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Zhang C, Zhou X, Hu N, Xu L. Effect of biofeedback intervention on neurological characteristics of children with attention deficit hyperactivity disorder. Int J Neurosci 2024:1-8. [PMID: 38416571 DOI: 10.1080/00207454.2024.2325029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 02/25/2024] [Indexed: 03/01/2024]
Abstract
OBJECTIVE To evaluate the effects of biofeedback intervention on the neurological characteristics of children with attention deficit hyperactivity disorder (ADHD). METHODS 150 children aged 6-12 years with ADHD were divided into two groups according to the treatment method. The atomoxetine group received atomoxetine drug treatment, and the combined treatment group received EEG biofeedback therapy. Continuous performance test (CPT), SNAP-IV and WFIRS-P were used to assess attention and behavior, and functional magnetic resonance imaging (fMRI) was used to observe changes in brain activity. RESULTS The response time, error times, error response rate and attention fluctuation index of CPT in the combined treatment group were significantly lower than those in the atomoxetine group (p < 0.05), and the correct response rate was higher than that in the atomoxetine group (p < 0.05). After intervention, SNAP-IV and WFIRS-P scores in the combined treatment group were significantly lower than those in the atomoxetine group (p < 0.001). fMRI results showed that the activity of the prefrontal, parietal, amygdala and hippocampus in the combined treatment group was significantly higher than that in the atomoxetine group (p < 0.001). CONCLUSION Biofeedback intervention can significantly improve the attention and behavior of ADHD children and positively regulate the neural activity in related brain areas on the basis of drug treatment, suggesting that biofeedback therapy can be considered as a potential effective nondrug treatment option for ADHD children.
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Affiliation(s)
- Cai Zhang
- Department of Pediatrics, Brain Hospital of Hunan Province (The Second People's Hospital of Hunan Province) College of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, P.R. China
| | - Xiaoxuan Zhou
- Department of Pediatrics, Brain Hospital of Hunan Province (The Second People's Hospital of Hunan Province) College of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, P.R. China
| | - Nanfei Hu
- Department of Pediatrics, Brain Hospital of Hunan Province (The Second People's Hospital of Hunan Province) College of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, P.R. China
| | - Lin Xu
- Department of Pediatrics, Brain Hospital of Hunan Province (The Second People's Hospital of Hunan Province) College of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, P.R. China
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Chen YC, Chang WP, Liang KJ, Chen CL, Chen HY, Chen SP, Chan PYS. The effects of neurofeedback training for children with cerebral palsy and co-occurring attention deficits: A pilot study. Child Care Health Dev 2024; 50:e13231. [PMID: 38465844 DOI: 10.1111/cch.13231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 12/13/2023] [Accepted: 01/04/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Limited research exists regarding the effectiveness of electroencephalogram (EEG) neurofeedback training for children with cerebral palsy (CP) and co-occurring attention deficits (ADs), despite the increasing prevalence of these dual conditions. This study aimed to fill this gap by examining the impact of neurofeedback training on the attention levels of children with CP and AD. METHODS Nineteen children with both CP and co-occurring ADs were randomly assigned to either a neurofeedback or control group. The neurofeedback group received 20 sessions of training, lasting approximately 1 h per day, twice a week. Theta/beta ratios of the quantitative electroencephalography (QEEG) recordings were measured pre-training and post-training in the resting state. The Continuous Performance Test (CPT), the Test of Visual Perceptual Skills-3rd Version (TVPS-3) and the Conners' Parent Rating Scale (CPRS) were measured at pre- and post-training. RESULTS The neurofeedback group showed both decreased theta/beta ratios compared with control group (p = 0.04) at post-training and a within-group improvement during training (p = 0.02). Additionally, the neurofeedback group had a trend of decreased omission rates of the CPT (p = 0.08) and the visual sequential memory and the visual closure subscores in the TVPS-3, compared with the control group (p = 0.02 and p = 0.01, respectively). CONCLUSIONS The results suggested that children with CP and co-occurring AD may benefit from neurofeedback training in their attention level. Further research is needed to explore long-term effects and expand its application in this population.
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Affiliation(s)
- Yuh-Chuan Chen
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Wen-Pin Chang
- Department of Occupational Therapy, College of Health Professions, University of Texas Rio Grande Valley, Edinburg, Texas, USA
| | - Kai-Jie Liang
- Department of Occupational Therapy, College of Medical Science and Technology, Chung Shan Medical University, Taichung, Taiwan
- Department of Occupational Therapy, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chia-Ling Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Hsin-Yung Chen
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Department of Occupational Therapy, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shu-Ping Chen
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Pei-Ying S Chan
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Department of Occupational Therapy, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Sideroff S, Wellisch D, Yarema V. A neurotherapy protocol to remediate cognitive deficits after adjuvant chemotherapy: a pilot study. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2023; 20:447-456. [PMID: 36031945 DOI: 10.1515/jcim-2021-0537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 06/20/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Adjuvant chemotherapy for breast cancer is undeniably effective in increasing survival rates but many breast cancer survivors (BCS) exhibit side effects including nausea, fatigue, stress, and neurocognitive deficits, known as "chemobrain." This pilot study explored how neurotherapy, or EEG biofeedback, a non-pharmacological approach, improved neurocognitive, behavioral, and neurophysiological deficits associated with BCS who underwent chemotherapy. METHODS Subjects underwent 18 sessions of EEG biofeedback training, in which audio and visual feedback occurred with successful shifting of EEG patterns. RESULTS Quantitative EEG and assessment tests demonstrated neurophysiological, cognitive, and behavioral deficits in all nine subjects prior to training. EEG biofeedback resulted in significant improvements in neurophysiological, neurocognitive, and psychological functions in all nine subjects after training. CONCLUSIONS We propose that this intervention and related forms of EEG biofeedback have the potential to significantly alleviate common side effects of chemotherapy in BCS and therefore merits additional research attention.
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Affiliation(s)
- Stephen Sideroff
- Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - David Wellisch
- Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Valerie Yarema
- Social Welfare, University of California, Los Angeles, CA, USA
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Wang M, Wang T, Ji H, Yan J, Wang X, Zhang X, Li X, Yuan Y. Modulation effect of non-invasive transcranial ultrasound stimulation in an ADHD rat model. J Neural Eng 2023; 20. [PMID: 36599159 DOI: 10.1088/1741-2552/acb014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 01/04/2023] [Indexed: 01/05/2023]
Abstract
Objective.Previous studies have demonstrated that transcranial ultrasound stimulation (TUS) with noninvasive high penetration and high spatial resolution has an effective neuromodulatory effect on neurological diseases. Attention deficit hyperactivity disorder (ADHD) is a persistent neurodevelopmental disorder that severely affects child health. However, the neuromodulatory effects of TUS on ADHD have not been reported to date. This study aimed to investigate the neuromodulatory effects of TUS on ADHD.Approach.TUS was performed in ADHD model rats for two consecutive weeks, and the behavioral improvement of ADHD, neural activity of ADHD from neurons and neural oscillation levels, and the plasma membrane dopamine transporter and brain-derived neurotrophic factor (BDNF) in the brains of ADHD rats were evaluated.Main results.TUS can improve cognitive behavior in ADHD rats, and TUS altered neuronal firing patterns and modulated the relative power and sample entropy of local field potentials in the ADHD rats. In addition, TUS can also enhance BDNF expression in the brain tissues.Significance. TUS has an effective neuromodulatory effect on ADHD and thus has the potential to clinically improve cognitive dysfunction in ADHD.
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Affiliation(s)
- Mengran Wang
- School of Electrical Engineering, Yanshan University, Qinhuangdao 066004, People's Republic of China
| | - Teng Wang
- School of Electrical Engineering, Yanshan University, Qinhuangdao 066004, People's Republic of China.,Key Laboratory of Intelligent Rehabilitation and Neuromodulation of Hebei Province, Yanshan University, Qinhuangdao 066004, People's Republic of China
| | - Hui Ji
- Department of Neurology, Hebei Key Laboratory of Vascular Homeostasis and Hebei Collaborative Innovation Center for Cardio-cerebrovascular Disease, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, People's Republic of China
| | - Jiaqing Yan
- College of Electrical and Control Engineering, North China University of Technology, Beijing 100041, People's Republic of China
| | - Xingran Wang
- School of Electrical Engineering, Yanshan University, Qinhuangdao 066004, People's Republic of China.,Key Laboratory of Intelligent Rehabilitation and Neuromodulation of Hebei Province, Yanshan University, Qinhuangdao 066004, People's Republic of China
| | - Xiangjian Zhang
- Department of Neurology, Hebei Key Laboratory of Vascular Homeostasis and Hebei Collaborative Innovation Center for Cardio-cerebrovascular Disease, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, People's Republic of China
| | - Xin Li
- School of Electrical Engineering, Yanshan University, Qinhuangdao 066004, People's Republic of China
| | - Yi Yuan
- School of Electrical Engineering, Yanshan University, Qinhuangdao 066004, People's Republic of China.,Key Laboratory of Intelligent Rehabilitation and Neuromodulation of Hebei Province, Yanshan University, Qinhuangdao 066004, People's Republic of China
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Results of Neurofeedback in Treatment of Children with ADHD: A Systematic Review of Randomized Controlled Trials. Appl Psychophysiol Biofeedback 2022; 47:145-181. [PMID: 35612676 DOI: 10.1007/s10484-022-09547-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2022] [Indexed: 11/02/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent disorders in children and adolescents. Neurofeedback, a nonpharmaceutical treatment, has shown promising results. To review the evidence of efficacy of neurofeedback as a treatment for children and adolescents with ADHD. A systematic review of the specific scientific studies published in 1995-2021, identifying and analyzing randomized controlled trials (RCT). A total of 1636 articles were identified and 165 met inclusion criteria, of which 67 were RCTs. Neurofeedback training was associated with significant long-term reduction in symptoms of ADHD. Though limitations exist regarding conclusions about the specific effects of neurofeedback, the review documents improvements in school, social, and family environments.
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Schneider H, Riederle J, Seuss S. Therapeutic Effect of Infra-Low-Frequency Neurofeedback Training on Children and Adolescents with ADHD. ARTIF INTELL 2022. [DOI: 10.5772/intechopen.97938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In this observational study the outcomes of an EEG-based infra-low-frequency (ILF) neurofeedback intervention on patients with attention deficit (hyperactivity) disorder (ADHD) are presented. The question is addressed whether this computer-aided treatment, which uses a brain-computer-interface to alleviate the clinical symptoms of mental disorders, is an effective non-pharmaceutical therapy for ADHD in childhood and adolescence. In a period of about 15 weeks 196 ADHD patients were treated with about 30 sessions of ILF neurofeedback in an ambulant setting. Besides regular evaluation of the severity of clinical symptoms, a continuous performance test (CPT) for parameters of attention and impulse control was conducted before and after the neurofeedback treatment. During and after the therapy, the patients did not only experience a substantial reduction in the severity of their ADHD-typical clinical symptoms, but also their performance in a continuous test procedure was significantly improved for all examined parameters of attention and impulse control, like response time, variability of reaction time, omission errors and commission errors. In a post neurofeedback intervention assessment 97% of patients reported improvement in symptoms of inattention, hyperactivity or impulsivity. Only 3% of the patients claimed no noticeable alleviation of ADHD-related symptoms. These results suggest that ILF neurofeedback is a clinically effective method that can be considered as a treatment option for ADHD and might help reducing or even avoiding psychotropic medication.
