The effect of an EEG neurofeedback intervention for corneal neuropathic pain: A single-case experimental design with multiple baselines.

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. Four Participants completed a predetermined baseline of 7, 10, 14, and 17 days, randomly assigned to each participant, followed by 20 intervention sessions over four weeks. Two one-week follow-ups occurred immediately and five weeks post-intervention during which participants were encouraged to practice mental strategies. Daily pain severity and pain interference observations were the outcome measures, while anxiety, depression, or sleep problems were the generalisation measures. The results showed a medium effect on pain severity and interference across participants when comparing baseline to five-week post-intervention according to Tau-U effect sizes. At the individual level, both Tau-U and NAP effect sizes indicated significant reductions in pain severity and interference for three participants when comparing baseline to five-week post-intervention. However, the reductions indicated by the visual inspection were not considered clinically meaningful. This single-case experimental design study raises the possibility that the intervention may improve pain severity and interference for some individuals; variability in outcomes highlights the need for future research to better understand individual responses and optimize the intervention effect. REGISTRATION: Australian New Zealand Clinical Trial Registry ACTRN12623000173695 PERSPECTIVE: This trial demonstrates the potential of EEG neurofeedback to reduce pain severity and interference in individuals with corneal neuropathic pain. It also highlights user preferences for technology-based interventions, emphasizing ease of use, accessibility, and self-administration to enhance adherence, especially for individuals with limited mobility or restricted healthcare access.