A Control Engineering Approach for Designing an Optimized Treatment Plan for Fibromyalgia.

Control engineering offers a systematic and efficient means for optimizing the effectiveness of behavioral interventions. In this paper, we present an approach to develop dynamical models and subsequently, hybrid model predictive control schemes for assigning optimal dosages of naltrexone as treatment for a chronic pain condition known as fibromyalgia. We apply system identification techniques to develop models from daily diary reports completed by participants of a naltrexone intervention trial. The dynamic model serves as the basis for applying model predictive control as a decision algorithm for automated dosage selection of naltrexone in the face of the external disturbances. The categorical/discrete nature of the dosage assignment creates a need for hybrid model predictive control (HMPC) schemes. Simulation results that include conditions of significant plant-model mismatch demonstrate the performance and applicability of hybrid predictive control for optimized adaptive interventions for fibromyalgia treatment involving naltrexone.