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Kaushik P, Jena SPK. Effect of cognitive behavioral intervention on electroencephalographic band powers of children with learning difficulty under eyes-closed and eyes-open conditions. ARQUIVOS DE NEURO-PSIQUIATRIA 2022; 80:224-232. [DOI: 10.1590/0004-282x-anp-2020-0503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 06/14/2021] [Indexed: 11/22/2022]
Abstract
ABSTRACT Background: Electroencephalography (EEG) plays an important role in assessing children with learning difficulties or related behavioral issues. Understanding EEG alterations in students with learning difficulties is crucial for evaluating cognitive functioning. Objective: The first aim was to examine the effects of the Program for Enhancing Academic and Behavioral Learning Skills (PEABLS), a cognitive-behavioral intervention on absolute and relative EEG band powers under eyes-closed and eyes-open conditions. Another aim was to examine the relationship between relative band powers of EEG waveforms through specific cognitive measurements like IQ, working memory and BGT for perceptual motor skills and organization. Methods: This study had a quasi-experimental pre-test post-test research design and involved a group of 50 students with learning problems. PEABLS, an accessible school-based intervention, was offered to academically low-performing students. EEG recordings were conducted before and after the intervention on prefrontal (FP1 FP2), temporal (T3 T4) and occipital (O1 O2) scalp locations. The data acquired were processed using MATLAB to find the absolute and relative band powers of waveforms. Results: Paired t tests on the recorded EEG data suggested that significant improvements in absolute and relative power values of waveforms were achieved, post-intervention. There were significant increases in relative alpha power values in the prefrontal and temporal regions under both eyes-closed and eyes-open conditions and significant increases in relative theta and delta power in the prefrontal and temporal regions. Pearson's correlation suggested that there was a significant relationship between relative alpha and beta power values in the prefrontal and occipital regions, through the cognitive measurements. Conclusion: PEABLS was significative in bringing changes to EEG band powers.
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9
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Validation of eyes-closed resting alpha amplitude predicting neurofeedback learning of upregulation alpha activity. Sci Rep 2021; 11:19615. [PMID: 34608244 PMCID: PMC8490456 DOI: 10.1038/s41598-021-99235-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 09/15/2021] [Indexed: 12/24/2022] Open
Abstract
Neurofeedback training (NFT) enables users to learn self-control of EEG activity of interest and then to create many benefits on cognitive function. A considerable number of nonresponders who fail to achieve successful NFT have often been reported in the within-session prediction. This study aimed to investigate successful EEG NFT of upregulation alpha activity in terms of trainability, independence, and between-session predictability validation. Forty-six participants completed 12 training sessions. Spectrotemporal analysis revealed the upregulation success on brain activity of 8-12 Hz exclusively to demonstrate trainability and independence of alpha NFT. Three learning indices of between-session changes exhibited significant correlations with eyes-closed resting state (ECRS) alpha amplitude before the training exclusively. Through a stepwise linear discriminant analysis, the prediction model of ECRS's alpha frequency band amplitude exhibited the best accuracy (89.1%) validation regarding the learning index of increased alpha amplitude on average. This study performed a systematic analysis on NFT success, the performance of the 3 between-session learning indices, and the validation of ECRS alpha activity for responder prediction. The findings would assist researchers in obtaining insight into the training efficacy of individuals and then attempting to adapt an efficient strategy in NFT success.
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Neurofeedback and Attention-Deficit/Hyperactivity-Disorder (ADHD) in Children: Rating the Evidence and Proposed Guidelines. Appl Psychophysiol Biofeedback 2021; 45:39-48. [PMID: 32206963 PMCID: PMC7250955 DOI: 10.1007/s10484-020-09455-2] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Stimulant medication and behaviour therapy are the most often applied and accepted treatments for Attention-Deficit/Hyperactivity-Disorder (ADHD). Here we explore where the non-pharmacological clinical intervention known as neurofeedback (NFB), fits on the continuum of empirically supported treatments, using standard protocols. In this quantitative review we utilized an updated and stricter version of the APA guidelines for rating ‘well-established’ treatments and focused on efficacy and effectiveness using effect-sizes (ES) and remission, with a focus on long-term effects. Efficacy and effectiveness are compared to medication and behaviour therapy using benchmark studies. Only recent systematic reviews and meta-analyses as well as multi-centre randomized controlled trials (RCT’s) will be included. Two meta-analyses confirmed significant efficacy of standard neurofeedback protocols for parent and teacher rated symptoms with a medium effect size, and sustained effects after 6–12 months. Four multicenter RCT’s demonstrated significant superiority to semi-active control groups, with medium-large effect sizes end of treatment or follow-up and remission rates of 32–47%. Effectiveness in open-label studies was confirmed, no signs of publication bias were found and no significant neurofeedback-specific side effects have been reported. Standard neurofeedback protocols in the treatment of ADHD can be concluded to be a well-established treatment with medium to large effect sizes and 32–47% remission rates and sustained effects as assessed after 6–12 months.
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11
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The Effects of Neurofeedback on Aging-Associated Cognitive Decline: A Systematic Review. Appl Psychophysiol Biofeedback 2021; 46:1-10. [PMID: 33389281 DOI: 10.1007/s10484-020-09497-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2020] [Indexed: 01/02/2023]
Abstract
For more than a decade, neurofeedback interventions have been applied with the goal of improving cognitive functions in older adults. Some of these studies have been reviewed, but only in combination with experiments conducted in young adults or with studies seeking to modify functions not related to cognition. The purpose of the present review is to assess whether neurofeedback interventions benefit cognition in elderly adults. We included all neurofeedback studies conducted in older adults, whether healthy or affected by a clinical condition, that attempted to ameliorate any domain of cognition, with no restrictions by publication date. Fourteen studies were eligible for this review. Neurofeedback improved memory in healthy and unhealthy participants mainly when the theta and sensorimotor rhythm (SMR) frequencies were trained. In addition, other cognitive domains benefited from this intervention. Conversely, neurofeedback had no effect on attention processes. Although different studies used markedly different methods, almost all of them reported positive effects of neurofeedback in at least one cognitive domain. New interventions under consideration should be tested using placebo-controlled, double-blind experimental designs with follow-up evaluations.
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Pazooki K, Leibetseder M, Renner W, Gougleris G, Kapsali E. Neurofeedback Treatment of Negative Symptoms in Schizophrenia: Two Case Reports. Appl Psychophysiol Biofeedback 2020; 44:31-39. [PMID: 30267339 PMCID: PMC6373527 DOI: 10.1007/s10484-018-9417-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Negative symptoms of schizophrenia, like diminished emotional expression and a dearth of self-initiated behavior do not respond reliably to anti-psychotic medication or to conventional psychotherapeutic approaches. Starting from evidence on the probable neural basis of such symptoms and on the effectiveness of neurofeedback with other psychological disorders, the present case study applied 20 sessions of EEG neurofeedback to a 45-year-old female and a 30-year-old male, both diagnosed with severe negative symptoms of schizophrenia. In both cases GAF scores were improved significantly and at the end of treatment, both patients did not meet the diagnostic criteria of negative symptomatology any longer. Symptom reduction went along with an obvious improvement of social, interpersonal, and cognitive abilities according to the clinical impression. Detailed data analysis revealed that these improvements went along with corresponding changes of EEG parameters and with distinct patterns and strategies of change in each of the two individuals. The results suggest that EEG neurofeedback should be examined on a larger scale as it offers a promising alternative to existing treatment approaches for negative symptoms in schizophrenia.
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Affiliation(s)
- Khashayar Pazooki
- Group Psylux, Neuroacademy & Traumainstitut Luxembourg, Cabinet de Psychologie & de Sciences de la Psychothérapie Khashayar Pazooki, Luxembourg, 53, route d´Arlon, 8211, Mamer, Luxembourg. .,Sigmund Freud University Vienna, Vienna, Austria.
| | | | - Walter Renner
- Sigmund Freud University Vienna, Vienna, Austria.,Pan-European University, Bratislava, Slovakia.,Sigmund Freud University Vienna, Vienna, Austria
| | - Gabriel Gougleris
- Medizinisches Versorgungszentrum Halberg/Saarbrücken, Saarbrücken, Germany
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Minimal Effects of Binaural Auditory Beats for Subclinical Insomnia: A Randomized Double-Blind Controlled Study. J Clin Psychopharmacol 2020; 39:499-503. [PMID: 31433343 DOI: 10.1097/jcp.0000000000001097] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Auditory binaural beat (BB) stimulation is known to modulate electroencephalographic activity by brain entrainment, but few studies have established whether BB can affect the sleep state. We examined the effect of θ BB in improving sleep disturbances and daytime alertness. METHODS We conducted double-blind and sham-controlled randomized trial. Subjects with subclinical insomnia were randomly assigned and listened to music for 2 weeks with or without θ BB for 30 minutes before going to sleep. RESULTS There were 43 participants (32 female; mean age, 34.3 ± 10.4 years) who finished the trial. The insomnia severity decreased at 2 weeks in both groups without significant differences in Insomnia Severity Index score (4.41 ± 4.32 vs 2.71 ± 4.66, P = 0.656), although the effect was much stronger for the music with the BB group than for the music-only group (Cohen d = 1.02 vs 0.58). In awake electroencephalographic analysis, the relative β power after 2 weeks was higher in the music with the BB group than in the music-only group (0.2 ± 7.02 vs -3.91 ± 6.97, P = 0.041). CONCLUSIONS Auditory θ BB with music does not induce evident improvement of sleep disturbances more than does pure music, but could alter brain activity toward increasing daytime alertness in subclinical insomnia, which needs to be corroborated in a clinical population.
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Bielas J, Michalczyk Ł. Beta Neurofeedback Training Improves Attentional Control in the Elderly. Psychol Rep 2020; 124:54-69. [PMID: 31937181 DOI: 10.1177/0033294119900348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
One of the well-documented behavioral changes that occur with advancing age is a decline in executive functioning, for example, attentional control. Age-related executive deficits are said to be associated with a deterioration of the frontal lobes. Neurofeedback is a training method which aims at acquiring self-control over certain brain activity patterns. It is considered as an effective approach to help improve attentional and self-management capabilities. However, studies evaluating the efficacy of neurofeedback training to boost executive functioning in an elderly population are still relatively rare and controversial. The aim of our study was to contribute to the assessment of the efficacy of neurofeedback as a method for enhancing executive functioning in the elderly. We provided a group of seniors with beta up-training (12-22 Hz), consisting of 20 sessions (30 minutes each), on the Cz site and tested its possible beneficiary influence on attentional control assessed by means of the Stroop and Simon tasks. The analysis of the subjects' mean reaction times during consecutive tasks in the test and the retest, after implementation of neurofeedback training, showed a significant improvement. In contrast, the difference in reaction times between the test and the retest in the control group who had not been submitted to neurofeedback training was not significant.
