A Neurofeedback System to Decrease Chronic Musculoskeletal Pain.

The existing methods for treating chronic musculoskeletal (MSK) pain do not address the restoration of altered brain activity, referred to as maladaptive plasticity, resulting from the effects of chronic MSK pain. Using electroencephalography (EEG) an increase in event-related alpha power over the somatosensory cortex was previously observed during movement in chronic MSK pain. A low cost neurofeedback system was developed that focuses on decreasing event-related alpha power. The system detects movement initiation by electromyography (EMG) and extracts movement-related alpha power over the somatosensory cortex. A graphical user interface (GUI) was developed to provide visual neurofeedback based on the event-related alpha power. The system was tested on healthy participants (n=4). Participants were asked to decrease their event-related alpha power during movement of the knee and elbow by the use of neurofeedback in a single session consisting of five blocks. Alpha power was compared between the first and the last block. The results showed that all participants were able to modulate their movement-related alpha power with a single session of training (p<0.05). The alpha power between blocks 5 and 1 decreased by 40%. The low-cost system enables the healthy participants to alter their alpha power during movement of the elbow or knee during a single session of training. We aim further investigate and validate this method in patients with chronic MSK pain.