Applications of neurofeedback training in cognitive rehabilitation / 中华行为医学与脑科学杂志

Cognitive impairment is a common dysfunction after central nervous system disease or injury, which seriously affects the daily life of patients and brings heavy economic burdens to the family and society. Neurofeedback training (NFT) based on electroencephalography (EEG) is a non-invasive method of neuroregulation, which can improve cognitive function and behavior by autonomously adjusting brain function through feedback. This paper reviews the application of EEG signal-based neurofeedback training in cognitive rehabilitation, and discusses the current problems and future development trends in this field, so as to provide new ideas for clinical research and treatment of cognitive disorders.

Effects of neurofeedback on major depressive disorder: a systematic review

ABSTRACT Background Major depressive disorder is a difficult-to-treat psychological disorder. Approximately 30% of patients with major depressive disorder do not respond to conventional therapies; thus, the efficacy of alternative therapies for treating major depressive disorder, such as neurofeedback, a non-invasive neuromodulation method used in the treatment of psychiatric diseases, must be investigated. Objective We aimed to evaluate the efficacy of neurofeedback in minimizing and treating major depressive disorder and its application as a substitute to or an adjuvant with conventional therapies. Methods We searched for experimental studies published between 1962-2021 in Scopus, PubMed, Web of Science, and Embase databases and identified 1,487 studies, among which 13 met the inclusion exclusion criteria. Results We noted that not all patients responded to neurofeedback. Based on depression scales, major depressive disorder significantly improved in response to neurofeedback only in a few individuals. Additionally, the number of training sessions did not influence the results. Conclusion Neurofeedback can reduce depression symptoms in patients; however, not all patients respond to the treatment. Therefore, further studies must be conducted to validate the effectiveness of neurofeedback in treating major depressive disorder.

Neurofeedback no tratamento do transtorno de deficit de atenção e hiperatividade / Neurofeedback in the treatment of attention deficit hyperactivity disorder / Neurofeedback en el tratamiento del trastorno por déficit de atención con hiperactividad

Introdução: o transtorno de Déficit de Atenção e Hiperatividade (TDAH) é compreendido como atraso no neurodesenvolvimento, estes que estão diretamente associados a interação e habilidade de comunicação. nas últimas décadas uma nova tecnologia intitulada Neurofeedback (NF) surge e infere em resultados positivos no tratamento. Objetivo: descrever o principal mecanismo de ação dessa tecnologia no tratamento de TDAH e qual impacto que a técnica pode trazer aos portadores da doença. Metodologia: trata-se de uma revisão de literatura, na qual foram utilizados os seguintes DeCs: neurofeedback, Transtorno do Déficit de Atenção e tratamento. Resultados: em relação a base de dados mais utilizada tem-se a Biblioteca Virtual de Saúde (BVS). Assim, de maneira quantitativa, 46,1% do total de estudos utilizados na revisão correspondeu a materiais retirado da base BVS, em contrapartida, 30,8% na SciELO e 23,1% PubMed. Conclusão: mediante os resultados obtidos, percebe-se que o neurofeedback é uma estratégia terapêutica não medicamentosa, além de não-invasiva que por meio de um sistema Interface Cérebro- Computador (ICC) recebe e interpreta sinais elétricos e induz a autorregulação, interferindo assim, diretamente no tratamento de indivíduos com TDAH, logo, conclui-se que essa estratégia, de fato possui fins terapêuticos, sendo considerada eficaz e eficiente no que diz respeito ao aumento dos indicadores de atenção.

Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is understood as a delay in neurodevelopment, which is directly associated with interaction and communication skills. In recent decades a new technology called Neurofeedback (NF) emerges and infers positive results in the treatment. Objective: To describe the main mechanism of action of this technology in the treatment of ADHD and what impact the technique can bring to sufferers of the disease. Methodology: This is a literature review, in which the following DeCs were used: neurofeedback, Attention Deficit Disorder, and treatment. Results: The Virtual Health Library (VHL) was the most used database. Thus, quantitatively, 46.1% of the total of studies used in the review corresponded to materials taken from the VHL, in contrast, 30.8% from SciELO, and 23.1% from PubMed. Conclusion: through the results obtained, it is clear that neurofeedback is a non-drug therapeutic strategy, in addition to being noninvasive, which by means of a Brain-Computer Interface (BCI) system receives and interprets electrical signals and induces self-regulation, thus interfering directly in the treatment of individuals with ADHD. KEYWORDS: Neurofeedback; Attention Deficit Disorder; Treatment.

