Neurofeedback-EEG-VR (NEVR) System for Non-opioid Pain Therapy

AbstractPain is one of the most common and debilitating symptoms of a wide range of injuries and diseasesIts treatment often relies on prescription or over the counter pharmaceutical medications and may include some non pharmacological pain management methods such as transcutaneous electrical nerve stimulationTENSor acupuncturewhich have poor support from the literaturePhysicians typically iteratively explore these options as they strive to identify the most suitable methods for each patientUnfortunatelyone of the most commonly prescribed pain treatmentsopioidshas a potential to lead to addictionwhich has led to an epidemic of opioid over prescription and abusewith dangerous personal and societal consequencesThis opioid crisis is a principal issue in public health with overrelated annual deathsas well as social and economic burden costing over $billion a year in the USASafe and effective alternatives for treating pain that reduce dependence on opioids arethereforea primary goal of the NIHand are urgently needed to address this emergencyThis project proposes a non invasivenon pharmacological alternative to treat pain by combining an innovative electroencephalographyEEGbased NeurofeedbackNFsolution in an immersive virtual realityVRenvironmentNF and VR have been shown to independently produce ameliorative effects on painand it is hypothesized that a NF training in VR would have synergistic effects as VR would distract from pain perception to improve patient compliance in more engaging NF protocols that improve their ability to control pain perceptionThis NF EEG VRNEVRpain treatment system combines three promising non pharmacological innovative technologies into a non invasive pain therapyQUASARandapos s easy to usenon invasivedry electrode EEG headsetwhich enables rapid and easy acquisition of high fidelity EEG without the gels or skin preparationintegrated witha VR display for cognitive immersionwhich has been shown to distract from and suppress pain awareness in the short termboth interfacing witha NF protocol that has been shown to reduce cLBP with effects lasting greater thanmonthsThis combined NEVR pain treatment system is designed to specifically address the underlying brain activity associated with perception ofor attention topain and is therefore expected to reduce both acute and chronic forms of painIn the scope of this projectwe will initially focus our work on chronic low back paincLBPas this is a growing segment of chronic pain sufferers with aworldwide lifetime prevalenceand whose sufferers have historically been a heavy user population of opiateshoweverlater stages of this project will expand this application to address other forms of pain NarrativePain is one of the most common and debilitating symptoms of a wide range of injuries and diseasesUnfortunatelyone of the most commonly prescribed pain treatmentsopioidshas a potential to lead to addictionwhich has led to an epidemic of opioid over prescription and abusewith dangerous personal and societal consequencesThis project proposes a non invasivenon pharmacological alternative that could treat pain by implementing an innovative dry electrode electroencephalographyEEGbased NeurofeedbackNFsolution into an immersive virtual realityVRenvironmentNF and VR have been shown to independently reduce painand it is hypothesized that a combined NF EEG VRNEVRpain treatment that simultaneously distracts and addresses the underlying brain activity associated with pain would benefit from synergistic effects and is therefore expected to reduce both acute and chronic forms of pain