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Neuromodulatory Treatments for Pain Management in Complex TBI Using Mobile Technology

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Technical Report,30 Sep 2017,29 Sep 2018

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Duke University Durham United States

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We aim to test whether mobile neurofeedback and mindfulness training lowers pain symptoms in Veterans with complex TBI. We arerandomly assigning 300 Veterans with TBI and chronic pain into three groups 100 Veterans per group. Veterans in all groups receive aniPod Touch with a mobile application app installed. Veterans in group 1 receive a Muse headset, used to measure brain activity, and theMobile Neurofeedback app Veterans in group 2 receive the Mindfulness Coach app, which provides mindfulness training Veterans ingroup 3 control, receive the Relaxing Nature app, which provides ambient sounds for unstructured relaxation.Veterans are instructed to use their respective mobile apps independently 10 minutes a day, 4 times a week, for 12 weeks. Over the 12weeks, research staff visit Veterans homes twice to reinforce training, troubleshoot technical problems, and collect usage data. Staff alsocontact participants by phone twice to provide technical support and collect usage data. We interview Veterans, measure clinical outcomes,and measure brain activity with an electroencephalograph EEG at 0, 3, and 6 months.We expect that Veterans in the neurofeedback and mindfulness groups will have significantly reduced pain symptoms at the end of 3months, with long-term improvement persisting at 6 months. We hypothesize reductions in pain symptoms will correlate with changes inbrainwave activity. Given links between pain and negative outcomes, we will also examine outcomes related to drug abuse, violence, andsuicidality. Finally, given these interventions may affect other biological systems, we will explore whether neurofeedback and mindfulnessimprove cardiovascular health by measuring heart rate variability.

Subject Categories:

  • Anatomy and Physiology
  • Medicine and Medical Research

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