Introducción: El Trastorno por Déficit de Atención e Hiperactividad (TDAH) se entiende como un retraso en el neurodesarrollo, que se asocia directamente con las habilidades de interacción y comunicación. En las últimas décadas surge una nueva tecnología denominada Neurofeedback (NF) que infiere resultados positivos en el tratamiento. Objetivo: Describir el principal mecanismo de acción de esta tecnología en el tratamiento del TDAH y qué impacto puede aportar la técnica a quienes padecen la enfermedad. Metodología: Se trata de una revisión bibliográfica, en la que se utilizaron los siguientes DeCs: neurofeedback, Trastorno por Déficit de Atención y tratamiento. Resultados: La Biblioteca Virtual en Salud (BVS) fue la base de datos más utilizada. Así, cuantitativamente, 46,1% del total de estudios utilizados en la revisión correspondieron a materiales extraídos de la BVS, en contraste, 30,8% de SciELO, y 23,1% de PubMed. Conclusión: a través de los resultados obtenidos, queda claro que el neurofeedback es una estrategia terapéutica no farmacológica, además de no invasiva, que mediante un sistema de Brain-Computer Interface (BCI) recibe e interpreta señales eléctricas e induce la autorregulación, interfiriendo así directamente en el tratamiento de individuos con TDAH.

Effect of neurofeedback training on cognitive function in the elderly: a systematic review / 中国康复理论与实践

ObjectiveTo systematically review the effect of neurofeedback training on cognitive function in the elderly within the framework of the International Classification of Diseases 11th Revision (ICD-11), and International Classification of Functioning, Disability and Health (ICF). MethodsA PICO framework was constructed. Randomized controlled trials on neurofeedback training for cognitive function in the elderly from PubMed, Web of Science, ProQuest, and CNKI up to July, 2023 were systematically reviewed. Methodological quality assessment of the included literature was performed using Physiotherapy Evidence Database scale. ResultsA total of 15 researches were included, from ten countries, involving 520 participants, who were healthy elderly individuals or those with mild cognitive impairment. Various neurofeedback waveforms were utilized, such as alpha, beta, theta, beta/alpha, and sensorimotor rhythm (SMR) waves. Intervention duration ranged from 20 to 90 minutes, with intervention frequencies spanning from a long-term intervention of 30 sessions over 12 weeks to a high-frequency short-term intervention of eight sessions over one week. The primary health outcomes focused on cognitive function, including memory, attention, inhibitory control and executive function. ConclusionNeurofeedback training can improve the cognitive function of the eldery, and alleviate cognitive aging.

Electroencephalographic biofeedback therapy with buspirone on the improvement of mood, mental symptoms and neuroendocrine in patients with schizophrenia with anxiety / 中国医师进修杂志

Objective:To explore the effect of electroencephalographic (EEG) biofeedback combined with buspirone on patients with schizophrenia with anxiety, in order to provide evidence-based reference for clinical treatment.Methods:From January 2018 to January 2020, 80 patients with schizophrenia and anxiety in Jinzhou Kangning Hospital were prospectively selected and divided into the study group and the control group by simple randomization, each group with 40 patients. The control group was given buspirone, and the study group was given EEG biofeedback combined with buspirone. Both were treated for 8 weeks. The efficacy, adverse reactions and the Positive and Negative Symptoms Scale (PANSS) and Hamilton Anxiety Scale (HAMA), the Pittsburgh Sleep Quality Scale (PSQI), Scale of Social Function in Psychosis Inpatients (SSPI), Barthel Index (BI) score, and serum neuroendocrine index thyroid stimulating hormone (TSH), cortisol (Cor) levels before treatment, 4 weeks and 8 weeks after treatment were compared between the two groups.Results:After 8 weeks of treatment, the total effective rate in the study group was higher than that in the control group: 95.0% (38/40) vs. 77.5% (31/40), the difference was statistically significant (χ 2 = 5.16, P<0.05). After 4, 8 weeks of treatment, the PANSS scores in the study group were lower than those in the control group: (49.57 ± 5.65) scores vs. (57.96 ± 6.48) scores, (37.69 ± 4.35) scores vs.(45.07 ± 5.74) scores, the differences were statistically significant ( P<0.05). After 4, 8 weeks of treatment, the HAMA and PSQI scores in the study group were lower than those in the control group, while the SSPI and BI scores were higher than those in the control group, the differences were statistically significant ( P<0.05). After 4, 8 weeks of treatment, the serum TSH and Cor levels in the study group were lower than those in the control group: after 4 weeks of treatment: (2.74 ± 0.84) mU/L vs. (3.35 ± 0.97) mU/L, (276.51 ± 45.96) μg/L vs. (346.42 ± 50.34) μg/L; after 8 weeks of treatment: (2.46 ± 0.72) mU/L vs. (2.82 ± 0.86) mU/L, (197.26 ± 36.84) μg/L vs. (264.19 ± 42.46) μg/L, the differences were statistically significant ( P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups during treatment ( P>0.05). Conclusions:EEG biofeedback combined with buspirone can enhance the therapeutic effect by regulating neuroendocrine, reduce the mental symptoms, anxiety and sleep disorders ofschizophrenia patients with anxiety. It can also improve social function and daily life ability, and have high safety.

