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Cited by 77Pain Management and TreatmentEEG and Brain-Computer InterfacesPain Mechanisms and Treatments

Neurofeedback for pain management: a systematic review

Open access
Roy, Rubén, de la Vega, Rocío, Jensen, Mark P., Miró, Jordi·2020·Frontiers in Neuroscience
DOI 10.3389/fnins.2020.00671PMC PMC7378966
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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. These findings support the need for continued – but higher quality – research in this area.

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  • Two reviews evaluated neuro/biofeedback interventions following injury and both reported moderate to high-level evidence for these interventions being beneficial for distress-related outcomes.

    “Two reviews evaluated neuro/biofeedback interventions following injury and both reported moderate to high-level evidence for these interventions being beneficial for distress-related outcomes.48 49”

    From Impact of healthcare interventions on distress following acute musculoskeletal/orthopaedic injury: A scoping review of systematic reviews (2024) · cites this paper as [48]

    The Discussion’s “Efficacy of NF” section reports improvements in anxiety and depression in studies of people with chronic pain, and the Results include studies involving spinal cord injury. But the review calls its overall evidence preliminary, not moderate to high-level, and does not establish that distress-related benefits apply specifically following injury. Page numbers are not available in our copy. (LLM, conf=0.87)

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Research works printed but not linked: 2

  1. Institute of Medicine (U.S) Committee on a National Agenda for the Prevention of Disabilities (1991). Disability in America: Toward a National Agenda for Prevention - Committee on a National Agenda for the Prevention of Disabilities, Institute of Medicine. editors Pope A. Tarlov A. Washington, DC: National Academy Press.
  2. Jensen M. Karoly P. (2001). Self-report scales and procedures for assessing pain in adults, in Handbook of Pain Assessment, 3 Edn. eds Turk D. Melzack R. (New York, NY: Guilford Press), 15– 34.

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Authors
Roy, R., de la Vega, R., Jensen, M. P., & Miró, J.
Affiliations
  • Universitat Rovira i Virgili (ES)
  • University of Washington (US)
Corresponding author
Miró, Jordi
ORCID
Venue
Frontiers in Neuroscience
Publisher
Frontiers Media SA
Published
2020-07-16
Volume
14
Pages
671-671
ISSN
1662-453X (ISSN-L)
DOI
10.3389/fnins.2020.00671
PMC
PMC7378966
OpenAlex
W3042473214
Cited by
77
References
76
Citations by year
2026: 5 · 2025: 25 · 2024: 18 · 2023: 8 · 2022: 10 · 2021: 9 · 2020: 2
FWCI
2.17
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Neuroscience (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Rovira & Virgili repository (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Ministerio de Economía y Competitividad (PSI2015-70966-P, RTI2018)
  • Fundación Grünenthal España (RTI2018-09870-B-I00)
  • National Institutes of Health (P01 HD33988)
  • European Regional Development Fund (RTI2018-09870-B-I00, RTI2018)
  • National Institute of Child Health and Human Development (P01 HD33988)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (P01HD033988)
  • National Center for Medical Rehabilitation Research
Topics
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
  • Life Sciences › Neuroscience › Cognitive Neuroscience › EEG and Brain-Computer Interfaces
  • Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
Keywords
neurofeedback, chronic pain, pain management, EEG-based neurofeedback, real-time fMRI neurofeedback, fibromyalgia, headache, migraine, pain intensity, fatigue, sleep, depression

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