title: Randomized controlled trial of neurofeedback on chemotherapy-induced peripheral neuropathy: A pilot study.
abstract: 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.
  
  
  
  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.
  
  
  
  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).
  
  
  
  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.
authors.affiliation: Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Sarah
authors.initials: S
authors.lastname: Prinsloo
authors.affiliation: Department of Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Diane
authors.initials: D
authors.lastname: Novy
authors.affiliation: Department of Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Larry
authors.initials: L
authors.lastname: Driver
authors.affiliation: Department of Marriage and Family Therapy, Mount Mercy University, Cedar Rapids, Iowa.
authors.forename: Randall
authors.initials: R
authors.lastname: Lyle
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Lois
authors.initials: L
authors.lastname: Ramondetta
authors.affiliation: Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Cathy
authors.initials: C
authors.lastname: Eng
authors.affiliation: Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Jennifer
authors.initials: J
authors.lastname: McQuade
authors.affiliation: Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Gabriel
authors.identifier: 0000-0002-3685-0280
authors.initials: G
authors.lastname: Lopez
authors.affiliation: Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Cohen
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy; D005833:Genital Neoplasms, Female / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D058765:Neurofeedback / Q000379:methods*; D009944:Organoplatinum Compounds / Q000009:adverse effects; D000077150:Oxaliplatin; D017239:Paclitaxel / Q000009:adverse effects; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced / Q000628:therapy*; D010865:Pilot Projects; D017671:Platinum Compounds / Q000009:adverse effects; D017741:Survivors; D043823:Taxoids / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome; D014850:Waiting Lists
chemical_list: D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D017671:Platinum Compounds; D043823:Taxoids; D000077150:Oxaliplatin; D017239:Paclitaxel
keywords: chemotherapy-induced neuropathy; electroencephalogram (EEG); neurofeedback; neuromodulation; pain