Clinical study of biofeedback combined with oral Liumo Decoction in the treatment of functional constipation and qi constipation syndrome / 国际中医中药杂志

Objective:To explore the curative effect of biofeedback combined with oral Liumo Decoction on functional constipation (FC) and qi constipation syndrome.Methods:According to random number table method, 120 patients with FC of qi constipation meeting inclusion criteria in Beijing Rectum Hospital were divided into two groups between January 2018 and December 2019, 60 in each group. The control group was treated with biofeedback, while the observation group was additionally treated with oral Liumo Decoction. All were treated for 4 weeks. Before and after treatment, TCM syndromes were scored and recorded. The resting anal pressure (RAP) was detected. The anal maximal contraction pressure (AMCP) was detected by forced systolic anus. In relaxation status, gas was injected into rectal balloon to record the rectal sensation threshold (RST) and rectal maximum tolerance (RMT). The levels of serum substance P and NO were detected by double-antibody sandwich ELISA and immunoturbidimetry. The adverse events were recorded, and clinical curative effect was evaluated.Results:The differences in total response rate between the observation group and the control group was statistically significant [89.3% (50/56) vs. 64.4% (38/59)] ( χ 2=9.90, P=0.002). After treatment, scores of TCM syndromes in observation group was significantly lower than that of the control group ( t=-15.36, P<0.01). After treatment, the RAP [(48.31±4.15) mmHg vs. (53.64±5.46) mmHg, t=-5.88], RST [(30.14±3.17) ml vs. (35.42±3.12) ml, t=-9.00] and RMT [(154.21±15.27) ml vs. (160.61±16.38)ml, t=-2.16] in observation group were significantly lower than those in the control group ( P<0.05), while AMCP [(156.67 ± 15.62) mmHg vs. (132.26 ± 13.21) mmHg, t=9.07] was significantly higher than that of the control group ( P<0.01). After treatment, the substance P in observation group was significantly higher than that of the control group ( t=9.08, P<0.01), while NO was significantly lower than that of the control group ( t=-6.58, P<0.01). There were no serious adverse events during treatment in either group. Conclusion:Biofeedback combined with oral Liumo Decoction can alleviate clinical symptoms, improve anorectal dynamics indexes and regulate levels of enteric neurotransmitters in patients with FC of qi constipation with safety.

Neurofeedback therapy used to treat sleep bruxism in adult subjects: a scoping review protocol

ABSTRACT Purpose: to identify evidence regarding the treatment of sleep bruxism with neurofeedback, as well as gaps in such evidence, through mapping studies, and how treatment protocols were performed. Methods: the proposed review will be conducted in accordance with the JBI methodology for scope reviews. The search strategy will aim to locate published and unpublished studies. The main databases to search include MEDLINE, Embase, LILACS, PsycINFO, Web of Science and Scopus. Gray literature and relevant materials will be included. Two independent reviewers will select titles and abstracts for evaluation, according to the inclusion criteria for the review. The search results will be reported and presented in a PRISMA flowchart. Data will be extracted from materials included in the scoping review using a data extraction tool. The results found will be presented in an organized table with the variables, with data being presented through diagrams, narratives and tables. Conclusion: a narrative summary will be performed that will accompany the tabulated results and describe the relationship of these results with the objectives and questions of this scoping review, that may lead to encouraging further research on this topic, bringing a new clinical approach evidence to the management of sleep bruxism.

Efectos de una terapia basada en estimulación eléctrica funcional de activación bimanual combinada con el entrenamiento de biofeedback electromiográfico en la función motora de la extremidad superior parética en sujetos secuelados de accidente cerebrovascular / Effects of a therapy based on a functional electrical stimulation of bimanual activation combined with the training of electromyographic biofeedback on the motor function of the upper limb in subjects with stroke

