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

Muhammad Abul Hansan, Matthew Fraser, Bernard A. Conway, David B. Allan, Aleksandra Vukovic

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

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. 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. 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.
LanguageEnglish
Article number200
Number of pages13
JournalBMC Neurology
Volume15
Early online date13 Oct 2015
DOIs
Publication statusPublished - 13 Oct 2015

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Neurofeedback
Paraplegia
Neuralgia
Electroencephalography
Frequency bands
Pain
Modulation
Therapeutics
Tomography
Brain
Electromagnetic Phenomena
Gyrus Cinguli
Clinical Protocols
Prefrontal Cortex
Spinal Cord Injuries
Cerebral Cortex
Electrodes
Power (Psychology)
Clinical Trials

Keywords

  • central neuropathic pain
  • neurofeedback
  • electroencephalography
  • paraplegia

Cite this

Hansan, Muhammad Abul ; Fraser, Matthew ; Conway, Bernard A. ; Allan, David B. ; Vukovic, Aleksandra. / The mechanism of neurofeedback training for treatment of central neuropathic pain in paraplegia : a pilot study. In: BMC Neurology. 2015 ; Vol. 15.
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The mechanism of neurofeedback training for treatment of central neuropathic pain in paraplegia : a pilot study. / Hansan, Muhammad Abul; Fraser, Matthew; Conway, Bernard A.; Allan, David B.; Vukovic, Aleksandra.

In: BMC Neurology, Vol. 15, 200, 13.10.2015.

Research output: Contribution to journalArticle

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