1
|
Zhou W, Nan W, Xiong K, Ku Y. Alpha neurofeedback training improves visual working memory in healthy individuals. NPJ SCIENCE OF LEARNING 2024; 9:32. [PMID: 38637595 PMCID: PMC11026515 DOI: 10.1038/s41539-024-00242-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 04/03/2024] [Indexed: 04/20/2024]
Abstract
Neurofeedback (NF) training is a closed-loop brain training in which participants learn to regulate their neural activation. NF training of alpha (8-12 Hz) activity has been reported to enhance working memory capacity, but whether it affects the precision in working memory has not yet been explored. Moreover, whether NF training distinctively influences performance in different types of working memory tasks remains unclear. Therefore, the present study conducted a randomized, single-blind, sham-controlled experiment to investigate how alpha NF training affected the capacity and precision of working memory, as well as the related neural change. Forty participants were randomly and equally assigned to the NF group and the sham control group. Both groups received NF training (about 30 min daily) for five consecutive days. The NF group received alpha (8-12 Hz) training, while the sham control group received sham NF training. We found a significant alpha increase within sessions but no significant difference across sessions. However, the behavioral performance and neural activity in the modified Sternberg task did not show significant change after alpha NF training. On the contrary, the alpha NF training group significantly increased visual working memory capacity measured by the Corsi-block tapping task and improved visual working memory precision in the interference condition in a color-recall task. These results suggest that alpha NF training influences performance in working memory tasks involved in the visuospatial sketchpad. Notably, we demonstrated that alpha NF training improves the quantity and quality of visual working memory.
Collapse
Affiliation(s)
- Wenbin Zhou
- School of Psychology, Shanghai Normal University, Shanghai, China
- Zhengzhou Shuqing Medical College, Zhengzhou, China
| | - Wenya Nan
- School of Psychology, Shanghai Normal University, Shanghai, China.
- The Research Base of Online Education for Shanghai Middle and Primary Schools, Shanghai, China.
| | - Kaiwen Xiong
- School of Psychology, Shanghai Normal University, Shanghai, China
| | - Yixuan Ku
- Guangdong Provincial Key Laboratory of Brain Function and Disease, Center for Brain and Mental Wellbeing, Department of Psychology, Sun Yat-sen University, Guangzhou, Guangdong, China.
- Peng Cheng Laboratory, Shenzhen, Guangdong, China.
| |
Collapse
|
2
|
Jackson LE, Han YJ, Evans LH. The efficacy of electroencephalography neurofeedback for enhancing episodic memory in healthy and clinical participants: A systematic qualitative review and meta-analysis. Neurosci Biobehav Rev 2023; 155:105455. [PMID: 37926240 DOI: 10.1016/j.neubiorev.2023.105455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/09/2023] [Accepted: 10/30/2023] [Indexed: 11/07/2023]
Abstract
Several studies have examined whether electroencephalography neurofeedback (EEG-NF), a self-regulatory technique where an individual receives real-time feedback on a pattern of brain activity that is theoretically linked to a target behaviour, can enhance episodic memory. The aim of this research was to i) provide a qualitative overview of the literature, and ii) conduct a meta-analysis of appropriately controlled studies to determine whether EEG-NF can enhance episodic memory. The literature search returned 46 studies, with 21 studies (44 effect sizes) meeting the inclusion criteria for the meta-analysis. The qualitative overview revealed that, across EEG-NF studies on both healthy and clinical populations, procedures and protocols vary considerably and many studies were insufficiently powered with inadequate design features. The meta-analysis, conducted on studies with an active control, revealed a small-size, significant positive effect of EEG-NF on episodic memory performance (g = 0.31, p = 0.003), moderated by memory modality and EEG-NF self-regulation success. These results are discussed with a view towards optimising EEG-NF training and subsequent benefits to episodic memory.
Collapse
Affiliation(s)
- Lucy E Jackson
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff CF24 4HQ, Wales, UK
| | - Yi-Jhong Han
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London SE5 9RJ, England, UK
| | - Lisa H Evans
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff CF24 4HQ, Wales, UK.
| |
Collapse
|
3
|
Shen L, Jiang Y, Wan F, Ku Y, Nan W. Successful alpha neurofeedback training enhances working memory updating and event-related potential activity. Neurobiol Learn Mem 2023; 205:107834. [PMID: 37757954 DOI: 10.1016/j.nlm.2023.107834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 07/19/2023] [Accepted: 09/24/2023] [Indexed: 09/29/2023]
Abstract
Neurofeedback (NF) is a promising method to self-regulate human brain activity for cognition enhancement. Due to the unclear results of alpha NF training on working memory updating as well as the impact of feedback modality on NF learning, this study aimed to understand further the underlying neural mechanism of alpha NF training effects on working memory updating, where the NF learning was also compared between visual and auditory feedback modalities. A total of 30 participants were assigned to Visual NF, Auditory NF, and Control groups. Working memory updating was evaluated by n-back (n =2,3) tasks before and after five alpha upregulation NF sessions. The result showed no significant difference in NF learning performance between the Visual and Auditory groups, indicating that the difference in feedback modality did not affect NF learning. In addition, compared to the control group, the participants who achieved successful NF learning showed a significant increase in n-back behavioral performance and P3a amplitude in 2-back and a significant decrease in P3a latency in 3-back. Our results in n-back further suggested that successful alpha NF training might improve updating performance in terms of the behavioral and related event-related potential (ERP) measures. These findings contribute to the understanding of the effect of alpha training on memory updating and the design of NF experimental protocol in terms of feedback modality selection.
Collapse
Affiliation(s)
- Lu Shen
- Department of Psychology, Shanghai Normal University, Shanghai, China; Department of Electrical and Computer Engineering, University of Macau, Macau; Centre for Cognitive and Brain Sciences, Institute of Collaborative Innovation, University of Macau, Macau
| | - Yali Jiang
- Department of Psychology, Shanghai Normal University, Shanghai, China
| | - Feng Wan
- Department of Electrical and Computer Engineering, University of Macau, Macau; Centre for Cognitive and Brain Sciences, Institute of Collaborative Innovation, University of Macau, Macau
| | - Yixuan Ku
- Department of Psychology, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Wenya Nan
- Department of Psychology, Shanghai Normal University, Shanghai, China.
| |
Collapse
|
4
|
Kleih-Dahms SC, Botrel L. Neurofeedback therapy to improve cognitive function in patients with chronic post-stroke attention deficits: a within-subjects comparison. Front Hum Neurosci 2023; 17:1155584. [PMID: 37497040 PMCID: PMC10367101 DOI: 10.3389/fnhum.2023.1155584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/12/2023] [Indexed: 07/28/2023] Open
Abstract
Introduction We investigated a slow-cortical potential (SCP) neurofeedback therapy approach for rehabilitating chronic attention deficits after stroke. This study is the first attempt to train patients who survived stroke with SCP neurofeedback therapy. Methods We included N = 5 participants in a within-subjects follow-up design. We assessed neuropsychological and psychological performance at baseline (4 weeks before study onset), before study onset, after neurofeedback training, and at 3 months follow-up. Participants underwent 20 sessions of SCP neurofeedback training. Results Participants learned to regulate SCPs toward negativity, and we found indications for improved attention after the SCP neurofeedback therapy in some participants. Quality of life improved throughout the study according to engagement in activities of daily living. The self-reported motivation was related to mean SCP activation in two participants. Discussion We would like to bring attention to the potential of SCP neurofeedback therapy as a new rehabilitation method for treating post-stroke cognitive deficits. Studies with larger samples are warranted to corroborate the results.