Resumen Introducción El accidente cerebrovascular constituye la principal causa de muerte y discapacidad en Chile. Más del 85% de los pacientes sufren hemiplejía y más del 69% discapacidad motora funcional de las extremidades superiores. Esta alteración genera impacto en el uso de la extremidad superior, afectando las diversas actividades de la vida diaria de las personas. No existen estudios que combinen terapia de biofeedback electromiográfico y activación bimanual con estimulación eléctrica funcional en sujetos secuelados de Accidente cerebrovascular (ACV). Por esto, surge el interés de determinar el efecto que tiene un protocolo de entrenamiento basado en Estimulación Eléctrica Funcional (EEF) con activación bimanual y terapia de biofeedback en la función de la extremidad superior. Metodología: 15 sujetos secuelados de ACV entre 40 y 85 años reclutados en el área de neurorrehabilitación ambulatoria de Clínica Dávila, aleatorizados en un grupo experimental y en dos grupos controles de 5 sujetos. En cada sesión el grupo experimental entrenará quince minutos de activación bimanual con electroestimulación funcional y luego un programa de entrenamiento de biofeedback de diez minutos, mientras que el grupo control 1 y control 2 entrenaron en las mismas condiciones pero con EEF placebo y BF-EMG placebo respectivamente Resultados Existieron cambios significativos en el grupo experimental luego de la intervención. Conclusión Este estudio sugiere la estimulación eléctrica funciona y biofeedback como una herramienta para la rehabilitación de la extremidad superior paréticas en sujetos secuelados de ACV.

Introduction: Stroke is the leading cause of death and disability in Chile. More than 85% of patients suffer from hemiplegia and more than 69% functional motor disability of the upper extremities. This alteration generates an impact on the use of the upper limb, affecting the various activities of people's daily lives. There are no studies that combine electromyographic biofeedback therapy and bimanual activation with functional electrical stimulation in subjects with stroke. Therefore, there is interest in determining the effect of a training protocol based on Functional Electrical Stimulation (FES) with bimanual activation and biofeedback therapy on the function of the upper limb. Methodology: 15 subjects with stroke between 40 and 85 years recruited in the outpatients neurorehabilitation program of Clínica Dávila, randomized in an experimental group and in two control groups of 5 subjects. In each session the experimental group will train fifteen minutes of bimanual activation with functional electrostimulation and then a ten-minute biofeedback training program, while the control 1 and control 2 group trained under the same conditions but with placebo FES and placebo BF-EMG respectively. Results There were significant changes in the experimental group after the intervention. Conclusion This study suggests the electrical stimulation works and biofeedback as a tool for the rehabilitation of the upper limb in subjects with stroke.

Brain-Computer Interfaces for upper limb motor rehabilitation of stroke patients / Interfaces Cerebro-Computadora para la Rehabilitación Motora de Miembro Superior de Pacientes con Enfermedad Vascular Cerebral

Abstract Brain-Computer Interfaces (BCI) decode users' intentions from the central nervous system and could be applied for upper limb motor rehabilitation of patients that have suffered stroke, one of the main causes of disability worldwide. Despite that research groups have reported the efficacy of these systems, a consensus has not yet been reached regarding their true potential. For this reason, a review of up-to-date assessments of BCI for upper limb stroke rehabilitation is presented from the perspective of analyzing common and different design variables presented across studies. Clinical and pilot studies with a control group were included in the review. Most BCI interventions assessments were performed with robotic assistive devices as feedback, followed by neuromuscular electrical stimulation (NMES) and visual feedbacks. Compared to other experimental interventions, the effects of a BCI intervention have been reported in a low number of patients. In addition, high variability between studies' designs such as stroke etiology and interventions' duration, do not allow to assess the potential of BCI for stroke rehabilitation. However, a trend towards significant rehabilitation outcomes with BCI systems can be highlighted, encouraging research groups to better coordinate in order to make valuable contributions to the field.

Resumen Las interfaces cerebro-computadora (BCI) decodifican del sistema nervioso central las intenciones de los usuarios, y pueden ser aplicadas para la rehabilitación motora del miembro superior de pacientes con enfermedad vascular cerebral (EVC), una de las principales causas de discapacidad a nivel mundial. A pesar de que diversos grupos han reportado la eficacia de estos sistemas, no se ha logrado un consenso sobre su verdadero potencial. Por esta razón, una revisión de la evaluación reciente de las BCI para rehabilitación del miembro superior en la EVC es presentado desde la perspectiva de analizar diferencias y similitudes entre las variables reportadas en los estudios. En la esta revisión se incluyeron estudios clínicos y pilotos con un grupo control. La mayor parte de los estudios utilizaron sistemas robóticos como retroalimentación, seguido por estimulación eléctrica neuromuscular y retroalimentación visual. En comparación con otras terapias experimentales, los efectos de intervenciones con BCI se han reportado en pocos pacientes. Además, la alta variabilidad en el diseño de los estudios, como la etiología de la EVC y la duración de las intervenciones, no permiten comparar los efectos de las terapias BCI. Sin embargo, se puede resaltar una tendencia hacia recuperaciones motoras significativas con BCI, motivando a grupos de investigación a coordinarse de mejor forma para continuar realizando contribuciones al campo.