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Affiliation(s)
- Jacek Bielas
- Institute of Psychology, Jesuit University Ignatianum in Cracow, Cracow, Poland
| | - Łukasz Michalczyk
- Institute of Psychology, Jesuit University Ignatianum in Cracow, Cracow, Poland
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15
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Kondo K, Noonan KM, Freeman M, Ayers C, Morasco BJ, Kansagara D. Efficacy of Biofeedback for Medical Conditions: an Evidence Map. J Gen Intern Med 2019; 34:2883-2893. [PMID: 31414354 PMCID: PMC6854143 DOI: 10.1007/s11606-019-05215-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 07/12/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Biofeedback is increasingly used to treat clinical conditions in a wide range of settings; however, evidence supporting its use remains unclear. The purpose of this evidence map is to illustrate the conditions supported by controlled trials, those that are not, and those in need of more research. METHODS We searched multiple data sources (MEDLINE, PsycINFO, CINAHL, Epistemonikos, and EBM Reviews through September 2018) for good-quality systematic reviews examining biofeedback for clinical conditions. We included the highest quality, most recent review representing each condition and included only controlled trials from those reviews. We relied on quality ratings reported in included reviews. Outcomes of interest were condition-specific, secondary, and global health outcomes, and harms. For each review, we computed confidence ratings and categorized reported findings as no effect, unclear, or insufficient; evidence of a potential positive effect; or evidence of a positive effect. We present our findings in the form of evidence maps. RESULTS We included 16 good-quality systematic reviews examining biofeedback alone or as an adjunctive intervention. We found clear, consistent evidence across a large number of trials that biofeedback can reduce headache pain and can provide benefit as adjunctive therapy to men experiencing urinary incontinence after a prostatectomy. Consistent evidence across fewer trials suggests biofeedback may improve fecal incontinence and stroke recovery. There is insufficient evidence to draw conclusions about effects for most conditions including bruxism, labor pain, and Raynaud's. Biofeedback was not beneficial for urinary incontinence in women, nor for hypertension management, but these conclusions are limited by small sample sizes and methodologic limitations of these studies. DISCUSSION Available evidence suggests that biofeedback is effective for improving urinary incontinence after prostatectomy and headache, and may provide benefit for fecal incontinence and balance and stroke recovery. Further controlled trials across a wide range of conditions are indicated.
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Affiliation(s)
- Karli Kondo
- Evidence Synthesis Program, VA Portland Health Care System, 3710 SW US Veterans Hospital Road, Portland, OR, 97239-2999, USA.
- Research Integrity Office, Oregon Health & Science University, Portland, OR, USA.
| | - Katherine M Noonan
- Physical Medicine and Rehabilitation, VA Portland Health Care System, Portland, OR, USA
| | - Michele Freeman
- Evidence Synthesis Program, VA Portland Health Care System, 3710 SW US Veterans Hospital Road, Portland, OR, 97239-2999, USA
| | - Chelsea Ayers
- Evidence Synthesis Program, VA Portland Health Care System, 3710 SW US Veterans Hospital Road, Portland, OR, 97239-2999, USA
| | - Benjamin J Morasco
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, USA
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | - Devan Kansagara
- Evidence Synthesis Program, VA Portland Health Care System, 3710 SW US Veterans Hospital Road, Portland, OR, 97239-2999, USA
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, USA
- Department of Medicine, Oregon Health & Science University, Portland, OR, USA
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Comparison of the Effect of Cognitive Rehabilitation and Neurofeedback on Sustained Attention Among Elementary School Students with Specific Learning Disorder: A Preliminary Randomized Controlled Clinical Trial. Appl Psychophysiol Biofeedback 2019; 43:301-307. [PMID: 30128952 DOI: 10.1007/s10484-018-9410-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Specific learning disorder (SLD) can occur along with the problems of attention performance and be complicated by them. Recent studies have reported the positive effects of cognitive rehabilitation (CR) and neurofeedback (NFB) on sustained attention (SA) in SLD. Nevertheless, it has not yet been determinedwhat kind of treatment may be the most appropriate option for this disorder in terms of the different functions of cognitive status, especially SA. This preliminary study aimed to compare CR and NFB effects on SA among elementary school students with SLD using a randomized controlled clinical trial (RCT). Fifty- three eligible students with a DSM-5 SLD diagnosis, aged 7-10, were randomly allocated in NFB (n = 18), CR (n = 18), and control groups (n = 17). All the participants were evaluated for SA by performing the continuous performance test (CPT) on the studied groups at the time of their inclusion in the study and 7 weeks after it. The intervention groups took part in 20 sessions of CR and 20 sessions of NFB. Conversely, the untreated group were evaluated without any intervention.15 boys and 30 girls in 3 groups completed the study (n = 15 per group). The mean and standard deviation of participants' age were (8.66 ± 1.48) years, (8.40 ± 1.73) years and (8.53 ± 1.63) years in CR, NFB and untreated groups, respectively. The results showed significant differences between the groups based on the variables of the CPT test (p < 0.05). Also, the significant effects of the variables represented the higher scores of the CR compared to the NFB group (p < 0.001). This study provides einitial evidence that CR is more effective than NFB on SA improvement among students with SLD.
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Shahmoradi L, Liraki Z, Karami M, Savareh BA, Nosratabadi M. Development of Decision Support System to Predict Neurofeedback Response in ADHD: an Artificial Neural Network Approach. Acta Inform Med 2019; 27:186-191. [PMID: 31762576 PMCID: PMC6853721 DOI: 10.5455/aim.2019.27.186-191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 08/05/2019] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Clinical decision support system (CDSS) is an analytical tool that converts raw data into useful information to help clinicians make better decisions for patients. AIM The purpose of this study was to investigate the efficacy of neurofeedback (NF), in Attention Deficit Hyperactivity Disorder (ADHD) by the development of CDSS based on artificial neural network (ANN). METHODS This study analyzed 122 patients with ADHD who underwent NF in the Parand-Human Potential Empowerment Institute in Tehran. The patients were divided into two groups according to the effects of NF: effective and non-effective groups. The patients' record information was mined by data mining techniques to identify effective features. Based on unsaturated condition of data and imbalanced classes between the patient groups (patients with successful NF response and those without it), the SMOTE technique was applied on dataset. Using MATLAB 2014a, a modular program was designed to test both multiple architectures of neural networks and their performance. Selected architecture of the neural networks was then applied in the procedure. RESULTS Eleven features from 28 features of the initial dataset were selected as effective features. Using the SMOTE technique, number of the samples rose to around 300 samples. Based on the multiple neural networks architecture testing, a network by 11-20-16-2 neurons was selected (specify>00.91%, sensivity=100%) and applied in the software. CONCLUSION The ANN used in this study has led to good results in sensivity, specificity, and AUC. The ANN and other intelligent techniques can be used as supportive tools for decision making by healthcare providers.
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Affiliation(s)
- Leila Shahmoradi
- Halal Research Center of IRI, FDA, Tehran, Iran
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Liraki
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahtab Karami
- Department of Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Behrouz Alizadeh Savareh
- Department of Health Information Technology and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoud Nosratabadi
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Imani MM, Safaei M, Afnaniesfandabad A, Moradpoor H, Sadeghi M, Golshah A, Sharifi R, Mozaffari HR. Efficacy of CPP-ACP and CPP-ACPF for Prevention and Remineralization of White Spot Lesions in Orthodontic Patients: a Systematic Review of Randomized Controlled Clinical Trials. Acta Inform Med 2019; 27:199-204. [PMID: 31762578 PMCID: PMC6853720 DOI: 10.5455/aim.2019.27.199-204] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 08/08/2019] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Enamel subsurface lesions or white spot lesions (WSLs) are commonly found in orthodontic patients with a prevalence of 5% to 97%. AIM This systematic review aimed to evaluate the efficacy of casein phosphopeptide amorphous calcium phosphate (CPP-ACP) and casein phosphopeptide amorphous calcium phosphate fluoride (CPP-ACPF) for prevention and remineralization of WSLs in orthodontic patients in human randomized controlled clinical trials (RCTs). METHODS Relevant articles were retrieved by searching the Web of Science, Scopus, PubMed, and Cochrane Library databases up to November 2018 with no language or date restriction. The collected data included examination method, groups included in each study with number of patients in each group, study design, follow-up period and summary of important findings of each study. The risk of bias of each study was assessed according to the guidelines of the Cochrane Collaboration's tool. RESULTS Of 213 articles retrieved, 13 RCTs were included in this systematic review (none of them were included in the meta-analysis). Three articles showed superior efficacy of CPP-ACP for remineralization of WSLs while four studies reported the superior clinical efficacy of CPP-ACPF for this purpose. CONCLUSION Both CPP-ACP and CPP-ACPF can decrease the prevalence and increase the remineralization of WSLs during/after orthodontic treatment.
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Affiliation(s)
- Mohammad Moslem Imani
- Department of Orthodontics, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohsen Safaei
- Oral and Dental Sciences Research Laboratory, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Aida Afnaniesfandabad
- Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hedaiat Moradpoor
- Department of Prosthodontics, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Sadeghi
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amin Golshah
- Department of Orthodontics, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Roohollah Sharifi
- Department of Endodontics, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hamid Reza Mozaffari
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Bioulac S, Purper-Ouakil D, Ros T, Blasco-Fontecilla H, Prats M, Mayaud L, Brandeis D. Personalized at-home neurofeedback compared with long-acting methylphenidate in an european non-inferiority randomized trial in children with ADHD. BMC Psychiatry 2019; 19:237. [PMID: 31370811 PMCID: PMC6676623 DOI: 10.1186/s12888-019-2218-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 07/23/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Neurofeedback (NF) has gained increasing interest among non-pharmacological treatments for Attention Deficit Hyperactivity Disorder (ADHD). NF training aims to enhance self-regulation of brain activities. The goal of the NEWROFEED study is to assess the efficacy of a new personalized NF training device, using two different protocols according to each child's electroencephalographic pattern, and designed for use at home. This study is a non-inferiority trial comparing NF to methylphenidate. METHODS The study is a prospective, multicentre, randomized, reference drug-controlled trial. One hundred seventy-nine children with ADHD, aged 7 to 13 years will be recruited in 13 clinical centres from 5 European countries. Subjects will be randomized to two groups: NF group (Neurofeedback Training Group) and MPH group (Methylphenidate group). Outcome measures include clinicians, parents and teachers' assessments, attention measures and quantitative EEG (qEEG). Patients undergo eight visits over a three-month period: pre-inclusion visit, inclusion visit, 4 "discovery" (NF group) or titration visits (MPH group), an intermediate and a final visit. Patients will be randomized to either the MPH or NF group. Children in the NF group will undergo either an SMR or a Theta/Beta training protocol according to their baselineTheta/Beta Ratio obtained from the qEEG. DISCUSSION This is the first non-inferiority study between a personalized NF device and pharmacological treatment. Innovative aspects of Mensia Koala™ include the personalization of the training protocol according to initial qEEG characteristics (SMR or Theta/Beta training protocols) and an improved accessibility of NF due to the opportunity to train at home with monitoring by the clinician through a dedicated web portal. TRIAL REGISTRATION NCT02778360 . Date registration (retrospectively registered): 5-12-2016. Registered May 19, 2016.