Collapse
|
5
|
Xu G, Hao F, Zhao W, Qiu J, Zhao P, Zhang Q. The influential factors and non-pharmacological interventions of cognitive impairment in children with ischemic stroke. Front Neurol 2022; 13:1072388. [PMID: 36588886 PMCID: PMC9797836 DOI: 10.3389/fneur.2022.1072388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 11/23/2022] [Indexed: 12/23/2022] Open
Abstract
Background The prevalence of pediatric ischemic stroke rose by 35% between 1990 and 2013. Affected patients can experience the gradual onset of cognitive impairment in the form of impaired language, memory, intelligence, attention, and processing speed, which affect 20-50% of these patients. Only few evidence-based treatments are available due to significant heterogeneity in age, pathological characteristics, and the combined epilepsy status of the affected children. Methods We searched the literature published by Web of Science, Scopus, and PubMed, which researched non-pharmacological rehabilitation interventions for cognitive impairment following pediatric ischemic stroke. The search period is from the establishment of the database to January 2022. Results The incidence of such impairment is influenced by patient age, pathological characteristics, combined epilepsy status, and environmental factors. Non-pharmacological treatments for cognitive impairment that have been explored to date mainly include exercise training, psychological intervention, neuromodulation strategies, computer-assisted cognitive training, brain-computer interfaces (BCI), virtual reality, music therapy, and acupuncture. In childhood stroke, the only interventions that can be retrieved are psychological intervention and neuromodulation strategies. Conclusion However, evidence regarding the efficacy of these interventions is relatively weak. In future studies, the active application of a variety of interventions to improve pediatric cognitive function will be necessary, and neuroimaging and electrophysiological measurement techniques will be of great value in this context. Larger multi-center prospective longitudinal studies are also required to offer more accurate evidence-based guidance for the treatment of patients with pediatric stroke.
Collapse
Affiliation(s)
- Gang Xu
- Rehabilitation Branch, Tianjin Children's Hospital/Tianjin University Children's Hospital, Tianjin, China
| | - Fuchun Hao
- Medicine & Nursing Faculty, Tianjin Medical College, Tianjin, China
| | - Weiwei Zhao
- Chinese Teaching and Research Section, Tianjin Beichen Experimental Middle School, Tianjin, China
| | - Jiwen Qiu
- Research Center of Experimental Acupuncture Science, Tianjin University of Traditional Chinese Medicine, Tianjin, China,School of Medical Technology, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Peng Zhao
- Rehabilitation Branch, Tianjin Children's Hospital/Tianjin University Children's Hospital, Tianjin, China,*Correspondence: Peng Zhao
| | - Qian Zhang
- Child Health Care Department, Tianjin Beichen Women and Children Health Center, Tianjin, China,Qian Zhang
| |
Collapse
|
6
|
Yang B, Huang Y, Li Z, Hu X. Management of Post-stroke Depression (PSD) by Electroencephalography for Effective Rehabilitation. ENGINEERED REGENERATION 2022. [DOI: 10.1016/j.engreg.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
|
7
|
Wang Z, Wong CM, Nan W, Tang Q, Rosa AC, Xu P, Wan F. Learning Curve of a Short-Time Neurofeedback Training: Reflection of Brain Network Dynamics Based on Phase-Locking Value. IEEE Trans Cogn Dev Syst 2022. [DOI: 10.1109/tcds.2021.3125948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Ze Wang
- Department of Electrical and Computer Engineering, Faculty of Science and Technology, Centre for Cognitive and Brain Sciences, and the Centre for Artificial Intelligence and Robotics, Institute of Collaborative Innovation, University of Macau, Macau, China
| | - Chi Man Wong
- Department of Electrical and Computer Engineering, Faculty of Science and Technology, Centre for Cognitive and Brain Sciences, and the Centre for Artificial Intelligence and Robotics, Institute of Collaborative Innovation, University of Macau, Macau, China
| | - Wenya Nan
- Department of Psychology, Shanghai Normal University, Shanghai, China
| | - Qi Tang
- Department of Electrical and Computer Engineering, Faculty of Science and Technology, Centre for Cognitive and Brain Sciences, and the Centre for Artificial Intelligence and Robotics, Institute of Collaborative Innovation, University of Macau, Macau, China
| | - Agostinho C. Rosa
- Department of Bioengineering, LaSEEBSystem and Robotics Institute, Instituto Superior Tecnico, University of Lisbon, Lisbon, Portugal
| | - Peng Xu
- Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, and the School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Feng Wan
- Department of Electrical and Computer Engineering, Faculty of Science and Technology, Centre for Cognitive and Brain Sciences, and the Centre for Artificial Intelligence and Robotics, Institute of Collaborative Innovation, University of Macau, Macau, China
| |
Collapse
|
8
|
Poststroke Cognitive Impairment Research Progress on Application of Brain-Computer Interface. BIOMED RESEARCH INTERNATIONAL 2022; 2022:9935192. [PMID: 35252458 PMCID: PMC8896931 DOI: 10.1155/2022/9935192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 12/20/2021] [Accepted: 12/23/2021] [Indexed: 12/19/2022]
Abstract
Brain-computer interfaces (BCIs), a new type of rehabilitation technology, pick up nerve cell signals, identify and classify their activities, and convert them into computer-recognized instructions. This technique has been widely used in the rehabilitation of stroke patients in recent years and appears to promote motor function recovery after stroke. At present, the application of BCI in poststroke cognitive impairment is increasing, which is a common complication that also affects the rehabilitation process. This paper reviews the promise and potential drawbacks of using BCI to treat poststroke cognitive impairment, providing a solid theoretical basis for the application of BCI in this area.
Collapse
|
9
|
Borisova VA, Isakova EV, Kotov SV. [Possibilities of the brain-computer interface in the correction of post-stroke cognitive impairments]. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:60-66. [PMID: 36582163 DOI: 10.17116/jnevro202212212260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In recent years, brain-computer interfaces have been widely used in neurorehabilitation, and an extensive database of results from clinical studies conducted around the world has been accumulated, demonstrating their effectiveness in restoring motor function after a stroke. Currently, their use in post-stroke cognitive impairment is expanding. This article discusses the potential and prospects for using brain-computer interfaces for the treatment of cognitive disorders, reviews the experience of using it, presents the results of clinical studies in stroke patients, evaluates the possibilities of using this technology, describes the prospects, new directions of work on studying its effects.
