EEG Neurofeedback in the Treatment of Chronic Pain: A Case Series

Edward H. Jacobs, Mark P. Jensen

Abstract


Neurofeedback has been used to treat a variety of problems and symptoms related to central nervous system dysregulation, including chronic pain conditions.  However, there is limited published work describing the application and efficacy of neurofeedback for chronic pain.  This case series describes the outcomes of neurofeedback treatment of four patients with diverse diagnoses and pain symptoms.  Although there was variability in patient response, all patients reported improvements in pain and other symptoms with treatment.  The findings indicate that more research to (1) clarify the benefits of neurofeedback for different conditions and (2) identify the most effective protocols for individual patients is warranted.


Keywords


neurofeedback; chronic pain; migraine; gastrointestinal pain; testicular pain

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References


Albert, A. O., Andrasik, F., Moore, J. L., & Dunn, B. R. (1998). Theta/beta training for attention, concentration and memory improvement in the geriatric population. Applied Psychophysiology and Biofeedback, 23(2), 109.

Andreychuk, T., & Skriver, C. (1975). Hypnosis and biofeedback in the treatment of migraine headache. International Journal of Clinical and Experimental Hypnosis, 23(3), 172–183.

Apkarian, A. V., Bushnell, M. C., Treede, R.-D., & Zubeita, J.-K. (2005). Human brain mechanisms of pain perception and regulation in health and disease. European Journal of Pain, 9(4), 463–484. http://dx.doi.org/10.1016/j.ejpain.2004.11.001

Arns, M., Conners, C. K., & Kraemer, H. C. (2013). A decade of EEG theta/beta ratio research in ADHD: A meta-analysis. Journal of Attention Disorders, 17(5), 374–383. http://dx.doi.org/10.1177/1087054712460087

Arns, M., de Ridder, S., Strehl, U., Breteler, M., & Coenen, A. (2009). Efficacy of neurofeedback treatment in ADHD: The effects on inattention, impulsivity and hyperactivity: A meta-analysis. Clinical EEG and Neuroscience, 40(3), 180–189. http://dx.doi.org/10.1177/155005940904000311

Arns, M., Heinrich, H., & Strehl, U. (2014). Evaluation of neurofeedback in ADHD: The long and winding road. Biological Psychology, 95, 108–115. http://dx.doi.org/10.1016/j.biopsycho.2013.11.013

Babiloni, C., Brancucci, A., Babiloni, F., Capotosto, P., Carducci, F., Cincotti, F., … Rossini, P. M. (2003). Anticipatory cortical responses during the expectancy of a predictable painful stimulation. A high-resolution electroencephalography study. European Journal of Neuroscience, 18(6), 1692–1700. http://dx.doi.org/10.1046/j.1460-9568.2003.02851.x

Babiloni, C., Capotosto, P., Brancucci, A., Del Percio, C., Petrini, L., Buttiglione, M., … Arendt-Nielsen, L. (2008). Cortical alpha rhythms are related to the anticipation of sensorimotor interaction between painful stimuli and movements: A high-resolution EEG study. The Journal of Pain, 9(10), 902–911. http://dx.doi.org/10.1016/j.jpain.2008.05.007

Baehr, E., Rosenfeld, J. P., Baehr, R., & Earnest, C. (1999). Clinical use of an alpha asymmetry neurofeedback protocol in the treatment of mood disorders. In J. R. Evans, & A. Arbarbanel (Eds.), Introduction to Quantitative EEG and Neurofeedback (pp. 181–203). New York: Academic Press.

