Professor James McAuley

What is the analgesic effect of EEG neurofeedback for people with chronic pain? A systematic review

Researchers: A/Prof Sylvia Gustin, Dr Negin Hesam-Shariati, Dr Wei-Ju Chang, A/Prof James McAuley, Dr Andrew Booth, A/Prof Toby Newton-John, Prof Chin-Teng Lin, A/Prof Zina Trost

Chronic pain is a global health problem, affecting around one in five individuals in the general population. The understanding of the key role of functional brain alterations in the generation of chronic pain has led researchers to focus on pain treatments that target brain activity. Electroencephalographic (EEG) neurofeedback attempts to modulate the power of maladaptive EEG frequency powers to decrease chronic pain. Although several studies provide promising evidence, the effect of EEG neurofeedback on chronic pain is uncertain. This systematic review aims to synthesise the evidence from randomised controlled trials (RCTs) to evaluate the analgesic effect of EEG neurofeedback.

The search strategy will be performed on five electronic databases (Cochrane Central, MEDLINE, Embase, PsycInfo, and CINAHL) for published studies and on clinical trial registries for completed unpublished studies. We will include studies that used EEG neurofeedback as an intervention for people with chronic pain. Risk of bias tools will be used to assess methodological quality of the included studies. RCTs will be included if they have compared EEG neurofeedback with any other intervention or placebo control. The data from RCTs will be aggregated to perform a meta-analysis for quantitative synthesis. In addition, non-randomised studies will be included for a narrative synthesis. The data from non-randomised studies will be extracted and summarised in a descriptive table. The primary outcome measure is pain intensity assessed by self-report scales. Secondary outcome measures include depressive symptoms, anxiety symptoms, and sleep quality measured by self-reported questionnaires. Further, we will investigate the non-randomised studies for additional outcomes addressing safety, feasibility, and resting-state EEG analysis.

MEMOIR – a clinical trial for Complex Regional Pain Syndrome

MEMOIR is an Australian government-funded clinical trial for Complex Regional Pain Syndrome (CRPS). MEMOIR is testing two treatments for people with CRPS – a drug, memantine and a rehabilitation program, Graded Motor Imagery. MEMOIR will be conducted remotely, via Telehealth, allowing for Australia-wide recruitment of eligible participants. Please click on the link below to check if you are eligible.

What is Complex Regional Pain Syndrome (CRPS)?

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[block] [click] CRPS is a disabling pain disorder. It affects approximately 5,000 people in Australia annually. CRPS is characterised by severe burning, stinging and stabbing pain. People with CRPS may not be able to use their affected limb and their ability to work or participate in normal social activities can be severely restricted. Currently, there are no interventions for CRPS whose efficacy is supported by high-quality evidence.

 

 

 

Social Media for Low Back Pain

Social media is a potentially powerful tool to provide a message of education and reassurance to the general public about low back pain. This project will use social media to educate the general public about low back pain and promote self-management.

The project involves three stages. Firstly, we will conduct a content analysis to gain an insight into social media users’ perceptions and understanding about low back pain. This could determine whether social media could serve as an educational tool through which accurate information related to low back pain could be disseminated to the public.

Second, a recent Delphi survey of 150 low back pain researchers identified 30 key messages considered to be important for the general public to know about LBP. These statements provide evidence-based information on the diagnosis, prognosis and management of LBP and are intended to educate, reassure and promote self-management. We will investigate the attitude of the general public towards these messages.

Third, working in conjunction with a media company Y&R, we will design and test a social media campaign to encourage self-management for people with low back pain.

The STOPain Study: Using brain-computer-interface intervention for people with neuropathic pain

Chronic pain is a significant problem worldwide affecting nearly 8 million Australians. Unfortunately, despite the availability of analgesics and other pain therapies, no treatment has been found that benefits the majority of individuals, and most of the available treatments have significant side effects or risks for serious adverse events, e.g. kidney failure.

RESOLVE Trial for Chronic Low Back Pain

For people with long term back pain that is not getting better. We are testing two pain treatment programs that target the brain, for people with chronic low back pain.

UPWaRD: Understanding persistent pain where it resides – in the brain.

Persistent musculoskeletal pain is one of the most significant health issues in the developed world. Termed a ‘Western epidemic’, low back pain is the most common form of persistent musculoskeletal pain and a leading cause of suffering and disability. Despite the enormity of the problem, many current therapies target generic symptoms, not underlying mechanisms, with limited effect. In 2010, the Australian National Pain Summit concluded ‘the management of pain is shockingly inadequate’. This assessment is not surprising given that critical information on the biological changes that underpin persistent low back pain is lacking. The UPWaRD study is a 5-year NHMRC-funded trial that investigates the role of brain plasticity, along with biological changes in the spinal cord, hormonal changes, genetics and stress, in the development of persistent low back pain.

 

https://www.upwardbackpainstudy.com

Medicines for Back Pain

AGReMA – A Guideline for Reporting Mediation Analyses

There are a growing number of studies using mediation analysis to understand the mechanisms of health interventions and exposures. Recent work has shown that the reporting of these studies is heterogenous and incomplete. This problem stifles clinical application, reproducibility, and evidence synthesis. The development and implementation of A Guideline for Reporting Mediation Analyses (AGReMA) will improve the standardization, transparency, and completeness in the reporting of studies that use mediation analysis to understand the mechanisms of health interventions and exposures.

AGReMA Publications

Cashin AG, McAuley JH, Lamb SE, Hopewell S, Kamper SJ, Williams CM, Henschke N, Lee H. (2020). Development of A Guideline for Reporting Mediation Analyses (AGReMA). BMC Med Res Methodol 20(1):19. doi: 10.1186/s12874-020-0915-5. PMID: 32013883

SLEEPain

For people with back pain who are having trouble with their sleep. We are testing whether a simple sleep tablet will help people reduce their pain and sleep better.

Patient Education to PREVENT Chronic Low Back Pain

For people with a new low back pain episode. We are testing early intervention to reduce the risk of developing chronic low back pain.