Collapse
Affiliation(s)
- V A Borisova
- Vladimirskii Moscow Regional Research Clinical Institute, Moscow, Russia
| | - E V Isakova
- Vladimirskii Moscow Regional Research Clinical Institute, Moscow, Russia
| | - S V Kotov
- Vladimirskii Moscow Regional Research Clinical Institute, Moscow, Russia
| |
Collapse
|
10
|
Singh S, Tiwari B, Dawar D, Kaur M, Pandian J, Sahonta R, Kumar CS, Mahadevappa M. Wavelet and Region-Specific EEG Signal Analysis for Studying Post-Stroke Rehabilitation. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:6251-6254. [PMID: 34892542 DOI: 10.1109/embc46164.2021.9630434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Post-stroke monitoring is a crucial step for properly studying the progress of stroke patients. The rehabilitation process consists of exercise regimes that help in constantly engaging the affected part of the brain leading to faster recovery. The work here studies the effectiveness of the rehabilitation regime by investigating several parameters that can play important role in observing the immediate effect of the exercises. Various parameters from different wavelet coefficients were extracted for monitoring rehabilitation for up to 90 days. Energy and waveform length show maximum variation when monitoring pre and post-exercise changes. The parameters were correlated with clinical(FMA) score. Centroid Index gave high correlation value for beta band (r = -0.559). Alpha band on the other hand showed a good correlation with all the extracted fe atures, maximum being -0.6988 with energy. So for monitoring post-stroke rehabilitation alpha and beta bands should be focused. Region-specific analyses were also done to monitor changes in different parts of the brain.
Collapse
|
11
|
Intrahemispheric EEG: A New Perspective for Quantitative EEG Assessment in Poststroke Individuals. Neural Plast 2021; 2021:5664647. [PMID: 34603441 PMCID: PMC8481048 DOI: 10.1155/2021/5664647] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/18/2021] [Accepted: 09/06/2021] [Indexed: 11/17/2022] Open
Abstract
The ratio between slower and faster frequencies of brain activity may change after stroke. However, few studies have used quantitative electroencephalography (qEEG) index of ratios between slower and faster frequencies such as the delta/alpha ratio (DAR) and the power ratio index (PRI; delta + theta/alpha + beta) for investigating the difference between the affected and unaffected hemisphere poststroke. Here, we proposed a new perspective for analyzing DAR and PRI within each hemisphere and investigated the motor impairment-related interhemispheric frequency oscillations. Forty-seven poststroke subjects and twelve healthy controls were included in the study. Severity of upper limb motor impairment was classified according to the Fugl-Meyer assessment in mild/moderate (n = 25) and severe (n = 22). The qEEG indexes (PRI and DAR) were computed for each hemisphere (intrahemispheric index) and for both hemispheres (cerebral index). Considering the cerebral index (DAR and PRI), our results showed a slowing in brain activity in poststroke patients when compared to healthy controls. Only the intrahemispheric PRI index was able to find significant interhemispheric differences of frequency oscillations. Despite being unable to detect interhemispheric differences, the DAR index seems to be more sensitive to detect motor impairment-related frequency oscillations. The intrahemispheric PRI index may provide insights into therapeutic approaches for interhemispheric asymmetry after stroke.
Collapse
|
12
|
Chornyy S, Das A, Borovicka JA, Patel D, Chan HH, Hermann JK, Jaramillo TC, Machado AG, Baker KB, Dana H. Cellular-resolution monitoring of ischemic stroke pathologies in the rat cortex. BIOMEDICAL OPTICS EXPRESS 2021; 12:4901-4919. [PMID: 34513232 PMCID: PMC8407830 DOI: 10.1364/boe.432688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 06/13/2023]
Abstract
Stroke is a leading cause of disability in the Western world. Current post-stroke rehabilitation treatments are only effective in approximately half of the patients. Therefore, there is a pressing clinical need for developing new rehabilitation approaches for enhancing the recovery process, which requires the use of appropriate animal models. Here, we demonstrate the use of nonlinear microscopy of calcium sensors in the rat brain to study the effects of ischemic stroke injury on cortical activity patterns. We longitudinally recorded from thousands of neurons labeled with a genetically-encoded calcium indicator before and after an ischemic stroke injury in the primary motor cortex. We show that this injury has an effect on the activity patterns of neurons not only in the motor and somatosensory cortices, but also in the more distant visual cortex, and that these changes include modified firing rates and kinetics of neuronal activity patterns in response to a sensory stimulus. Changes in neuronal population activity provided animal-specific, circuit-level information on the post-stroke cortical reorganization process, which may be essential for evaluating the efficacy of new approaches for enhancing the recovery process.
Collapse
Affiliation(s)
- Sergiy Chornyy
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - Aniruddha Das
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - Julie A. Borovicka
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - Davina Patel
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - Hugh H. Chan
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - John K. Hermann
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - Thomas C. Jaramillo
- Rodent Behavioral Core, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - Andre G. Machado
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
- Department of Neurosurgery, Neurological Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - Kenneth B. Baker
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - Hod Dana
- Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| |
Collapse
|
13
|
Dewiputri WI, Schweizer R, Auer T. Brain Networks Underlying Strategy Execution and Feedback Processing in an Efficient Functional Magnetic Resonance Imaging Neurofeedback Training Performed in a Parallel or a Serial Paradigm. Front Hum Neurosci 2021; 15:645048. [PMID: 34113243 PMCID: PMC8185020 DOI: 10.3389/fnhum.2021.645048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 04/06/2021] [Indexed: 11/13/2022] Open
Abstract
Neurofeedback (NF) is a complex learning scenario, as the task consists of trying out mental strategies while processing a feedback signal that signifies activation in the brain area to be self-regulated and acts as a potential reward signal. In an attempt to dissect these subcomponents, we obtained whole-brain networks associated with efficient self-regulation in two paradigms: parallel, where the task was performed concurrently, combining feedback with strategy execution; and serial, where the task was performed consecutively, separating feedback processing from strategy execution. Twenty participants attempted to control their anterior midcingulate cortex (aMCC) using functional magnetic resonance imaging (fMRI) NF in 18 sessions over 2 weeks, using cognitive and emotional mental strategies. We analyzed whole-brain fMRI activations in the NF training runs with the largest aMCC activation for the serial and parallel paradigms. The equal length of the strategy execution and the feedback processing periods in the serial paradigm allows a description of the two task subcomponents with equal power. The resulting activation maps were spatially correlated with functionally annotated intrinsic connectivity brain maps (BMs). Brain activation in the parallel condition correlates with the basal ganglia (BG) network, the cingulo-opercular network (CON), and the frontoparietal control network (FPCN); brain activation in the serial strategy execution condition with the default mode network (DMN), the FPCN, and the visual processing network; while brain activation in the serial feedback processing condition predominantly with the CON, the DMN, and the FPCN. Additional comparisons indicate that BG activation is characteristic to the parallel paradigm, while supramarginal gyrus (SMG) and superior temporal gyrus (STG) activations are characteristic to the serial paradigm. The multifaceted view of the subcomponents allows describing the cognitive processes associated with strategy execution and feedback processing independently in the serial feedback task and as combined processes in the multitasking scenario of the conventional parallel feedback task.
