Immediate and intermediate effects of intensive Alpha Neurofeedback training on mood states and pain symptoms in Tension Type Headache: A randomized sham controlled study
Keywords:
Alpha Neurofeedback, Tension type headache, Sham controlled, Depression and anxiety levelsAbstract
Abstract:
Aim: The current study aims to explore the effects of neurofeedback training on primary and associated symptoms of tension type headache (TTH) using a randomized sham control study design.
Methods: 20 participants with the diagnosis of tension type headache with or without mild to moderate level of depression were recruited for the study after which they were randomly allocated to either the active intervention or the sham group. They underwent ten sessions of alpha enhancing or sham neurofeedback respective to their groups within a span of two weeks. Participants completed an assessment on three baselines i.e. pre intervention, after 5th session and post intervention on domains of mood states, anxiety levels, pain intensity and level of depression in both groups. The groups were compared using repeated measures ANOVA and spearman correlation coefficient was also computed.
Results: The active neurofeedback group was associated with significant changes in mood states, state anxiety, affective and sensory domains of pain and depression levels when compared to the sham group (p<0.05).In addition significant negative correlations were found between the sensori-motor rhythms (SMR) and reported sensory pain.
Conclusion: The present study provides evidence for efficacy of using alpha neurofeedback training in tension type headache as it has shown to be effective in reducing levels of anxiety, depression and pain in addition to being a non-invasive and time efficient process with minimum placebo effects.
Key Words: Alpha Neurofeedback, Tension type headache, Mood states
References
Ailani, J., Burch, R. C., Robbins, M. S., & Board of Directors of the American Headache Society
(2021). The American Headache Society Consensus Statement: Update on integrating new
migraine treatments into clinical practice. Headache, 61(7), 1021–1039.
https://doi.org/10.1111/head.14153
Aliño Costa, M., Gadea, M., Hidalgo, V., Pérez, V., & Sanjuán, J. (2016). An effective Neurofeedback training, with cortisol correlates, in a clinical case of anxiety. Universitas Psychologica, 15(spe5), 1-10.
Ashina, S., Buse, D. C., Bjorner, J. B., Bendtsen, L., Lyngberg, A. C., Jensen, R. H., & Lipton,
R. B. (2021). Health-related quality of life in tension-type headache: a population-based
study. Scandinavian Journal of Pain, 21(4), 778-787.
Beck, A. T., Ward, C., Mendelson, M., Mock, J., & Erbaugh, J. J. A. G. P. (1961). Beck depression inventory (BDI). Arch Gen Psychiatry, 4(6), 561-571.
Boland, C., Jalihal, V., Organ, C., Oak, K., McLean, B., Laugharne, R., ... & Shankar, R. (2021).
EEG Markers in emotionally unstable personality disorder—a possible outcome measure
for neurofeedback: a narrative review. Clinical EEG and Neuroscience, 52(4), 254-273.
Caponnetto, V., Deodato, M., Robotti, M., Koutsokera, M., Pozzilli, V., Galati, C., ... &
European Headache Federation School of Advanced Studies (EHF-SAS). (2021).
Comorbidities of primary headache disorders: a literature review with meta-analysis. The
Journal of Headache and Pain, 22, 1-18.
Dhiman, V., Menon, G. R., Kaur, S., Mishra, A., John, D., Vishnu, M. V. R., ... & Dhaliwal, R.
S. (2021). A systematic review and meta-analysis of prevalence of epilepsy, dementia,
headache, and Parkinson disease in India. Neurology India, 69(2), 294.
Escolano, C., Navarro-Gil, M., Garcia-Campayo, J., Congedo, M., De Ridder, D., & Minguez, J. (2014). A controlled study on the cognitive effect of alpha neurofeedback training in patients with major depressive disorder. Frontiers in Behavioral Neuroscience, 8, 296.
Gadea, M., Aliño, M., Hidalgo, V., Espert, R., & Salvador, A. (2020). Effects of a single session
of SMR neurofeedback training on anxiety and cortisol levels. Neurophysiologie
Clinique, 50(3), 167-173.
Ghogare, A. S., & Patil, P. S. (2020). A cross-sectional study of co-morbid generalized anxiety
disorder and major depressive disorder in patients with tension-type headache attending
tertiary health care centre in central rural India. The Nigerian Postgraduate Medical
Journal, 27(3), 224–229. https://doi.org/10.4103/npmj.npmj_23_20
Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery, and
Psychiatry, 23(1), 56.
Hoedlmoser, K., Pecherstorfer, T., Gruber, G., Anderer, P., Doppelmayr, M., Klimesch, W., & Schabus, M. (2008). Instrumental conditioning of human sensorimotor rhythm (12-15 Hz) and its impact on sleep as well as declarative learning. Sleep, 31(10), 1401-1408.
