Abstract
Fibromyalgia is a chronic primary pain condition contributing to significant disability worldwide. Neuroimaging studies have identified abnormal effective connectivity between cortical areas responsible for descending pain modulation and sensory components of pain experience [i.e., between pregenual anterior cingulate cortex (pgACC), and primary somatosensory cortex (S1), respectively]. Neurofeedback, a brain-computer interface technique, can normalize dysfunctional brain activity, and thereby improve pain and function. The aim of this double-blinded randomised placebo-controlled pilot study was to investigate the safety and acceptability of a novel electroencephalography-based neurofeedback (EEG-NF) training protocol, targeting effective connectivity from the pgACC to S1 in the alpha band and exploring its trend of effect on pain and function.
Preliminary analysis included 16 participants with fibromyalgia (n=16; 8 intervention, 8 placebo) who received 12 sessions of either EEG-NF targeting effective connectivity from pgACC to S1, or placebo NF. Outcome measures of pain (Brief Pain Inventory) and function [Revised Fibromyalgia Impact Questionnaire (RFIQ)] were collected at baseline, immediately (~two days), ten days and one-month post-intervention.
Descriptive statistics demonstrated that effective connectivity NF training is safe (no adverse events reported) and highly acceptable (average score 8.3). A greater decrease was observed in pain and functional measures in the active treatment group [median pain severity: -25.6%, pain interference: -10.7%, RFIQ: -22.4%] when compared to placebo group [median pain severity: -7.5, pain interference: -6.7, RFIQ: -6.8]. Our pilot study showed EEG NF training effective connectivity is a safe and acceptable treatment approach for fibromyalgia. Future studies could evaluate efficacy of this technique for improving clinical outcomes in people with fibromyalgia.