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Affiliation(s)
- Stéphanie Bioulac
- CHU Pellegrin, Clinique du Sommeil, F-33076, Bordeaux, France. .,Université de Bordeaux, Sommeil, Addiction et Neuropsychiatrie, USR 3413, F-33000, Bordeaux, France. .,CNRS, SANPSY, USR 3413, F-33000, Bordeaux, France.
| | - Diane Purper-Ouakil
- grid.414352.5Unit of Child and Adolescent Psychiatry (MPEA1), CHU Montpellier-Saint Eloi Hospital, Montpellier, France
| | - Tomas Ros
- 0000 0001 2322 4988grid.8591.5Department of Neurosciences, Laboratory for Neurology and Imaging of Cognition, University of Geneva, Geneva, Switzerland
| | - Hilario Blasco-Fontecilla
- 0000 0004 1767 8416grid.73221.35Department of Psychiatry, Segovia de Arana Health Research Institute (IDIPHISA)-Puerta de Hierro University Hospital, Avenida Manuel de Falla s/n, Majadahonda, Madrid, Spain ,0000000119578126grid.5515.4Autonoma University, Madrid, Spain
| | - Marie Prats
- grid.476574.3Mensia Technologies, 130, rue de Lourmel, 75015 Paris, France
| | - Louis Mayaud
- grid.476574.3Mensia Technologies, 130, rue de Lourmel, 75015 Paris, France
| | - Daniel Brandeis
- 0000 0004 1937 0650grid.7400.3University of Zurich and ETH Zurich, Neuroscience Center Zurich, Zurich, Switzerland ,0000 0004 0477 2235grid.413757.3Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
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No Effects of Successful Bidirectional SMR Feedback Training on Objective and Subjective Sleep in Healthy Subjects. Appl Psychophysiol Biofeedback 2019; 43:37-47. [PMID: 29090400 DOI: 10.1007/s10484-017-9384-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
There is a growing interest in the application of psychophysiological signals in more applied settings. Unidirectional sensory motor rhythm-training (SMR) has demonstrated consistent effects on sleep. In this study the main aim was to analyze to what extent participants could gain voluntary control over sleep-related parameters and secondarily to assess possible influences of this training on sleep metrics. Bidirectional training of SMR as well as heart rate variability (HRV) was used to assess the feasibility of training these parameters as possible brain computer interfaces (BCI) signals, and assess effects normally associated with unidirectional SMR training such as the influence on objective and subjective sleep parameters. Participants (n = 26) received between 11 and 21 training sessions during 7 weeks in which they received feedback on their personalized threshold for either SMR or HRV activity, for both up- and down regulation. During a pre- and post-test a sleep log was kept and participants used a wrist actigraph. Participants were asked to take an afternoon nap on the first day at the testing facility. During napping, sleep spindles were assessed as well as self-reported sleep measures of the nap. Although the training demonstrated successful learning to increase and decrease SMR and HRV activity, no effects were found of bidirectional training on sleep spindles, actigraphy, sleep diaries, and self-reported sleep quality. As such it is concluded that bidirectional SMR and HRV training can be safely used as a BCI and participants were able to improve their control over physiological signals with bidirectional training, whereas the application of bidirectional SMR and HRV training did not lead to significant changes of sleep quality in this healthy population.
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Shereena EA, Gupta RK, Bennett CN, Sagar KJV, Rajeswaran J. EEG Neurofeedback Training in Children With Attention Deficit/Hyperactivity Disorder: A Cognitive and Behavioral Outcome Study. Clin EEG Neurosci 2019; 50:242-255. [PMID: 30453757 DOI: 10.1177/1550059418813034] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Attention deficit/hyperactivity disorder (ADHD) is a highly prevalent childhood disorder with symptoms of inattention, impulsivity, and hyperactivity. EEG neurofeedback training (NFT) is a new intervention modality based on operant conditioning of brain activity, which helps reduce symptoms of ADHD in children. METHODS AND PROCEDURES To examine the efficacy of NFT in children with ADHD, an experimental longitudinal design with pre-post comparison was adopted. A total of 30 children in the age range of 6 to 12 years diagnosed as ADHD with or without comorbid conditions were assigned to treatment group (TG; n = 15) and treatment as usual group (TAU; n = 15). TG received EEG-NFT along with routine clinical management and TAU received routine clinical management alone. Forty sessions of theta/beta NFT at the C3 scalp location, 3 to 4 sessions in a week for a period of 3.5 to 5 months were given to children in TG. Children were screened using sociodemographic data and Binet-Kamat test of intelligence. Pre-and postassessment tools were neuropsychological tests and behavioral scales. Follow-up was carried out on 8 children in TG using parent-rated behavioral measures. RESULTS Improvement was reported in TG on cognitive functions (sustained attention, verbal working memory, and response inhibition), parent- and teacher-rated behavior problems and on academic performance rated by teachers. Follow-up of children who received NFT showed sustained improvement in ADHD symptoms when assessed 6 months after receiving NFT. CONCLUSION The present study suggests that NFT is an effective method to enhance cognitive deficits and helps reduce ADHD symptoms and behavior problems. Consequently, academic performance was found to be improved in children with ADHD. Improvement in ADHD symptoms induced by NFT were maintained at 6-month follow-up in children with ADHD.
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Affiliation(s)
- E A Shereena
- 1 National Institute of Mental Health & Neuro Sciences, Bengaluru, Karnataka, India
| | - R K Gupta
- 1 National Institute of Mental Health & Neuro Sciences, Bengaluru, Karnataka, India
| | - C N Bennett
- 2 Department of Psychology, Christ (Deemed to be University), Bengaluru, Karnataka, India
| | - K J V Sagar
- 1 National Institute of Mental Health & Neuro Sciences, Bengaluru, Karnataka, India
| | - J Rajeswaran
- 1 National Institute of Mental Health & Neuro Sciences, Bengaluru, Karnataka, India
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Shokhmgar Z, Sanagoo A, Mohammadpour M, Khaleghi H, Ahangi A, Mehrandish N, Mirshekari L. Comparison of the Effectiveness of Cognitive-Behavioral Therapy and Neurofeedback for Reducing Symptoms of Anxiety. JOURNAL OF CLINICAL AND BASIC RESEARCH 2019. [DOI: 10.29252/jcbr.3.2.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Papo D. Neurofeedback: Principles, appraisal, and outstanding issues. Eur J Neurosci 2019; 49:1454-1469. [PMID: 30570194 DOI: 10.1111/ejn.14312] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 11/21/2018] [Accepted: 11/27/2018] [Indexed: 12/16/2022]
Abstract
Neurofeedback is a form of brain training in which subjects are fed back information about some measure of their brain activity which they are instructed to modify in a way thought to be functionally advantageous. Over the last 20 years, neurofeedback has been used to treat various neurological and psychiatric conditions, and to improve cognitive function in various contexts. However, in spite of a growing popularity, neurofeedback protocols typically make (often covert) assumptions on what aspects of brain activity to target, where in the brain to act and how, which have far-reaching implications for the assessment of its potential and efficacy. Here we critically examine some conceptual and methodological issues associated with the way neurofeedback's general objectives and neural targets are defined. The neural mechanisms through which neurofeedback may act at various spatial and temporal scales, and the way its efficacy is appraised are reviewed, and the extent to which neurofeedback may be used to control functional brain activity discussed. Finally, it is proposed that gauging neurofeedback's potential, as well as assessing and improving its efficacy will require better understanding of various fundamental aspects of brain dynamics and a more precise definition of functional brain activity and brain-behaviour relationships.
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Affiliation(s)
- David Papo
- SCALab, CNRS, Université de Lille, Villeneuve d'Ascq, France
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Cueli M, Rodríguez C, Cabaleiro P, García T, González-Castro P. Differential Efficacy of Neurofeedback in Children with ADHD Presentations. J Clin Med 2019; 8:E204. [PMID: 30736419 PMCID: PMC6406571 DOI: 10.3390/jcm8020204] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 01/28/2019] [Accepted: 02/04/2019] [Indexed: 12/11/2022] Open
Abstract
Training in neurofeedback (NF) reduces the symptomatology associated with attention deficit with hyperactivity disorder (ADHD). However, ADHD differs in terms of the type of presentation, i.e., inattentive (ADHD-I), impulsive/hyperactive (ADHD-HI), or combined (ADHD-C). This study examines the efficacy of NF in ADHD presentations. Participants were 64 students (8⁻12 years old). Cortical activation, executive control, and observed symptomatology by parents were assessed. Results indicated that ADHD-C and ADHD-HI demonstrated greater improvements than ADHD-I. It was concluded that this kind of training produces an improvement and that it is necessary to explore it further in terms of the protocol used.
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Affiliation(s)
- Marisol Cueli
- Department of Psychology, University of Oviedo, Plaza Feijoo s/n, 33003 Oviedo (Asturias), Spain.
| | - Celestino Rodríguez
- Department of Psychology, University of Oviedo, Plaza Feijoo s/n, 33003 Oviedo (Asturias), Spain.
| | - Paloma Cabaleiro
- Department of Psychology, University of Oviedo, Plaza Feijoo s/n, 33003 Oviedo (Asturias), Spain.
| | - Trinidad García
- Department of Psychology, University of Oviedo, Plaza Feijoo s/n, 33003 Oviedo (Asturias), Spain.
| | - Paloma González-Castro
- Department of Psychology, University of Oviedo, Plaza Feijoo s/n, 33003 Oviedo (Asturias), Spain.
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Moreno-García I, Meneres-Sancho S, Camacho-Vara de Rey C, Servera M. A Randomized Controlled Trial to Examine the Posttreatment Efficacy of Neurofeedback, Behavior Therapy, and Pharmacology on ADHD Measures. J Atten Disord 2019; 23:374-383. [PMID: 29254414 DOI: 10.1177/1087054717693371] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To examine the efficacy of neurofeedback (NF), behavior therapy (BT), and pharmacology (PH) on the improvement of ADHD-related symptoms. METHOD Fifty-nine children with ADHD ( M = 8.80 years, SD = 1.92 years) were randomly assigned to one of the three treatments in a pre/post assessment design. Mother- and teacher-rated ADHD scales and children were assessed using The Integrated Visual and Auditory Continuous Performance Test (IVA/CPT). RESULTS The three treatments were effective on the IVA/CPT, but with different trends. BT and especially NF achieved improvement on response control and attention, and PH mainly in visual attention. On the rating scales, BT improved all measures, and NF and PH had a minor but interesting influence. CONCLUSION From a global perspective, behavior therapy had the most extensive results, but PH had the greatest capacity to improve overall attention. NF was able to improve both control response and inattention. Clinical implications are discussed.
