Alpha entrainment drives pain relief using visual stimulation in a sample of chronic pain patients. A proof-of-concept controlled study.

One-third of the population in the UK and worldwide struggle with chronic pain. Entraining brain alpha activity through non-invasive visual stimulation has been shown to reduce experimental pain in healthy volunteers. Neural oscillations entrainment offers a potential non-invasive and non-pharmacological intervention for patients with chronic pain, which can be delivered in the home setting and has the potential to reduce use of medications. However, evidence supporting its use in patients with chronic pain is lacking. This study explores whether a) alpha entrainment increase alpha power in patients and b) whether this increase in alpha correlates with analgesia. 28 patients with chronic pain sat in a comfortable position and underwent 4-minute visual stimulation using customised goggles at 10 Hz (alpha) and 7 Hz (control) frequency blocks in a randomised cross-over design. 64-channel Electroencephalography (EEG) and 11-point Numeric Rating Scale (NRS) pain intensity and pain unpleasantness scores were recorded before and after stimulation. EEG analysis revealed frontal alpha power was significantly higher when stimulating at 10 Hz when compared to 7 Hz. There was a significant positive correlation between increased frontal alpha and reduction in pain intensity (r=0.33, p<0.05) and pain unpleasantness (r=0.40, p<0.05) in the 10 Hz block. This study provides the first proof of concept that changes in alpha power resulting from entrainment correlate with an analgesic response in patients with chronic pain. Further studies are warranted to investigate dose-response parameters and equivalence to analgesia provided by medications.