Introduction
pain
CHRONIC LOW BACK PAIN
Chronic low back pain (CLBP) is a significant and disabling health condition affecting individuals, the wider community, and the healthcare systemResting-state cortical activity alterations have been demonstrated in individuals with CLBPElectroencephalography (EEG) based Neurofeedback (NF) is a brain-computer interface biofeedback technique that facilitates an individual’s ability to self-control their real-time cortical activity of the targeted brain regions and reinforces learning through operant conditioningTherefore, this investigation explored the feasibility and safety of a novel source localised EEG-based ISF-NF training technique, targeting the pgACC and dACC + SSC regions for treating CLBP. The specific objectives of this study were to.to assess the feasibility, safety, and acceptability of the targeted EEG ISF-NF training in people with CLBP,to explore the immediate, intermediate, and short-term trends of the effects of the targeted ISF-NF training on pain and function.to explore the EEG changes [current density (CD) and functional connectivity (FC)] in the ISF band at the targeted brain regions following training.We hypothesize that pgACC up-training will improve pain modulation through activation of descending pain inhibitory controls; while down-training medial (dACC) and lateral (SSC) pathways will disrupt pain-provoking activity; but that most benefit may be obtained by normalizing the pain provoking/pain inhibitory balance (up-training pgACC, and down-training dACC and SSC pathway simultaneously by ratio training).A study is therefore set up to test these hypotheses and compare these three groups versus placebo-NF. The study results will support brain-computer interface training as a treatment tool for improving clinical outcomes in people with CLBP. This study will provide central tendency and variability data of clinical outcomes for estimating sample size for a full RCT.