This K01 proposal will provide Dr. Prinsloo with the resources, training, and protected time necessary to help her transition to an independent researcher in Complementary and Integrative Medicine (CIM). Her primary research interest is in the utilization of neurofeedback as a treatment approach for symptom control and treatment and more generally neuroscientific methods to explore the efficacy and mechanisms of integrative medicine modalities. Training in three main areas are proposed: (1) complementary and integrative medicine;(2) clinical trial investigation;and (3) multimodal neuroimaging techniques. The applicant will complete formal coursework and other educational venues, meet regularly with mentors who are leaders in their respective fields, receive hands-on training, and publish research findings. Dr. Prinsloo's career goal is relevant to the scope of the National Center for Complementary and Alternative Medicine (NCCAM), as this investigation aligns with two of NCCAM's funding priorities: (1) studies of the biological effects and mechanisms of action underlying CAM approaches, as well as studies characterizing the active elements of an intervention and (2) investigations of the impact of CAM modalities in alleviating chronic pain syndromes and improving health and wellness. The proposed project is a randomized, placebo controlled trial to treat chemotherapy-induced peripheral neuropathy (CIPN), a common side effect of cancer treatment, with few treatment options, that diminishes a patient's quality of life (QOL). Neuroplasticity, or the brain's ability to change itself, is the basis for the current reseach interest and is the foundation of neurofeedback training. Ninety breast cancer survivors who have been diagnosed with CIPN will be randomly assigned to real treatment, placebo or a waitlist control group. They will complete assessments including CIPN-symptoms, EEG, pain, cancer-related symptoms, quality of life, mental health, and functional performance at baseline, end of treatment, and 1 and 3 months post treatment. The project has four specific aims: (1) Examine the effects of a neurofeedback training program on perceptions of CIPN versus a placebo and waitlist control;(2) examine the cortical and subcortical regions of the pain matrix associated with CIPN and neurofeedback, including connectivity analysis;(3) examine the effects of a neurofeedback training program on other aspects of pain, cancer-related symptoms, QOL, mental health, and functional performance;(4) explore moderators/mediators of the intervention by examining the extent to which changes in EEG patterns mediate the effects of the intervention, the extent to which placebo brain regions mediate the effects of the intervention, and explore whether therapeutic alliance and expectations moderate the effect of neurofeedback.
This project will demonstrate the effectiveness of an applied neuroscience technique (neurofeedback) to improve neuropathic pain symptoms and improve quality of life in cancer survivors, and yield significant information about the way the brain functions through a mind/body intervention. Separately, we will examine the electrophysiological mechanisms of the placebo response in an attempt to understand the role of placebo in the effectiveness of neurofeedback as well as in chronic pain conditions.