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Presesnters: Sarah Prinsloo, PhD; Randall Lyle, PhD; Diane Novy, PhD; Larry Driver, MD; Lois Ramondetta, MD; Cathy Eng, MD; Gabriel Lopez, MD; Sunil Patel, MD; Jennifer McQuade, MD; Lorenzo Cohen, PhD
Background: CIPN is a common side effect of chemotherapy, leading to impairment in daily activities and diminished quality of life. Neurofeedback (NF) is a brain-training paradigm that induces neuroplasticity to modulate brain activity and we have previously shown it leads to improved CIPN symptoms that were mediated by NF-induced brain changes. Methods: Seventy-one (62 female; mean age=63; 52 breast, 8 gynecologic, 11 other; average length of symptoms=24 mos) cancer survivors >3 months from completing chemotherapy who reported >3 on the NCI’s neuropathy rating scale, were randomized to a NF group (n=35) and underwent 20 sessions of electroencephalography (EEG) NF or a wait-list control group (WL; n=36). We used quantitative EEG imaging to determine any EEG patterns unique to CIPN and then provided NF to change aberrant brain signatures. The primary outcome measure was the Brief Pain Inventory (BPI). Secondary outcome measures included the Pain Quality Assessment Scale (PQAS), MD Anderson Symptom Inventory (MDASI), Short Form 36 (SF-36); Brief Fatigue Inventory (BFI); and Pittsburgh Sleep Quality Index (PSQI), which were completed at baseline, at the end of treatment, 1 and 4 months later. Analyses were done using a general linear mixed model regression (GLMM), and general linear regression (GLM) determined between group differences at each time point. Results: 89% of the participants who were randomized completed treatment and 100% of participants who started NF completed treatment. Change scores from baseline to end of treatment demonstrate NF lead to significant reduction in neuropathic symptoms such as pain and numbness (previously reported), and in cancer-related symptom interference (NF=-5.3 vs WL=-0.5, p=.000); symptom severity (NF=-5.1 vs WL=-0.8, p=.000); fatigue (NF=-3.7 vs WL=-0.8, p=.001), and sleep disturbances (NF=-2.3 vs WL=0.8, p=.030); and improved physical functioning (NF=3.3 vs WL= 1.4, p=.003). At 4 months, the outcomes remained for targeted symptoms but not for secondary outcomes. Conclusion: NF clinically and significantly improved primary outcomes at 4 months post-treatment, and reduced secondary symptoms associated with CIPN.