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Eliminating chronic pain with neurofeedback

December 26, 2023 | UCI Health
Nikki Daurio and her service dog, Tiki, having a hug.
Nikki Daurio and her service dog, Tiki, have a hug by the living wall at the UCI Susan Samueli Integrative Health Institute.

Three years ago, Nikki Daurio woke up in such pain she was barely able to move, launching a health journey that few would have predicted for the former elite water polo player.

Daurio can pinpoint where the arduous journey began. She was hiking, slipped in the mud, and hit her head on the ground. The resulting concussion was not her first. She had experienced a few concussions as a water polo player for a community club, for Arnold O. Beckman High School, Harvard and the U.S. Women’s Cadet National Team. She knew it would take time to recover.

“A week into my bed rest for the concussion, I was out in the courtyard with my friend and her dog started throwing up,” says Daurio. “I lunged to help the dog at the same time my friend did. We hit heads. I wasn't fully recovered from my concussion, so it just was not good.”

Daurio began waking up with headaches and pains throughout her body so severe that she could barely move. Then, Harvard closed its campus in response to the COVID-19 pandemic, sending her and every other student home.

“My health really just deteriorated from there,” says Daurio. “I wouldn’t say I was bedridden, but it was exhausting to even walk up and down the stairs. It was overwhelming pain and exhaustion and a wide array of different symptoms.”

On good days, she could manage one activity until the pain took over.

Daurio completed her final semester from her family home in Tustin, earning a degree in cognitive neuroscience and evolutionary psychology. People were still working from home, so she was able to launch her career from her couch, which, on many days, was as far as her pain would let her travel. 

When Daurio wasn’t working, she visited specialists, hoping to learn why the headaches and body pains continued. Although the diagnostic tests and procedures often produced abnormal results, the cause of her pains remained a mystery.

Finding an answer

Ultimately, she found answers with three UCI Health doctors: Kim Hecht, DO, physical medicine and rehabilitation specialist and medical director of the UCI Health Susan Samueli Integrative Health Institute; rheumatologist Michael Cheng, DO, and clinical neuropsychologist Christine Kraus, PhD, director of integrative neuropsychology for the Institute. This clinical team, which benefited from the ability to share medical information through Daurio’s electronic medical record, offered her a promising path forward.

“I finally found doctors who believed my symptoms; they were wonderful,” Daurio says. “What really turned the tables for me was the neurofeedback with Dr. Kraus.”

Nikki Daurio and Dr. Christine Kraus holding neurofeedback device.
Daurio and Christine Kraus, PhD, hold a neurofeedback device she uses to relieve pain.

Kraus has used neurofeedback with patients for more than two decades. She has seen it improve the health of individuals experiencing pain and the effects of concussions, as well as anxiety, sleeplessness and more. Ongoing research has demonstrated positive outcomes from neurofeedback for these conditions and many others, according to International Society for Neuroregulation and Research.

Neurofeedback therapy is a non-invasive treatment that relies on a stimulus such as a video game or movie to condition a person to increase or inhibit specific brainwaves to help them more effectively manage a condition. Based on what Daurio had learned as a student of cognitive science, she was optimistic that the approach could help her.

Kraus also used quantitative electroencephalography to identify areas where Daurio’s brainwaves were dysregulated. This test records the brain’s electrical activity, allowing the physician to view the electrical signals as patterns displayed on a monitor. She observed activity in the pain network of Daurio’s brain, then developed a treatment plan focused on that region.

The goal of Daurio’s neurofeedback therapy was to decrease her brain’s hypersensitivity to pain and improve her ability to tolerate the discomfort.

By early 2023, the 26-year-old was living in Los Angeles and working as a manager and producer for a talent agency. Encouraged by her employer, she made the long drive to Irvine twice a week to play video games under Kraus' watchful eye. These games helped train Daurio's brain to adapt to and achieve a reward state that ultimately helped reduce her pain.

Persistence pays off

It wasn’t easy. Daurio says the pain and exhaustion initially got worse. But. Kraus encouraged her to keep trying.

"It’s like going to the gym," Kraus explains. "You go whatever frequency is recommended and you’re going to keep it up; you’re going to exercise that muscle. If you go once every two weeks, you’re wasting your time. Nikki wanted to get better and she was willing to do the work.”

The clinical neuropsychologist also observed Daurio closely throughout the sessions, watching for signs that the neurofeedback techniques had sparked a reaction that would be best handled with cognitive therapy, which Kraus considers an essential element of caring for the whole person.

“Neurofeedback can bring things up because your brain is finally saying, ‘Okay, we can handle this now,’” Kraus says. “You want to make sure if that happens, you’re ready for it and you can treat the person. Occasionally, Nikki would experience a bout of depression. We would talk about it and make sure she was on the right track.”

Eventually, the long commutes and hard work paid off. After 20 sessions, Daurio was waking up with fewer headaches and more energy. She found herself able to manage more than one daily activity.

“Now, I have work and then I hang out with friends," she says. "I still call my mom and I’m like, ‘How is this happening?’ I can do two things in a day. I thought this wasn’t in the cards for me.”

With her pain subsided, Daurio also is finding it easier to travel to Irvine to address chronic health conditions with her other doctors, Cheng and Hecht.

In fact many things are easier for her now.

“I feel like I have my life back," she says, "like I have more control over what’s happening to me. I’m on the road to recovery. I know I won’t ever be a top-tier athlete again. But just to know that I can be myself again, it’s unbelievable!”

Daurio describes how neurofeedback training helped relieve her pain ›

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