The mechanism of neurofeedback training for treatment of central neuropathic pain in paraplegia: a pilot study

Hassan, M. A., Fraser, M., Conway, B. A., Allan, D. B. and Vuckovic, A. (2015) The mechanism of neurofeedback training for treatment of central neuropathic pain in paraplegia: a pilot study. BMC Neurology, 15(1), 200. (doi: 10.1186/s12883-015-0445-7) (PMID:26462651) (PMCID:PMC4604632)

[img]
Preview
Text
111389.pdf - Published Version
Available under License Creative Commons Attribution.

2MB

Abstract

Background: Central neuropathic pain has a prevalence of 40 % in patients with spinal cord injury. Electroencephalography (EEG) studies showed that this type of pain has identifiable signatures, that could potentially be targeted by a neuromodulation therapy. The aim of the study was to investigate the putative mechanism of neurofeedback training on central neuropathic pain and its underlying brain signatures in patients with chronic paraplegia. Methods: Patients’ EEG activity was modulated from the sensory-motor cortex, electrode location C3/Cz/C4/P4 in up to 40 training sessions Results. Six out of seven patients reported immediate reduction of pain during neurofeedback training. Best results were achieved with suppressing Ɵ and higher β (20–30 Hz) power and reinforcing α power at C4. Four patients reported clinically significant long-term reduction of pain (>30 %) which lasted at least a month beyond the therapy. EEG during neurofeedback revealed a wide spread modulation of power in all three frequency bands accompanied with changes in the coherence most notable in the beta band. The standardized low resolution electromagnetic tomography analysis of EEG before and after neurofeedback therapy showed the statistically significant reduction of power in beta frequency band in all tested patients. Areas with reduced power included the Dorsolateral Prefrontal Cortex, the Anterior Cingulate Cortex and the Insular Cortex. Conclusions: Neurofeedback training produces both immediate and longer term reduction of central neuropathic pain that is accompanied with a measurable short and long term modulation of cortical activity. Controlled trials are required to confirm the efficacy of this neurofeedback protocol on treatment of pain. The study is a registered UKCRN clinical trial Nr 9824.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Vuckovic, Dr Aleksandra
Authors: Hassan, M. A., Fraser, M., Conway, B. A., Allan, D. B., and Vuckovic, A.
College/School:College of Science and Engineering > School of Engineering > Biomedical Engineering
Journal Name:BMC Neurology
Publisher:Biomed Central
ISSN:1471-2377
ISSN (Online):1471-2377
Copyright Holders:Copyright © 2015 Hassan et al.
First Published:First published in BMC Neurology 15(1):200
Publisher Policy:Reproduced under a Creative Commons License

University Staff: Request a correction | Enlighten Editors: Update this record

Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
533931Neurofeedback for treatent of neuropathic pain in patients with spinal cord injuryAleksandra VuckovicMedical Research Council (MRC)G0902257ENG - BIOMEDICAL ENGINEERING