21 Sep 2021

Chronic pain: retraining the brain's response

From Nine To Noon, 9:20 am on 21 September 2021

A New Zealand health-tech company is trialling technology that could help sufferers of chronic pain 'retrain' how their brain responds to nerve signals from the body.

It will be the world's largest clinical trial using EEG neurofeedback.

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Photo: Exsurgo

Exsurgo has developed a headset using a pre-existing medical device called electroencephalography (EEG).

Chief executive Richard Little tells Kathryn Ryan it has traditionally been used since 1924 for diagnosis of brain-related conditions like epilepsy.

"So we made this smaller wearable version of the EEG device, you put that on your head, and it's linked up to Bluetooth to a mobile application on a tablet.

"We represent those brainwaves that are associated with pain in a game interface, so you might see a balloon or a barograph or a puzzle or whatever it is.

"The [neurofeedback] that comes from the brain is in real time, so what's happening in the brain is being reflected in that game interface."

The process is called neurofeedback and feeds data back to the patient in a way that reinforces positive changes to the pain signals, Little says.

"Because it's happening in real time, the brain makes the connection between what's happening in the brain and what's happening on the screen.

"They're actually very simple neurological exercises that we do, the games are not overly stimulating so you're not playing full-on Space Invaders or something like that.

"It's something that allows the person to see they're making those positive changes and different people like different games and relate to different things on the screen."

When done often enough, it will reinforce 'helpful behaviour' to change the hardwiring of the negative feedback loop that causes chronic pain, he says.

"We use exactly the same mechanism that got it into that state to get out of that state.

"So we retrain the brain there and we keep moving those [pain] signals down and it also affects things like sleep and anxiety as well.

"You start to get better sleep, you'll get less anxiety about moving the part [where pain is] ... and you get less depression associated with that too because now you can do more of the things you love."

While it's not guaranteed it will work for everyone, there are positive results for the majority with early indications showing 70 percent will get a clinical benefit, he says.

The sessions last for 30 minutes a day, done at least four days a week over eight weeks to see benefits, Little says.

The trial has involved people with chronic pain from the upper North Island (and restricted to Auckland under Covid-19 restriction), he says.

"What the trial's about is really it's for our own satisfaction but also to satisfy the needs of the medical community and the regulators in proving the system does what we say it does."

Little says people interested in getting involved in the trial can register their interest on the company's website to go on a waitlist, but they are not the ones picking participants.