New neuroimaging study neurofeedback for pain after spinal cord injury



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Dr. Jeanne Zanca, PhD, MPT, Kessler Foundation, received a $ 299,000 grant from the Craig H. Neilsen Foundation for a pilot study to develop new strategies for the management of neuropathic pain in people with lesions of the spinal cord. This will be the first study to examine functional magnetic resonance imaging (fMRI) -induced neurofeedback to facilitate learning strategies for self-management of post-traumatic neuropathic pain in the spinal cord.

Dr. Zanca is a senior scientist at the Kessler Foundation's Spinal Cord Injury Research Center and a research badociate in the federally funded spinal cord injury system in northern New Jersey.

Neuropathic pain is common in people with chronic spinal cord injury, is often severe and can significantly affect daily life. Medications often provide only partial relief from pain and can produce side effects such as constipation or drowsiness that reduce quality of life. Complementary therapies such as acupuncture and cognitive-behavioral therapy have been tested with limited success. The development of effective non-pharmacological means to help individuals manage neuropathic pain will improve their quality of life and participation in the home, community and workplace.

This pilot study is based on a new approach – training individuals to use neurofeedback to modulate their pain using real-time fMRI of the anterior cingulate cortex – the region of the brain badociated with pain. According to Dr. Zanca, this fMRI neurofeedback technique has been studied in other populations suffering from chronic pain of nerve origin and helped them reduce their pain sensations through self-controlled brain activity. "We'll see if this technique helps people with spinal cord injuries learn strategies for thinking that they can use in everyday life to reduce the intensity and inconvenience of their pain," she said.

The study will use a randomized plan with two groups of 15 participants. Both groups will receive identical instructions regarding the cognitive strategies they can use to control brain activity, but the comments will be different to determine if different types of comments produce different effects. Imaging studies will be conducted at the Rocco Ortenzio Neuroimaging Center of the Kessler Foundation, a facility dedicated to rehabilitation research.

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