Collapse
Affiliation(s)
- Wan Ilma Dewiputri
- International Max Planck Research School for Neurosciences, Georg-August-University, Göttingen, Göttingen, Germany
| | - Renate Schweizer
- Functional Imaging Laboratory, German Primate Center, Göttingen, Germany.,Leibniz Science Campus Primate Cognition, Göttingen, Germany
| | - Tibor Auer
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| |
Collapse
|
14
|
Esteves I, Nan W, Alves C, Calapez A, Melício F, Rosa A. An Exploratory Study of Training Intensity in EEG Neurofeedback. Neural Plast 2021; 2021:8881059. [PMID: 33777137 PMCID: PMC7979284 DOI: 10.1155/2021/8881059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 01/21/2021] [Accepted: 02/21/2021] [Indexed: 11/30/2022] Open
Abstract
Neurofeedback training has shown benefits in clinical treatment and behavioral performance enhancement. Despite the wide range of applications, no consensus has been reached about the optimal training schedule. In this work, an EEG neurofeedback practical experiment was conducted aimed at investigating the effects of training intensity on the enhancement of the amplitude in the individual upper alpha band. We designed INTENSIVE and SPARSE training modalities, which differed regarding three essential aspects of training intensity: the number of sessions, the duration of a session, and the interval between sessions. Nine participants in the INTENSIVE group completed 4 sessions with 37.5 minutes each during consecutive days, while nine participants in the SPARSE group performed 6 sessions of 25 minutes spread over approximately 3 weeks. As a result, regarding the short-term effects, the upper alpha band amplitude change within sessions did not significantly differ between the two groups. Nonetheless, only the INTENSIVE group showed a significant increase in the upper alpha band amplitude. However, for the sustained effects across sessions, none of the groups showed significant changes in the upper alpha band amplitude across the whole course of training. The findings suggest that the progression within session is favored by the intensive design. Therefore, based on these findings, it is proposed that training intensity influences EEG self-regulation within sessions. Further investigations are needed to isolate different aspects of training intensity and effectively confirm if one modality globally outperforms the other.
Collapse
Affiliation(s)
- Inês Esteves
- Evolutionary Systems and Biomedical Engineering Lab, Institute for Systems and Robotics, Instituto Superior Técnico, University of Lisbon, 1049-001 Lisbon, Portugal
| | - Wenya Nan
- Department of Psychology, Shanghai Normal University, Shanghai 200234, China
| | - Cristiana Alves
- Evolutionary Systems and Biomedical Engineering Lab, Institute for Systems and Robotics, Instituto Superior Técnico, University of Lisbon, 1049-001 Lisbon, Portugal
| | - Alexandre Calapez
- Evolutionary Systems and Biomedical Engineering Lab, Institute for Systems and Robotics, Instituto Superior Técnico, University of Lisbon, 1049-001 Lisbon, Portugal
| | - Fernando Melício
- Evolutionary Systems and Biomedical Engineering Lab, Institute for Systems and Robotics, Instituto Superior Técnico, University of Lisbon, 1049-001 Lisbon, Portugal
- Instituto Superior de Engenharia de Lisboa (ISEL), Instituto Politécnico de Lisboa, 1959-007 Lisbon, Portugal
| | - Agostinho Rosa
- Evolutionary Systems and Biomedical Engineering Lab, Institute for Systems and Robotics, Instituto Superior Técnico, University of Lisbon, 1049-001 Lisbon, Portugal
- Department of Bioengineering, Instituto Superior Técnico, University of Lisbon, 1049-001 Lisbon, Portugal
| |
Collapse
|
15
|
Domingos C, Peralta M, Prazeres P, Nan W, Rosa A, Pereira JG. Session Frequency Matters in Neurofeedback Training of Athletes. Appl Psychophysiol Biofeedback 2021; 46:195-204. [PMID: 33528679 DOI: 10.1007/s10484-021-09505-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2021] [Indexed: 01/13/2023]
Abstract
Neurofeedback training has been an increasingly used technique and is taking its first steps in sport. Being at an embryonic stage, it is difficult to find consensus regarding the applied methodology to achieve the best results. This study focused on understanding one of the major methodological issues-the training session frequency. The aim of the investigation was to understand if there are differences between performing two sessions or three sessions per week in enhancement of alpha activity and improvement of cognition; and in case there are differences, infer the best protocol. Forty-five athletes were randomly assigned to the three-session-training-per-week group, the two-session-training-per-week group and a control group. The results showed that neurofeedback training with three sessions per week was more effective in increase of alpha amplitude during neurofeedback training than two sessions per week. Furthermore, only the three-session-per-week group showed significant enhancement in N-back and oddball performance after training. The findings suggested more condensed training protocol lead to better outcomes, providing guidance on neurofeedback protocol design in order to optimize training efficacy.
Collapse
Affiliation(s)
- Christophe Domingos
- Laboratory of Physiology and Biochemistry of Exercise, Faculty of Human Kinetics, University of Lisbon, Cruz Quebrada, Portugal.,Department of Bioengineering, LaSEEB - System and Robotics Institute, Instituto Superior Técnico, University of Lisbon, Lisbon, Portugal
| | - Miguel Peralta
- CIPER, Faculty of Human Kinetics, University of Lisbon, Cruz Quebrada, Portugal.,ISAMB, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Pedro Prazeres
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, Scotland, UK
| | - Wenya Nan
- Department of Psychology, College of Education, Shanghai Normal University, Shanghai, China.
| | - Agostinho Rosa
- Department of Bioengineering, LaSEEB - System and Robotics Institute, Instituto Superior Técnico, University of Lisbon, Lisbon, Portugal
| | - José G Pereira
- Laboratory of Physiology and Biochemistry of Exercise, Faculty of Human Kinetics, University of Lisbon, Cruz Quebrada, Portugal
| |
Collapse
|
16
|
Kober SE, Neuper C, Wood G. Differential Effects of Up- and Down-Regulation of SMR Coherence on EEG Activity and Memory Performance: A Neurofeedback Training Study. Front Hum Neurosci 2020; 14:606684. [PMID: 33424569 PMCID: PMC7793696 DOI: 10.3389/fnhum.2020.606684] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 11/27/2020] [Indexed: 11/15/2022] Open
Abstract
Modulating connectivity measures in EEG-based neurofeedback studies is assumed to be a promising therapeutic and training tool. However, little is known so far about its effects and trainability. In the present study, we investigated the effects of up- and down-regulating SMR (12-15 Hz) coherence by means of neurofeedback training on EEG activity and memory functions. Twenty adults performed 10 neurofeedback training sessions in which half of them tried to increase EEG coherence between Cz and CPz in the SMR frequency range, while the other half tried to down-regulate coherence. Up-regulation of SMR coherence led to between- and within-session changes in EEG coherence. SMR power increased across neurofeedback training sessions but not within training sessions. Cross-over training effects on baseline EEG measures were also observed in this group. Up-regulation of SMR coherence was also associated with improvements in memory functions when comparing pre- and post-test results. Participants were not able to down-regulate SMR coherence. This group did not show any changes in baseline EEG measures or memory functions comparing pre- and post-test. Our results provide insights in the trainability and effects of connectivity-based neurofeedback training and indications for its practical application.
