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Mergl R, Karch S, Henl J, Meindl D, Schöpf F, Szabo SI, Hallweger P, Heiler P, Maywald M, Tschentscher N, Allgaier AK, Pogarell O. Effects of Four Different EEG-Neurofeedback Reinforcement Types in Healthy Individuals - A Pilot Study. Clin EEG Neurosci 2024; 55:305-316. [PMID: 36373604 DOI: 10.1177/15500594221138278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
EEG neurofeedback (EEG-NFB) is a promising tool for the treatment of depressive disorders. However, many methods for the presentation of neurobiological reactions are available and it is widely unknown which of these feedback options are preferrable. Moreover, the influence of motivation on NFB training success is insufficiently studied. This study analyzed the efficacy of a novel EEG protocol (FC3/Pz) based on findings for NFB in depression. The role of four feedback options (Rumination, Anxiety, Meditation Master, Moving Art) from the NFB software "Brain Assistant" and motivation in EEG-based NFB performance was studied. Regarding "Anxiety" and "Rumination" visual feedback was used to evoke emotions; reinforcement (both negative and positive operant conditioning) was continuous. Regarding "Meditation Master" visual feedback was combined with continuous positive reinforcement. Regarding "Moving Art" 20-min calm nature films with neutral character were used; both visual and auditive feedback were applied. The reinforcement was positive and continuous. 13 healthy participants completed 15 EEG sessions over four months combining simultaneous frontal (aims: reduction of theta-, alpha- and high beta-activity, increase of low and mid beta-activity) and parietal training (aims: reduction of theta-, alpha 1-, mid and high beta-activity, increase of alpha 2- and low beta-activity). We observed significantly more pronounced percentage change in the expected direction for Anxiety than Moving Art (mean difference = 3.32; p = 0.003). The association between motivation and performance was non-significant. Based on these results we conclude that feedback with both negative and positive operant conditioning and emotion evoking effects should be preferred.
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Affiliation(s)
- Roland Mergl
- Institute of Psychology, Universität der Bundeswehr München, Neubiberg, Germany
| | - Susanne Karch
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Jennifer Henl
- Institute of Psychology, Universität der Bundeswehr München, Neubiberg, Germany
| | - Dorothea Meindl
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Felix Schöpf
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Szilard I Szabo
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Paulina Hallweger
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Philipp Heiler
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Medical Practice for Neurofeedback Philipp Heiler, Munich, Germany
| | - Maximilian Maywald
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Nadja Tschentscher
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | | | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
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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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Glazebrook AJ, Shakespeare-Finch J, Andrew B, van der Meer J. Posttraumatic growth EEG neuromarkers: translational neural comparisons with resilience and PTSD in trauma-exposed healthy adults. Eur J Psychotraumatol 2023; 14:2272477. [PMID: 37965734 PMCID: PMC10653763 DOI: 10.1080/20008066.2023.2272477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 07/26/2023] [Indexed: 11/16/2023] Open
Abstract
Background: Supporting wellbeing beyond symptom reduction is necessary in trauma care. Research suggests increased posttraumatic growth (PTG) may promote wellbeing more effectively than posttraumatic stress disorder (PTSD) symptom reduction alone. Understanding neurobiological mechanisms of PTG would support PTG intervention development. However, most PTG research to-date has been cross-sectional data self-reported through surveys or interviews.Objective: Neural evidence of PTG and its coexistence with resilience and PTSD is limited. To advance neural PTG literature and contribute translational neuroscientific knowledge necessary to develop future objectively measurable neural-based PTG interventions.Method: Alpha frequency EEG and validated psychological inventories measuring PTG, resilience, and PTSD symptoms were collected from 30 trauma-exposed healthy adults amidst the COVID-19 pandemic. EEG data were collected using custom MNE-Python software, and a wireless OpenBCI 16-channel dry electrode EEG headset. Psychological inventory scores were analysed in SPSS Statistics and used to categorise the EEG data. Power spectral density analyses, t-tests and ANOVAs were conducted within EEGLab to identify brain activity differentiating high and low PTG, resilience, and PTSD symptoms.Results: Higher PTG was significantly differentiated from low PTG by higher alpha power in the left centro-temporal brain area around EEG electrode C3. A trend differentiating high PTG from PTSD was also indicated in this same location. Whole-scalp spectral topographies revealed alpha power EEG correlates of PTG, resilience and PTSD symptoms shared limited, but potentially meaningful similarities.Conclusion: This research provides the first comparative neural topographies of PTG, resilience and PTSD symptoms in the known literature. Results provide objective neural evidence supporting existing theory depicting PTG, resilience and PTSD as independent, yet co-occurring constructs. PTG neuromarker alpha C3 significantly delineated high from low PTG and warrants further investigation for potential clinical application. Findings provide foundation for future neural-based interventions and research for enhancing PTG in trauma-exposed individuals.
