• Pain Med · Feb 2021

    Randomized Controlled Trial Clinical Trial

    Mobile Neurofeedback for Pain Management in Veterans with TBI and PTSD.

    • Eric B Elbogen, Amber Alsobrooks, Sara Battles, Kiera Molloy, Paul A Dennis, Jean C Beckham, Samuel A McLean, Julian R Keith, and Carmen Russoniello.
    • Veterans Affairs (VA) Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC), Durham, North Carolina, USA.
    • Pain Med. 2021 Feb 23; 22 (2): 329337329-337.

    ObjectiveChronic pain is common in military veterans with traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD). Neurofeedback, or electroencephalograph (EEG) biofeedback, has been associated with lower pain but requires frequent travel to a clinic. The current study examined feasibility and explored effectiveness of neurofeedback delivered with a portable EEG headset linked to an application on a mobile device.DesignOpen-label, single-arm clinical trial.SettingHome, outside of clinic.SubjectsN = 41 veterans with chronic pain, TBI, and PTSD.MethodVeterans were instructed to perform "mobile neurofeedback" on their own for three months. Clinical research staff conducted two home visits and two phone calls to provide technical assistance and troubleshoot difficulties.ResultsN = 36 veterans returned for follow-up at three months (88% retention). During this time, subjects completed a mean of 33.09 neurofeedback sessions (10 minutes each). Analyses revealed that veterans reported lower pain intensity, pain interference, depression, PTSD symptoms, anger, sleep disturbance, and suicidal ideation after the three-month intervention compared with baseline. Comparing pain ratings before and after individual neurofeedback sessions, veterans reported reduced pain intensity 67% of the time immediately following mobile neurofeedback. There were no serious adverse events reported.ConclusionsThis preliminary study found that veterans with chronic pain, TBI, and PTSD were able to use neurofeedback with mobile devices independently after modest training and support. While a double-blind randomized controlled trial is needed for confirmation, the results show promise of a portable, technology-based neuromodulatory approach for pain management with minimal side effects.2019 American Academy of Pain Medicine.

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