Collapse
Affiliation(s)
- Silvia Erika Kober
- Institute of Psychology, University of Graz, Graz, Austria
- BioTechMed-Graz, Graz, Austria
| | - Christa Neuper
- Institute of Psychology, University of Graz, Graz, Austria
- BioTechMed-Graz, Graz, Austria
| | - Guilherme Wood
- Institute of Psychology, University of Graz, Graz, Austria
- BioTechMed-Graz, Graz, Austria
| |
Collapse
|
17
|
Lin NH, Liu CH, Lee P, Guo LY, Sung JL, Yen CW, Liaw LJ. Backward Walking Induces Significantly Larger Upper-Mu-Rhythm Suppression Effects Than Forward Walking Does. SENSORS 2020; 20:s20247250. [PMID: 33348821 PMCID: PMC7767098 DOI: 10.3390/s20247250] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/06/2020] [Accepted: 12/15/2020] [Indexed: 11/24/2022]
Abstract
Studies have compared the differences and similarities between backward walking and forward walking, and demonstrated the potential of backward walking for gait rehabilitation. However, current evidence supporting the benefits of backward walking over forward walking remains inconclusive. Considering the proven association between gait and the cerebral cortex, we used electroencephalograms (EEG) to differentiate the effects of backward walking and forward walking on cortical activities, by comparing the sensorimotor rhythm (8–12 Hz, also called mu rhythm) of EEG signals. A systematic signal procedure was used to eliminate the motion artifacts induced by walking to safeguard EEG signal fidelity. Statistical test results of our experimental data demonstrated that walking motions significantly suppressed mu rhythm. Moreover, backward walking exhibited significantly larger upper mu rhythm (10–12 Hz) suppression effects than forward walking did. This finding implies that backward walking induces more sensorimotor cortex activity than forward walking does, and provides a basis to support the potential benefits of backward walking over forward walking. By monitoring the upper mu rhythm throughout the rehabilitation process, medical experts can adaptively adjust the intensity and duration of each walking training session to improve the efficacy of a walking ability recovery program.
Collapse
Affiliation(s)
- Nan-Hung Lin
- Department of Mechanical and Electro-Mechanical Engineering, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan; (N.-H.L.); (J.-L.S.)
| | - Chin-Hsuan Liu
- Department of Occupational Therapy, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung 82445, Taiwan;
- Department of Occupational Therapy, I-Shou University, Kaohsiung 82445, Taiwan;
| | - Posen Lee
- Department of Occupational Therapy, I-Shou University, Kaohsiung 82445, Taiwan;
| | - Lan-Yuen Guo
- Department of Sports Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
| | - Jia-Li Sung
- Department of Mechanical and Electro-Mechanical Engineering, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan; (N.-H.L.); (J.-L.S.)
| | - Chen-Wen Yen
- Department of Mechanical and Electro-Mechanical Engineering, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan; (N.-H.L.); (J.-L.S.)
- Department of Physical Therapy, College of Health Science, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Correspondence: (C.-W.Y.); (L.-J.L.); Tel.: +886-7-52-54-232 (C.-W.Y.); +886-7-31-21-101 (ext. 2663) (L.-J.L.)
| | - Lih-Jiun Liaw
- Department of Physical Therapy, College of Health Science, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Physical Medicine and Rehabilitation, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Correspondence: (C.-W.Y.); (L.-J.L.); Tel.: +886-7-52-54-232 (C.-W.Y.); +886-7-31-21-101 (ext. 2663) (L.-J.L.)
| |
Collapse
|
18
|
|
19
|
Nagappan PG, Chen H, Wang DY. Neuroregeneration and plasticity: a review of the physiological mechanisms for achieving functional recovery postinjury. Mil Med Res 2020; 7:30. [PMID: 32527334 PMCID: PMC7288425 DOI: 10.1186/s40779-020-00259-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 05/24/2020] [Indexed: 12/12/2022] Open
Abstract
Neuronal networks, especially those in the central nervous system (CNS), evolved to support extensive functional capabilities while ensuring stability. Several physiological "brakes" that maintain the stability of the neuronal networks in a healthy state quickly become a hinderance postinjury. These "brakes" include inhibition from the extracellular environment, intrinsic factors of neurons and the control of neuronal plasticity. There are distinct differences between the neuronal networks in the peripheral nervous system (PNS) and the CNS. Underpinning these differences is the trade-off between reduced functional capabilities with increased adaptability through the formation of new connections and new neurons. The PNS has "facilitators" that stimulate neuroregeneration and plasticity, while the CNS has "brakes" that limit them. By studying how these "facilitators" and "brakes" work and identifying the key processes and molecules involved, we can attempt to apply these theories to the neuronal networks of the CNS to increase its adaptability. The difference in adaptability between the CNS and PNS leads to a difference in neuroregenerative properties and plasticity. Plasticity ensures quick functional recovery of abilities in the short and medium term. Neuroregeneration involves synthesizing new neurons and connections, providing extra resources in the long term to replace those damaged by the injury, and achieving a lasting functional recovery. Therefore, by understanding the factors that affect neuroregeneration and plasticity, we can combine their advantages and develop rehabilitation techniques. Rehabilitation training methods, coordinated with pharmacological interventions and/or electrical stimulation, contributes to a precise, holistic treatment plan that achieves functional recovery from nervous system injuries. Furthermore, these techniques are not limited to limb movement, as other functions lost as a result of brain injury, such as speech, can also be recovered with an appropriate training program.
Collapse
Affiliation(s)
| | - Hong Chen
- Shengli Clinical College of Fujian Medical University; Department of Neurology, Fujian Provincial Hospital, Fuzhou, Fujian, 350001, China.
| | - De-Yun Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
| |
Collapse
|
20
|
Li J, Ying Y, Su F, Chen L, Yang J, Jia J, Jia X, Xu W. The Hua-Shan rehabilitation program after contralateral seventh cervical nerve transfer for spastic arm paralysis. Disabil Rehabil 2020; 44:404-411. [PMID: 32478582 DOI: 10.1080/09638288.2020.1768597] [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: 01/23/2023]
Abstract
Purpose: To propose the novel Hua-Shan rehabilitation program for patients undergoing the contralateral seventh cervical nerve transfer, and explore the influence of different rehabilitation on the postoperative recovery.Materials and methods: The Hua-Shan program was established in consideration of the three elements: the nerve regeneration, brain plasticity and group therapy. Its effect was evaluated by comparing the postoperative recovery of the hemorrhagic stroke survivors among the following three groups: Group A-standard Hua-Shan program after surgery; Group B-standard traditional program after surgery; Group C-no standard rehabilitation after surgery.Results: Significantly better functions after surgery were detected in all the groups, while the absence of standard rehabilitation massively offset the benefits of the surgery. Furthermore, the Hua-Shan program showed advantage over the traditional rehabilitation, which may largely be attributed to its improvements for the fine action of wrist&finger.Conclusions: The Hua-Shan program provided the opportunity to maximize the benefits of contralateral seventh cervical nerve transfer.IMPLICATIONS FOR REHABILITATIONStandard rehabilitation plays key roles in the recovery process for patients undergoing contralateral seventh cervical nerve transfer.The Hua-Shan program targeting nerve regeneration, brain plasticity and group therapy further improved the benefits of patients undergoing contralateral seventh cervical nerve transfer.