Improving college students sub-threshold depression by music neurofeedback / 生物医学工程学杂志

Sub-threshold depression refers to a psychological sub-health state that fails to meet the diagnostic criteria for depression. Appropriate intervention can improve the state and reduce the risks of disease development. In this paper, we focus on music neurofeedback stimulation improving emotional state of sub-threshold depression college students.Twenty-four college students with sub-threshold depression participated in the experiment, 16 of whom were members of the experimental group. Decompression music based on spectrum classification was applied to 16 experimental group participants for 10 min/d music neural feedback stimulation with a period of 14 days, and no stimulation was applied to 8 control group participants. Three feature parameters of electroencephalogram (EEG) relative power, sample entropy and complexity were extracted for analysis. The results showed that the relative power of α、β and θ rhythm increased, while δ rhythm decreased after the stimulation of musical nerofeedback in the experimental group. The sample entropy and complexity were significantly increased after the stimulation, and the differences of these parameters pre and post stimulation were statistically significant ( < 0.05), while the differences of all feature parameters in the control group were not statistically significant. In the experimental group, the scores of self-rating depression scale(SDS) decreased after the stimulation of musical nerofeedback, indicating that the depression was improved. The result of this study showed that music neurofeedback stimulation can improve sub-threshold depression and may provides an effective new way for college students to self-regulation of emotion.

Use of biofeedback combined with conventional therapy in the swallowing rehabilitation of older adults: an integrative literature review / Uso do biofeedback associado a terapia convencional na reabilitação da deglutição em idosos: revisão integrativa da literatura

ABSTRACT Purpose: to identify biofeedback methods combined with conventional therapy in the swallowing rehabilitation of older adults. Methods :an integrative literature review that searched the LILACS, MEDLINE/PubMed, BIREME, SciELO, and Scopus databases, with no restrictions of time or language. The search items used were deglutition, biofeedback, elderly, rehabilitation, and their corresponding terms in Portuguese. The articles were evaluated with the adapted Newcastle-Ottawa Scale (NOS). Results: out of the 73 articles found in the databases, four, with a longitudinal design, were considered eligible. The biofeedback methods described were accelerometry, pressure balloon, and surface electromyography. The swallowing disorders observed were hypofunctioning of articulatory organs, increased oral transit, decreased laryngeal elevation, residues in pyriform sinuses and vallecula, reduced cough reflex, and change in voice quality. Regarding the effectiveness assessment of the recommended technique, a study used the clinical assessment combined with videofluoroscopy, before and after the treatment, two studies used the videofluoroscopy before the treatment and clinical assessment after it, and one study used clinical assessment prior to the treatment and swallowing videoendoscopy after it. As for the assessment of bias risk, one article was classified as low, two as intermediate, and one as high, in terms of risk. Conclusion: the biofeedback methods combined with conventional therapy to treat dysphagia in older adults were accelerometry, pressure balloon, and surface electromyography, whose use had positive effects.

RESUMO Objetivo: identificar os métodos de biofeedback associados à terapia convencional, na reabilitação da deglutição em idosos. Métodos: trata-se de uma revisão integrativa da literatura, cujas bases de dados utilizadas foram LILACS, MEDLINE/PubMed, BIREME, Scielo e Scopus, sem restrição temporal ou de linguagem. Foram utilizados os termos de busca "deglutição", "biofeedback", "idoso", "reabilitação" e os correspondentes em ingles. Os artigos foram avaliados pelo instrumento The Newcastle-Ottawa Scale (NOS) adaptado. Resultados: dos 73 artigos provenientes das bases de dados, quatro foram considerados elegíveis e apresentaram delineamento de estudo longitudinal. Os métodos de biofeedback descritos foram: acelerometria, balão de pressão e eletromiografia de superfície.Os distúrbios da deglutição observados nos estudos foram hipofuncionalidade dos órgãos fonoarticulatórios, aumento do trânsito oral, diminuição da elevação laríngea, resíduos em seios piriformes e valécula, redução do reflexo de tosse e alteração na qualidade vocal. Em relação à avaliação da efetividade da técnica preconizada, um estudo utilizou a avaliação clínica associada videofluoroscopia pré e pós-tratamento, dois estudos utilizaram a videofluoroscopia pré-tratamento e a avaliação clínica pós-tratamento e um estudo realizou avaliação clínica pré-tratamento e videoendoscopia da deglutição no pós. Segundo a análise do risco de viés, um artigo foi classificado como de baixo risco, dois com risco intermediário, e um alto. Conclusão: os métodos de biofeedback associados à terapia convencional para tratamento da disfagia em idosos foram: acelerometria, balão de pressão e eletromiografia de superfície, que apresentaram efeitos positivos após sua utilização.

