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Alpha-phase synchrony EEG training for multi-resistant chronic low back pain patients: an open-label pilot study

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A Correction to this article was published on 01 December 2020

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Abstract

Purpose

Chronic low back pain (cLBP) affects a quarter of a population during its lifetime. The most severe cases include patients not responding to interventions such as 5-week-long in-hospital multi-disciplinary protocols. This document reports on a pilot study offering an alpha-phase synchronization (APS) brain rehabilitation intervention to a population of n = 16 multi-resistant cLBP patients.

Methods

The intervention consists of 20 sessions of highly controlled electroencephalography (EEG) APS operant conditioning (neurofeedback) paradigm delivered in the form of visual feedback. Visual analogue scale for pain, Dallas, Hamilton, and HAD were measured before, after, at 6-month and 12-month follow-up. Full-scalp EEG data were analyzed to study significant changes in the brain’s electrical activity.

Results

The intervention showed a great and lasting response of most measured clinical scales. The clinical improvement was lasting beyond the 6-month follow-up endpoints. The EEG data confirm that patients did control (intra-session trends) and learned to better control (intersession trends) their APS neuromarker resulting in (nonsignificant) baseline changes in their resting state activity. Last and most significantly, the alpha-phase concentration (APC) neuromarker, specific to phase rather than amplitude, was found to correlate significantly with the reduction in clinical symptoms in a typical dose–response effect.

Conclusion

This first experiment highlights the role of the APC neuromarker in relation to the nucleus accumbens activity and its role on nociception and the chronicity of pain. This study suggests APC rehabilitation could be used clinically for the most severe cases of cLBP. Its excellent safety profile and availability as a home-use intervention makes it a potentially disruptive tool in the context of nonsteroidal anti-inflammatory drugs and opioid abuses.

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Funding

This work was supported by Covea and Mensia Technologies.

Author information

Authors and Affiliations

  1. Centre de l’Arche, Le Mans, France

    Yannick Delpierre & Michel Ritz

  2. Mensia Technologies SA, 130, rue de Lourmel, Paris, France

    Louis Mayaud & Quentin Barthélemy

  3. Covea, Paris, France

    Hélène Wu & Patrick Favennec

  4. GIPSA-Lab, Grenoble, France

    Marco Congedo

  5. Hôpital Universitaire de Nîmes, Nîmes, France

    Arnaud Dupeyron

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  1. Louis Mayaud
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Contributions

LM contributed to this work’s hypotheses, the clinical protocol, the technical environment setup, the data analysis, and manuscript redaction; HW completed all the sessions with patients; QB implemented the methods for real-time processing, contributed to the data analysis, and manuscript redaction; PF contributed to the clinical protocol and the interpretation of results; YD supported the analysis (EMG), MC consulted on the analysis of EEG data and the real-time methods; AD supported the interpretation of neurophysiological results; MR included all patients and contributed to the clinical protocol and interpretation of data. All authors discussed the results and commented on the manuscript.

Corresponding author

Correspondence to Quentin Barthélemy.

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Conflict of interest

Mensia Technologies is a medical device company offering therapeutic solutions for psychiatric and neurological disorders. LM and QB were employed and shared owner at Mensia Technologies at the time this study was carried out; MC was scientific advisor at Mensia Technologies at the time this study was carried out.

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Mayaud, L., Wu, H., Barthélemy, Q. et al. Alpha-phase synchrony EEG training for multi-resistant chronic low back pain patients: an open-label pilot study. Eur Spine J 28, 2487–2501 (2019). https://doi.org/10.1007/s00586-019-06051-9

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  • DOI: https://doi.org/10.1007/s00586-019-06051-9

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