Collapse
Affiliation(s)
- Jie Li
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China.,Department of Hand and Upper Extremity Surgery, Jing'an District Central Hospital, Fudan University, Shanghai, China
| | - Ying Ying
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China.,Department of Hand and Upper Extremity Surgery, Jing'an District Central Hospital, Fudan University, Shanghai, China
| | - Fan Su
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Liwen Chen
- Department of Hand and Upper Extremity Surgery, Jing'an District Central Hospital, Fudan University, Shanghai, China
| | - Jingrui Yang
- Department of Hand and Upper Extremity Surgery, Jing'an District Central Hospital, Fudan University, Shanghai, China
| | - Jie Jia
- Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiaofeng Jia
- Department of Neurosurgery, Orthopaedics, Anatomy Neurobiology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Wendong Xu
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China
| |
Collapse
|
21
|
Bucho T, Caetano G, Vourvopoulos A, Accoto F, Esteves I, I Badia SB, Rosa A, Figueiredo P. Comparison of Visual and Auditory Modalities for Upper-Alpha EEG-Neurofeedback .. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:5960-5966. [PMID: 31947205 DOI: 10.1109/embc.2019.8856671] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Electroencephalography (EEG) neurofeedback (NF) training has been shown to produce long-lasting effects on the improvement of cognitive function as well as the normalization of aberrant brain activity in disease. However, the impact of the sensory modality used as the NF reinforcement signal on training effectiveness has not been systematically investigated. In this work, an EEG-based NF-training system was developed targeting the individual upper-alpha (UA) band and using either a visual or an auditory reinforcement signal, so as to compare the effects of the two sensory modalities. Sixteen healthy volunteers were randomly assigned to the Visual or Auditory group, where a radius-varying sphere or a volume-varying sound, respectively, reflected the relative amplitude of UA measured at EEG electrode Cz. Each participant underwent a total of four NF sessions, of approximately 40 min each, on consecutive days. Both groups showed significant increases in UA at Cz within sessions, and also across sessions. Effects subsequent to NF training were also found beyond the target frequency UA and scalp location Cz, namely in the lower-alpha and theta bands and in posterior brain regions, respectively. Only small differences were found on the EEG between the Visual and Auditory groups, suggesting that auditory reinforcement signals may be as effective as the more commonly used visual signals. The use of auditory NF may potentiate training protocols conducted under mobile conditions, which are now possible due to the increasing availability of wireless EEG systems.
Collapse
|
22
|
Pichiorri F, Mattia D. Brain-computer interfaces in neurologic rehabilitation practice. HANDBOOK OF CLINICAL NEUROLOGY 2020; 168:101-116. [PMID: 32164846 DOI: 10.1016/b978-0-444-63934-9.00009-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The brain-computer interfaces (BCIs) for neurologic rehabilitation are based on the assumption that by retraining the brain to specific activities, an ultimate improvement of function can be expected. In this chapter, we review the present status, key determinants, and future directions of the clinical use of BCI in neurorehabilitation. The recent advancements in noninvasive BCIs as a therapeutic tool to promote functional motor recovery by inducing neuroplasticity are described, focusing on stroke as it represents the major cause of long-term motor disability. The relevance of recent findings on BCI use in spinal cord injury beyond the control of neuroprosthetic devices to restore motor function is briefly discussed. In a dedicated section, we examine the potential role of BCI technology in the domain of cognitive function recovery by instantiating BCIs in the long history of neurofeedback and some emerging BCI paradigms to address cognitive rehabilitation are highlighted. Despite the knowledge acquired over the last decade and the growing number of studies providing evidence for clinical efficacy of BCI in motor rehabilitation, an exhaustive deployment of this technology in clinical practice is still on its way. The pipeline to translate BCI to clinical practice in neurorehabilitation is the subject of this chapter.
Collapse
Affiliation(s)
- Floriana Pichiorri
- Neuroelectrical Imaging and Brain Computer Interface Laboratory, Fondazione Santa Lucia IRCCS, Rome, Italy
| | - Donatella Mattia
- Neuroelectrical Imaging and Brain Computer Interface Laboratory, Fondazione Santa Lucia IRCCS, Rome, Italy.
| |
Collapse
|
23
|
Białkowska J, Mroczkowska D, Wickland-Białkowska M. The use of EEG biofeedback to improve memory, concentration, attention and reduce emotional tension. REHABILITACJA MEDYCZNA 2019. [DOI: 10.5604/01.3001.0013.5097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Biofeedback is a method of giving patients computerised feedback signals about changes in the physiological state of their body. This allows them to learn how to consciously modify functions not controlled consciously. This method allows active and conscious involvement of the patient in controlling their own physiological processes. The therapy aims to regulate the frequency of human brain waves. The human brain produces different ranges of waves that are characteristic of different types of human activity, a mechanism used in this method. The use of this method in routine rehabilitation with a specifically designed computer programme provides physicians, physiotherapists, neuropsychologists and speech therapists with a new tool for treatment, opportunities for improvement in treatment, and helps them better plan and develop treatment strategies using Evidence-Based Medicine. The aim of the work is to discuss how EEG Biofeedback software can be applied in neurorehabilitation and to discuss the use of EEG Biofeedback software in order to improve memory, concentration, attention, reduce emotional tension, increase resistance to stress, improve self-control, self-esteem and relaxation.
Key words
EEG biofeedback, neurorehabilitation, computer software in rehabilitation
Article received: 14.01.2019; Accepted: 17.09.2019
Collapse
Affiliation(s)
- Joanna Białkowska
- Department of Public Health, Faculty of Health Sciences, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Clinical University Hospital in Olsztyn, Poland / Wydział Nauk o Zdrowiu, Collegium Medicum. Uniwersytet Warmińsko-Mazurski w Olsztynie
| | - Dorota Mroczkowska
- Department of Public Health, Faculty of Health Sciences, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Clinical University Hospital in Olsztyn, Poland / Wydział Nauk o Zdrowiu, Collegium Medicum. Uniwersytet Warmińsko-Mazurski w Olsztynie
| | - Martyna Wickland-Białkowska
- Voivodeship Specialist Children’s Hospital in Olsztyn, Poland / Wojewódzki Specjalistyczny Szpital Dziecięcy w Olsztynie
| |
Collapse
|
24
|
Kober SE, Pinter D, Enzinger C, Damulina A, Duckstein H, Fuchs S, Neuper C, Wood G. Self-regulation of brain activity and its effect on cognitive function in patients with multiple sclerosis - First insights from an interventional study using neurofeedback. Clin Neurophysiol 2019; 130:2124-2131. [PMID: 31546180 DOI: 10.1016/j.clinph.2019.08.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 07/26/2019] [Accepted: 08/19/2019] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To investigate the effects of EEG-based neurofeedback training, in which one can learn to self-regulate one's own brain activity, on cognitive function in patients with multiple sclerosis (pwMS). METHODS Fourteen pwMS performed ten neurofeedback training sessions within 3-4 weeks at home using a tele-rehabilitation system. The aim of the neurofeedback training was to increase voluntarily the sensorimotor rhythm (SMR, 12-15 Hz) in the EEG over central brain areas by receiving visual real-time feedback thereof. Cognitive function was assessed before and after all neurofeedback training sessions using a comprehensive standardized neuropsychological test battery. RESULTS Half of the pwMS (N = 7) showed cognitive improvements in long-term memory and executive functions after neurofeedback training. These patients successfully learned to self-regulate their own brain activity by means of neurofeedback training. The other half of pwMS (N = 7) did neither show any cognitive changes when comparing the pre- and post-assessment nor were they able to modulate their own brain activity in the desired direction during neurofeedback training. CONCLUSIONS Data from this interventional study provide first preliminary evidence that successful self-regulation of one's own brain activity may be associated with cognitive improvements in pwMS. SIGNIFICANCE These promising results should stimulate further studies. Neurofeedback might be a promising and alternative tool for future cognitive rehabilitation.