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Affiliation(s)
- AJ Glazebrook
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Australia
| | - Jane Shakespeare-Finch
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Australia
| | - Brooke Andrew
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Australia
| | - Johan van der Meer
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centre, Amsterdam, the Netherlands
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Piarulli A, Vanneste S, Nemirovsky IE, Kandeepan S, Maudoux A, Gemignani A, De Ridder D, Soddu A. Tinnitus and distress: an electroencephalography classification study. Brain Commun 2023; 5:fcad018. [PMID: 36819938 PMCID: PMC9927883 DOI: 10.1093/braincomms/fcad018] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 11/08/2022] [Accepted: 01/27/2023] [Indexed: 02/04/2023] Open
Abstract
There exist no objective markers for tinnitus or tinnitus disorders, which complicates diagnosis and treatments. The combination of EEG with sophisticated classification procedures may reveal biomarkers that can identify tinnitus and accurately differentiate different levels of distress experienced by patients. EEG recordings were obtained from 129 tinnitus patients and 142 healthy controls. Linear support vector machines were used to develop two classifiers: the first differentiated tinnitus patients from controls, while the second differentiated tinnitus patients with low and high distress levels. The classifier for healthy controls and tinnitus patients performed with an average accuracy of 96 and 94% for the training and test sets, respectively. For the distress classifier, these average accuracies were 89 and 84%. Minimal overlap was observed between the features of the two classifiers. EEG-derived features made it possible to accurately differentiate healthy controls and tinnitus patients as well as low and high distress tinnitus patients. The minimal overlap between the features of the two classifiers indicates that the source of distress in tinnitus, which could also be involved in distress related to other conditions, stems from different neuronal mechanisms compared to those causing the tinnitus pathology itself.
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Affiliation(s)
| | | | - Idan Efim Nemirovsky
- Western Institute for Neuroscience, Physics & Astronomy Department, University of Western Ontario, London, ON N6A 3K7, Canada
| | - Sivayini Kandeepan
- Department of Physics, University of Sri Jayewardenepura, Nugegoda 10250, Sri Lanka
| | - Audrey Maudoux
- Robert Debré University Hospital, APHP, Paris 75019, France
| | - Angelo Gemignani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa 56124, Italy
| | | | - Andrea Soddu
- Correspondence to: Andrea Soddu Physics & Astronomy Department Western Institute for Neuroscience University of Western Ontario 1151 Richmond Street, London, ON N6A 3K7, Canada E-mail:
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Vidaurre C, Nikulin VV, Herrojo Ruiz M. Identification of spatial patterns with maximum association between power of resting state neural oscillations and trait anxiety. Neural Comput Appl 2023; 35:5737-5749. [PMID: 36212215 PMCID: PMC9525925 DOI: 10.1007/s00521-022-07847-5] [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: 11/16/2021] [Accepted: 09/14/2022] [Indexed: 12/01/2022]
Abstract
Anxiety affects approximately 5-10% of the adult population worldwide, placing a large burden on the health systems. Despite its omnipresence and impact on mental and physical health, most of the individuals affected by anxiety do not receive appropriate treatment. Current research in the field of psychiatry emphasizes the need to identify and validate biological markers relevant to this condition. Neurophysiological preclinical studies are a prominent approach to determine brain rhythms that can be reliable markers of key features of anxiety. However, while neuroimaging research consistently implicated prefrontal cortex and subcortical structures, such as amygdala and hippocampus, in anxiety, there is still a lack of consensus on the underlying neurophysiological processes contributing to this condition. Methods allowing non-invasive recording and assessment of cortical processing may provide an opportunity to help identify anxiety signatures that could be used as intervention targets. In this study, we apply Source-Power Comodulation (SPoC) to electroencephalography (EEG) recordings in a sample of participants with different levels of trait anxiety. SPoC was developed to find spatial filters and patterns whose power comodulates with an external variable in individual participants. The obtained patterns can be interpreted neurophysiologically. Here, we extend the use of SPoC to a multi-subject setting and test its validity using simulated data with a realistic head model. Next, we apply our SPoC framework to resting state EEG of 43 human participants for whom trait anxiety scores were available. SPoC inter-subject analysis of narrow frequency band data reveals neurophysiologically meaningful spatial patterns in the theta band (4-7 Hz) that are negatively correlated with anxiety. The outcome is specific to the theta band and not observed in the alpha (8-12 Hz) or beta (13-30 Hz) frequency range. The theta-band spatial pattern is primarily localised to the superior frontal gyrus. We discuss the relevance of our spatial pattern results for the search of biomarkers for anxiety and their application in neurofeedback studies.
