Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jul 16:14:671.
doi: 10.3389/fnins.2020.00671. eCollection 2020.

Neurofeedback for Pain Management: A Systematic Review

Rubén Roy  1 , Rocío de la Vega  2 , Mark P Jensen  3 , Jordi Miró  1
Affiliations

Neurofeedback for Pain Management: A Systematic Review

Rubén Roy et al. Front Neurosci. .

Abstract

Background: Chronic pain is a significant global health issue. For most individuals with chronic pain, biomedical treatments do not provide adequate relief. Given the evidence that neurophysiological abnormalities are associated with pain, it is reasonable to consider treatments that target these factors, such as neurofeedback (NF). The primary objectives of this review were to summarize the current state of knowledge regarding: (1) the different types of NF and NF protocols that have been evaluated for pain management; (2) the evidence supporting each NF type and protocol; (3) if targeted brain activity changes occur with NF training; and (4) if such brain activity change is associated with improvements on treatment outcomes. Methods: Inclusion criteria were intentionally broad to encompass every empirical study using NF in relation to pain. We considered all kinds of NF, including both electroencephalogram- (EEG-) and functional magnetic resonance imagining- (fMRI-) based. We searched the following databases from inception through September 2019: Pubmed, Ovid, Embase, Web of Science, PsycINFO. The search strategy consisted of a combination of key terms referring to all NF types and pain conditions (e.g., neurofeedback, rt-fMRI-NF, BOLD, pain, migraine). Results: A total of 6,552 citations were retrieved; 24 of these that were included in the review. Most of the studies were of moderate quality, included a control condition and but did not include a follow-up. They focused on studying pain intensity (83%), pain frequency, and other variables (fatigue, sleep, depression) in samples of adults (n = 7-71) with headaches, fibromyalgia and other pain conditions. Most studies (79%) used EEG-based NF. A wide variety of NF types and protocols have been used for pain management aiming to either increase, decrease or regulate brain activity in certain areas theoretically associated with pain. Conclusions: Given the generally positive results in the studies reviewed, the findings indicate that NF procedures have the potential for reducing pain and improving other related outcomes in individuals with chronic pain. However, the current evidence does not provide definitive conclusions or allow for reliable recommendations on which protocols or methods of administration may be the most effective. These findings support the need for continued - but higher quality - research in this area.

Keywords: neurofeedback; neuromodulation; pain management; systematic review; treatment outcome.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Study selection diagram flow.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Apkarian A. V., Hashmi J. A., Baliki M. N. (2011). Pain and the brain: specificity and plasticity of the brain in clinical chronic pain. Pain 152 (Suppl. 3), S49–S64. 10.1016/j.pain.2010.11.010 - DOI - PMC - PubMed
    1. Arns M., Conners C. K., Kraemer H. C. (2013). A decade of EEG theta/beta ratio research in ADHD: a meta-analysis. J. Atten. Disord. 17, 374–383. 10.1177/1087054712460087 - DOI - PubMed
    1. Bair M. J., Robinson R. L., Katon W., Kroenke K. (2003). Depression and pain comorbidity. Arch. Intern. Med. 163, 2433–2445. 10.1001/archinte.163.20.2433 - DOI - PubMed
    1. Boord P., Siddall P. J., Tran Y., Herbert D., Middleton J., Craig A. (2008). Electroencephalographic slowing and reduced reactivity in neuropathic pain following spinal cord injury. Spinal Cord. 46, 118–123. 10.1038/sj.sc.3102077 - DOI - PubMed
    1. Carmen J. A. (2004). Passive infrared hemoencephalography: four years and 100 migraines. J. Neurother. 8, 23–51. 10.1300/J184v08n03_03 - DOI

Publication types

LinkOut - more resources