Bromm, B., & Lorenz, J. (1998). Neurophysiological evaluation of pain. Electroencephalography and Clinical Neurophysiology, 107(4), 227–253. http://dx.doi.org/10.1016/S0013-4694(98)00075-3

Burroughs, R. D. (2011). Quantitative EEG Analysis of Patients with Chronic Pain: An Exploratory Study. (Master of Science thesis). Retrieved from University of North Texas (UNT) Digital Library, Denton, Texas.

http://digital.library.unt.edu/ark:/67531/metadc103294

Chen, A. C. N. (2001). New perspectives in EEG/MEG brain mapping and PET/fMRI neuroimaging of human pain. International Journal of Psychophysiology, 42(2), 147–159. http://dx.doi.org/10.1016/S0167-8760(01)00163-5

Choobforoushzadeh, A., Neshat-Doost, H. T., Molavi, H., & Abedi, M. R. (2015). Effect of neurofeedback training on depression and fatigue in patients with multiple sclerosis. Applied Psychophysiology and Biofeedback, 40(1), 1–8. http://dx.doi.org/10.1007/s10484-014-9267-4

Cohen, M. J., McArthur, D. L., & Rickles, W. H. (1980). Comparison of four biofeedback treatments for migraine headache: physiological and headache variables. Psychosomatic Medicine, 42(5), 463–480.

Craig, A. D. (2003a). Interoception: The sense of physiological condition of the body. Current Opinion in Neurobiology, 13(4), 500–505. http://dx.doi.org/10.1016/S0959-4388(03)00090-4

Craig, A. D. (2003b). Pain mechanisms: Labeled lines versus convergence in central processing. Annual Review of Neuroscience, 26, 1–30. http://dx.doi.org/ 10.1146/annurev.neuro.26.041002.131022

Cunningham, M., & Murphy, P. (1981). The effects of bilateral EEG biofeedback on verbal, visuospatial and creative skills in LD male adolescents. Journal of Learning Disabilities, 14(4), 204–208.

DeCharmes, R. C., Maeda, F., Glover, G. H., Ludlow, D., Pauly, J. M., Soneji, D., … Mackey, S. C. (2005). Control over brain activation and pain learned by using real-time functional fMRI. Proceedings of the National Academy of Sciences of the United States of America, 102(51), 18626–18631. http://dx.doi.org/10.1073/pnas.0505210102

DeLeo, J. A. (2006). Basic science of pain. The Journal of Bone and Joint Surgery, 88(Suppl. 2), 58–62.

http://dx.doi.org/10.2106/JBJS.E.01286

Dworkin, R. H., Turk, D. C., Farrar, J. T., Haythornthwaite, J. A., Jensen, M. P., Katz, N. P., … Winter, J.. (2005). Core outcome measures for chronic pain clinical trials: IMMPACT recommendations. Pain, 113(1–2), 9–19. http://dx.doi.org/10.1016/j.pain.2004.09.012

Egner, T., & Gruzelier, J. H. (2003). Ecological validity of neurofeedback: Modulation of slow wave EEG enhances musical performance. NeuroReport, 14(9), 1221–1224. http://dx.doi.org/10.1097/00001756-200307010-00006

Escolano, C., Navarro-Gil, M., Garcia-Campayo, J., Congedo, M., & Minguez, J. (2014). The effects of individual upper alpha neurofeedback in ADHD: An open-label pilot study. Applied Psychophysiology and Biofeedback, 39(3–4), 193–202. http://dx.doi.org/10.1007/s10484-014-9257-6

Fenger, T. N. (1995, September). Visual-motor integration and its relation to EEG neurofeedback brain wave patterns, reading, spelling, and arithmetic achievement in attention deficit disorders and learning disabled students. Paper presented at the meeting of the Society for the Study of Neuronal Regulation, Scottsdale, AZ.

Flor, H. (2003). Cortical reorganisation and chronic pain: Implications for rehabilitation. Journal of Rehabilitation Medicine, 35(41), 66–72. http://dx.doi.org/ 10.1080/16501960310010179

Gannon, L., & Sternbach, R. A. (1971). Alpha enhancement as a treatment for pain: A case study. Journal of Behavior Therapy and Experimental Psychiatry, 2, 209–213.

