Home used, patient self-managed, brain-computer interface for the management of central neuropathic pain post spinal cord injury: usability study

Al-Taleb, M.K.H., Purcell, M., Fraser, M., Petric-Gray, N. and Vuckovic, A. (2019) Home used, patient self-managed, brain-computer interface for the management of central neuropathic pain post spinal cord injury: usability study. Journal of NeuroEngineering and Rehabilitation, 16, 128. (doi: 10.1186/s12984-019-0588-7) (PMID:31666096) (PMCID:PMC6822418)

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Background: Central Neuropathic Pain (CNP) is a frequent chronic condition in people with spinal cord injury (SCI). Previously, we showed that using laboratory brain-computer interface (BCI) technology for neurofeedback (NFB) training, it was possible to reduce CNP in people with SCI. In this study, we show results of patient self-managed treatment in their homes with a BCI-NFB using a consumer EEG device. Methods Users: People with chronic SCI (17 M, 3 F, 50.6 ± 14.1 years old), and CNP ≥4 on a Visual Numerical Scale. Location: Laboratory training (up to 4 sessions) followed by home self-managed NFB. User Activity: Upregulating the EEG alpha band power by 10% above a threshold and at the same time downregulating the theta and upper beta (20-30 Hz) band power by 10% at electrode location C4. Technology: A consumer grade multichannel EEG headset (Epoch, Emotiv, USA), a tablet computer and custom made NFB software. Evaluation: EEG analysis, before and after NFB assessment, interviews and questionnaires. Results Effectiveness: Out of 20 initially assessed participants, 15 took part in the study. Participants used the system for 6.9 ± 5.5 (median 4) weeks. Twelve participants regulated their brainwaves in a frequency specific manner and were most successful upregulating the alpha band power. However they typically upregulated power around their individual alpha peak (7.6 ± 0.8 Hz) that was lower than in people without CNP. The reduction in pain experienced was statistically significant in 12 and clinically significant (greater than 30%) in 8 participants. Efficiency: The donning was between 5 and 15 min, and approximately 10–20% of EEG data recorded in the home environment was noise. Participants were mildly stressed when self-administering NFB at home (2.4 on a scale 1–10). User satisfaction: Nine participants who completed the final assessment reported a high level of satisfaction (QUESQ, 4.5 ± 0.8), naming effectiveness, ease of use and comfort as main priorities. The main factors influencing frequency of NFB training were: health related issues, free time and pain intensity. Conclusion: Portable NFB is a feasible solution for home-based self-managed treatment of CNP. Compared to pharmacological treatments, NFB has less side effects and provides users with active control over pain. Trial registration: GN15NE124, Registered 9th June 2016.

Item Type:Articles
Additional Information:This study has been funded by Inspire Foundation UK, EPSCR EP/M506539/1 and EP/M506539/1and by the Higher Committee for Education Development, Iraq.
Glasgow Author(s) Enlighten ID:Petric-Gray, Miss Nina and Al-Taleb, Mr Manaf and Vuckovic, Dr Aleksandra
Authors: Al-Taleb, M.K.H., Purcell, M., Fraser, M., Petric-Gray, N., and Vuckovic, A.
College/School:College of Science and Engineering > School of Engineering > Biomedical Engineering
Journal Name:Journal of NeuroEngineering and Rehabilitation
Publisher:BioMed Central
ISSN (Online):1743-0003
Copyright Holders:Copyright © 2019 The Authors
First Published:First published in Journal of NeuroEngineering and Rehabilitation 16:128
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
679091QT-EPSRC: QT DemonstratorGiles HammondEngineering and Physical Sciences Research Council (EPSRC)EP/M506539/1S&E P&A - PHYSICS & ASTRONOMY