# Neurobiological and Psychological Benefits of Exercise in Fibromyalgia and PTSD

> **NIH VA I21** · VA BOSTON HEALTH CARE SYSTEM · 2021 · —

## Abstract

This study will compare the effects of a 12-week progressive exercise training program on 1) Fibromyalgia
(FM) pain and PTSD symptoms, 2) pain threshold and tolerance, and 3) relevant biomarkers and
neuromodulators including: a) anti-stress, anti-nociceptive, immune modulating factors such as neuropeptide
Y (NPY) and GABAergic neuroactive steroids such as allopregnanolone and pregnanolone (together termed
ALLO) b) factors that upregulate the expression of NPY and the GABAergic neuroactive steroids, and
otherwise modulate inflammation, such as cortisol, c) excitatory factors such as substance P that directly
promote pain transduction and d) pro-inflammatory cytokines such as IL-6 and IL-8 that not only increase pain
and inflammation, but also contribute to psychological dysfunction (e.g. anhedonia and depression) via impact
on the CNS reward system. This study will focus on Veterans with FM/PTSD. The study design includes a
baseline, acute, cardiopulmonary exercise assessment (CPX) that will inform the exercise prescription for a 12-
week “progressive exercise” training program, comprised of three 30-45 minute exercise sessions per week
(walking or running, depending on the ability/capacity of the participant). Exercise sessions will be initially
supervised by an exercise physiologist in the Clinical Studies Unit (CSU) at the VA Boston Healthcare System
and then each participant will transition into the home. Weekly telephone calls by the PI will provide additional
motivational support and problem solving. Implementation of the prescribed exercise regimen will also be
supported by the use of heart rate and actigraph monitors programmed for the participant to achieve their
prescribed heart rate range (HRR). Finally, an “endpoint” CPX assessment will occur at week 13 to track
changes in psychological and neurobiological factors and to delineate their impact on pain and PTSD
symptoms. Both CPX, maximum load, exercise tests will be performed in accordance with guidelines
published by the American College of Cardiology. Among Veterans with FM/PTSD, changes in the biomarkers
assessed after acute, CPX exercise testing will be associated with improvements in pain and PTSD symptoms.
Once identified, such biomarkers could be augmented by modification of the exercise regimen to help enhance
the anti-stress hormone levels for the FM/PTSD population and experience clinically significant reductions in
their symptoms. To obtain sufficient power, 36 participants (18/year) will be recruited. Data from this pilot
work will be used to demonstrate feasibility and inform the further development of individually prescribed
exercise regimens and a motivationally based exercise behavior change intervention aimed at reducing chronic
musculoskeletal pain, including FM, and PTSD symptoms in Veterans. In the short-term, this SPiRE proposal
will allow the PI to develop a more effective, motivationally based, exercise behavior change protocol that
fosters long-term exercise adh...

## Key facts

- **NIH application ID:** 10401751
- **Project number:** 5I21RX002395-04
- **Recipient organization:** VA BOSTON HEALTH CARE SYSTEM
- **Principal Investigator:** Erica Rose Checko (Scioli)
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2018-01-01 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10401751

## Citation

> US National Institutes of Health, RePORTER application 10401751, Neurobiological and Psychological Benefits of Exercise in Fibromyalgia and PTSD (5I21RX002395-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10401751. Licensed CC0.

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