A pilot study on clinical and neurological effects of neurofeedback training for treatment of central neuropathic pain

The aim of the study was to investigate the effect of neurofeedback training on central neuropathic pain in patients with chronic paraplegia. Patients EEG activity was modulated from the central areas of the cortex, electrode location C3/Cz/C4. Training consisted of reducing EEG power in theta (4-8 Hz) and higher beta (20-30 Hz) frequency ranges and increasing power in the higher alpha range (9-12 Hz). Patients received 20-40 neurofeedback treatment and four out of five patients reported clinically significant reduction of pain (>30%). EEG during neurofeedback revealed a wide spread modulation of power in all three frequency bands accompanied with changes in the coherence. LORETA analysis of EEG before and after neurofeedback therapy revealed general reduction of power in all frequency bands, most notably in 12-15 Hz and 20-30 Hz bands. Areas with reduced power included the Anterior Cingulate Cortex and the Insular Cortex, known to be involved in processing of chronic pain. Further studies on larger number of patients will be needed to confirm clinical relevance of neurofeedback therapy for treatment of central neuropathic pain