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Campos da Paz VK, Garcia A, Campos da Paz Neto A, Tomaz C. SMR Neurofeedback Training Facilitates Working Memory Performance in Healthy Older Adults: A Behavioral and EEG Study. Front Behav Neurosci 2018; 12:321. [PMID: 30618671 PMCID: PMC6306463 DOI: 10.3389/fnbeh.2018.00321] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 12/07/2018] [Indexed: 11/13/2022] Open
Abstract
Cognitive aging has become a major concern because life expectancy has increased and elderly populations are socially and economically active. Neurofeedback is a technique of neuromodulation through operant conditioning paradigm that uses a computer interface to provide real-time information about brain activity to increase individual self-perception and assist in modulation. The sensorimotor rhythm (SMR) training protocol is known to enhance attention and has been applied to improve cognitive performance, primarily for attention and memory gains. The aim of this study is to test if the SMR protocol can improve working memory performance in an aging population and consequently favor cognitive reserve. Seventeen older adults (12 females) took part in a randomized placebo-controlled study. They completed a visual working memory test, Delayed Matching to Sample Task (DMTS), before and after the SMR neurofeedback protocol in order to compare their visual working memory performance. Moreover, a 19-channels EEG was collected while they perform the DMTS pre- and post-training. The experimental group showed an improvement in their working memory performance after the training with similar activation power, mainly in theta and beta frequency band at frontal and alpha at temporal regions. The sham group showed some variations in the score of working memory after the training, but were not statistically significant and their power spectrum demonstrate enhancement in alpha and beta band frontal and temporal. The group that did not receive neurofeedback training did not show a change in their working memory performance, neither in their EEG spectrum. The results suggest that neurofeedback can benefit brain reserve in an aging population because individuals enhanced their working memory performance after training and have their EEG activation changed according to expected in working memory tasks.
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Affiliation(s)
| | - Ana Garcia
- Department of Psychology, Euro-American University Center (UNIEURO), Brasília, Brazil
| | | | - Carlos Tomaz
- Laboratory of Neuroscience and Behavior, CEUMA University, São Luis, Brazil
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Fielenbach S, Donkers FC, Spreen M, Bogaerts S. Effects of a Theta/Sensorimotor Rhythm Neurofeedback Training Protocol on Measures of Impulsivity, Drug Craving, and Substance Abuse in Forensic Psychiatric Patients With Substance Abuse: Randomized Controlled Trial. JMIR Ment Health 2018; 5:e10845. [PMID: 30538087 PMCID: PMC6305873 DOI: 10.2196/10845] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 09/12/2018] [Accepted: 09/13/2018] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Forensic psychiatric patients are often diagnosed with psychiatric disorders characterized by high levels of impulsivity as well as comorbid substance use disorders (SUD). The combination of psychiatric disorders and SUD increases the risk of future violence. Chronic substance abuse can lead to a structural state of disinhibition, resulting in more drug taking and eventually loss of control over drug intake. When treating SUD, it is crucial to address high levels of impulsivity and lack of inhibitory control. OBJECTIVE This study set out to investigate the effects of a theta/sensorimotor rhythm (SMR) neurofeedback training protocol on levels of impulsivity, levels of drug craving, and actual drug intake in a population of forensic psychiatric patients with a diagnosis of SUD. METHODS A total of 21 participants received 20 sessions of theta/SMR neurofeedback training in combination with treatment-as-usual (TAU). Results of the intervention were compared with results from 21 participants who received TAU only. RESULTS SMR magnitude showed a significant (P=.02) increase post training for patients in the neurofeedback training group, whereas theta magnitude did not change (P=.71). Levels of drug craving as well as scores on the motor subscale of the Barratt Impulsivity Scale-11 decreased equally for patients in the neurofeedback training group and the TAU group. Other measures of impulsivity as well as drug intake did not change posttreatment (P>.05). Therefore, neurofeedback+TAU was not more effective than TAU only. CONCLUSIONS This study demonstrated evidence that forensic psychiatric patients are able to increase SMR magnitude over the course of neurofeedback training. However, at the group level, the increase in SMR activity was not related to any of the included impulsivity or drug craving measures. Further research should focus on which patients will be able to benefit from neurofeedback training at an early stage of the employed training sessions. TRIAL REGISTRATION Dutch National Trial Register: NTR5386; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5386 (Archived by WebCite at http://www.webcitation.org/6nXLQuoLl).
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Affiliation(s)
- Sandra Fielenbach
- Research Department, Forensic Psychiatric Centre Dr S van Mesdag, Groningen, Netherlands.,Department of Developmental Psychology, Tilburg University, Tilburg, Netherlands
| | - Franc Cl Donkers
- Department of Cognitive Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Marinus Spreen
- Research Department, Forensic Psychiatric Centre Dr S van Mesdag, Groningen, Netherlands
| | - Stefan Bogaerts
- Department of Developmental Psychology, Tilburg University, Tilburg, Netherlands.,Fivoor Science and Treatment Innovation, Poortugaal, Netherlands
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Sudnawa KK, Chirdkiatgumchai V, Ruangdaraganon N, Khongkhatithum C, Udomsubpayakul U, Jirayucharoensak S, Israsena P. Effectiveness of neurofeedback versus medication for attention-deficit/hyperactivity disorder. Pediatr Int 2018; 60:828-834. [PMID: 29931709 DOI: 10.1111/ped.13641] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 05/27/2018] [Accepted: 06/20/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Neurofeedback (NF) is an operant conditioning procedure that trains participants to self-regulate brain activity. NF is a promising treatment for attention-deficit/hyperactivity disorder (ADHD), but there have been only a few randomized controlled trials comparing the effectiveness of NF with medication with various NF protocols. The aim of this study was therefore to evaluate the effectiveness of unipolar electrode NF using theta/beta protocol compared with methylphenidate (MPH) for ADHD. METHODS Children with newly diagnosed ADHD were randomly organized into NF and MPH groups. The NF group received 30 sessions of NF. Children in the MPH group were prescribed MPH for 12 weeks. Vanderbilt ADHD rating scales were completed by parents and teachers to evaluate ADHD symptoms before and after treatment. Student's t-test and Cohen's d were used to compare symptoms between groups and evaluate the effect size (ES) of each treatment, respectively. RESULTS Forty children participated in the study. No differences in ADHD baseline symptoms were found between groups. After treatment, teachers reported significantly lower ADHD symptoms in the MPH group (P = 0.01), but there were no differences between groups on parent report (P = 0.55). MPH had a large ES (Cohen's d, 1.30-1.69), while NF had a moderate ES (Cohen's d, 0.49-0.68) for treatment of ADHD symptoms. CONCLUSION Neurofeedback is a promising alternative treatment for ADHD in children who do not respond to or experience significant adverse effects from ADHD medication.
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Affiliation(s)
- Khemika Khemakanok Sudnawa
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Vilawan Chirdkiatgumchai
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Nichara Ruangdaraganon
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Chaiyos Khongkhatithum
- Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Umaporn Udomsubpayakul
- Section for Clinical Epidemiology and Biostatistics, Ramathibodi Hospital, Bangkok, Thailand
| | | | - Pasin Israsena
- National Electronics and Computer Technology Center, Pathumthani, Thailand
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La Marca JP, Cruz D, Fandino J, Cacciaguerra FR, Fresco JJ, Guerra AT. Evaluation of artifact-corrected electroencephalographic (EEG) training: a pilot study. J Neural Transm (Vienna) 2018; 125:1087-1097. [PMID: 29582150 DOI: 10.1007/s00702-018-1877-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 03/23/2018] [Indexed: 02/01/2023]
Abstract
This double-blind study examined the effect of electromyographical (EMG) artifacts, which contaminate electroencephalographical (EEG) signals, by comparing artifact-corrected (AC) and non-artifact-corrected (NAC) neurofeedback (NF) training procedures. 14 unmedicated college students were randomly assigned to two groups: AC (n = 7) or NAC (n = 7). Both groups received 12 sessions of NF and were trained using identical NF treatment protocols to reduce their theta/beta power ratios (TBPR). Outcomes on a continuous performance test revealed that the AC group had statistically significant increases across measures of auditory and visual attention. The NAC group showed smaller gains that only reached statistical significance on measures of visual attention. Only the AC group reduced their TBPR, the NAC group did not. AC NF appears to play an important role during training that leads to improvements in both auditory and visual attention. Additional research is required to confirm the results of this study.
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Bosch-Bayard J, Galán-García L, Fernandez T, Lirio RB, Bringas-Vega ML, Roca-Stappung M, Ricardo-Garcell J, Harmony T, Valdes-Sosa PA. Stable Sparse Classifiers Identify qEEG Signatures that Predict Learning Disabilities (NOS) Severity. Front Neurosci 2018; 11:749. [PMID: 29379411 PMCID: PMC5775224 DOI: 10.3389/fnins.2017.00749] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 12/22/2017] [Indexed: 11/30/2022] Open
Abstract
In this paper, we present a novel methodology to solve the classification problem, based on sparse (data-driven) regressions, combined with techniques for ensuring stability, especially useful for high-dimensional datasets and small samples number. The sensitivity and specificity of the classifiers are assessed by a stable ROC procedure, which uses a non-parametric algorithm for estimating the area under the ROC curve. This method allows assessing the performance of the classification by the ROC technique, when more than two groups are involved in the classification problem, i.e., when the gold standard is not binary. We apply this methodology to the EEG spectral signatures to find biomarkers that allow discriminating between (and predicting pertinence to) different subgroups of children diagnosed as Not Otherwise Specified Learning Disabilities (LD-NOS) disorder. Children with LD-NOS have notable learning difficulties, which affect education but are not able to be put into some specific category as reading (Dyslexia), Mathematics (Dyscalculia), or Writing (Dysgraphia). By using the EEG spectra, we aim to identify EEG patterns that may be related to specific learning disabilities in an individual case. This could be useful to develop subject-based methods of therapy, based on information provided by the EEG. Here we study 85 LD-NOS children, divided in three subgroups previously selected by a clustering technique over the scores of cognitive tests. The classification equation produced stable marginal areas under the ROC of 0.71 for discrimination between Group 1 vs. Group 2; 0.91 for Group 1 vs. Group 3; and 0.75 for Group 2 vs. Group1. A discussion of the EEG characteristics of each group related to the cognitive scores is also presented.
