Randomized controlled trial of neurofeedback on chemotherapy‐induced peripheral neuropathy: A pilot study

• Published in: Cancer Vol. 123; no. 11; pp. 1989 - 1997
• Main Authors: Prinsloo, Sarah, Novy, Diane, Driver, Larry, Lyle, Randall, Ramondetta, Lois, Eng, Cathy, McQuade, Jennifer, Lopez, Gabriel, Cohen, Lorenzo
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01-06-2017
• Subjects: Aged; Antineoplastic Agents - adverse effects; Biofeedback; Breast Neoplasms - drug therapy; Cancer; Chemotherapy; chemotherapy‐induced neuropathy; Clinical trials; Confidence intervals; Cortex; EEG; electroencephalogram (EEG); Electroencephalography; Feedback; Female; Gastrointestinal Neoplasms - drug therapy; Genital Neoplasms, Female - drug therapy; Humans; Intervention; Male; Middle Aged; Neoplasms - drug therapy; neurofeedback; Neurofeedback - methods; Neuromodulation; Oncology; Organoplatinum Compounds - adverse effects; Oxaliplatin; Paclitaxel - adverse effects; Pain; Patients; Peripheral Nervous System Diseases - chemically induced; Peripheral Nervous System Diseases - therapy; Peripheral neuropathy; Pilot Projects; Platinum Compounds - adverse effects; Quality assessment; Quality control; Randomization; Sensory integration; Survivors; Taxoids - adverse effects; Time Factors; Treatment Outcome; Waiting Lists; chemotherapy-induced neuropathy; neuromodulation; pain; electroencephalogram (EEG); neurofeedback
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.30649

BACKGROUND
Chemotherapy‐induced peripheral neuropathy (CIPN) is a significant problem for cancer patients, and there are limited treatment options for this often debilitating condition. Neuromodulatory interventions could be a novel modality for patients trying to manage CIPN symptoms; however, they are not yet the standard of care. This study examined whether electroencephalogram (EEG) neurofeedback (NFB) could alleviate CIPN symptoms in survivors.
METHODS
This was a randomized controlled trial with survivors assigned to an NFB group or a wait‐list control (WLC) group. The NFB group underwent 20 sessions of NFB, in which visual and auditory rewards were given for voluntary changes in EEGs. The Brief Pain Inventory (BPI) worst‐pain item was the primary outcome. The BPI, the Pain Quality Assessment Scale, and EEGs were collected before NFB and again after treatment. Outcomes were assessed with general linear modeling.
RESULTS
Cancer survivors with CIPN (average duration of symptoms, 25.3 mo), who were mostly female and had a mean age of 62.5 years, were recruited between April 2011 and September 2014. One hundred percent of the participants starting the NFB program completed it (30 in the NFB group and 32 in the WLC group). The NFB group demonstrated greater improvement than the controls on the BPI worst‐pain item (mean change score, –2.43 [95% confidence interval, –3.58 to –1.28] vs 0.09 [95% confidence interval, –0.72 to –0.90]; P =·.001; effect size, 0.83).
CONCLUSIONS
NFB appears to be effective at reducing CIPN symptoms. There was evidence of neurological changes in the cortical location and in the bandwidth targeted by the intervention, and changes in EEG activity were predictive of symptom reduction. Cancer 2017;123:1989–1997. © 2017 American Cancer Society.
Neuromodulatory interventions could be a novel modality for patients trying to manage symptoms of chemotherapy‐induced peripheral neuropathy, but they are not yet the standard of care. Therefore, this article examines whether electroencephalogram neurofeedback can alleviate symptoms of chemotherapy‐induced peripheral neuropathy in survivors. A randomized controlled trial shows that neurofeedback is effective at reducing pain and other symptoms of chemotherapy‐induced peripheral neuropathy. See also pages 1898–900.