EchoWave: Evaluating EEG-Driven Serious Game for Pain Relief in Middle-aged and Older Ovarian Cancer Patients

Persistent pain in middle-aged and older ovarian cancer patients presents a significant barrier to effective non-pharmacological pain management. This study introduces EchoWave, an innovative serious game that utilizes real-time EEG-based biofeedback to adapt game difficulty dynamically, aiming to enhance pain relief through optimized user immersion. By integrating a comprehensive EEG analysis pipeline, EchoWave adjusts its challenge level in response to players’ physiological engagement, promoting sustained immersion during gameplay. In a randomized controlled trial with 42 participants, the adaptive biofeedback-driven game demonstrated superior outcomes, yielding significantly higher immersion and greater reductions in self-reported pain compared to a fixed-difficulty version. Key contributions include the design and implementation of a novel EEG-informed adaptive mechanism within serious games and empirical evidence supporting its efficacy in improving therapeutic outcomes. These findings underscore the potential of biofeedback-adaptive interactive systems to advance personalized pain management for older oncology populations, offering new directions for human–computer interaction in healthcare contexts.