Poster Presentation Sydney Spinal Symposium 2025

A home-based self-directed EEG neurofeedback intervention for people with corneal neuropathic pain (#17)

Negin Hesam-Shariati 1 2 , Lara Alexander 1 2 , Fiona Stapleton 3 , Toby Newton-John 4 , Chin-Teng Lin 5 , Ian Skinner 6 , James Mcauley 2 7 , Lorimer Moseley 8 , Mark Jensen 9 , Sylvia Gustin 1 2
  1. School of Psychology, UNSW, Sydney, New South Wales, Australia
  2. Neuroscience Research Australia, Sydney, New South Wales, Australia
  3. School of Optometry and Visual Science, UNSW, Sydney, New South Wales, Australia
  4. Graduate School of Health, UTS, Sydney, New South Wales, Australia
  5. CIBCI Lab, Australian AI Institute, FEIT, UTS, Sydney, New South Wales, Australia
  6. School of Allied Health Exercise and Sports Sciences, Charles Sturt University, Port Macquarie, New South Wales, Australia
  7. School of Health Sciences, UNSW, Sydney, New South Wales, Australia
  8. IIMPACT in Health, University of South Australia, Adelaide, South Australia, Australia
  9. Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA

Corneal neuropathic pain is a complex condition, rarely responsive to current treatments. This trial investigated the potential effect of a novel home-based self-directed EEG neurofeedback intervention on corneal neuropathic pain using a multiple-baseline single-case experimental design. EEG neurofeedback has been used to reduce pain by aiming to regulate the abnormal brain rhythms responsible for the ongoing experience of pain. The EEG neurofeedback system used in this study was an in-house-developed headset with gamified software. Games were designed to reinforce sensorimotor rhythms and suppress high-beta and theta bands. Four participants completed a predetermined baseline of 7, 10, 14, and 17 days, randomly assigned to each participant, followed by 20 intervention sessions (5x2.5-minute games daily) over four weeks. Two one-week follow-ups occurred immediately and five weeks post-intervention during which participants were encouraged to practice mindfulness-based mental strategies. Daily pain severity and pain interference observations were the outcome measures. The System Usability Scale (SUS) and a post-intervention Zoom interview assessed the system’s usability and acceptability. Pain severity and pain interference showed medium improvements across participants from baseline to five weeks post-intervention, as indicated by Tau-U effect sizes (pain severity: Tau = -0.54, 95% CI [-0.82, -0.25]; pain interference: Tau = -0.39, 95% CI [-0.67, -0.11]). At the individual level, Tau-U effect sizes indicated significant reductions in pain severity and pain interference for three participants when comparing baseline to five-week post-intervention. Quantitative (SUS scores) and qualitative (Zoom interview) assessments revealed that the participants found the intervention easy to use and acceptable. This trial provides preliminary evidence for the possible efficacy and user experience of a home-based self-directed EEG neurofeedback intervention in reducing corneal neuropathic pain. While SCEDs are valuable for evaluating technological health interventions with small samples and a focus on individual-level effects, further investigations are necessary to draw more definitive conclusions.