Efeitos do treinamento com neurofeedback no tempo de reação: uma revisão sistemática / Effects of neurofeedback training on reaction times: a systematic review

O Neurofeedback é uma técnica de treinamento psicofisiológico não invasivo que estimula o desenvolvimento da autorregulação psíquica e neurofisiológica. Além de ser aplicada com eficiência no tratamento de diversas demandas clínicas, o treinamento com neurofeedback tem sido adotado para modulação funcional do cérebro. O objetivo do presente estudo foi realizar uma revisão sistemática de estudos que tenham investigado efeitos do neurofeedback através de testes com medidas de tempo de reação. As consultas foram realizadas no período entre março e junho de 2018 nas bases de dados Pubmed (US National Library of Medicine) e Web of Science (Science Citation Index Expanded). Adotaram-se os seguintes descritores para a pesquisa ("neurofeedback") AND ("reaction time") AND ("cognitive" OR "cognition"). Após aplicação dos filtros para a seleção, foram encontrados 23 trabalhos, dentre os quais apenas 8 obedeceram aos critérios de elegibilidade. Alguns destes estudos mostram complexos delineamentos metodológicos. Verificou-se também que metade dos trabalhos validados se referem a adultos saudáveis, mas destaca-se também, em menor número, estudos com TDAH

Neurofeedback is a non-invasive psychophysiological training technique that stimulates the development of psychic and neurophysiological self-regulation. In addition to being effectively applied in the treatment of various clinical demands, neurofeedback training protocols have been adopted for functional neuromodulation. The present study aims to carry out a systematic review of studies that have investigated neurofeedback effects through tests measuring reaction times. Consultations of the Pubmed (US National Library of Medicine) and Web of Science (Science Citation Index Expanded) databases were carried out between March and June of 2018. The following descriptors were used in the consultation: ("neurofeedback") AND ("reaction time") AND ("cognitive" OR "cognition"). After applying filters for the selection, 23 papers were found, of which only 8 met the eligibility criteria. Some of these studies present complex methodological delineations. Half of the validated papers were found to refer to healthy adults, but it is worth highlighting studies with ADHD, even though those were found in a smaller number

Spectral Modification by Operant Conditioning of Cortical Theta Suppression in Rats

OBJECTIVE: Brain activity is known to be voluntarily controllable by neurofeedback, a kind of electroencephalographic (EEG) operant conditioning. Although its efficacy in clinical effects has been reported, it is yet to be uncovered whether or how a specific band activity is controllable. Here, we examined EEG spectral profiles along with conditioning training of a specific brain activity, theta band (4–8 Hz) amplitude, in rats. METHODS: During training, the experimental group received electrical stimulation to the medial forebrain bundle contingent to suppression of theta activity, while the control group received stimulation non-contingent to its own band activity. RESULTS: In the experimental group, theta activity gradually decreased within the training session, while there was an increase of theta activity in the control group. There was a significant difference in theta activity during the sessions between the two groups. The spectral theta peak, originally located at 7 Hz, shifted further towards higher frequencies in the experimental group. CONCLUSION: Our results showed that an operant conditioning technique could train rats to control their specific EEG activity indirectly, and it may be used as an animal model for studying how neuronal systems work in human neurofeedback.

Electroencephalographic Changes Induced by a Neurofeedback Training : A Preliminary Study in Primary Insomniac Patients / 수면정신생리

OBJECTIVES: Insomnia is one of the most prevalent sleep disorders. Recent studies suggest that cognitive and physical arousal play an important role in the generation of primary insomnia. Studies have also shown that information processing disorders due to cortical hyperactivity might interfere with normal sleep onset and sleep continuity. Therefore, focusing on central nervous system arousal and normalizing the information process have become current topics of interest. It has been well known that neurofeedback can reduce the brain hyperarousal by modulating patients' brain waves during a sequence of behavior therapy. The purpose of this study was to investigate effects of neurofeedback therapy on electroencephalography (EEG) characteristics in patients with primary insomnia. METHODS: Thirteen subjects who met the criteria for an insomnia diagnosis and 14 control subjects who were matched on sex and age were included. Neurofeedback and sham treatments were performed in a random order for 30 minutes, respectively. EEG spectral power analyses were performed to quantify effects of the neurofeedback therapy on brain wave forms. RESULTS: In patients with primary insomnia, relative spectral theta and sigma power during a therapeutic neurofeedback session were significantly lower than during a sham session (13.9 ± 2.6 vs. 12.2 ± 3.8 and 3.6 ± 0.9 vs. 3.2 ± 1.0 in %, respectively; p < 0.05). There were no statistically significant changes in other EEG spectral bands. CONCLUSION: For the first time in Korea, EEG spectral power in the theta band was found to increase when a neurofeedback session was applied to patients with insomnia. This outcome might provide some insight into new interventions for improving sleep onset. However, the treatment response of insomniacs was not precisely evaluated due to limitations of the current pilot study, which requires follow-up studies with larger samples in the future.

