Cognitive behavioral therapy eases orthodontic pain: EEG states and functional connectivity analysis

To assess the effects of CBT on electroencephalogram activity in patients with orthodontic pain.

We recruited 24 young (18-28 years), healthy individuals with matched baseline characteristics, including pain intensity, anxiety levels, personality traits, and life-quality scores. Participants were randomly assigned to either the CBT intervention group (n = 12) or the blank control group (n = 12). Multichannel continuous electroencephalogram signals and visual analog scale (VAS) scores were recorded before and after initial archwire placement for 1 week. A 1-month follow-up was conducted, when participants' daily VAS scores were recorded.

The overall EEG spectral power of the CBT group was lower than that of the control group, especially in the theta (4-7 Hz) and beta (14-30 Hz) bands during the treatment period. An enhanced coupling of theta and beta frequencies was observed in frontal and occipital electrodes, respectively. The EEG power in delta and theta bands correlated positively with pain intensity. Network coherence for the CBT group exhibited higher connectivity in the theta band.

Specific cerebral responses to CBT instructions could be detected with continuous electroencephalograms and related to orthodontic pain processing, which may provide a new insight in exploring CBT for orthodontic pain control.