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Affiliation(s)
- Jorge Bosch-Bayard
- Departamento de Neurobiología Conductual y Cognitiva, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Querétaro, Mexico
| | | | - Thalia Fernandez
- Departamento de Neurobiología Conductual y Cognitiva, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Querétaro, Mexico
| | | | - Maria L Bringas-Vega
- The Clinical Hospital of Chengdu Brain Science Institute, Ministry of Education, Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Milene Roca-Stappung
- Departamento de Neurobiología Conductual y Cognitiva, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Querétaro, Mexico
| | - Josefina Ricardo-Garcell
- Departamento de Neurobiología Conductual y Cognitiva, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Querétaro, Mexico
| | - Thalía Harmony
- Departamento de Neurobiología Conductual y Cognitiva, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Querétaro, Mexico
| | - Pedro A Valdes-Sosa
- Cuban Neuroscience Center, La Habana, Cuba.,The Clinical Hospital of Chengdu Brain Science Institute, Ministry of Education, Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
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Gazzellini S, Napolitano A, Bauleo G, Bisozzi E, Lispi ML, Ardu E, Castelli E, Benso F. Time-frequency analyses of reaction times and theta/beta EEG ratio in pediatric patients with traumatic brain injury: A preliminary study. Dev Neurorehabil 2017; 20:393-407. [PMID: 27629793 DOI: 10.1080/17518423.2016.1216470] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE The literature on patients with attention deficit reports peculiar reaction time (RT) oscillation at very low frequencies (VLFO=0.06-0.2 Hz). The data were explained as default mode network (DMN) intrusion in goal-oriented activity. The present study investigates whether a pattern of recurrent lapses in attention can be detected in TBI patients and whether VLFO can be generalized to the sustained attention deficit, regardless of etiology. METHODS Groups of pediatric TBIs and healthy controls performed four attentional tasks. RT and theta/beta timeseries were subjected to wavelet analyses. RESULTS Significant high-power VLFOs were recorded in patient group performances but not in those of controls, both for RTs and theta/beta in all the tasks. CONCLUSION This preliminary study suggests that central-midline theta/beta ratio could be considered a neurophysiological correlate of RT variability and that the general continuous goal-oriented activity can be cross-etiologically affected by recurrent lapses in attention regardless of the specific cognitive component involved.
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Affiliation(s)
- Simone Gazzellini
- a Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital IRCCS , Rome , Italy
| | - Antonio Napolitano
- b Clinical Technology Innovations Research Area, Bambino Gesù Children's Hospital IRCCS , Rome , Italy
| | - Graziella Bauleo
- c "Il filo dalla Torre" Centre for Education, Autism and Disability , Rome , Italy
| | - Eleonora Bisozzi
- a Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital IRCCS , Rome , Italy
| | - Maria Luisa Lispi
- a Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital IRCCS , Rome , Italy
| | | | - Enrico Castelli
- a Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital IRCCS , Rome , Italy
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Cognitive Performance Enhancement: Do Biofeedback and Neurofeedback Work? JOURNAL OF COGNITIVE ENHANCEMENT 2017. [DOI: 10.1007/s41465-017-0039-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Abstract
Brain-computer interface (BCI) technology can restore communication and control to people who are severely paralyzed. There has been speculation that this technology might also be useful for a variety of diverse therapeutic applications. This survey considers possible ways that BCI technology can be applied to motor rehabilitation following stroke, Parkinson's disease, and psychiatric disorders. We consider potential neural signals as well as the design and goals of BCI-based therapeutic applications. These diverse applications all share a reliance on neuroimaging and signal processing technologies. At the same time, each of these potential applications presents a series of unique challenges.
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Affiliation(s)
| | - Janis Daly
- Brain Rehabilitation Research Program, McKnight Brain Institute, University of Florida, Gainesville, FL
| | - Chadwick Boulay
- The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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Testing the Benefits of Neurofeedback on Selective Attention Measured Through Dichotic Listening. Appl Psychophysiol Biofeedback 2017; 41:157-64. [PMID: 26683198 DOI: 10.1007/s10484-015-9323-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The electrophysiological changes after a single session of neurofeedback training (↑SMR/↓Theta) and its effects on executive attention during a dichotic listening test with forced attentional procedures were measured in a sample of 20 healthy women. A pre-post moment test double blind design, with the inclusion of a group receiving sham neurofeedback, allowed for minimization of alien influences. The interaction of Moment × Group was significant, indicating an enhancement of SMR band after the real neurofeedback. The dichotic listening scores were correlated with the amplitude of Beta band in baseline conditions. The performance on the forced left attentional condition in dichotic listening was significantly improved and correlated positively with the post-training enhancement of the SMR band. The sham neurofeedback group also improved DL scores, so a clear affirmation about the benefits of neurofeedback training over cognitive performance could not be unambiguously established. It is concluded that the protocol showed a good independence and acceptable trainability in modifying the EEG results, but there was limited interpretability regarding cognitive outcomes.
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Abstract
Although evidence supports the efficacy of biofeedback for treating a number of disorders and for enhancing performance, significant barriers block both needed research and payer support for this method. Biofeedback has demonstrated effects in changing psychophysiological substrates of various emotional, physical, and psychosomatic problems, but payers are reluctant to reimburse for biofeedback services. A considerable amount of biofeedback research is in the form of relatively small well-controlled trials (Phase II trials). This article argues for greater payer support and research support for larger trials in the “real life” clinical environment (Phase III trials) and meta-analytic reviews.
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Affiliation(s)
- Paul Lehrer
- Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA
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Rodríguez C, González-Castro P, Cueli M, Areces D, González-Pienda JA. Attention Deficit/Hyperactivity Disorder (ADHD) Diagnosis: An Activation-Executive Model. Front Psychol 2016; 7:1406. [PMID: 27708600 PMCID: PMC5030780 DOI: 10.3389/fpsyg.2016.01406] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Accepted: 09/02/2016] [Indexed: 01/27/2023] Open
Abstract
Attention deficit with, or without, hyperactivity and impulsivity (ADHD) is categorized as neuro-developmental disorder. ADHD is a common disorder in childhood and one of the most frequent conditions affecting school ages. This disorder is characterized by a persistent behavioral pattern associated with inattention, over-activity (or hyperactivity), and difficulty in controlling impulses. Current research suggests the existence of certain patterns of cortical activation and executive control, which could more objectively identify ADHD. Through the use of a risk and resilience model, this research aimed to analyze the interaction between brain activation variables (nirHEG and Q-EEG) and executive variables (Continuous performance test -CPT-) in subjects with ADHD. The study involved 499 children, 175 females (35.1%) and 324 males (64.91%); aged from 6 to 16 years (M = 11.22, SD = 1.43). Two hundred and fifty six of the children had been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and 243 were without ADHD. For the analysis of this objective, a causal model was designed to include the following different measures of task-execution: CPT TOVA (omissions, commissions, response time, variability, D prime and the ADHD Index); electrical activity (using Q-EEG); and blood-flow oxygenation activity (using nirHEG). The causal model was tested by means of structural equation modeling (SEM). The model that had been constructed was based upon three general assumptions: (1) There are different causal models for children with ADHD and those without ADHD; (2) The activation measures influence students' executive performance; and (3) There are measurable structural differences between the ADHD and control group models (executive and activation). In general, the results showed that: (a) activation measures influence executive patterns differently, (b) the relationship between activation variables (nirHEG and Q-EEG) depends on the brain zone being studied, (c) both groups showed important differences in variables correlation, with a good fit in each model (with and without ADHD). Lastly, the results were analyzed with a view to the diagnosis procedure. Therefore, we discuss the implications for future research.
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Affiliation(s)
- Celestino Rodríguez
- Department of Psychology, Faculty of Psychology, University of Oviedo Oviedo, Spain
| | | | - Marisol Cueli
- Department of Psychology, Faculty of Psychology, University of Oviedo Oviedo, Spain
| | - Debora Areces
- Department of Psychology, Faculty of Psychology, University of Oviedo Oviedo, Spain
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Abstract
Mind-body therapies are popular and are ranked among the top 10 complementary and integrative medicine practices reportedly used by adults and children in the 2007-2012 National Health Interview Survey. A growing body of evidence supports the effectiveness and safety of mind-body therapies in pediatrics. This clinical report outlines popular mind-body therapies for children and youth and examines the best-available evidence for a variety of mind-body therapies and practices, including biofeedback, clinical hypnosis, guided imagery, meditation, and yoga. The report is intended to help health care professionals guide their patients to nonpharmacologic approaches to improve concentration, help decrease pain, control discomfort, or ease anxiety.
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Cowley B, Kirjanen S, Partanen J, Castrén ML. Epileptic Electroencephalography Profile Associates with Attention Problems in Children with Fragile X Syndrome: Review and Case Series. Front Hum Neurosci 2016; 10:353. [PMID: 27462212 PMCID: PMC4941803 DOI: 10.3389/fnhum.2016.00353] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 06/28/2016] [Indexed: 01/18/2023] Open
Abstract
Fragile X syndrome (FXS) is the most common cause of inherited intellectual disability and a variant of autism spectrum disorder (ASD). The FXS population is quite heterogeneous with respect to comorbidities, which implies the need for a personalized medicine approach, relying on biomarkers or endophenotypes to guide treatment. There is evidence that quantitative electroencephalography (EEG) endophenotype-guided treatments can support increased clinical benefit by considering the patient's neurophysiological profile. We describe a case series of 11 children diagnosed with FXS, aged one to 14 years, mean 4.6 years. Case data are based on longitudinal clinically-observed reports by attending physicians for comorbid symptoms including awake and asleep EEG profiles. We tabulate the comorbid EEG symptoms in this case series, and relate them to the literature on EEG endophenotypes and associated treatment options. The two most common endophenotypes in the data were diffuse slow oscillations and epileptiform EEG, which have been associated with attention and epilepsy respectively. This observation agrees with reported prevalence of comorbid behavioral symptoms for FXS. In this sample of FXS children, attention problems were found in 37% (4 of 11), and epileptic seizures in 45% (5 of 11). Attention problems were found to associate with the epilepsy endophenotype. From the synthesis of this case series and literature review, we argue that the evidence-based personalized treatment approach, exemplified by neurofeedback, could benefit FXS children by focusing on observable, specific characteristics of comorbid disease symptoms.