Neurofeedback Treatment on Depressive Symptoms and Functional Recovery in Treatment-Resistant Patients with Major Depressive Disorder: an Open-Label Pilot Study

BACKGROUND: We evaluated the effects of neurofeedback as an augmentation treatment on depressive symptoms and functional recovery in patients with treatment-resistant depression (TRD). METHODS: We included 24 adult patients with TRD and 12 healthy adults. 24 TRD patients were assigned to the neurofeedback augmentation group (n = 12) and the medication-only (treatment as usual [TAU]) group (n = 12). The neurofeedback augmentation group underwent combined therapy comprising medication and 12–24 sessions of neurofeedback training for 12 weeks. To assess the serum levels of brain-derived neurotrophic factor (BDNF) in both groups, pre- and post-treatment blood samples were obtained. Patients were evaluated using the Hamilton Depression Rating Scale (HAM-D), Beck Depression Inventory (BDI), Clinical Global Impression-Severity (CGI-S), 5-level version of European Quality of Life Questionnaire 5-Dimensional Classification (EQ-5D-5L), and Sheehan Disability Scale (SDS) at baseline, and at the 1-, 4-, and 12-week. RESULTS: From baseline to week 12, neurofeedback training reduced mean scores on HAM-D, BDI-II, CGI-S, and SDS, and increased mean EQ-5D-5L tariff score. In the neurofeedback augmentation group, the response and remission rates were 58.3% and 50.0%, respectively, at week 12. Changes in HAM-D, EQ-5D-5L tariff score, and SDS were significantly larger in the neurofeedback group than in the medication-only (TAU) group. No significant difference in BDNF level was found pre- vs. post-treatment in any of the groups. CONCLUSION: Despite the small sample size, these results suggest that neurofeedback treatment may be effective as an augmentation treatment, not only for depressive symptoms, but also for functional recovery, in patients with TRD. TRIAL REGISTRATION: Clinical Research Information Service Identifier: KCT0004183 ClinicalTrials.gov Identifier: NCT04078438

Control of intelligent car based on electroencephalogram and neurofeedback / 生物医学工程学杂志

To improve the performance of brain-controlled intelligent car based on motor imagery (MI), a method based on neurofeedback (NF) with electroencephalogram (EEG) for controlling intelligent car is proposed. A mental strategy of MI in which the energy column diagram of EEG features related to the mental activity is presented to subjects with visual feedback in real time to train them to quickly master the skills of MI and regulate their EEG activity, and combination of multi-features fusion of MI and multi-classifiers decision were used to control the intelligent car online. The average, maximum and minimum accuracy of identifying instructions achieved by the trained group (trained by the designed feedback system before the experiment) were 85.71%, 90.47% and 76.19%, respectively and the corresponding accuracy achieved by the control group (untrained) were 73.32%, 80.95% and 66.67%, respectively. For the trained group, the average, longest and shortest time consuming were 92 s, 101 s, and 85 s, respectively, while for the control group the corresponding time were 115.7 s, 120 s, and 110 s, respectively. According to the results described above, it is expected that this study may provide a new idea for the follow-up development of brain-controlled intelligent robot by the neurofeedback with EEG related to MI.

Effects of Quantitative Electroencephalography Based Neurofeedback Training on Autonomous Regulations in Patients with Alcohol Use Disorder

