Efficacy of tDCS and EEG Neurofeedback, individually and combined, on Neuropathic Pain following spinal cord injury: Protocol for a Randomised Controlled Trial

Efficacy of tDCS and EEG Neurofeedback, individually and combined, on Neuropathic Pain following spinal cord injury: Protocol for a Randomised Controlled Trial | medRxiv Skip to main content Home About Submit ALERTS / RSS Search for this keyword Advanced Search Efficacy of tDCS and EEG Neurofeedback, individually and combined, on Neuropathic Pain following spinal cord injury: Protocol for a Randomised Controlled Trial View ORCID Profile Nahian S Chowdhury , Negin Hesam-Shariati , View ORCID Profile Yann Quide , Pauline Zahara , Robert Herbert , Sebastian Restrepo , Kevin Chen , Angus Mcyntire , Toby Newton John , James W Middleton , View ORCID Profile Ashley Craig , Mark P Jensen , Jane Butler , Nancy Briggs , James McAuley , Sylvia M Gustin doi: https://doi.org/10.64898/2026.03.11.26347999 Nahian S Chowdhury 1 Centre for Pain IMPACT, Neuroscience Research Australia , Sydney, New South Wales, Australia 2 NeuroRecovery Research Hub, School of Psychology, University of New South Wales , Sydney, New South Wales, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Nahian S Chowdhury For correspondence: n.chowdhury{at}neura.edu.au Negin Hesam-Shariati 1 Centre for Pain IMPACT, Neuroscience Research Australia , Sydney, New South Wales, Australia 2 NeuroRecovery Research Hub, School of Psychology, University of New South Wales , Sydney, New South Wales, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site Yann Quide 1 Centre for Pain IMPACT, Neuroscience Research Australia , Sydney, New South Wales, Australia 2 NeuroRecovery Research Hub, School of Psychology, University of New South Wales , Sydney, New South Wales, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Yann Quide Pauline Zahara 1 Centre for Pain IMPACT, Neuroscience Research Australia , Sydney, New South Wales, Australia 2 NeuroRecovery Research Hub, School of Psychology, University of New South Wales , Sydney, New South Wales, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site Robert Herbert 1 Centre for Pain IMPACT, Neuroscience Research Australia , Sydney, New South Wales, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site Sebastian Restrepo 2 NeuroRecovery Research Hub, School of Psychology, University of New South Wales , Sydney, New South Wales, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site Kevin Chen 2 NeuroRecovery Research Hub, School of Psychology, University of New South Wales , Sydney, New South Wales, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site Angus Mcyntire 2 NeuroRecovery Research Hub, School of Psychology, University of New South Wales , Sydney, New South Wales, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site Toby Newton John 3 Faculty of Health, University of Technology Sydney , Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site James W Middleton 4 John Walsh Centre for Rehabilitation Research, The Kolling Institute, Faculty of Medicine and Health, University of Sydney , Sydney, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site Ashley Craig 4 John Walsh Centre for Rehabilitation Research, The Kolling Institute, Faculty of Medicine and Health, University of Sydney , Sydney, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Ashley Craig Mark P Jensen 5 Department of Rehabilitation Medicine, University of Washington , Seattle, USA Find this author on Google Scholar Find this author on PubMed Search for this author on this site Jane Butler 6 The Kolling Institute, Faculty of Medicine and Health, University of Sydney , Sydney, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site Nancy Briggs 7 Statistical Consulting Unit, University of New South Wales , Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site James McAuley 1 Centre for Pain IMPACT, Neuroscience Research Australia , Sydney, New South Wales, Australia 8 School of Health Science, University of New South Wales , Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site Sylvia M Gustin 1 Centre for Pain IMPACT, Neuroscience Research Australia , Sydney, New South Wales, Australia 2 NeuroRecovery Research Hub, School of Psychology, University of New South Wales , Sydney, New South Wales, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site Abstract Full Text Info/History Metrics Data/Code Preview PDF Abstract Neuropathic pain (NP) affects approximately 60% of individuals with spinal cord injury (SCI). Existing pharmacological treatments provide only modest relief and are often limited by adverse effects, while non-pharmacological options show small effects at best. As such, there remains a need for accessible, mechanism-informed treatments for SCI-NP. This protocol describes a trial evaluating two promising home-based neuromodulatory interventions for SCI-NP - electroencephalography neurofeedback (EEG-NF) and transcranial direct current stimulation (tDCS) - tested both independently and when applied in combination. We will employ a partially double-blinded (i.e. 1 treatment blinded, the other not), 2×2 factorial randomised controlled trial. Adults with chronic SCI-NP (N=192) will be randomised to: (1) EEG-NF + active tDCS, (2) EEG-NF + sham tDCS, (3) active tDCS alone, or (4) sham tDCS alone, in