Randomized controlled trial of neurofeedback on chemotherapy‐induced peripheral neuropathy: A pilot study

Abstract

BACKGROUND Chemotherapy-induced peripheral neuropathy (CIPN) is a significant problem for cancer patients, and there are limited treatment options for this often debilitating condition. Neuromodulatory interventions could be a novel modality for patients trying to manage CIPN symptoms; however, they are not yet the standard of care. This study examined whether electroencephalogram (EEG) neurofeedback (NFB) could alleviate CIPN symptoms in survivors. METHODS This was a randomized controlled trial with survivors assigned to an NFB group or a wait-list control (WLC) group. The NFB group underwent 20 sessions of NFB, in which visual and auditory rewards were given for voluntary changes in EEGs. The Brief Pain Inventory (BPI) worst-pain item was the primary outcome. The BPI, the Pain Quality Assessment Scale, and EEGs were collected before NFB and again after treatment. Outcomes were assessed with general linear modeling. RESULTS Cancer survivors with CIPN (average duration of symptoms, 25.3 mo), who were mostly female and had a mean age of 62.5 years, were recruited between April 2011 and September 2014. One hundred percent of the participants starting the NFB program completed it (30 in the NFB group and 32 in the WLC group). The NFB group demonstrated greater improvement than the controls on the BPI worst-pain item (mean change score, −2.43 [95% confidence interval, −3.58 to −1.28] vs 0.09 [95% confidence interval, −0.72 to −0.90]; P 5 .001; effect size, 0.83). CONCLUSIONS NFB appears to be effective at reducing CIPN symptoms. There was evidence of neurological changes in the cortical location and in the bandwidth targeted by the intervention, and changes in EEG activity were predictive of symptom reduction.

The Long-Term Impact of Neurofeedback on Symptom Burden and Interference in Patients With Chronic Chemotherapy-Induced Neuropathy: Analysis of a Randomized Controlled Trial

“…31 However, in our recently published article of the primary outcomes for this study (up to the end of treatment time point), we analyzed changes in brain activity in relation to NFB and in association with pain outcomes and found statistically significant differences over time and between groups within the EEG frequencies and scalp locations we were training. 15 We also explored changes in brain function in regions known to be active with a placebo and concluded that although placebo could be a factor in this study, it was not the only factor leading to improvement in symptoms because placebo brain regions showed activity in both the NFB and WLC groups. 15 Future research would benefit from the addition of a placebo feedback group to control for attention and also to examine brain activity associated with placebo NFB.…”

“…15 We also explored changes in brain function in regions known to be active with a placebo and concluded that although placebo could be a factor in this study, it was not the only factor leading to improvement in symptoms because placebo brain regions showed activity in both the NFB and WLC groups. 15 Future research would benefit from the addition of a placebo feedback group to control for attention and also to examine brain activity associated with placebo NFB. Finally, we hypothesize that NFB has distinct effects depending on location of the feedback on the scalp.…”

“…Our primary aim was to evaluate the effect of 20 sessions of NFB vs. waitlist controls (WLCs) on self-report of worst pain as measured by the Brief Pain Inventory (BPI), 18 where we previously reported that NFB resulted in statistically and clinically significant group difference between treatment and control groups after the 20 sessions of NFB. 15 The article explored the secondary aims and the long-term effects of NFB on CIPN symptoms and other aspects of QOL.…”

Evidence Based Complementary Approaches in the Management of Chemotherapy-Induced Peripheral Neuropathy in Cancer Patients

“…(42) EEG nörofeedback in değerlendirildiği bir çalışmada ise uygulama haftada 2 kez olacak şekilde toplam 20 seans uygulanmış ve nöropati semptomlarını azaltmada etkili olduğu EEG sonuçlarıyla tespit edilmiştir. (43)…”

Chemotherapy‐induced neuropathy: Central resolution of a peripherally perceived problem?

“…A randomized controlled trial by Prinsloo et al introduces a different approach to the treatment of CIPN using electroencephalogram (EEG) neurofeedback. In this trial, 30 participants with CIPN were randomized to the neurofeedback arm.…”