Neurofeedback for Nociplastic Pain in Rheumatoid Arthritis (NECTAR)

Summary

Rheumatoid arthritis is an autoimmune condition, causing inflammation and pain. Yet pain may persist even when inflammation has been treated. This residual pain, called nociplastic pain, has symptoms of a chronic pain condition called fibromyalgia. There are few effective therapies to address this residual pain. Published literature shows that fibromyalgia can be treated by neurofeedback, a noninvasive method that is based on the voluntary modulation of cortical activity. In this pilot study, the investigators want to test the effect of neurofeedback on the fibromyalgia component of pain in rheumatoid arthritis, and also to investigate its effects on related symptoms such as fatigue and sleep disturbance.

Eligibility

Inclusion Criteria:

* Fulfilment of the ACR/EULAR Classification Criteria for rheumatoid arthritis (RA)
* Fulfilment of the American College of Rheumatology criteria for chronic widespread pain
* Stable disease (swollen joint count ≤1 and CRP ≤10)
* Has normal or corrected to normal vision and hearing abilities
* Right-handed (to reduce baseline motor response test heterogeneity)
* Pain intensity equal or larger than 4 on the Visual Numerical Scale (0 no pain, 10, max pain imaginable)

Exclusion Criteria:

* Unable to understand the task.
* Unable to provide a written informed consent.
* Unable to understand English.
* Major confounding neurological diseases including Multiple Sclerosis, Stroke, Traumatic Brain Injury, Parkinson's Disease, and Alzheimer's Disease)
* Medical or psychiatric conditions that in the judgment of study personnel would preclude participation in the study (psychosis, suicidal ideation etc)
* Under active management of pain team (changing medications, other non pharmacological pain treatment)
* Involved in other interventional experimental studies

Conditions3

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