Jacobs, E. H., & Jensen, M. P. (2015). EEG neurofeedback in the treatment of chronic pain: a case series. NeuroRegulation, 2(2), 86-86.
Jensen, M. P., Hakimian, S., Sherlin, L. H., & Fregni, F. (2008). New insights into neuromodulatory approaches for the treatment of pain. The Journal of Pain, 9(3), 193-199.
Johnston, S., Linden, D. E. J., Healy, D., Goebel, R., Habes, I., & Boehm, S. G. (2011). Upregulation of emotion areas through neurofeedback with a focus on positive mood. Cognitive, Affective, & Behavioral Neuroscience, 11, 44-51.
Kaniecki, R. G. (2015). Tension-type headache. Headache and Migraine Biology and
Management, 149-160.
Kosinski, M., Bayliss, M. S., Bjorner, J. B., Ware, J. E., Garber, W. H., Batenhorst, A., ... & Tepper, S. (2003). A six-item short-form survey for measuring headache impact: The HIT-6™. Quality of life Research, 12, 963-974.
Mandal, M. K., Pandey, G., Singh, G., & Asthana, S. H. (1992). Sidedness bias schedule. Indian Journal of Psychiatry, 27, 433-442.
Melnikov, M. Y. (2021). The current evidence levels for biofeedback and neurofeedback
interventions in treating depression: A narrative review. Neural Plasticity.
Melzack, R., & Raja, S. N. (2005). The McGill pain questionnaire: from description to measurement. The Journal of the American Society of Anesthesiologists, 103(1), 199-202.
Mesa-Jimenez, J. A., Lozano-Lopez, C., Angulo-Diaz-Parreno, S., Rodríguez-Fernández, Á. L.,
De-la-Hoz-Aizpurua, J. L., & Fernández-de-Las-Peñas, C. (2015). Multimodal manual
therapy vs. pharmacological care for management of tension type headache: A meta-
analysis of randomized trials. Cephalalgia, 35(14), 1323-1332.
Nestoriuc, Y., Martin, A., Rief, W., & Andrasik, F. (2008). Biofeedback treatment for headache
disorders: a comprehensive efficacy review. Applied Psychophysiology and
Biofeedback, 33, 125-140.
Rizzoli, P., & Mullally, W. J. (2018). Headache. The American Journal of Medicine, 131(1), 17–
https://doi.org/10.1016/j.amjmed.2017.09.005
Rogel A, Guez J, Getter N, Keha E, Cohen T, Amor T, Todder D. Transient adverse side effects during neurofeedback training: a randomized, sham-controlled, double blind study. Applied psychophysiology and biofeedback. 2015;40(3):209-18
Romero-Godoy, R., Romero-Godoy, S. R., Romero-Acebal, M., & Gutiérrez-Bedmar, M.(2022).
Psychiatric Comorbidity and Emotional Dysregulation in Chronic Tension-Type
Headache: A Case-Control Study. Journal of Clinical Medicine, 11(17), 5090.
Roy, R., de la Vega, R., Jensen, M. P., & Miró, J. (2020). Neurofeedback for pain management:
A systematic review. Frontiers in Neuroscience, 671.
Sahraee, S. (2016). Effect of neurofeedback training on consumption temptation, depression and anxiety of smokers. Iranian Journal of Educational Sociology, 1(1), 121-131.
Spielberger, C. D. (1983). State Trait Anxiety Inventory for Adults: Sampler Set: Manual, Test, Scoring Key;[form Y]; STAIS-AD. Mind Garden.
Steingrimsson, S., Bilonic, G., Ekelund, A. C., Larson, T., Stadig, I., Svensson, M., ... &
Bernhardsson, S. (2020). Electroencephalography-based neurofeedback as treatment
for post-traumatic stress disorder: A systematic review and meta-analysis. European
Psychiatry, 63(1), e7.
Terry, P. C., Lane, A. M., & Fogarty, G. J. (2003). Construct validity of the Profile of Mood States—Adolescents for use with adults. Psychology of Sport and Exercise, 4(2), 125-139.
Warner, S. (2013) Cheat sheet for neurofeedback, Docslib. Scribd. Available at: https://docslib.org/doc/7711363/cheat-sheet-for-neurofeedback
Wu, Y. L., Fang, S. C., Chen, S. C., Tai, C. J., & Tsai, P. S. (2021). Effects of Neurofeedback on
Fibromyalgia: A Randomized Controlled Trial. Pain Management Nursing : official
Journal of the American Society of Pain Management Nurses, 22(6), 755–763.
https://doi.org/10.1016/j.pmn.2021.01.004
Yu, S., & Han, X. (2015). Update of chronic tension-type headache. Current Pain and Headache
Reports, 19, 1-8.
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