Brain-Computer Interface to Deliver Individualized Multisensory Intervention for Neuropathic Pain
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Date
2023-09
Publication Type
Journal Article
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Abstract
To unravel the complexity of the neuropathic pain experience, researchers have tried to identify reliable pain signatures (biomarkers) using electroencephalography (EEG) and skin conductance (SC). Nevertheless, their use as a clinical aid to design personalized therapies remains scarce and patients are prescribed with common and inefficient painkillers. To address this need, novel non-pharmacological interventions, such as transcutaneous electrical nerve stimulation (TENS) to activate peripheral pain relief via neuromodulation and virtual reality (VR) to modulate patients' attention, have emerged. However, all present treatments suffer from the inherent bias of the patient's self-reported pain intensity, depending on their predisposition and tolerance, together with unspecific, pre-defined scheduling of sessions which does not consider the timing of pain episodes onset. Here, we show a Brain-Computer Interface (BCI) detecting in real-time neurophysiological signatures of neuropathic pain from EEG combined with SC and accordingly triggering a multisensory intervention combining TENS and VR. After validating that the multisensory intervention effectively decreased experimentally induced pain, the BCI was tested with thirteen healthy subjects by electrically inducing pain and showed 82% recall in decoding pain in real time. Such constructed BCI was then validated with eight neuropathic patients reaching 75% online pain precision, and consequently releasing the intervention inducing a significant decrease (50% NPSI score) in neuropathic patients' pain perception. Our results demonstrate the feasibility of real-time pain detection from objective neurophysiological signals, and the effectiveness of a triggered combination of VR and TENS to decrease neuropathic pain. This paves the way towards personalized, data-driven pain therapies using fully portable technologies.
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published
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Journal / series
Volume
20 (5)
Pages / Article No.
1316 - 1329
Publisher
Springer
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Subject
Neuropathic pain; Transcutaneous electrical nerve stimulation; Virtual reality; EEG; Skin conductance; BCI
Organisational unit
09632 - Raspopovic, Stanisa (ehemalig) / Raspopovic, Stanisa (former)
Notes
Funding
197271 - Multimodal targeted neurotechnology for gait improvement and neuropathic pain suppression in diabetic neuropathy (MOVEIT) (SNF)