The study has significant methodological limitations, including a small sample size (n=66) that reduces statistical power and a short intervention duration (3 hours), which is unlikely to induce measurable neurobiological changes. The lack of control for confounding factors, such as genetic variations in BDNF expression, further undermines the validity of the findings. Moreover, both groups experienced pain reduction, raising concerns about potential placebo effects rather than a true intervention impact, suggesting that the claims about PNE’s efficacy may be overstated. I urge the authors to critically reassess these limitations to strengthen the study’s design, ensure more robust methodology, and provide clearer, more reliable conclusions.
