Home used, patient self-managed, brain-computer interface for the management of central neuropathic pain post spinal cord injury: usability study.
M K H Al-Taleb, M Purcell, M Fraser and 2 others
PMID 31666096WHAT IT FOUND
People with spinal cord injury and chronic central pain could self-manage a home neurofeedback headset, but eight of fifteen who tried it stopped.
Twelve reported lower pain, and eight had a drop larger than 30%. This was not a controlled test.
Key findings
01Fifteen of the twenty recruited participants used the home system, all learned to self-manage it, but eight discontinued and only seven used it for the required two months.
02Among the fifteen home users, twelve had pain scores the authors reported as lower beyond chance, and eight had a reduction larger than 30%.
03Nine participants rated satisfaction 4.5 out of 5 for the device and 4.9 out of 5 for the service.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study had no control group, no blinding and no placebo test, so pain changes cannot be attributed to neurofeedback alone. Participants continued their prescribed pain medications, and some needed caregiver-assisted setup, so the contribution of neurofeedback cannot be separated from those supports. Only fifteen of twenty recruited participants used the home system, eight discontinued, and only seven used it for the required two months. Only nine participants completed the final interviews and user-experience questionnaires, and six participants did not answer some usability questions. The participants were described as early adopters of technology, so their satisfaction and commitment may not apply to a wider group. EEG was recorded from a single electrode with a consumer headset not designed for the central cortex, and 10 to 20% of home EEG data was noisy. Side effects such as reduced spasm or improved sleep were reported in interviews but were not systematically measured.
Declared interests
Funding came from Research Councils UK and the Inspire Foundation.
The easy way to misread this
Do not conclude that neurofeedback alone reduced central neuropathic pain. Participants also used prescribed pain medications and some needed caregiver-assisted setup, and the study had no control group, no blinding and no placebo test.