"The brainwaves of people with neuropathic pain show a distinct pattern: more slow theta waves, fewer alpha waves, and more fast, high beta waves," Professor Gustin said. These fluctuations are not merely symptoms of the pain but are believed to be part of the mechanism that sustains it. "We believe these changes interfere with how the thalamus talks to other parts of the brain, especially the sensory motor cortex, which registers pain."
This realization led Professor Gustin to a pivotal question: could a treatment be developed that directly targets and normalizes these abnormal waves? If the brain could be "retrained" to produce a more balanced pattern of theta, alpha, and beta waves, it might be possible to reduce the perception of pain at its neurological source.
To answer this question, an interdisciplinary team was formed, bringing together experts from UNSW Science and Neuroscience Research Australia (NeuRA). The result of their collaboration was the PainWaive system, a combination of hardware and software designed to facilitate neurofeedback. Neurofeedback is a process where a person receives real-time information about their brain activity and uses that information to attempt to change it. In the case of PainWaive, the "information" is delivered through the mechanics of a video game.
During the trial, participants were provided with a comprehensive kit that included a custom-designed EEG headset and a tablet preloaded with the PainWaive app. The app is designed to be responsive; as the headset detects shifts in brainwave patterns, the game reacts in real time. To succeed in the game, the user must successfully steer their brain activity toward a more "normal" or healthy state.
To assist in this process, the researchers provided participants with various mental strategies. These included techniques such as deep relaxation, mindfulness, or focusing on positive, happy memories. By experimenting with these mental states and observing the immediate feedback from the game, users learned which internal strategies were most effective at suppressing the abnormal brain waves associated with their pain.
One of the most significant aspects of the PainWaive system is its accessibility. Traditionally, neurofeedback therapy requires expensive equipment and frequent visits to a specialized clinic. PainWaive was designed from the ground up to be a telehealth-compatible, at-home solution. Participants in the study were able to master the system quickly.
"After just a couple of Zoom sessions, participants were able to run the treatment entirely on their own," Dr. Hesam-Shariati said. This autonomy is a critical component of the treatment’s success, as it allows patients to take control of their own recovery. "Participants felt empowered to manage their pain in their own environment. That’s a huge part of what makes this special."
