Two randomised trials from one team show reduced pain, numbness and balance problems, with benefits that persist while those of placebo feedback fade. The second trial is now published in full.
Updated :
What the research shows
EEG neurofeedback — standard amplitude training
qEEG-guided EEG neurofeedback (beta regulation over targeted cortical regions)
Ages
Adult (18+)
Techniques
qEEG-guided (incl. z-score), Beta training
AAPB3Probably efficaciousNeuroLogic3Probably efficacioussame vs AAPB
Level 3 maintained. Two randomised trials, both from one team at one centre, support neurofeedback for established CIPN. Prinsloo 2017 randomised 62 survivors to 20 sessions or a waitlist: greater improvement on the Brief Pain Inventory worst-pain item (mean change −2.43, 95 % CI −3.58 to −1.28, vs 0.09; effect size 0.83), with numbness, symptom severity and interference, physical functioning and fatigue still better at 4 months (Prinsloo 2018). The double-blind placebo-controlled trial is now published in full: Prinsloo 2024, three arms, 91 breast cancer survivors, 20 sessions — both the neurofeedback and the placebo-feedback arms reduced Pain Quality Assessment Scale scores relative to waitlist (effect sizes 1.07 and 0.9), but only the neurofeedback group continued to improve at 1 month and only there did targeted brain changes predict later symptoms. Level 4 requires the result in at least two independent settings: every trial so far comes from the same team.
In short
Clinical reading
NeuroLogic Level 3, the same as the AAPB. Prinsloo 2017/2018 (n = 62, 20 sessions vs waitlist, effect size 0.83 on worst pain, sustained at 4 months) and Prinsloo 2024 (n = 91, three arms, double-blind: neurofeedback 1.07 and placebo feedback 0.9 vs waitlist, with only neurofeedback still improving at 1 month). No Level 4 while replication stays within the originating team.
Protocols
EEG neurofeedback guided by the cortical targets associated with symptoms (beta regulation, Brodmann areas 3, 6 and 7), 20 sessions.
Limits
Findings come from a single research group; independent replication is needed before a higher rating. Placebo feedback produces almost as much benefit at end of the intervention — the difference lies in persistence and in the link with targeted brain change. No prevention trials. No biofeedback trial (EMG, thermal, HRV) in CIPN: there is no biofeedback row. Adult population only.
Study base
Two RCTs against waitlist and placebo, with objective measures and sustained effects; 2022-2026 base: 6 publications indexed in the archive, including the full publication of the second trial and adjacent work on peripheral neuropathic pain.
Brendan's perspective
Level 3, the same as the AAPB, and for the reason this field keeps tripping over: two good randomised trials, one team. Prinsloo 2017 and Prinsloo 2024 are careful work — twenty clinician-delivered sessions, explicit cortical targets, real follow-up — and I would take them over a dozen uncontrolled series. But when a literature is still, years on, the work of the same group at the same centre, that is not a gap waiting to be filled; it is a finding in itself. The placebo-feedback arm nearly matching real feedback at end of the intervention does not trouble me: sham is a partially active comparator, and the informative contrast is the divergence at one month. Chemotherapy-induced neuropathy is not a condition I see often. If I did, I would work from a qEEG rather than from Prinsloo's coordinates, with HRV biofeedback alongside. Nobody has shown prevention, or that this holds in anyone else's hands.
Prinsloo et al. (2017) Randomized controlled trial of neurofeedback on chemotherapy-induced peripheral neuropathy doi:10.1002/cncr.30649
Prinsloo et al. (2018) The long-term impact of neurofeedback on symptom burden and interference in patients with chronic chemotherapy-induced neuropathy: Analysis of a randomized controlled trial doi:10.1016/j.jpainsymman.2018.01.010
Prinsloo et al. (2024) Brain-computer interface relieves chronic chemotherapy-induced peripheral neuropathy: A randomized, double-blind, placebo-controlled trial doi:10.1002/cncr.35027
Wang et al. (2022) Evaluating the safety, feasibility, and efficacy of non-invasive neuromodulation techniques in chemotherapy-induced peripheral neuropathy: A systematic review doi:10.1016/j.ejon.2022.102124
