Employing α-wave EEG-based neurofeedback in low-back pain management: a longitudinal study
Poster No:
2514
Submission Type:
Abstract Submission
Authors:
Manal Ikram1, Camille Grande2, Djamel Dabli3, Alexis Hom3, Jean Paul Beregi3, Arnaud Dupeyron1, Fabricio Pereira4
Institutions:
1University of Montpellier, Montpellier, Occitanie, 2Aix-Marseille University, Marseille, Provence-Alpes-Côte d’Azur, 3University Hospital Center of Nimes, Nimes, Occitanie, 4University of Nimes, Nimes, Occitanie
First Author:
Co-Author(s):
Introduction:
Chronic low back pain (cLBP) is a pervasive issue impacting nearly a quarter of the population, highlighting its widespread prevalence and impact across various age groups.[1] This enduring condition, persisting for a minimum of 12 weeks, casts a significant shadow over the lives of those affected, subjecting them to prolonged discomfort and distress. Despite the manifold therapeutic approaches, including traditional pharmacological and manual treatments, many individuals grapple with ongoing pain, revealing the insufficiency of existing methods in providing lasting relief.[2] As this chronic ailment persists and substantially impairs the well-being of a significant portion of society, the quest for novel and more efficacious interventions becomes increasingly urgent.
Studies suggest that higher power of alpha waves, neural oscillations ranging from 8 to 12 Hz, could lessen the intensity of pain. Thus, inducing alpha waves in cLBP individuals might offer a better pain management, though the exact mechanisms are still under exploration in neuroscience. In this longitudinal study, quantitative EEG (qEEG) was utilized to capture real-time measurements of individuals' alpha-wave power and induce alpha-wave synchronization in patients experiencing chronic low back pain (cLBP). Daily sessions of neurofeedback were implemented and followed-up. EEG pattern was correlated with physical and mental pain. Finally, the efficacy of this intervention was assessed through comprehensive clinical evaluations. This comprehensive methodological framework aimed to provide a thorough understanding of the intervention's impact on both the subjective experiences of pain and the overall clinical status of individuals enduring chronic low back pain
Studies suggest that higher power of alpha waves, neural oscillations ranging from 8 to 12 Hz, could lessen the intensity of pain. Thus, inducing alpha waves in cLBP individuals might offer a better pain management, though the exact mechanisms are still under exploration in neuroscience. In this longitudinal study, quantitative EEG (qEEG) was utilized to capture real-time measurements of individuals' alpha-wave power and induce alpha-wave synchronization in patients experiencing chronic low back pain (cLBP). Daily sessions of neurofeedback were implemented and followed-up. EEG pattern was correlated with physical and mental pain. Finally, the efficacy of this intervention was assessed through comprehensive clinical evaluations. This comprehensive methodological framework aimed to provide a thorough understanding of the intervention's impact on both the subjective experiences of pain and the overall clinical status of individuals enduring chronic low back pain
Methods:
The study was registered as Trial #NCT03929952, and all participants provided informed consent. Twelve patients diagnosed with cLBP aged from 28 to 58 years were enroled. Their pain intensity, rated above 5 on the Visual Analog Scale (EVA), significantly impacted their daily functionality, indicated by high scores on the Oswestry Disability Index (ODI). During the study, participants engaged in daily 30-minute sessions of an EEG-based closed-loop neurofeedback program for 20 consecutive days, focusing on a visual stimulus resembling a flame while real-time alpha-wave power was computed. They were rewarded based on achieving predominant EEG frequencies between 7 and 14 hertz. The collected EEG data underwent preprocessing, including file conversion, band-pass filtering, Independent Component Analysis (ICA), brain map generation, normalization, and statistical analyses, examining changes in alpha-synchrony and its correlation with clinical assessments
Results:
Longitudinal analysis revealed a significant increase (p<.05) in alpha-wave power in the frontal regions, particularly around electrode Fz, while a decrease in activity was observed in parieto-temporal regions throughout the neurofeedback program [Figure 1: first (a) and last (b) sessions]. Additionally, statistical tendencies (p<.06) indicated negative correlations between F3, F4, and Fz with EVA (r=-.42/-.46/.51) and ODI (r=-.37/-.33/.43), whereas C3 and C4 electrodes exhibited positive correlations for EVA (r=.29/.32) and ODI (r=.25/.29).
·The alpha-synchrony levels were compared between the initial (a) and final (b) EEG sessions.
Conclusions:
Neuromodulation based on alpha-synchronization is associated with electrical changes in frontal regions and may play a critical role in managing pain in cLBP
Brain Stimulation:
Non-Invasive Stimulation Methods Other 2
Perception, Attention and Motor Behavior:
Perception: Pain and Visceral 1
Keywords:
Electroencephaolography (EEG)
FUNCTIONAL MRI
Pain
Other - Neurofeedback
1|2Indicates the priority used for review
Provide references using author date format
[2] Bushnell, M. C. (2013), ‘Cognitive and emotional control of pain and its disruption in chronic pain’, Nature Reviews Neuroscience, 14(7), 502–511.