The Metaanalysis of the Analgesic Effect of Electroencephalographic Neurofeedback for People with Chronic Pain
DOI:
https://doi.org/10.61404/mutiara.v4i1.487Keywords:
Pain, Neurofeedback, EEG, NeuromodulationAbstract
Chronic pain represents a major global health burden and often remains resistant to conventional pharmacological treatment, prompting the exploration of alternative therapeutic strategies. Electroencephalographic (EEG) neurofeedback has emerged as a non-invasive neuromodulatory intervention that enables patients to self-regulate brain activity and potentially alleviate persistent pain symptoms. This systematic review addresses the research problem of inconsistent evidence regarding the clinical efficacy and underlying mechanisms of EEG-based neurofeedback for chronic pain management in adults. A comprehensive analysis of 80 studies involving adults with chronic pain lasting at least three months was conducted, examining neurofeedback protocols, clinical pain outcomes, neurophysiological changes, secondary benefits, and methodological quality. Findings revealed heterogeneous results, with several studies reporting statistically significant and clinically meaningful pain reduction, particularly in conditions such as chemotherapy-induced neuropathy, fibromyalgia, and chronic back pain. Observed neurophysiological changes, including increased alpha power and modified connectivity in pain-related brain regions, were sometimes associated with clinical improvement, alongside reported benefits in sleep quality, mood, and overall well-being. However, evidence from sham-controlled randomized trials showed no significant differences between intervention and control groups, highlighting methodological limitations and challenges in blinding procedures. The review concludes that EEG neurofeedback is a safe and feasible intervention with potential therapeutic value for chronic pain, although current evidence remains inconsistent. The novelty of this study lies in its integrative evaluation of clinical outcomes, neurophysiological mechanisms, and protocol-specific effects, while emphasizing the need for personalized approaches, biomarker identification, and rigorous experimental designs to clarify efficacy and optimize treatment implementation.
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References
Cohen, Steven P., Lene Vase, dan William M. Hooten. “Chronic Pain: an Update on Burden, Best Practices, and New Advances.” The Lancet 397, no. 10289 (2021): 2082–2097. https://www.sciencedirect.com/science/article/abs/pii/S0140673621003937.
Elbogen, Eric B, Amber Alsobrooks, Sara Battles, Kiera Molloy, Paul A. Dennis, Jean C. Beckham, Samuel A. McLean, Julian R. Keith, dan Carmen Russoniello. “Mobile Neurofeedback for Pain Management in Veterans with TBI and PTSD.” Pain Medicine 22, no. 2 (2021): 329–337. https://academic.oup.com/painmedicine/article/22/2/329/5614403.
Farnia, Samaneh, Mousa Kiani-Chelmardi, Maryam Mobini, Azin Mehrpour, Samineh Fattahi, Mehran Zarghami, Jamshid Yazdani-Charati, dan Nadia Abedi-Omali. “Comparison of Alpha–Theta Neurofeedback Versus Sensorimotor Rhythm Neurofeedback in the Treatment of Patients with Fibromyalgia: A Randomized, Double-Blind, Controlled Clinical Trial.” Chronic Diseases Journal 8, no. 3 (2020): 105–111. https://www.cabidigitallibrary.org/doi/full/10.5555/20210019984.
Fishman, Michael A., Ajay Antony, Michael Esposito, Timothy Deer, dan Robert Levy. “The Evolution of Neuromodulation in the Treatment of Chronic Pain: Forward-Looking Perspectives.” Pain Medicine (Malden, Mass.) 20, no. 1 (2019): 58–68. https://pmc.ncbi.nlm.nih.gov/articles/PMC6600066/.
Gruzelier, John H. “EEG-Neurofeedback for Optimising Performance. I: A review of cognitive and Affective Outcome in Healthy Participants.” Neuroscience and Biobehavioral Reviews 44 (2014): 124–141. https://www.sciencedirect.com/science/article/abs/pii/S0149763413002248.
Hassan, Muhammad Abul, Matthew Fraser, Bernard A. Conway, David B. Allan, dan Aleksandra Vuckovic. “The Mechanism of Neurofeedback Training for Treatment of central Neuropathic Pain in Paraplegia: a Pilot Study.” BMC Nutritioneurology 15, no. 200 (2015): 1–13. https://pmc.ncbi.nlm.nih.gov/articles/PMC4604632/.
Hesam-Shariati, Negin, Lara Alexander, Fiona Stapleton, Toby Newton-John, Chin-Teng Lin, Pauline Zahara, Kevin Yi Chen, et al. “The Effect of an EEG Neurofeedback Intervention for Corneal Neuropathic Pain: A Single-Case Experimental Design with Multiple Baselines.” The Journal of Pain 32 (2025): 1–15. https://www.sciencedirect.com/science/article/abs/pii/S1526590025006212.
Hesam-Shariati, Negin, Wei-Ju Chang, Michael A. Wewege, James H. McAuley, Andrew Booth, Zina Trost, Chin-Teng Lin, Toby Newton-John, dan Sylvia M. Gustin. “The Analgesic Effect of Electroencephalographic Neurofeedback for People With Chronic Pain: Protocol for a Systematic Review and Meta-analysis.” European Journal of Neurology 29, no. 3 (2022): 921–936. https://pubmed.ncbi.nlm.nih.gov/34813662/.