Gruzelier, J., Egner, T., & Vernon, D. (2006). Validating the efficacy of neurofeedback for optimizing performance. Progress in Brain Research, 159, 421–431.

Gruzelier, J. (2009). A theory of alpha/theta neurofeedback, creative performance enhancement, long distance functional connectivity and psychological integration. Cognitive Processing, 10(Suppl. 1), 101–109.

http://dx.doi.org/10.1007/s10339-008-0248-5

Jensen, M. P. (2010). A neuropsychological model of pain: Research and clinical implications. The Journal of Pain, 11(1), 2–12. http://dx.doi.org/10.1016/j.jpain.2009.05.001

Jensen, M. P., Grierson, C., Tracy-Smith, V., Bacigalupi, S. C., & Othmer, S. (2007). Neurofeedback treatment for pain associated with complex regional pain syndrome type I. Journal of Neurotherapy, 11(1), 45–53. http://dx.doi.org/10.1300/J184v11n01_04

Jensen, M. P., Sherlin, L. H., Hakimian, S., & Fregni, F. (2009). Neuromodulatory approaches for chronic pain management: Research findings and clinical implications. Journal of Neurotherapy, 13(4), 196–213.

http://dx.doi.org/10.1080/10874200903334371

Katz, J., & Melzack, R. (1990). Pain “memories” in phantom limbs: Review and clinical observations. Pain, 43, 319–336.

Katz, W. A., & Rothenberg, R. (2005). The nature of pain: Pathophysiology. Journal of Clinical Rheumatology, 11(2 Suppl.), S11–S15. http://dx.doi.org/ 10.1097/01.rhu.0000158686.43637.af

Lansbergen, M. M., van Dongen-Boomsma, M., Buitelaar, J. K., & Slaats-Willemse, D. (2011). ADHD and EEG-neurofeedback: A double-blind randomized placebo-controlled feasibility study. Journal of Neural Transmission, 118(2), 275–284. http://dx.doi.org/10.1007/s00702-010-0524-2

Linden, M., Habib, T., & Radojevic, V. (1996). A controlled study of the effects of EEG biofeedback on cognition and behavior of children with attention deficit disorder and learning disabilities. Biofeedback and Self-Regulation, 21(1), 35–49.

Lindsay, P., & Wyckoff, M. (1981). The depression-pain syndrome and its response to antidepressants. Psychosomatics, 22(7), 571–577.

Logemann, H. N. A., Lansbergen, M. M., Van Os, T. W. D. P., Böcker, K. B. E., & Kenemans, J. L. (2010). The effectiveness of EEG-feedback on attention, impulsivity and EEG: A sham feedback controlled study. Neuroscience Letters, 479(1), 49–53. http://dx.doi.org/10.1016/j.neulet.2010.05.026

Lubar, J. F. (1991). Discourse on the development of EEG diagnostics and biofeedback for attention-deficit/hyperactivity disorders. Biofeedback and Self-Regulation, 16(3), 201–225. http://dx.doi.org/10.1007/BF01000016

McCraty, R., Atkinson, M., & Tomasino, D. (2001). Science of the Heart: Exploring the Role of the Heart in Human Performance (Publication No. 01-001). Boulder Creek, CA: HeartMath Research Center, Institute of HeartMath.

Melzack, R., Coderre, T. J., Katz, J., & Vaccarino, A. L. (2001). Central neuroplasticity and pathological pain. Annals of the New York Academy of Sciences, 933, 157–174, http://dx.doi.org/10.1111/j.1749-6632.2001.tb05822.x

Melzack, R., & Perry, C. (1975). Self-regulation of pain: The use of alpha-feedback and hypnotic training for the control of chronic pain. Experimental Neurology, 46, 452–469.

Miltner, W. H. R., & Weiss, T. (1998). Brain electrical correlates of pain processing. Zeitschrift für Rheumatologie, 57(2 Suppl.), S14–S18. http://dx.doi.org/10.1007/s003930050227

Monastra, V. J., Monastra, D. M., & George, S. (2002). The effects of stimulant therapy, EEG biofeedback, and parenting style on the primary symptoms of attention-deficit/hyperactivity disorder. Applied Psychophysiology and Biofeedback, 27(4), 231–249.