Collapse
Affiliation(s)
- Silvia Erika Kober
- University of Graz, Institute of Psychology, Graz, Austria; BioTechMed-Graz, Graz, Austria.
| | - Daniela Pinter
- Medical University of Graz, Department of Neurology, Graz, Austria.
| | - Christian Enzinger
- Medical University of Graz, Department of Neurology, Graz, Austria; Medical University of Graz, Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Graz, Austria.
| | - Anna Damulina
- Medical University of Graz, Department of Neurology, Graz, Austria.
| | | | - Siegrid Fuchs
- Medical University of Graz, Department of Neurology, Graz, Austria.
| | - Christa Neuper
- University of Graz, Institute of Psychology, Graz, Austria; BioTechMed-Graz, Graz, Austria; Graz University of Technology, Laboratory of Brain-Computer Interfaces, Institute of Neural Engineering, Graz, Austria.
| | - Guilherme Wood
- University of Graz, Institute of Psychology, Graz, Austria; BioTechMed-Graz, Graz, Austria.
| |
Collapse
|
25
|
Nan W, Dias APB, Rosa AC. Neurofeedback Training for Cognitive and Motor Function Rehabilitation in Chronic Stroke: Two Case Reports. Front Neurol 2019; 10:800. [PMID: 31396152 PMCID: PMC6668042 DOI: 10.3389/fneur.2019.00800] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 07/11/2019] [Indexed: 11/13/2022] Open
Abstract
Stroke is a debilitating neurological condition which usually results in the abnormal electrical brain activity and the impairment of sensation, motor, or cognition functions. In this context, neurofeedback training, i.e., a non-invasive and relatively low cost technique that contributes to neuroplasticity and behavioral performance, might be promising for stroke rehabilitation. We intended to explore neurofeedback training on a 63-year-old male patient and a 77-year-old female patient with chronic stroke. Both of them had suffered from an ischemic stroke for rather long period (more than 3 years) and could not gain further improvement by traditional therapy. The neurofeedback training was designed to enhance alpha activity by 15 sessions distributed over 2 months, for the purpose of overall cognitive improvement and hopefully also motor function improvement for the female patient. We found that the two patients showed alpha enhancement during NFT compared to eyes open baseline within most sessions. Furthermore, both patients reduced their anxiety and depression level. The male patient showed an evolution in speech pattern in terms of naming, sentences completion and verbal fluency, while the female patient improved functionality of the march. These results suggested that alpha neurofeedback training could provide a spectrum of improvements, providing new hope for chronic stroke patients who could not gain further improvements through traditional therapies.
Collapse
Affiliation(s)
- Wenya Nan
- Department of Psychology, Shanghai Normal University, Shanghai, China
| | - Ana Paula Barbosa Dias
- Department of Bioengineering, LaSEEB-System and Robotics Institute, Instituto Superior Tecnico, Universidade de Lisboa, Lisbon, Portugal
| | - Agostinho C Rosa
- Department of Bioengineering, LaSEEB-System and Robotics Institute, Instituto Superior Tecnico, Universidade de Lisboa, Lisbon, Portugal
| |
Collapse
|
26
|
De A, Mondal S. Immediate effect of yogic postures on autonomic neural responses. Res Cardiovasc Med 2019. [DOI: 10.4103/rcm.rcm_26_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
27
|
Lim H, Ku J. A Brain-Computer Interface-Based Action Observation Game That Enhances Mu Suppression. IEEE Trans Neural Syst Rehabil Eng 2018; 26:2290-2296. [PMID: 30371380 DOI: 10.1109/tnsre.2018.2878249] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Action observation training based on the theory of activation of the mirror-neuron system has been used for the rehabilitation of patients with stroke. In this paper, we sought to assess whether a brain-computer interface (BCI)-based action observation rehabilitation game, using a flickering action video, could preferentially activate the mirror-neuron system. Feedback of stimulus observation, evoked by the flickering action video, was provided using steady state visually evoked potential and event-related desynchronization. Fifteen healthy subjects have experienced the game with BCI interaction (game and interaction), without BCI interaction (game without interaction), observed non-flickering stimuli, and flickering stimuli without the game background (stimuli only) in a counter-balanced order. The game and interface condition was resulted in significantly stronger activation of the mirror-neuron system than did the other three conditions. In addition, the amount of mirror-neuron system activation is gradually decreased in the game without interface, non-flickering stimuli, and stimuli only conditions in a time-dependent manner; however, in the game and interface condition, the amount of mirror-neuron system activation was maintained until the end of the training. Taken together, these data suggest that the proposed game paradigm, which integrates the action observation paradigm with BCI technology, could provide interactive responses for whether watching video clips can engage patients and enhance rehabilitation.
Collapse
|
28
|
Goh HT, Tan MP, Mazlan M, Abdul-Latif L, Subramaniam P. Social Participation Determines Quality of Life Among Urban-Dwelling Older Adults With Stroke in a Developing Country. J Geriatr Phys Ther 2018; 42:E77-E84. [PMID: 29851747 DOI: 10.1519/jpt.0000000000000196] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND PURPOSE Poor quality of life (QoL) is a well-recognized consequence after stroke. Quality of life is influenced by a complex interaction between personal and environmental factors. Most previous investigations of the QoL after stroke have focused on personal factors, for example, physical deficits directly resulting from stroke. The influence of environmental factors, including social participation, is relatively understudied partly due to its high variation across different sociocultural contexts. The purpose of this study was to investigate the determinants of QoL among older adults with stroke living in an urban area of a developing country. METHODS This cross-sectional observational study included 75 older adults who were at least 3 months poststroke and 50 age-matched healthy controls. Depressive symptoms were quantified using the World Health Organization Quality of Life Brief version (WHOQoL-BREF). Physical function was examined using Functional Ambulation Category, grip strength, 5 times Sit-to-Stand test, and Box and Block tests. The Montreal Cognitive Assessment and visual-manual reaction time were used to index cognitive function. Depressive symptom was quantified using the Patient Health Questionnaire-9. The Barthel Index and Fatigue Severity Scale were used to quantify activity limitation. Social participation and environmental participation were assessed using the Assessment of Life Habit and Craig Hospital Inventory of Environment Factors, respectively. Linear stepwise regression models were used to determine explanators for WHOQoL-BREF domain scores. RESULTS Individuals with stroke demonstrated significantly worse QoL on all WHOQoL-BREF domains compared with healthy controls. Stroke was a strong determinant for QoL and explained 16% to 43% of variances. Adding other outcome measures significantly improved the robustness of the models (R change = 12%-32%). The physical, psychological, social, and environmental domains of WHOQoL-BREF were all explained by the LIFE-H scores (β = -10.58, -3.37, 4.24, -5.35, respectively), while psychological, social, and environmental domains were explained by Montreal Cognitive Assessment scores (β = .47, 0.78, 0.54, respectively). CONCLUSION Social participation and cognition were strong determinants of QoL among urban-dwelling older adults with stroke. Social and recreational activities and cognitive rehabilitation should therefore be evaluated as potential strategies to improve the well-being of older adults affected by stroke.