PURPOSE: The study investigated whether neurofeedback training (NFT) can normalize the excessive high beta and low alpha waves indicative of hyperarousal and subsequently improve autonomous regulation based on the self-determination theory in alcohol use disorders. METHODS: A nonequivalent control group preteste-posttest design was used. Data were collected using self-report questionnaires from 36 Korean inpatients who met the Alcohol Use Disorder Identification Test in Korea criteria. Data were collected from quantitative electroencephalography to assess alpha (8–12 Hz) and high beta (21–30 Hz) waves for hyperarousal. The questionnaires included Basic Psychological Need Satisfaction scales that assessed autonomy, competence, and relatedness, and the Alcohol Abstinence Self-Efficacy Scale and Treatment Self-Regulation Questionnaire. The experimental group underwent 10 sessions of NFT over 4 weeks. Data were analyzed using the Chi-squared, Manne-Whitney U, and Wilcoxon signed-rank tests. RESULTS: In the experimental group, the alpha wave was increased in 15 of 19 sites and high beta waves were decreased in 15 of 19 sites, but this difference was not significant. However, high beta waves were increased in 15 of 19 sites in the control group, with seven sites (Fz, Cz, Pz, Fp2, F4, C4, and P4) showing significant increases. The experimental group showed a significant increase in basic psychological need satisfaction, alcohol abstinence self-efficacy, and self-regulation compared with the control group. CONCLUSION: NFT is recommended for improving autonomous regulation in alcohol use disorder as a nursing intervention. However, for significantly attenuating hyperarousal through brain wave correction, it may be necessary to increase the number of neurofeedback sessions.

The Effects of Neurofeedback Training on Physical, Psychoemotional Stress Response and Self-Regulation for Late Adolescence: A Non-Randomized Trial

PURPOSE: The aim of this study was to analyze the effects of neurofeedback training for reducing stress and enhancing self-regulation in late adolescence to identify the possibility of use for nursing intervention. METHODS: A nonequivalent control group pre-post quasi-experimental design was used. Participants were 78 late adolescents assigned to the experimental group (n=39) that received the neurofeedback training and the control group (n=39). Data were collected on heart rate variability (HRV) and skin conductance level (SCL) to assess stress-biomarker response. The questionnaire contained 164 items from: Positive and Negative Affect Schedule (PANAS), Symptom Checklist-90-Revised (SCL-90-R) and Self-regulatory Ability scale. The neurofeedback training was based on the general adaptation syndrome and body-mind medicine. The intervention was conducted in a total of 10 sessions for 30 minutes per session with high-beta, theta and sensory motor rhythm training on scalp at central zero. RESULTS: There were significant difference in standard deviation of normal to normal interval (p=.036) in HRV and SCL (p=.029) of stress-biomarker response between the two groups. Negative affect (p=.036) in PANAS and obsessive compulsive (p=.023) and depression (p < .001) in SCL-90-R were statistically significant. Self-regulation mode (p=.004) in self-regulation ability scale showed a significant difference between the two groups. CONCLUSION: The results indicated that the neurofeedback training is effective in stress-biomarkers, psychoemotional stress response and self-regulation. Therefore, neurofeedback training using neuroscientific approach based on brain-mind-body model can be used as an effective nursing intervention for late adolescents in clinics and communities for effective stress responses.

Application of Neurofeedback for Parkinson's Disease (review) / 中国康复理论与实践

@# Neurofeedback may improve cognitive function and behaviour by regulating the cerebral neural activities. Neurofeedback works as a kind of therapy for patients with Parkinson's disease, primarily based on electroencephalogram signals and hemodynamic signals. It regulates abnormal neuronal rhythm oscillations in the cortical-spinal system by electroencephalogram neurofeedback and sensory motor rhythm as the main adjustment frequency band, and modulates activation in the cortical-basal ganglia-thalamic-cortical network of brain with the supplementary motor area as the target area via functional magnetic resonance imaging neurofeedback. Neurofeedback effectively improves the motor symptoms of Parkinson's patients, both dynamic and static. However, the number of samples is limited in these researches, and the assessments before and after neurofeedback training are not yet comprehensive. Neurofeedback technology might be a potential effective rehabilitation for patients with Parkinson's disease.

Research evolution and hotspots of electroencephalogram (EEG) biofeedback in attention-deficit/hyperactivity disorder / 中国心理卫生杂志

Objective:To review the research hotspots and evolution of electroencephalogram (EEG) biofeedback in attention-deficit/hyperactivity disorder (ADHD) by knowledge mapping software.Methods:Based on web of science core collection database,we searched the literature with keywords (EEG biofeedback OR neurofeedback) AND (ADHD OR attention-deficit/hyperactivity disorder) in topic and time limit set before December 31,2015.319 literature were accepted,using the CiteSpace to depict the hot keywords,cited references and countries.Results:United States of America,Germany,Netherlands were top 3 countries in publishing papers of EEG biofeedback in ADHD.Based on burst of cited references,the research evolution of EEG biofeedback in ADHD could be divided into three stages.The hotspots of EEG biofeedback in ADHD were Slow Cortical Potentials protocol and double-blind placebo-controlled study.Conclusion:Future research should focus on the mechanism of EEG biofeedback and such known protocols for individualized treatment,or be designed along the lines of learning theory.