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Affiliation(s)
- Benjamin Cowley
- Brain Work Research Centre, Finnish Institute of Occupational HealthHelsinki, Finland; Cognitive Brain Research Unit, Cognitive Science, Institute of Behavioral Sciences, University of HelsinkiHelsinki, Finland
| | | | - Juhani Partanen
- Department of Clinical Neurophysiology, University Hospital of Helsinki Helsinki, Finland
| | - Maija L Castrén
- Faculty of Medicine, Physiology, University of HelsinkiHelsinki, Finland; Autism Foundation in FinlandHelsinki, Finland
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Cowley B, Holmström É, Juurmaa K, Kovarskis L, Krause CM. Computer Enabled Neuroplasticity Treatment: A Clinical Trial of a Novel Design for Neurofeedback Therapy in Adult ADHD. Front Hum Neurosci 2016; 10:205. [PMID: 27242472 PMCID: PMC4860393 DOI: 10.3389/fnhum.2016.00205] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 04/22/2016] [Indexed: 12/13/2022] Open
Abstract
Background: We report a randomized controlled clinical trial of neurofeedback therapy intervention for ADHD/ADD in adults. We focus on internal mechanics of neurofeedback learning, to elucidate the primary role of cortical self-regulation in neurofeedback. We report initial results; more extensive analysis will follow. Methods: Trial has two phases: intervention and follow-up. The intervention consisted of neurofeedback treatment, including intake and outtake measurements, using a waiting-list control group. Treatment involved ~40 h-long sessions 2–5 times per week. Training involved either theta/beta or sensorimotor-rhythm regimes, adapted by adding a novel “inverse-training” condition to promote self-regulation. Follow-up (ongoing) will consist of self-report and executive function tests. Setting: Intake and outtake measurements were conducted at University of Helsinki. Treatment was administered at partner clinic Mental Capital Care, Helsinki. Randomization: We randomly allocated half the sample then adaptively allocated the remainder to minimize baseline differences in prognostic variables. Blinding: Waiting-list control design meant trial was not blinded. Participants: Fifty-four adult Finnish participants (mean age 36 years; 29 females) were recruited after screening by psychiatric review. Forty-four had ADHD diagnoses, 10 had ADD. Measurements: Symptoms were assessed by computerized attention test (T.O.V.A.) and self-report scales, at intake and outtake. Performance during neurofeedback trials was recorded. Results: Participants were recruited and completed intake measurements during summer 2012, before assignment to treatment and control, September 2012. Outtake measurements ran April-August 2013. After dropouts, 23 treatment and 21 waiting-list participants remained for analysis. Initial analysis showed that, compared to waiting-list control, neurofeedback promoted improvement of self-reported ADHD symptoms, but did not show transfer of learning to T.O.V.A. Comprehensive analysis will be reported elsewhere. Trial Registration: “Computer Enabled Neuroplasticity Treatment (CENT),” ISRCTN13915109.
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Affiliation(s)
- Benjamin Cowley
- BrainWork Research Centre, Finnish Institute of Occupational HealthHelsinki, Finland; Cognitive Brain Research Unit, Cognitive Science, Institute of Behavioural Sciences, University of HelsinkiHelsinki, Finland
| | - Édua Holmström
- Formally affiliated with Faculty of Behavioural Sciences, University of Helsinki Helsinki, Finland
| | - Kristiina Juurmaa
- Cognitive Brain Research Unit, Cognitive Science, Institute of Behavioural Sciences, University of Helsinki Helsinki, Finland
| | - Levas Kovarskis
- Formally affiliated with Faculty of Behavioural Sciences, University of Helsinki Helsinki, Finland
| | - Christina M Krause
- Cognitive Brain Research Unit, Cognitive Science, Institute of Behavioural Sciences, University of Helsinki Helsinki, Finland
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40
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Thibault RT, Lifshitz M, Birbaumer N, Raz A. Neurofeedback, Self-Regulation, and Brain Imaging: Clinical Science and Fad in the Service of Mental Disorders. PSYCHOTHERAPY AND PSYCHOSOMATICS 2015; 84:193-207. [PMID: 26021883 DOI: 10.1159/000371714] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 12/18/2014] [Indexed: 11/19/2022]
Abstract
Neurofeedback draws on multiple techniques that propel both healthy and patient populations to self-regulate neural activity. Since the 1970s, numerous accounts have promoted electroencephalography-neurofeedback as a viable treatment for a host of mental disorders. Today, while the number of health care providers referring patients to neurofeedback practitioners increases steadily, substantial methodological and conceptual caveats continue to pervade empirical reports. And yet, nascent imaging technologies (e.g., real-time functional magnetic resonance imaging) and increasingly rigorous protocols are paving the road towards more effective applications and a better scientific understanding of the underlying mechanisms. Here, we outline common neurofeedback methods, illuminate the tenuous state of the evidence, and sketch out future directions to further unravel the potential merits of this contentious therapeutic prospect.
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41
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González-Castro P, Cueli M, Rodríguez C, García T, Álvarez L. Efficacy of Neurofeedback Versus Pharmacological Support in Subjects with ADHD. Appl Psychophysiol Biofeedback 2015; 41:17-25. [DOI: 10.1007/s10484-015-9299-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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42
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Daly JJ, Huggins JE. Brain-computer interface: current and emerging rehabilitation applications. Arch Phys Med Rehabil 2015; 96:S1-7. [PMID: 25721542 PMCID: PMC4383183 DOI: 10.1016/j.apmr.2015.01.007] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 01/07/2015] [Accepted: 01/07/2015] [Indexed: 11/19/2022]
Abstract
A formal definition of brain-computer interface (BCI) is as follows: a system that acquires brain signal activity and translates it into an output that can replace, restore, enhance, supplement, or improve the existing brain signal, which can, in turn, modify or change ongoing interactions between the brain and its internal or external environment. More simply, a BCI can be defined as a system that translates "brain signals into new kinds of outputs." After brain signal acquisition, the BCI evaluates the brain signal and extracts signal features that have proven useful for task performance. There are 2 broad categories of BCIs: implantable and noninvasive, distinguished by invasively and noninvasively acquired brain signals, respectively. For this supplement, we will focus on BCIs that use noninvasively acquired brain signals.
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Affiliation(s)
- Janis J Daly
- Brain Rehabilitation Research Program, McKnight Brain Institute, University of Florida, Gainesville, FL; Department of Neurology, College of Medicine, University of Florida, Gainesville, FL; Brain Rehabilitation Research Center of Excellence, Gainesville, FL; North Florida/South Georgia Veterans Affairs Medical Center, Gainesville, FL.
| | - Jane E Huggins
- Department of Physical Medicine and Rehabilitation, Department of Biomedical Engineering, and Program of Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI
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43
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Schoenberg PLA, David AS. Biofeedback for psychiatric disorders: a systematic review. Appl Psychophysiol Biofeedback 2015; 39:109-35. [PMID: 24806535 DOI: 10.1007/s10484-014-9246-9] [Citation(s) in RCA: 115] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Biofeedback potentially provides non-invasive, effective psychophysiological interventions for psychiatric disorders. The encompassing purpose of this review was to establish how biofeedback interventions have been used to treat select psychiatric disorders [anxiety, autistic spectrum disorders, depression, dissociation, eating disorders, schizophrenia and psychoses] to date and provide a useful reference for consultation by clinicians and researchers planning to administer a biofeedback treatment. A systematic search of EMBASE, MEDLINE, PsycINFO, and WOK databases and hand searches in Applied Psychophysiology and Biofeedback, and Journal of Neurotherapy, identified 227 articles; 63 of which are included within this review. Electroencephalographic neurofeedback constituted the most investigated modality (31.7%). Anxiety disorders were the most commonly treated (68.3%). Multi-modal biofeedback appeared most effective in significantly ameliorating symptoms, suggesting that targeting more than one physiological modality for bio-regulation increases therapeutic efficacy. Overall, 80.9% of articles reported some level of clinical amelioration related to biofeedback exposure, 65.0% to a statistically significant (p < .05) level of symptom reduction based on reported standardized clinical parameters. Although the heterogeneity of the included studies warrants caution before explicit efficacy statements can be made. Further development of standardized controlled methodological protocols tailored for specific disorders and guidelines to generate comprehensive reports may contribute towards establishing the value of biofeedback interventions within mainstream psychiatry.
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Affiliation(s)
- Poppy L A Schoenberg
- Section of Cognitive Neuropsychiatry, Division of Psychological Medicine, Institute of Psychiatry, King's College London, Box P068, De Crespigny Park, London, SE5 8AF, UK,
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Soekadar SR, Birbaumer N, Slutzky MW, Cohen LG. Brain-machine interfaces in neurorehabilitation of stroke. Neurobiol Dis 2014; 83:172-9. [PMID: 25489973 DOI: 10.1016/j.nbd.2014.11.025] [Citation(s) in RCA: 169] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 10/29/2014] [Accepted: 11/26/2014] [Indexed: 01/17/2023] Open
Abstract
Stroke is among the leading causes of long-term disabilities leaving an increasing number of people with cognitive, affective and motor impairments depending on assistance in their daily life. While function after stroke can significantly improve in the first weeks and months, further recovery is often slow or non-existent in the more severe cases encompassing 30-50% of all stroke victims. The neurobiological mechanisms underlying recovery in those patients are incompletely understood. However, recent studies demonstrated the brain's remarkable capacity for functional and structural plasticity and recovery even in severe chronic stroke. As all established rehabilitation strategies require some remaining motor function, there is currently no standardized and accepted treatment for patients with complete chronic muscle paralysis. The development of brain-machine interfaces (BMIs) that translate brain activity into control signals of computers or external devices provides two new strategies to overcome stroke-related motor paralysis. First, BMIs can establish continuous high-dimensional brain-control of robotic devices or functional electric stimulation (FES) to assist in daily life activities (assistive BMI). Second, BMIs could facilitate neuroplasticity, thus enhancing motor learning and motor recovery (rehabilitative BMI). Advances in sensor technology, development of non-invasive and implantable wireless BMI-systems and their combination with brain stimulation, along with evidence for BMI systems' clinical efficacy suggest that BMI-related strategies will play an increasing role in neurorehabilitation of stroke.
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Affiliation(s)
- Surjo R Soekadar
- Applied Neurotechnology Lab, Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen, Germany; Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany.
| | - Niels Birbaumer
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany; Ospedale San Camillo, IRCCS, Venice, Italy.
| | - Marc W Slutzky
- Northwestern University, Feinberg School of Medicine, Chicago, USA.
| | - Leonardo G Cohen
- Human Cortical Physiology and Neurorehabilitation Section, NINDS, NIH, Bethesda, MD, USA.
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45
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Christiansen H, Reh V, Schmidt MH, Rief W. Slow cortical potential neurofeedback and self-management training in outpatient care for children with ADHD: study protocol and first preliminary results of a randomized controlled trial. Front Hum Neurosci 2014; 8:943. [PMID: 25505396 PMCID: PMC4244863 DOI: 10.3389/fnhum.2014.00943] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 11/05/2014] [Indexed: 11/13/2022] Open
Abstract
Background: Treatment for children with attention deficit/hyperactivity disorder (ADHD) today is predominantly pharmacological. While it is the most common treatment, it might not always be the most appropriate one. Moreover, long term effects remain unclear. Behavior therapy (BT) and non-pharmacological treatments such as neurofeedback (NF) are promising alternatives, though there are no routine outpatient care/effectiveness studies yet that have included children with medication or changes in medication. Methods/design: This paper presents the protocol of a randomized controlled trial to compare the effectiveness of a Slow Cortical Potential (SCP) NF protocol with self-management (SM) in a high frequent outpatient care setting. Both groups (NF/SM) receive a total of 30 high frequent therapy sessions. Additionally, 6 sessions are reserved for comorbid problems. The primary outcome measure is the reduction of ADHD core symptoms according to parent and teacher ratings. Preliminary Results: Untill now 58 children were included in the study (48 males), with a mean age of 8.42 (1.34) years, and a mean IQ of 110 (13.37). Conners-3 parent and teacher ratings were used to estimate core symptom change. Since the study is still ongoing, and children are in different study stages, pre-post and follow-up results are not yet available for all children included. Preliminary results suggest overall good pre-post effects, though. For parent and teacher ratings an ANOVA with repeated measures yielded overall satisfying pre-post effects (η2 0.175–0.513). Differences between groups (NF vs. SM) could not yet be established (p = 0.81). Discussion: This is the first randomized controlled trial to test the effectiveness of a NF protocol in a high frequent outpatient care setting that does not exclude children on or with changes in medication. First preliminary results show positive effects. The rationale for the trial, the design, and the strengths and limitations of the study are discussed. Trial registration: This trial is registered in www.clinicaltrials.gov as NCT01879644.
