Relief of neuropathic pain after spinal cord injury by brain–computer interface training

Objectives: The aim of this study was to report the effects of brain–computer interface (BCI) training, a neurofeedback rehabilitation technique, on persistent neuropathic pain (NP) after cervical spinal cord injury (SCI). Subjects and methods: We present the case of a 71-year-old woman with NP in her left upper extremity after SCI (C8). She underwent BCI training as outpatient rehabilitation for 4 months to enhance event-related desynchronization (ERD), which is triggered by the patient’s motor intuition. Scalp electroencephalography was recorded to observe the ERD during every BCI training session. The patient’s pain was evaluated with the McGill Pain Questionnaire (MPQ) and a visual analog scale (VAS). The MPQ was performed after every BCI training session, and the patient assessed the VAS score on her own, once every few days during the BCI training period. Results: After the BCI training started, the patient’s ERD during the BCI training period increased significantly, from 15.6–30.3%. Moreover, her VAS score decreased gradually, from 8 to 5, after the BCI training started, although the MPQ did not change significantly. Conclusion: BCI training has the potential to provide relief for patients with persistent NP via brain plasticity, and to improve their activities of daily living and quality of life.