreased reliance on medication. However, further research is needed to guide clinical application, particularly in complex pain patients.\n                  <\/ns4:p>","DOI":"10.12688\/f1000research.11494.1","type":"journal-article","created":{"date-parts":[[2017,6,15]],"date-time":"2017-06-15T10:10:16Z","timestamp":1497521416000},"page":"920","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Case report: Percutaneous electrical neural field stimulation in two cases of sympathetically-mediated pain"],"prefix":"10.12688","volume":"6","author":[{"given":"Lynn","family":"Fraser","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0644-6049","authenticated-orcid":false,"given":"Anna","family":"Woodbury","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2017,6,15]]},"reference":[{"key":"ref-1","doi-asserted-by":"publisher","first-page":"99-108","DOI":"10.1016\/j.psyneuen.2016.07.202","article-title":"Posttraumatic stress disorder influences the nociceptive and intrathecal cytokine response to a painful stimulus in combat veterans.","volume":"73","author":"I Lerman","year":"2016","journal-title":"Psychoneuroendocrinology."},{"key":"ref-2","doi-asserted-by":"publisher","first-page":"31-37","DOI":"10.1016\/j.ptsp.2016.03.003","article-title":"Parameters of low back pain chronicity among athletes: Associations with physical and mental stress.","volume":"21","author":"J Heidari","year":"2016","journal-title":"Phys Ther Sport."},{"key":"ref-3","doi-asserted-by":"publisher","first-page":"1257-1270","DOI":"10.1002\/jnr.23802","article-title":"Psychological stress in early life as a predisposing factor for the development of chronic pain: Clinical and preclinical evidence and neurobiological mechanisms.","volume":"95","author":"N Burke","year":"2016","journal-title":"J Neurosci Res."},{"key":"ref-4","doi-asserted-by":"publisher","first-page":"49-55","DOI":"10.1016\/j.jneuroim.2015.02.002","article-title":"Evidence of different mediators of central inflammation in dysfunctional and inflammatory pain--interleukin-8 in fibromyalgia and interleukin-1 \u03b2 in rheumatoid arthritis.","volume":"280","author":"E Kosek","year":"2015","journal-title":"J Neuroimmunol."},{"key":"ref-5","doi-asserted-by":"publisher","first-page":"301-309","DOI":"10.5535\/arm.2016.40.2.301","article-title":"Heart Rate Variability for Quantification of Autonomic Dysfunction in Fibromyalgia.","volume":"40","author":"J Kang","year":"2016","journal-title":"Ann Rehabil Med."},{"key":"ref-6","first-page":"S53-57","article-title":"Relationship between sympathetic activity and pain intensity in fibromyalgia.","volume":"33","author":"A Zamun\u00e9r","year":"2015","journal-title":"Clin Exp Rheumatol."},{"key":"ref-7","doi-asserted-by":"publisher","first-page":"68-75","DOI":"10.1016\/j.semarthrit.2014.01.001","article-title":"Central sensitization in fibromyalgia? A systematic review on structural and functional brain MRI.","volume":"44","author":"B Cagnie","year":"2014","journal-title":"Semin Arthritis Rheum."},{"key":"ref-8","doi-asserted-by":"publisher","first-page":"1478-89","DOI":"10.1002\/ejp.872","article-title":"Differential psychophysiological effects of operant and cognitive behavioural treatments in women with fibromyalgia.","volume":"20","author":"K Thieme","year":"2016","journal-title":"Eur J Pain."},{"key":"ref-9","doi-asserted-by":"publisher","first-page":"114-129","DOI":"10.1016\/j.neuroscience.2016.06.006","article-title":"Neurobiology of fibromyalgia and chronic widespread pain.","volume":"338","author":"K Sluka","year":"2016","journal-title":"Neuroscience."},{"key":"ref-10","doi-asserted-by":"publisher","first-page":"339-352","DOI":"10.1016\/j.semarthrit.2007.09.003","article-title":"Central sensitivity syndromes: a new paradigm and group nosology for fibromyalgia and overlapping conditions, and the related issue of disease versus illness.","volume":"37","author":"M Yunus","year":"2008","journal-title":"Semin Arthritis Rheum."},{"key":"ref-11","doi-asserted-by":"publisher","first-page":"16","DOI":"10.3389\/fnhum.2016.00016","article-title":"Neurocognitive and Neuroplastic Mechanisms of Novel Clinical Signs in CRPS.","volume":"10","author":"A Kuttikat","year":"2016","journal-title":"Front Hum Neurosci."},{"key":"ref-12","doi-asserted-by":"publisher","first-page":"1224-1236","DOI":"10.1016\/j.pain.2013.03.033","article-title":"Epidermal adrenergic signaling contributes to inflammation and pain sensitization in a rat model of complex regional pain syndrome.","volume":"154","author":"W Li","year":"2013","journal-title":"Pain."},{"key":"ref-13","doi-asserted-by":"publisher","first-page":"102-107","DOI":"10.1016\/j.autneu.2013.12.011","article-title":"Inflammation in CRPS: role of the sympathetic supply.","volume":"182","author":"T Schlereth","year":"2014","journal-title":"Auton Neurosci."},{"key":"ref-14","doi-asserted-by":"publisher","first-page":"CD009416","DOI":"10.1002\/14651858.CD009416.pub2","article-title":"Interventions for treating pain and disability in adults with complex regional pain syndrome.","author":"N O'Connell","year":"2013","journal-title":"Cochrane Database Syst Rev."},{"key":"ref-15","doi-asserted-by":"publisher","first-page":"1498-1508","DOI":"10.1111\/j.1742-1241.2007.01480.x","article-title":"Characteristics and healthcare costs of patients with fibromyalgia syndrome.","volume":"61","author":"A Berger","year":"2007","journal-title":"Int J Clin Pract."