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Affiliation(s)
- Hanna Christiansen
- Department of Psychology, Child and Adolescent Psychology, Philipps-University Marburg Marburg, Germany
| | - Verena Reh
- Department of Psychology, Clinical Psychology, Philipps-University Marburg Marburg, Germany
| | - Martin H Schmidt
- Department of Psychology, Clinical Psychology, Philipps-University Marburg Marburg, Germany
| | - Winfried Rief
- Department of Psychology, Clinical Psychology, Philipps-University Marburg Marburg, Germany
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Micoulaud-Franchi JA, Geoffroy PA, Fond G, Lopez R, Bioulac S, Philip P. EEG neurofeedback treatments in children with ADHD: an updated meta-analysis of randomized controlled trials. Front Hum Neurosci 2014; 8:906. [PMID: 25431555 PMCID: PMC4230047 DOI: 10.3389/fnhum.2014.00906] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 10/23/2014] [Indexed: 11/21/2022] Open
Abstract
Objective: We undertook a meta-analysis of published Randomized Controlled Trials (RCT) with semi-active control and sham-NF groups to determine whether Electroencephalogram-neurofeedback (EEG-NF) significantly improves the overall symptoms, inattention and hyperactivity/impulsivity dimensions for probably unblinded assessment (parent assessment) and probably blinded assessment (teacher assessment) in children with Attention Deficit Hyperactivity Disorder (ADHD). Data sources: A systematic review identified independent studies that were eligible for inclusion in a random effects meta-analysis. Data extraction: Effect sizes for ADHD symptoms were expressed as standardized mean differences (SMD) with 95% confidence intervals. Results: Five identified studies met eligibility criteria, 263 patients with ADHD were included, 146 patients were trained with EEG-NF. On parent assessment (probably unblinded assessment), the overall ADHD score (SMD = −0.49 [−0.74, −0.24]), the inattention score (SMD = −0.46 [−0.76, −0.15]) and the hyperactivity/impulsivity score (SMD = −0.34 [−0.59, −0.09]) were significantly improved in patients receiving EEG-NF compared to controls. On teacher assessment (probably blinded assessment), only the inattention score was significantly improved in patients receiving EEG-NF compared to controls (SMD = −0.30 [−0.58, −0.03]). Conclusions: This meta-analysis of EEG-NF in children with ADHD highlights improvement in the inattention dimension of ADHD symptoms. Future investigations should pay greater attention to adequately blinded studies and EEG-NF protocols that carefully control the implementation and embedding of training.
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Affiliation(s)
- Jean-Arthur Micoulaud-Franchi
- Solaris, Unité de Neurophysiologie, Pôle de Psychiatrie Universitaire, Hôpital Sainte-Marguerite Marseille, France ; Institut de Neurosciences Cognitives de la Méditerranée, INCM-CNRS UMR 6193 Marseille, France
| | - Pierre Alexis Geoffroy
- Inserm, UMR-S 1144 Paris, France ; AP-HP, GH Saint-Louis - Lariboisière - Fernand Widal, Pôle Neurosciences Paris, France ; UMR-S 1144, Université Paris Descartes and Université Paris Diderot Paris, France ; Fondation FondaMental Créteil, France
| | - Guillaume Fond
- Fondation FondaMental Créteil, France ; Université Paris Est-Créteil, Pôle de Psychiatrie du Groupe des Hôpitaux Universitaires de Mondor, DHU Pe-psy, INSERM U955, Eq Psychiatrie Génétique, Réseau des Centres Experts Schizophrénie de France Créteil, France
| | - Régis Lopez
- Centre de Référence National Narcolepsie-hypersomnie Idiopathique, Unité des Troubles du Sommeil, CHU Gui de Chauliac Montpellier, France ; NSERM U1061 Montpellier, France
| | - Stéphanie Bioulac
- Centre Hospitalier Charles Perrens, Pôle Universitaire de Psychiatrie de l'Enfant et de l'Adolescent Bordeaux, France ; USR CNRS 3413 SANPSY, Clinique du Sommeil, CHU Pellegrin, Université de Bordeaux Bordeaux, France
| | - Pierre Philip
- USR CNRS 3413 SANPSY, Clinique du Sommeil, CHU Pellegrin, Université de Bordeaux Bordeaux, France
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47
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Holtmann M, Sonuga-Barke E, Cortese S, Brandeis D. Neurofeedback for ADHD: a review of current evidence. Child Adolesc Psychiatr Clin N Am 2014; 23:789-806. [PMID: 25220087 DOI: 10.1016/j.chc.2014.05.006] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Considerable scientific effort has been directed at developing effective treatments for attention-deficit/hyperactivity disorder (ADHD). Among alternative treatment approaches, neurofeedback has gained some promising empirical support in recent years from controlled studies as a treatment of core ADHD symptoms. However, a recent stringent meta-analysis of 8 randomized controlled trials published in 2013 found that the effects were stronger for unblinded measures and 3 recent subsequently published well-controlled trials found no effects for the most blinded ADHD outcome. Firmer conclusions must await upcoming evidence from larger controlled studies and future meta-analyses contrasting different forms of neurofeedback and different outcome measures.
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Affiliation(s)
- Martin Holtmann
- LWL-University Hospital for Child and Adolescent Psychiatry, Ruhr University Bochum, Heithofer Allee 64, D 59071 Hamm, Germany.
| | - Edmund Sonuga-Barke
- Developmental Brain-Behaviour Laboratory, Psychology, Institute for Disorders of Impulse & Attention, University of Southampton, University Road SO17 1BJ, Southampton, UK; Department of Experimental Clinical & Health Psychology, Ghent University, Henri Dunantlaan 2. B-9000, Ghent, Belgium
| | - Samuele Cortese
- Department of Child Psychiatry, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge PE29 2BQ, UK; Division of Psychiatry, Institute of Mental Health, University of Nottingham, Triumph Road, NG7 2TU Nottingham, UK
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry, University of Zürich, Neumünsterallee 9/Fach, CH-8032 Zürich, Switzerland; Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J5, D-68159 Mannheim, Germany
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48
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Beljan P, Bree KD, Reuter AEF, Reuter SD, Wingers L. Private pediatric neuropsychology practice multimodal treatment of ADHD: an applied approach. APPLIED NEUROPSYCHOLOGY-CHILD 2014; 3:188-96. [PMID: 25010085 DOI: 10.1080/21622965.2013.875300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
As neuropsychologists and psychologists specializing in the assessment and treatment of pediatric mental health concerns, one of the most prominent diagnoses we encounter is attention-deficit hyperactivity disorder (ADHD). Following a pediatric neuropsychological evaluation, parents often request recommendations for treatment. This article addresses our approach to the treatment of ADHD from the private practice perspective. We will review our primary treatment methodology as well as integrative and alternative treatment approaches.
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Affiliation(s)
- Paul Beljan
- a Beljan Psychological Services , Scottsdale , Arizona
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49
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Simkin DR, Thatcher RW, Lubar J. Quantitative EEG and neurofeedback in children and adolescents: anxiety disorders, depressive disorders, comorbid addiction and attention-deficit/hyperactivity disorder, and brain injury. Child Adolesc Psychiatr Clin N Am 2014; 23:427-64. [PMID: 24975621 DOI: 10.1016/j.chc.2014.03.001] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
This article explores the science surrounding neurofeedback. Both surface neurofeedback (using 2-4 electrodes) and newer interventions, such as real-time z-score neurofeedback (electroencephalogram [EEG] biofeedback) and low-resolution electromagnetic tomography neurofeedback, are reviewed. The limited literature on neurofeedback research in children and adolescents is discussed regarding treatment of anxiety, mood, addiction (with comorbid attention-deficit/hyperactivity disorder), and traumatic brain injury. Future potential applications, the use of quantitative EEG for determining which patients will be responsive to medications, the role of randomized controlled studies in neurofeedback research, and sensible clinical guidelines are considered.
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Affiliation(s)
- Deborah R Simkin
- Committee on Integrative Medicine, American Academy of Child and Adolescent Psychiatry, Attention, Memory and Cognition Center, 4641 Gulfstarr Drive, Suite 106, Destin, FL 32541, USA; Department of Psychiatry, Emory University Medical School, Atlanta, Georgia.
| | - Robert W Thatcher
- Neuroimaging Laboratory, Applied Neuroscience Research Institute, 7985 113th Street, Suite 210, Seminole, FL 33772, USA
| | - Joel Lubar
- University of Tennessee, Knoxville, TN, USA; Southeastern Neurofeedback Institute, Inc, 111 North Pompano Beach Boulevard, Suite 1214, Pompano Beach, FL 33062, USA; International Society for Neurofeedback and Research
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50
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Hurt E, Arnold LE, Lofthouse N. Quantitative EEG neurofeedback for the treatment of pediatric attention-deficit/hyperactivity disorder, autism spectrum disorders, learning disorders, and epilepsy. Child Adolesc Psychiatr Clin N Am 2014; 23:465-86. [PMID: 24975622 DOI: 10.1016/j.chc.2014.02.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Neurofeedback (NF) using surface electroencephalographic signals has been used to treat various child psychiatric disorders by providing patients with video/audio information about their brain's electrical activity in real-time. Research data are reviewed and clinical recommendations are made regarding NF treatment of youth with attention deficit/hyperactivity disorder, autism, learning disorders, and epilepsy. Most NF studies are limited by methodological issues, such as failure to use or test the validity of a full-blind or sham NF. The safety of NF treatment has not been thoroughly investigated in youth or adults, although clinical experience suggests reasonable safety.
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Affiliation(s)
- Elizabeth Hurt
- School of Professional Psychology, Wright State University, 053 Student Union, Dayton, OH 45435, USA.
| | - L Eugene Arnold
- Department of Psychiatry, Nisonger Center, The Ohio State University, 1581 Dodd Drive, Columbus, OH 43210, USA
| | - Nicholas Lofthouse
- School of Professional Psychology, 130 Northwood's Boulevard, Suite B, Columbus, OH 43235, USA
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