Chemotherapy-induced peripheral neuropathy (CIPN) may be significantly reduced by electroencephalogram (EEG) neurofeedback training, according to research published in Cancer (published online March 3, 2017; doi:10.1002/cncr.30649).
CIPN is an adverse event caused by damage to the nerves that control sensation and movement in the arms and legs. An overwhelming majority of patients after chemotherapy treatment (71%-96%) exhibit symptoms of CIPN, including pain, burning, tingling, and loss of feeling. There is only one approved treatment strategy for CIPN, but it is associated with muscle aches and nausea. Neuromodulatory interventions have the potential to manage CIPN symptoms by targeting brain areas that are active during pain episodes, but they are not yet considered standard of care.
Sarah Prinsloo, PhD, assistant professor of palliative, rehabilitation, and integrative medicine, University of Texas (Austin, TX), and colleagues conducted a randomized, controlled study involving 71 patients of all varying cancer types with CIPN to assess the efficacy of EEG neurofeedback training. All patients were at least 3-months postchemotherapy treatment and reported higher than a 3 on the National Cancer Institute’s neuropathy rating scale. Patients were assigned to a neurofeedback group, in which they received 20 sessions of neurofeedback and were rewarded for voluntary changes in EEGs, or a wait-list control group, in which they were offered neurofeedback intervention at the conclusion of the study.
The Brief Pain Inventory (BPI) assessment was used to determine the severity of pain and impact on daily functioning. The BPI, Pain Quality Assessment Scale, and EEGs were collected before and after treatment. BPI worst-pain item was the primary outcome.
Results of the study showed that neurofeedback significantly reduced BPI scores for worst pain, activity interference, numbness, tingling, and unpleasantness. Patients in the neurofeedback group demonstrated greater improvement on the BPI worst-pain item (mean change score, -2.43; 95% CI, -3.58 to -1.28) compared with patients in the wait-list control group (mean change score, 0.09; 95% CI, -0.72 to -0.90). Patients undergoing neurofeedback training also exhibited specific and predictable EEG signatures in the targeted brain regions, researchers reported.
Researchers concluded that “neurofeedback may be a valuable approach to reduce neuropathy symptoms and their impact on daily activities.” Limitations of the study included a lack of a placebo group and a majority female, breast cancer survivor patient sample. Future research is necessary that includes a broader participant base to determine if the findings apply across the general population.—Zachary Bessette
