¹Soerojo Hospital, Psychiatric, Magelang, Indonesia, ²Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada, Doctoral Program, Yogyakarta, Indonesia

Background: Chronic pain and depression frequently co-occur, creating a complex, bidirectional burden that impairs functional outcomes and quality of life. Alpha brain wave stimulation has emerged as a novel non-pharmacological intervention aimed at enhancing relaxation and modulating mood through neuromodulation. This study compares the effectiveness of alpha brain wave stimulation with cognitive behavioral therapy (CBT), a standard evidence-based treatment for depression.

Aims & Objectives: This study aims to evaluate the efficacy of alpha brain wave stimulation in reducing depressive symptoms in patients with chronic pain. The specific objectives are:

1. To assess changes in depression severity following alpha brain wave stimulation using PHQ-9.
2. To compare outcomes with a control group receiving cognitive behavioral therapy.
3. To explore the feasibility and individual variability in response to alpha wave stimulation in a clinical setting.

Method: A comparative case study was conducted involving 4 patients diagnosed with chronic pain and comorbid moderate-to-severe depression. Two patients received 10 sessions of alpha brain wave stimulation using EEG-based neurofeedback focused on enhancing alpha activity (8–12 Hz), while two others received 10 sessions of manualized cognitive behavioral therapy (CBT) over 5 weeks. Depression levels were assessed pre- and post-intervention using the Patient Health Questionnaire-9 (PHQ-9). Descriptive comparison was used to evaluate changes in depression scores between the two groups.

Results: All four patients demonstrated a reduction in PHQ-9 scores after intervention. The two patients receiving alpha stimulation showed an average reduction of 7 and 6 points, respectively, while the CBT group showed a reduction of 8 and 7 points. Although limited by sample size, the findings suggest that alpha brain wave stimulation may reduce depression severity to a degree comparable with CBT.

Discussion & Conclusions: This small case study indicates that alpha brain wave stimulation may be a promising non-pharmacological approach to treating depression in patients with chronic pain. While preliminary, these findings support further investigation through larger trials to evaluate efficacy, safety, and long-term effects.