Optimizing Neurofeedback to Treat CIPN

Chemotherapy-induced peripheral neuropathy (CIPN) is often a side effect of cancer treatment and can diminish a patient’s quality of life (QOL) by affecting everyday activities such as driving a car, putting on clothing, using utensils, and walking. CIPN also leads to treatment delays, dose reductions, and chemotherapy discontinuations which negatively affect treatment outcomes. Only two therapies have been shown to be effective to treat CIPN, neurofeedback (NFB) and duloxetine. Neurofeedback is a treatment that is customized to the individual, relatively inexpensive, non-invasive, and provided alongside conventional medicine. It is a reward system comprised of a brain-computer interface where participants are taught to change activity in brain regions that contribute to symptom perception. In our prior studies of NFB to treat CIPN, we found that patients with CIPN can learn to control activity in brain areas that are associated with CIPN, leading to QOL improvements such as restoration of normal exercise and recreational activities. This project aims to address three major obstacles to clinical improvement in CIPN symptoms. First, this project will help us understand CIPN at the level of individual brain function and will explore neurofeedback training in conjunction with duloxetine to maximize benefit to patients. Second, we will also discover the optimal amount of neurofeedback sessions needed to result in long-term relief of CIPN in a large group of participants and across socioeconomic groups. Lastly, this project will provide valuable information on the interplay between pain perceptions, treatments, and brain function.