Collapse
Affiliation(s)
- Hui-Ting Goh
- School of Physical Therapy, Texas Woman's University, Dallas.,Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaya
| | - Maw-Pin Tan
- Ageing and Age-Associated Research Group, University of Malaya, Kuala Lumpur, Malaya.,Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaya
| | - Mazlina Mazlan
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaya
| | - Lydia Abdul-Latif
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaya
| | - Pathmawati Subramaniam
- Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaya
| |
Collapse
|
29
|
Güntensperger D, Thüring C, Meyer M, Neff P, Kleinjung T. Neurofeedback for Tinnitus Treatment - Review and Current Concepts. Front Aging Neurosci 2017; 9:386. [PMID: 29249959 PMCID: PMC5717031 DOI: 10.3389/fnagi.2017.00386] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 11/09/2017] [Indexed: 12/18/2022] Open
Abstract
An effective treatment to completely alleviate chronic tinnitus symptoms has not yet been discovered. However, recent developments suggest that neurofeedback (NFB), a method already popular in the treatment of other psychological and neurological disorders, may provide a suitable alternative. NFB is a non-invasive method generally based on electrophysiological recordings and visualizing of certain aspects of brain activity as positive or negative feedback that enables patients to voluntarily control their brain activity and thus triggers them to unlearn typical neural activity patterns related to tinnitus. The purpose of this review is to summarize and discuss previous findings of neurofeedback treatment studies in the field of chronic tinnitus. In doing so, also an overview about the underlying theories of tinnitus emergence is presented and results of resting-state EEG and MEG studies summarized and critically discussed. To date, neurofeedback as well as electrophysiological tinnitus studies lack general guidelines that are crucial to produce more comparable and consistent results. Even though neurofeedback has already shown promising results for chronic tinnitus treatment, further research is needed in order to develop more sophisticated protocols that are able to tackle the individual needs of tinnitus patients more specifically.
Collapse
Affiliation(s)
- Dominik Güntensperger
- Neuroplasticity and Learning in the Healthy Aging Brain (HAB LAB), Department of Psychology, University of Zurich, Zurich, Switzerland.,University Research Priority Program 'Dynamics of Healthy Aging', University of Zurich, Zurich, Switzerland
| | - Christian Thüring
- Department of Otorhinolaryngology, University Hospital of Zurich, Zurich, Switzerland
| | - Martin Meyer
- Neuroplasticity and Learning in the Healthy Aging Brain (HAB LAB), Department of Psychology, University of Zurich, Zurich, Switzerland.,University Research Priority Program 'Dynamics of Healthy Aging', University of Zurich, Zurich, Switzerland
| | - Patrick Neff
- Neuroplasticity and Learning in the Healthy Aging Brain (HAB LAB), Department of Psychology, University of Zurich, Zurich, Switzerland.,University Research Priority Program 'Dynamics of Healthy Aging', University of Zurich, Zurich, Switzerland
| | - Tobias Kleinjung
- Department of Otorhinolaryngology, University Hospital of Zurich, Zurich, Switzerland
| |
Collapse
|
30
|
Aminov A, Rogers JM, Johnstone SJ, Middleton S, Wilson PH. Acute single channel EEG predictors of cognitive function after stroke. PLoS One 2017; 12:e0185841. [PMID: 28968458 PMCID: PMC5624638 DOI: 10.1371/journal.pone.0185841] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 09/20/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Early and accurate identification of factors that predict post-stroke cognitive outcome is important to set realistic targets for rehabilitation and to guide patients and their families accordingly. However, behavioral measures of cognition are difficult to obtain in the acute phase of recovery due to clinical factors (e.g. fatigue) and functional barriers (e.g. language deficits). The aim of the current study was to test whether single channel wireless EEG data obtained acutely following stroke could predict longer-term cognitive function. METHODS Resting state Relative Power (RP) of delta, theta, alpha, beta, delta/alpha ratio (DAR), and delta/theta ratio (DTR) were obtained from a single electrode over FP1 in 24 participants within 72 hours of a first-ever stroke. The Montreal Cognitive Assessment (MoCA) was administered at 90-days post-stroke. Correlation and regression analyses were completed to identify relationships between 90-day cognitive function and electrophysiological data, neurological status, and demographic characteristics at admission. RESULTS Four acute qEEG indices demonstrated moderate to high correlations with 90-day MoCA scores: DTR (r = -0.57, p = 0.01), RP theta (r = 0.50, p = 0.01), RP delta (r = -0.47, p = 0.02), and DAR (r = -0.45, p = 0.03). Acute DTR (b = -0.36, p < 0.05) and stroke severity on admission (b = -0.63, p < 0.01) were the best linear combination of predictors of MoCA scores 90-days post-stroke, accounting for 75% of variance. CONCLUSIONS Data generated by a single pre-frontal electrode support the prognostic value of acute DAR, and identify DTR as a potential marker of post-stroke cognitive outcome. Use of single channel recording in an acute clinical setting may provide an efficient and valid predictor of cognitive function after stroke.
Collapse
Affiliation(s)
- Anna Aminov
- School of Psychology, Australian Catholic University, Sydney, NSW, Australia
| | | | | | - Sandy Middleton
- Nursing Research Institute, St Vincent’s Health Australia and Australian Catholic University, Sydney, NSW Australia
| | - Peter H. Wilson
- School of Psychology, Australian Catholic University, Melbourne, VIC, Australia
- Centre for Disability and Development Research, Australian Catholic University, Melbourne, VIC, Australia
| |
Collapse
|
31
|
Kober SE, Witte M, Neuper C, Wood G. Specific or nonspecific? Evaluation of band, baseline, and cognitive specificity of sensorimotor rhythm- and gamma-based neurofeedback. Int J Psychophysiol 2017; 120:1-13. [PMID: 28652143 DOI: 10.1016/j.ijpsycho.2017.06.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 06/09/2017] [Accepted: 06/23/2017] [Indexed: 11/30/2022]
Abstract
Neurofeedback (NF) is often criticized because of the lack of empirical evidence of its specificity. Our present study thus focused on the specificity of NF on three levels: band specificity, cognitive specificity, and baseline specificity. Ten healthy middle-aged individuals performed ten sessions of SMR (sensorimotor rhythm, 12-15Hz) NF training. A second group (N=10) received feedback of a narrow gamma band (40-43Hz). Effects of NF on EEG resting measurements (tonic EEG) and cognitive functions (memory, intelligence) were evaluated using a pre-post design. Both training groups were able to linearly increase the target training frequencies (either SMR or gamma), indicating the trainability of these EEG frequencies. Both NF training protocols led to nonspecific changes in other frequency bands during NF training. While SMR NF only led to concomitant changes in slower frequencies, gamma training affected nearly the whole power spectrum. SMR NF specifically improved memory functions. Gamma training showed only marginal effects on cognitive functions. SMR power assessed during resting measurements significantly increased after SMR NF training compared to a pre-assessment, indicating specific effects of SMR NF on baseline/tonic EEG. The gamma group did not show any pre-post changes in their EEG resting activity. In conclusion, SMR NF specifically affects cognitive functions (cognitive specificity) and tonic EEG (baseline specificity), while increasing SMR during NF training nonspecifically affects slower EEG frequencies as well (band non-specificity). Gamma NF was associated with nonspecific effects on the EEG power spectrum during training, which did not lead to considerable changes in cognitive functions or baseline EEG activity.
Collapse
Affiliation(s)
- Silvia Erika Kober
- Department of Psychology, University of Graz, Austria; BioTechMed-Graz, Austria.
| | | | - Christa Neuper
- Department of Psychology, University of Graz, Austria; BioTechMed-Graz, Austria; Laboratory of Brain-Computer Interfaces, Institute of Neural Engineering, Graz University of Technology, Austria.
| | - Guilherme Wood
- Department of Psychology, University of Graz, Austria; BioTechMed-Graz, Austria.
| |
Collapse
|