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Affiliation(s)
- Carmen Vidaurre
- Neuroengineering Group, TECNALIA, Basque Research and Technology Alliance (BRTA), Donostia-San Sebastian, Spain ,IKERBASQUE, Basque Foundation for Science, Bilbao, Spain ,Department of Statistics, Computer Science and Mathematics, Public University of Navarre, Pamplona, Spain
| | - Vadim V. Nikulin
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany ,Institute for Cognitive Neuroscience, National Research University Higher School of Economics, Moscow, Russian Federation
| | - Maria Herrojo Ruiz
- Institute for Cognitive Neuroscience, National Research University Higher School of Economics, Moscow, Russian Federation ,Psychology Department, Goldsmiths University of London, London, UK
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Spreyermann R. Case Report: Infra-Low-Frequency Neurofeedback for PTSD: A Therapist's Perspective. Front Hum Neurosci 2022; 16:893830. [PMID: 35685333 PMCID: PMC9170915 DOI: 10.3389/fnhum.2022.893830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 04/15/2022] [Indexed: 11/30/2022] Open
Abstract
The practical use of a combination of trauma psychotherapy and neurofeedback [infra-low-frequency (ILF) neurofeedback and alpha-theta training] is described for the treatment of patients diagnosed with complex post-traumatic stress disorder (C-PTSD). The indication for this combined treatment is the persistence of symptoms of a hyper-aroused state, anxiety, and sleep disorders even with adequate trauma-focused psychotherapy and supportive medication, according to the Guidelines of the German Society of Psycho-Traumatology (DeGPT). Another indication for a supplementary treatment with neurofeedback is the persistence of dissociative symptoms. Last but not least, the neurofeedback treatment after a trauma-focused psychotherapy session helps to calm the trauma-related reactions and to process the memories. The process of the combined therapy is described and illustrated using two representative case reports. Overall, a rather satisfying result of this outpatient treatment program can be seen in the qualitative appraisal of 7 years of practical application.
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Hamed R, Mizrachi L, Granovsky Y, Issachar G, Yuval-Greenberg S, Bar-Shalita T. Neurofeedback Therapy for Sensory Over-Responsiveness-A Feasibility Study. SENSORS 2022; 22:s22051845. [PMID: 35270991 PMCID: PMC8914621 DOI: 10.3390/s22051845] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 12/22/2022]
Abstract
Background: Difficulty in modulating multisensory input, specifically the sensory over-responsive (SOR) type, is linked to pain hypersensitivity and anxiety, impacting daily function and quality of life in children and adults. Reduced cortical activity recorded under resting state has been reported, suggestive of neuromodulation as a potential therapeutic modality. This feasibility study aimed to explore neurofeedback intervention in SOR. Methods: Healthy women with SOR (n = 10) underwent an experimental feasibility study comprising four measurement time points (T1—baseline; T2—preintervention; T3—postintervention; T4—follow-up). Outcome measures included resting-state EEG recording, in addition to behavioral assessments of life satisfaction, attaining functional goals, pain sensitivity, and anxiety. Intervention targeted the upregulation of alpha oscillatory power over ten sessions. Results: No changes were detected in all measures between T1 and T2. Exploring the changes in brain activity between T2 and T4 revealed power enhancement in delta, theta, beta, and gamma oscillatory bands, detected in the frontal region (p = 0.03−<0.001; Cohen’s d = 0.637−1.126) but not in alpha oscillations. Furthermore, a large effect was found in enhancing life satisfaction and goal attainment (Cohen’s d = 1.18; 1.04, respectively), and reduced pain sensitivity and anxiety trait (Cohen’s d = 0.70). Conclusion: This is the first study demonstrating the feasibility of neurofeedback intervention in SOR.
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Affiliation(s)
- Ruba Hamed
- Department of Occupational Therapy, Faculty of Medicine, School of Health Professions, Tel Aviv University, Tel Aviv 6997801, Israel; (R.H.); (L.M.)
| | - Limor Mizrachi
- Department of Occupational Therapy, Faculty of Medicine, School of Health Professions, Tel Aviv University, Tel Aviv 6997801, Israel; (R.H.); (L.M.)
| | - Yelena Granovsky
- Laboratory of Clinical Neurophysiology, Department of Neurology, Faculty of Medicine, Rambam Health Care Campus, Technion, Haifa 3109601, Israel;
| | - Gil Issachar
- Biomedical Engineering Department, Faculty of Engineering, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Shlomit Yuval-Greenberg
- School of Psychological Sciences, Tel Aviv University, Tel Aviv 6997801, Israel;
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Tami Bar-Shalita
- Department of Occupational Therapy, Faculty of Medicine, School of Health Professions, Tel Aviv University, Tel Aviv 6997801, Israel; (R.H.); (L.M.)
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
- Correspondence: ; Tel.: +972-525437631
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