Mind-body (including meditation and yoga)
Secondary Topic: Manual medicine/body work (including chiropractic and massage)
Tertiary Topic: Whole systems and acupuncture (including TCM and Ayurveda)
Utilization of Neuroimaging and Neurofeedback to Treat Chemotherapy-Induced Peripheral Neuropathy--Results of a Randomized Controlled Trial
Sarah Prinsloo, PhD; Diane Novy, PhD; Larry Driver, MD; Lois Ramondetta, MD; Cathy Eng, MD; Gabriel Lopez, MD; Randall Lyle, PhD; Lorenzo Cohen, PhD, , Houston, TX, United States
Late Breaker: No
We examined neurophysiological correlates and patient reported outcomes of chemotherapy-induced peripheral neuropathy (CIPN) to understand CIPN as it relates directly to brain activity. We used a brain training paradigm, neurofeedback (NF), to teach patients to modify brain activity to alleviate symptoms of CIPN.
Seventy-one (62 female; mean age=63; 52 breast, 8 gynecologic, 11 other; average length of symptoms=24 mos) cancer survivors >3 months from completing chemotherapy who reported >3 on the NCI’s neuropathy rating scale, were randomized to a NF group (n=35) and underwent 20 sessions of electroencephalography (EEG) NF or a wait-list control group (WL; n=36). We used EEG imaging to determine any EEG patterns unique to CIPN and then provided NF to change aberrant brain signatures. The primary outcome was the Brief Pain Inventory (BPI). Secondary outcomes included the Pain Quality Assessment Scale (PQAS), MD Anderson Symptom Inventory (MDASI), Short Form 36 (SF-36); Brief Fatigue Inventory (BFI); and Pittsburgh Sleep Quality Index (PSQI), measured at baseline, at the end of treatment, 1 and 4 months later. Analyses were done using a general linear mixed model regression (GLMM) and general linear regression (GLM).
83% of participants demonstrated similar EEG patterns, which was significantly related to improvement in symptoms after NF. 100% of participants who started NF completed treatment. NF lead to significant reduction in neuropathic symptoms such as pain and numbness (previously reported), and in cancer-related symptom interference (NF=-5.3 vs WL=-0.5, p=.000); symptom severity (NF=-5.1 vs WL=-0.8, p=.000); fatigue (NF=-3.7 vs WL=-0.8, p=.001), and sleep disturbances (NF=-2.3 vs WL=0.8, p=.030); and improved physical functioning (NF=3.3 vs WL= 1.4, p=.003). At 4 months, the outcomes remained for targeted symptoms.
CIPN may have distinct electrophysiological correlates. NF clinically and significantly improved primary outcomes at 4 months post-treatment, and reduced secondary symptoms associated with CIPN.