Murphy, P. J., Darwin, J., & Murphy, D. (1977). EEG feedback training for cerebral dysfunction: A research program with learning disabled adolescents. Biofeedback and Self-Regulation, 2, 288.

Nall, A. (1973). Alpha training and the hyperkinetic child—Is it effective? Intervention in School and Clinic, 9(1), 5–19. http://dx.doi.org/10.1177/105345127300900101

National Institute of Neurological Disorders and Stroke, National Institutes of Health. (2015). Pain in America.

Nishigami, T., Nakano, H., Osumi, M., Tsujishita, M., Mibu, A., & Ushida, T. (2014). Central neural mechanisms of interindividual difference in discomfort during sensorimotor incongruence in healthy volunteers: An experimental study. Rheumatology, 53(7), 1194–1199. http://dx.doi.org/10.1093/rheumatology/ket494

Othmer, S. F. (2005). Interhemispheric EEG training. Journal of Neurotherapy, 9(2), 87–96. http://dx.doi.org/10.1300/J184v09n02_08

Othmer, S., Othmer, S. F., & Kaiser, D. A. (1999). EEG biofeedback: Training for AD/HD and related disruptive behavior disorders. Chapter in J. A. Incorvaia, B. S. Mark-Goldstein, & D. Tessmer (Eds.), Understanding, Diagnosing, and Treating AD/HD in Children and Adolescents: An Integrative Approach (235–296). New York: Jason Aronson Press. Peyron, R., Laurent, B., & Garcia-Larrea, L. (2000). Functional imaging of brain responses to pain. A review and meta-analysis. Clinical Neurophysiology, 30(5), 263–288.

Pfurtscheller, G. (2003). Induced oscillations in the alpha band: Functional meaning. Epilepsia, 44(Suppl. 12), 2–8. http://dx.doi.org/10.1111/j.0013-9580.2003.12001.x

Prinsloo, S., Gabel, S., Lyle, R., & Cohen, L. (2012). Neuromodulation of cancer pain. Integrative Cancer Therapies,13(1), 30–37. http://dx.doi.org/10.1177/1534735413477193

Rainville, P., Duncan, G. H., Price, D. D., Carrier, B., & Bushnell, M. C. (1997). Pain affect encoded in human anterior cingulate but not in somatosensory cortex. Science, 277(5328), 968–971.

Rasey, H. W., Lubar, J. E., McIntyre, A., Zoffuto, A. C., & Abbott, P. L. (1996). EEG biofeedback for the enhancement of attentional processing in normal college students. Journal of Neurotherapy, 1(3), 15–21.

Thompson, L., &, Thompson, M. (1998). Neurofeedback combined with training in metacognitive strategies: Effectiveness in students with ADD. Applied Psychophysiology and Biofeedback, 23(4), 243–263. http://dx.doi.org/10.1023/A:1022213731956

Tinazzi, M., Fiaschi, A., Rosso, T., Faccioli, F., Grosslercher, J., & Aglioti, S. M. (2000). Neuroplastic changes related to pain occur at multiple levels of the human somatosensory system: A somatosensory-evoked potentials study in patients with cervical radicular pain. The Journal of Neuroscience, 20(24), 9277–9283.

Vernon, D., Egner, T., Cooper, N., Compton, T., Neilands, C., Sheri, A., & Gruzelier, J. (2003). The effect of training distinct neurofeedback protocols on aspects of cognitive performance. International Journal of Psychophysiology, 47(1), 75–85.

Whisenant, W. F., & Murphy, P. J. (1977). Bilateral EEG biofeedback and creativity. Biofeedback and Self-Regulation, 2, 322.




DOI: http://dx.doi.org/10.15540/nr.2.2.86

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