Higgins, Julian P. T., dan Sally Green. Cochrane Handbook for Systematic Reviews of Interventions. England: John Wiley and Sons Ltd., 2008.
Jensen, M. P., L. H. Sherlin, K. J. Gertz, A. L. Braden, A. E. Kupper, A. Gianas, J. D. Howe, dan S. Hakimian. “Brain EEG Activity Correlates of Chronic Pain in Persons with Spinal Cord Injury: Clinical Implications.” Spinal Cord 51, no. 1 (2013): 55–58. https://www.nature.com/articles/sc201284.
Jensen, Mark P., Caroline Grierson, Veronika Tracy-Smith, Stacy C. Bacigalupi, dan Siegfried Othmer. “Neurofeedback Treatment for Pain Associated with Complex Regional Pain Syndrome Type I.” Journal of Neurotherapy 11, no. 1 (2007): 45–53. https://www.isnr-jnt.org/article/view/16704.
Kayiran, Sadi, Erbil Dursun, Nigar Dursun, Numan Ermutlu, dan Sacit Karamürsel. “Neurofeedback Intervention in Fibromyalgia Syndrome; a Randomized, Controlled, Rater Blind Clinical Trial.” Applied Psychophysiology and Biofeedback 35, no. 4 (2010): 293–302. https://pubmed.ncbi.nlm.nih.gov/20614235/.
Kravitz, Howard M., Mary Lee Esty, Robert S. Katz, dan Jan Fawcett. “Treatment of Fibromyalgia Syndrome Using Low-Intensity Neurofeedback with the Flexyx Neurotherapy System: A Randomized Controlled Clinical Trial.” Journal of Neurotherapy 10, no. 2–3 (2006): 41–58. https://www.isnr-jnt.org/article/view/16722.
Moher, David, Alessandro Liberati, Jennifer Tetzlaff, dan Douglas G. Altman. “Preferred Reporting Items for Systematic Reviews and Meta-analyses: the PRISMA Statement.” PLoS Medicine 6, no. 7 (2009). https://pubmed.ncbi.nlm.nih.gov/19621072/.
Page, Matthew J., David Moher, Patrick M. Bossuyt, Isabelle Boutron, Tammy C. Hoffmann, Cynthia D. Mulrow, Larissa Shamseer, et al. “PRISMA 2020 Explanation and Elaboration: Updated Guidance and Exemplars for Reporting Systematic Reviews.” BMJ (Clinical Research ed.) 372, no. 160 (2021): 1–36. https://www.bmj.com/content/372/bmj.n160.
Page, Matthew J., Joanne E. McKenzie, Patrick M. Bossuyt, Isabelle Boutron, Tammy C. Hoffmann, Cynthia D. Mulrow, Larissa Shamseer, et al. “The PRISMA 2020 Statement: an Updated Guideline for Reporting Systematic Reviews.” BMJ (Clinical Research ed.) 372, no. 71 (2021): 1–9. https://www.bmj.com/content/372/bmj.n71.
Prinsloo, Sarah, Diane Novy, Larry Driver, Randall Lyle, Lois Ramondetta, Cathy Eng, Jennifer McQuade, Gabriel Lopez, dan Lorenzo Cohen. “Randomized Controlled Trial of Neurofeedback on Chemotherapy-Induced Peripheral Neuropathy: A Pilot Study.” Cancer 123, no. 11 (2017): 1989–1997. https://pubmed.ncbi.nlm.nih.gov/28257146/.
Sielski, Robert, Winfried Rief, dan Julia Anna Glombiewski. “Efficacy of Biofeedback in Chronic back Pain: a Meta-Analysis.” International Tournal of Behavioral Medicine 24, no. 1 (2017): 25–41. https://pubmed.ncbi.nlm.nih.gov/27307013/.
Treede, Rolf-Detlef, Winfried Rief, Antonia Barke, Qasim Aziz, Michael I. Bennett, Rafael Benoliel, Milton Cohen, et al. “Chronic Pain as a Symptom or a Disease: the IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11).” PAIN: The Journal of the International Association for the Study of Pain 160, no. 1 (2019): 19–27. https://journals.lww.com/pain/abstract/2019/01000/chronic_pain_as_a_symptom_or_a_disease__the_iasp.3.aspx.
Vučković, Aleksandra, Manaf Kadum Hussein Altaleb, Matthew Fraser, Ciarán McGeady, dan Mariel Purcell. “EEG Correlates of Self-Managed Neurofeedback Treatment of Central Neuropathic Pain in Chronic Spinal Cord Injury.” Front. Neurosci 13, no. 762 (2019): 1–17. https://www.frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2019.00762/full.
Wu, Yu-Lin, Su-Chen Fang, Shih-Ching Chen, Chen-Jei Tai, dan Pei-Shan Tsai. “Effects of Neurofeedback on Fibromyalgia: A Randomized Controlled Trial.” Pain management nursing: official journal of the American Society of Pain Management Nurses 22, no. 6 (2021): 755–763. https://pubmed.ncbi.nlm.nih.gov/33579615/.
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