},{"key":"ref-16","doi-asserted-by":"publisher","first-page":"CD007070","DOI":"10.1002\/14651858.CD007070.pub2","article-title":"Acupuncture for treating fibromyalgia.","author":"J Deare","year":"2013","journal-title":"Cochrane Database Syst Rev."},{"key":"ref-17","doi-asserted-by":"publisher","first-page":"469-479","DOI":"10.2147\/JPR.S111035","article-title":"Fixed-site high-frequency transcutaneous electrical nerve stimulation for treatment of chronic low back and lower extremity pain.","volume":"9","author":"S Gozani","year":"2016","journal-title":"J Pain Res."},{"key":"ref-18","first-page":"E121-128","article-title":"A Novel Mini-invasive Approach to the Treatment of Neuropathic Pain: The PENS Study.","volume":"19","author":"M Rossi","year":"2016","journal-title":"Pain Physician."},{"key":"ref-19","doi-asserted-by":"publisher","first-page":"777-789","DOI":"10.1111\/j.1526-4637.2012.01385.x","article-title":"Evoked pain analgesia in chronic pelvic pain patients using respiratory-gated auricular vagal afferent nerve stimulation.","volume":"13","author":"V Napadow","year":"2012","journal-title":"Pain Med."},{"key":"ref-20","doi-asserted-by":"publisher","first-page":"71-78","DOI":"10.1111\/head.12647","article-title":"Vagus Nerve and Vagus Nerve Stimulation, a Comprehensive Review: Part I.","volume":"56","author":"H Yuan","year":"2016","journal-title":"Headache."},{"key":"ref-21","doi-asserted-by":"publisher","first-page":"479-490","DOI":"10.1111\/head.12649","article-title":"Vagus Nerve and Vagus Nerve Stimulation, a Comprehensive Review: Part III.","volume":"56","author":"H Yuan","year":"2016","journal-title":"Headache."},{"key":"ref-22","doi-asserted-by":"publisher","first-page":"611-621","DOI":"10.1213\/ane.0b013e318160644d","article-title":"Acupuncture analgesia: II. Clinical considerations.","volume":"106","author":"S Wang","year":"2008","journal-title":"Anesth Analg."},{"key":"ref-23","doi-asserted-by":"publisher","first-page":"84-103","DOI":"10.1016\/j.brainres.2009.06.061","article-title":"Acupuncture mobilizes the brain's default mode and its anti-correlated network in healthy subjects.","volume":"1287","author":"K Hui","year":"2009","journal-title":"Brain Res."},{"key":"ref-24","first-page":"17-21","article-title":"Decrease in VAS Score Following Placement of a Percutaneous Peri-Auricular Peripheral Nerve Field Stimulator.","volume":"5","author":"A Roberts","year":"2015","journal-title":"Clinical Medicine and Diagnostics."},{"key":"ref-25","doi-asserted-by":"publisher","first-page":"E202-212","DOI":"10.1111\/aor.12621","article-title":"Modulation of Muscle Tone and Sympathovagal Balance in Cervical Dystonia Using Percutaneous Stimulation of the Auricular Vagus Nerve.","volume":"39","author":"S Kampusch","year":"2015","journal-title":"Artif Organs."},{"key":"ref-26","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1007\/s11916-015-0528-6","article-title":"Review of the Uses of Vagal Nerve Stimulation in Chronic Pain Management.","volume":"19","author":"K Chakravarthy","year":"2015","journal-title":"Curr Pain Headache Rep."},{"key":"ref-27","doi-asserted-by":"publisher","first-page":"592-598","DOI":"10.1111\/nmo.12760","article-title":"Modulation of vagal tone enhances gastroduodenal motility and reduces somatic pain sensitivity.","volume":"28","author":"J Fr\u00f8kjaer","year":"2016","journal-title":"Neurogastroenterol Motil."}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/6-920\/v1\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/6-920\/v1\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/6-920\/v1\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2018,12,6]],"date-time":"2018-12-06T09:21:20Z","timestamp":1544088080000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/6-920\/v1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,6,15]]},"references-count":27,"URL":"https:\/\/doi.org\/10.12688\/f1000research.11494.1","relation":{"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.12413.r23509","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.12413.r24043","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.12413.r23904","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.12413.r24043","asserted-by":"object"},{"id-type":"doi","id":"10.5256\/f1000research.12413.r23904","asserted-by":"object"},{"id-type":"doi","id":"10.5256\/f1000research.12413.r23509","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,6,15]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/6-920\/v1#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.12413.r24043, Katie Schenning, Andrei Sdrulla, Department of Anesthesiology & Perioperative Medicine, Oregon Health & Science University, Portland, OR, USA, 11 Jul 2017, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/6-920\/v1#referee-response-24043","order":0,"name":"referee-response-24043","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.12413.r23509, Albert Leung, Department of Anesthesiology, University of California, San Diego, La Jolla, CA, USA, 06 Sep 2017, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/6-920\/v1#referee-response-23509","order":1,"name":"referee-response-23509","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.12413.r23904, Dalia Elmofty, Department of Anesthesia & Critical Care, University of Chicago, Chicago, IL, USA, 04 Oct 2017, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/6-920\/v1#referee-response-23904","order":2,"name":"referee-response-23904","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":3,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}