Pain is closely linked to alpha oscillations (8 -13 Hz) which are thought to represent a supra-modal, top-down mediated gating mechanism that shapes sensory processing. Consequently, alpha oscillations might also shape the cerebral processing of nociceptive input and eventually the perception of pain. To test this mechanistic hypothesis, the investigators designed a sham-controlled and double-blind electroencephalography (EEG)-based neurofeedback study. In a short-term neurofeedback training protocol, healthy participants will learn to up- and downregulate somatosensory alpha oscillations using attention. Subsequently, the investigators will investigate how this manipulation impacts experimental pain applied during neurofeedback. Using Bayesian statistics and mediation analysis, the investigators will test whether alpha oscillations mediate attention effects on pain perception. This approach promises causal insights into the role of alpha oscillations in shaping pain, and thereby extends previous correlative evidence. Beyond, it can aid the development of novel, non-invasive modulatory treatment approaches for chronic pain, which are urgently needed. The prosed study protocol has been granted in-principle acceptance from PLOS Biology and the corresponding registration can be found at the OSF online repository \[www.osf.io/qbkj2\].
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
75
In a first verum neurofeedback condition, participants will be instructed to focus attention on their right hand and the up-regulation of alpha oscillations in the right hemisphere relative to alpha oscillations in the left hemisphere will be incentivized through neurofeedback.
In a second verum neurofeedback condition, participants will be instructed to focus attention on their left hand and the down-regulation of right relative to left alpha oscillations will be incentivized.
During the first sham neurofeedback condition, participants will be instructed to focus attention on their right hand. However, the feedback signal will not mirror their brain activity. Instead, the feedback signal and the corresponding reward of the last matching verum condition completed by a previous participant, i.e., ARTNF for ARTsham, will be replayed (yoked feedback).
During the second sham neurofeedback condition, participants will be instructed to focus attention on their left hand. However, the feedback signal will not mirror their brain activity. Instead, the feedback signal and the corresponding reward of the last matching verum condition completed by a previous participant, i.e., ALTNF for ALTsham, will be replayed (yoked feedback).
Department of Neurology, Klinikum rechts der Isar, Technical University of Munich
Munich, Bavaria, Germany
Alpha asymmetry index (AAI) during neurofeedback
During neurofeedback, brain activity will be recorded continuously and the AAI will be extracted. Subsequently, AAIs will be compared between neurofeedback conditions. Details regarding the complete analysis pipeline can be found at the OSF online repository \[www.osf.io/qbkj2\].
Time frame: During procedure (neurofeedback)
Pain ratings during neurofeedback (NRS; 1: 'no pain' to 100: 'worst tolerable pain')
At the end of each neurofeedback trial, participants will verbally rate the perceived intensity of a cutaneous laser stimulus. Subsequently, pain ratings will be compared between neurofeedback conditions. Details regarding the complete analysis pipeline can be found at the OSF online repository \[www.osf.io/qbkj2\].
Time frame: During procedure (neurofeedback)
Pain-related brain responses during neurofeedback
During neurofeedback, brain activity will be recorded continuously, and the pain-related brain responses will be extracted. Subsequently, pain-related brain responses will be compared between neurofeedback conditions. Details regarding the complete analysis pipeline can be found at the OSF online repository \[www.osf.io/qbkj2\].
Time frame: During procedure (neurofeedback)
Motivation to participate in the training measured by a numerical rating scale (NRS; 1: 'very low' to 7: 'very high')
The motivation to participate in the training will be assessed using a self-report measure.
Time frame: Before each session
General self-efficacy (German version of the General Self-Efficacy Scale, GSE, minimum score: 10, maximum score: 40)
General self-efficacy will be assessed using the German version of the General Self-efficacy Scale.
Time frame: Before each session
Health-related locus of control (Multidimensional Health Locus of Control Scales, MHLC, minimum score: 3, maximum score: 15)
The health-related locus of control will be assessed using Multidimensional Health Locus of Control Scales.
Time frame: Before each session
Current positive or negative affect (Positive and Negative Affect Schedule, PNAS, minimum score: 10, maximum score: 50)
The current positive or negative affect will be assessed using the Positive and Negative Affect Schedule.
Time frame: Before each session
Perceived task demand (NRS; 1: 'very low' to 7: 'very high')
The perceived task demand will be assessed using a self-report measure.
Time frame: After each condition
Effort exerted (NRS; 1: 'very low' to 7: 'very high')
The effort exerted will be assessed using a self-report measure.
Time frame: After each condition
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