Overview
Background: Chronic functional pain syndromes (AMPS, CRPS) in children are sustained by dysregulated large-scale brain networks, particularly hyperactivity within the default mode network (DMN), which sustains rumination and heightened pain sensitivity. Conventional mindfulness training poses operational barriers for medically distressed youth suffering from chronic pain. Integrating immersive virtual reality with real-time EEG neurofeedback offers an accessible mechanism to directly target DMN dysfunction.
Aims: To evaluate whether NeuroMind, a closed-loop VR-EEG neurofeedback intervention, reduces pain and psychological comorbidities more effectively than active control VR, and whether clinical improvements are mediated by normalized DMN-related electrophysiological indices.
Methods: Randomized, double-blind, active-controlled trial (N=46) in adolescents aged 13-18 with chronic functional pain. Participants complete four 20-minute sessions of either NeuroMind (real-time EEG-derived arousal feedback) or non-feedback VR. Primary outcome is pain intensity (NRS); secondary outcomes include depression, anxiety, and mindfulness. Exploratory analyses examine EEG-derived arousal and DMN connectivity (posterior cingulate-medial prefrontal alpha coherence) as mediators of analgesia.
Preliminary Data: NeuroMind reduces pain (40% reduction in procedural pain) and anxiety in adults and pediatric populations. In healthy volunteers, NeuroMind attenuates DMN connectivity relative to sham VR, with reductions in DMN coherence predicting increased tranquility and attentional stability.
Significance: This study validates a precision neuroscience framework targeting brain mechanisms of pediatric functional pain, generating neurophysiological biomarkers predictive of response and advancing scalable digital therapeutics for medically vulnerable youth.