addition to treatment as usual. Participants will complete 20 home-based sessions over 5 weeks. The primary outcome is change in overall pain severity with the primary endpoint being 6 weeks post-randomisation, with secondary endpoints at 16, 26 and 52 weeks post-randomisation. Secondary outcomes (worst pain intensity, pain interference, sleep, depressive symptoms, health-related quality of life) will be assessed at 6 weeks, 16 weeks, 26 weeks and 52 weeks post-randomisation. This will be the first large-scale trial of home-based EEG-NF and tDCS for SCI-NP. If found to be effective, these scalable interventions could be integrated into routine care and inform further optimisation of neuromodulation strategies for managing SCI-NP. Competing Interest Statement The authors have declared no competing interest. Clinical Trial ACTRN12625000737437 Funding Statement This work was supported by the Medical Research Future Fund awarded to Sylvia M Gustin Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The protocol has been approved by the University of New South Wales Human Research Ethics Committee (iRECS9099) I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Footnotes ↵ * Co-first author Data Availability This is a trial protocol with no new data Copyright The copyright holder for this preprint is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license . Back to top Previous Next Posted March 18, 2026. Download PDF Data/Code Email Thank you for your interest in spreading the word about medRxiv. NOTE: Your email address is requested solely to identify you as the sender of this article. Your Email * Your Name * Send To * Enter multiple addresses on separate lines or separate them with commas. You are going to email the following Efficacy of tDCS and EEG Neurofeedback, individually and combined, on Neuropathic Pain following spinal cord injury: Protocol for a Randomised Controlled Trial Message Subject (Your Name) has forwarded a page to you from medRxiv Message Body (Your Name) thought you would like to see this page from the medRxiv website. Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Share Efficacy of tDCS and EEG Neurofeedback, individually and combined, on Neuropathic Pain following spinal cord injury: Protocol for a Randomised Controlled Trial Nahian S Chowdhury , Negin Hesam-Shariati , Yann Quide , Pauline Zahara , Robert Herbert , Sebastian Restrepo , Kevin Chen , Angus Mcyntire , Toby Newton John , James W Middleton , Ashley Craig , Mark P Jensen , Jane Butler , Nancy Briggs , James McAuley , Sylvia M Gustin medRxiv 2026.03.11.26347999; doi: https://doi.org/10.64898/2026.03.11.26347999 Share This Article: Copy Citation Tools Efficacy of tDCS and EEG Neurofeedback, individually and combined, on Neuropathic Pain following spinal cord injury: Protocol for a Randomised Controlled Trial Nahian S Chowdhury , Negin Hesam-Shariati , Yann Quide , Pauline Zahara , Robert Herbert , Sebastian Restrepo , Kevin Chen , Angus Mcyntire , Toby Newton John , James W Middleton , Ashley Craig , Mark P Jensen , Jane Butler , Nancy Briggs , James McAuley , Sylvia M Gustin medRxiv 2026.03.11.26347999; doi: https://doi.org/10.64898/2026.03.11.26347999 Citation Manager Formats BibTeX Bookends EasyBib EndNote (tagged) EndNote 8 (xml) Medlars Mendeley Papers RefWorks Tagged Ref Manager RIS Zotero Tweet Widget Facebook Like Google Plus One Subject Area Pain Medicine Subject Areas All Articles Addiction Medicine (638) Allergy and Immunology (917) Anesthesia (348) Cardiovascular Medicine (4976) Dentistry and Oral Medicine (493) Dermatology (426) Emergency Medicine (674) Endocrinology (including Diabetes Mellitus and Metabolic Disease) (1683) Epidemiology (16216) Forensic Medicine (36) Gastroenterology (1238) Genetic and Genomic Medicine (7257) Geriatric Medicine (751) Health Economics (1093) Health Informatics (5263) Health Policy (1463) Health Systems and Quality Improvement (1826) Hematology (599) HIV/AIDS (1376) Infectious Diseases (except HIV/AIDS) (16469) Intensive Care and Critical Care Medicine (1199) Medical Education (697) Medical Ethics (156) Nephrology (748) Neurology (7554) Nursing (377) Nutrition (1120) Obstetrics and Gynecology (1293) Occupational and Environmental Health (1038) Oncology (3733) Ophthalmology (1087) Orthopedics (407) Otolaryngology (464) Pain Medicine (499) Palliative Medicine (143) Pathology (720) Pediatrics (1854) Pharmacology and Therapeutics (752) Primary Care Research (785) Psychiatry and Clinical Psychology (6105) Public and Global Health (9961) Radiology and Imaging (2516) Rehabilitation Medicine and Physical Therapy (1506) Respiratory Medicine (1264) Rheumatology (657) Sexual and Reproductive Health (799) Sports Medicine (595) Surgery (799) Toxicology (109) Transplantation (318) Urology (307)

Related documents

• Impact of High‐Definition Cathodal tDCS Preconditioning on Enhancing the Therapeutic Efficacy of iTBS Combined With FES for Improving Walking Function in Patients With Spinal Cord Injury: A Randomized Controlled Trial.#193646
• Concurrent tDCS for Chronic Pain in Adults With Cerebral Palsy#1139993
• Brain-Train Home Based Pain Treatment#879848
• Rehabilitative Trial With tDCS in Amyotrophic Lateral Sclerosis#832423
• Brain-spine interface: an exploration of a potential future treatment for spinal cord injury.#483389