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脑电图神经反馈治疗老年人神经性疼痛——一项机制综述

EEG neurofeedback for the treatment of neuropathic pain in the elderly-a mechanistic review.

作者信息

Chmiel James, Kopańska Marta, Leszek Jerzy, Trojniak Julia, Ros Tomas

机构信息

Institute of Physical Culture Sciences, University of Szczecin, Szczecin, Poland.

Department of Medical Psychology, Faculty of Medicine, University of Rzeszów, Rzeszów, Poland.

出版信息

Geroscience. 2025 Aug 30. doi: 10.1007/s11357-025-01848-7.


DOI:10.1007/s11357-025-01848-7
PMID:40884627
Abstract

Neuropathic pain (NP) is a complex pain disorder that constitutes a significant problem in the aging population, impacting quality of life and everyday functioning. In the quest to develop effective treatments, much research effort has been made to understand brain activity in people with NP, revealing a number of disordered electroencephalogram (EEG) patterns. This information can then be used to inform neurofeedback therapy, a novel approach that involves volitionally training brain activity in a closed loop. In this review of the existent literature we had three main objectives: (1) to summarize the reported EEG signatures of NP, (2) to evaluate the therapeutic efficacy of neurofeedback in the treatment of NP, and (3) to present the potential mechanisms of neurofeedback action in NP. Consequently, literature searches were conducted on the PubMed/Medline, Research Gate, and Cochrane databases. We identified 18 studies that examined resting-state EEG patterns in NP, and seven studies that investigated EEG-based neurofeedback in NP. Most biomarker studies of NP showed typical EEG patterns consisting of excess theta activity and decreased alpha activity. Neurofeedback study outcomes were largely promising in terms of treatment efficacy, but their quality was low. In turn, based on these results, we proposed hypothesis-based neurofeedback protocols and discussed the potential mechanisms of neurofeedback in the treatment of NP, including why this treatment option may be beneficial in the elderly population. Neurofeedback is a promising treatment option for NP, but caution should be exercised in interpreting the results due to the low number and methodological quality of research studies. A larger body of research studies points to common patterns of EEG abnormality in NP, which could be directly targeted with neurofeedback. The main advantage of this therapeutic approach is that it has no side effects and may be considered a valuable form of treatment in more frail populations such as the elderly.

摘要

神经病理性疼痛(NP)是一种复杂的疼痛障碍,在老年人群中是一个重大问题,影响生活质量和日常功能。在寻求有效治疗方法的过程中,人们进行了大量研究以了解NP患者的大脑活动,揭示了一些紊乱的脑电图(EEG)模式。然后,这些信息可用于指导神经反馈疗法,这是一种涉及在闭环中自主训练大脑活动的新方法。在对现有文献的综述中,我们有三个主要目标:(1)总结已报道的NP的EEG特征,(2)评估神经反馈治疗NP的疗效,(3)阐述神经反馈在NP中的潜在作用机制。因此,我们在PubMed/Medline、Research Gate和Cochrane数据库中进行了文献检索。我们确定了18项研究NP静息态EEG模式的研究,以及7项研究基于EEG的神经反馈治疗NP的研究。大多数NP的生物标志物研究显示典型的EEG模式,包括θ活动过多和α活动减少。神经反馈研究结果在治疗效果方面大多很有前景,但研究质量较低。基于这些结果,我们提出了基于假设的神经反馈方案,并讨论了神经反馈治疗NP的潜在机制,包括为什么这种治疗方法可能对老年人群有益。神经反馈是一种有前景的NP治疗选择,但由于研究数量少和方法学质量低,在解释结果时应谨慎。更多的研究表明NP中存在EEG异常的常见模式,这可以通过神经反馈直接靶向。这种治疗方法的主要优点是没有副作用,在老年人等更脆弱的人群中可能被视为一种有价值的治疗形式。

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本文引用的文献

[1]
Electroencephalography Longitudinal Markers of Central Neuropathic Pain Intensity in Spinal Cord Injury: A Home-Based Pilot Study.

Biomedicines. 2024-11-30

[2]
Advancements in Modern Treatment Approaches for Central Post-Stroke Pain: A Narrative Review.

J Clin Med. 2024-9-11

[3]
Exploring the Thalamus as a Target for Neuropathic Pain Management: An Integrative Review.

Cureus. 2024-5-12

[4]
The Complexity of Neuropathic Pain and Central Sensitization: Exploring Mechanisms and Therapeutic Prospects.

J Integr Neurosci. 2024-4-25

[5]
A Scoping Review of the Effect of EEG Neurofeedback on Pain Complaints in Adults with Chronic Pain.

J Clin Med. 2024-5-10

[6]
Tonic excitation by astrocytic GABA causes neuropathic pain by augmenting neuronal activity and glucose metabolism.

Exp Mol Med. 2024-5

[7]
Relation between heart rate variability and spectral analysis of electroencephalogram in chronic neuropathic pain patients.

Korean J Physiol Pharmacol. 2024-5-1

[8]
BDNF as a biomarker for neuropathic pain: Consideration of mechanisms of action and associated measurement challenges.

Brain Behav. 2023-3

[9]
EEG frequency band analysis in chronic neuropathic pain: A linear and nonlinear approach to classify pain severity.

Comput Methods Programs Biomed. 2023-3

[10]
Neuropathic Pain in Parkinson's Disease.

Neurol India. 2022

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