A novel theta-controlled vibrotactile brain–computer interface to treat chronic pain: a pilot study

Abstract

Limitations in chronic pain therapies necessitate novel interventions that are effective, accessible, and safe. Brain–computer interfaces (BCIs) provide a promising modality for targeting neuropathology underlying chronic pain by converting recorded neural activity into perceivable outputs. Recent evidence suggests that increased frontal theta power (4–7 Hz) reflects pain relief from chronic and acute pain. Further studies have suggested that vibrotactile stimulation decreases pain intensity in experimental and clinical models. This longitudinal, non-randomized, open-label pilot study's objective was to reinforce frontal theta activity in six patients with chronic upper extremity pain using a novel vibrotactile neurofeedback BCI system. Patients increased their BCI performance, reflecting thought-driven control of neurofeedback, and showed a significant decrease in pain severity (1.29 ± 0.25 MAD, p = 0.03, q = 0.05) and pain interference (1.79 ± 1.10 MAD p = 0.03, q = 0.05) scores without any adverse events. Pain relief significantly correlated with frontal theta modulation. These findings highlight the potential of BCI-mediated cortico-sensory coupling of frontal theta with vibrotactile stimulation for alleviating chronic pain.

Evaluating the effectiveness of neurofeedback in chronic pain management: a narrative review

“…The types оf neurofeedback used іn the studies considered include electroencephalographic (EEG) neurofeedback, infra-low frequency (ILF) neurofeedback, volitional limbic neuromodulation, SMR-based neurofeedback, alpha-wave neurofeedback, and rt-fMRI neurofeedback ( Jensen et al, 2013 ; Guan et al, 2015 ; Hassan et al, 2015 ; Goldway et al, 2019 ; Terrasa et al, 2020 ; Arina et al, 2022 ; Demarest et al, 2024 ). These studies have shown promising results, with notable reductions іn non-pain-related symptoms and pain relief іn patients with chronic pain ( Terrasa et al, 2020 ; Barbosa-Torres and Delgado, 2021 ; Shimizu et al, 2022 ) and with a significant impact оn pain intensity іn the immediate period ( Hesam-Shariati et al, 2022 ).…”