Shutting down sensorimotor interference unblocks the networks for stimulus processing: an SMR neurofeedback training study

A single session of sensorimotor rhythm neurofeedback enhances long-game performance in professional golfers

Enhanced Sensorimotor Rhythm activity has been linked to increased automation in motor execution. Although existing research demonstrates the positive effects of SMR neurofeedback training on improving golf putting performance, its influence on golf long-game performance remains unexplored. This study sought to address this gap by involving seventeen professional female golfers (Age =24.63 ± 3.24 years, Handicap＝2.06 ± 1.18) in a crossover-designed experiment incorporating both NFT and a no-training control condition. During the study, participants executed 40 150-yard swings while receiving continuous SMR neurofeedback. Pre- and post-testing included visual analog scales to assess psychological processes associated with SMR activities, including attention engagement, conscious motor control, and physical relaxation levels. The results revealed that a single session of NFT effectively heightened SMR power irrespective of T1 (p = .02) or T2 (p = .03), which was observed with improved swing accuracy compared to the control conditions, particularly in "To Pin" (p = .04, the absolute distance to the hole after the ball comes to a stop). Subjective assessments further indicated that SMR NFT contributed to a sense of ease and tranquility during motor preparation for the golf swing (attention engagement: p = .01, conscious motor control: p = .033, physical relaxation: p = .013), and which offered valuable insights into the potential mechanisms underlying the impact of SMR NFT on long-game performance. Additionally, in such practical applications professional athletes can utilize our single-session neurofeedback protocol to train efficiently and cost-effectively before competitions, thereby enhancing their opportunity to achieve a higher rank.

Brain regulation training improves emotional competences in patients with alcohol use disorder

Alcohol use disorder (AUD) is defined as the impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences and still represents one of the biggest challenges for society regarding health conditions, social consequences, and financial costs, including the high relapse rates after traditional alcohol rehabilitation treatment. Especially, the deficient emotional competence in AUD is said to play a key role in the development of AUD and hinders the interruption of substance compulsion, often leading to a viscous circle of relapse. Although the empirical evidence of a neurophysiological basis of AUD is solid and increases even further, clinical interventions based on neurophysiology are still rare for individuals with AUD. This randomized controlled trial investigates changes in emotional competences, alcohol-related cognitions, and drinking behavior before and after an established alcohol rehabilitation treatment (control group: nCG = 29) compared to before and after an optimized, add-on neurofeedback (NF) training (experimental group: nEG = 27). Improvements on the clinical-psychological level, i.e. increases in emotional competences as well as life satisfaction, were found after the experimental electroencephalography (EEG) NF training. Neurophysiological measurements via resting-state EEG indicate decreases in low beta frequency band, while alpha and theta bands remained unaffected.

Evaluating EEG neurofeedback in sport psychology: a systematic review of RCT studies for insights into mechanisms and performance improvement

Electroencephalographic Neurofeedback Training (EEG NFT) aims to improve sport performance by teaching athletes to control their mental states, leading to better cognitive, emotional, and physical outcomes. The psychomotor efficiency hypothesis suggests that optimizing brain function could enhance athletic ability, indicating the potential of EEG NFT. However, evidence for EEG-NFT's ability to alter critical brain activity patterns, such as sensorimotor rhythm and frontal midline theta-key for concentration and relaxation-is not fully established. Current research lacks standardized methods and comprehensive studies. This shortfall is due to inconsistent EEG target selection and insufficient focus on coherence in training. This review aims to provide empirical support for EEG target selection, conduct detailed control analyses, and examine the specificity of electrodes and frequencies to relation to the psychomotor efficiency hypothesis. Following the PRISMA method, 2,869 empirical studies were identified from PubMed, Science Direct, Web of Science, Embase, CNKI, and PsycINFO. Thirteen studies met the inclusion criteria: (i) proficient skill levels; (ii) use of EEG; (iii) neurofeedback training (NFT); (iv) motor performance metrics (reaction time, precision, dexterity, balance); (v) control group for NFT comparison; (vi) peer-reviewed English-language publication; and (vii) randomized controlled trial (RCT) design. Studies indicate that NFT can enhance sports performance, including improvements in shooting accuracy, golf putting, and overall motor skills, as supported by the psychomotor efficiency hypothesis. EEG NFT demonstrates potential in enhancing sports performance by optimizing performers' mental states and psychomotor efficiency. However, the current body of research is hampered by inconsistent methodologies and a lack of standardized EEG target selection. To strengthen the empirical evidence supporting EEG NFT, future studies need to focus on standardizing target selection, employing rigorous control analyses, and investigating underexplored EEG markers. These steps are vital to bolster the evidence for EEG NFT and enhance its effectiveness in boosting sport performance.

Sensori-motor neurofeedback improves inhibitory control and induces neural changes: a placebo-controlled, double-blind, event-related potentials study

Background/Objective

Inhibition is crucial for controlling behavior and is impaired in various psychopathologies. Neurofeedback holds promise in addressing cognitive deficits, and experimental research is essential for identifying its functional benefits. This study aimed to investigate whether boosting sensorimotor activity (SMR) improves inhibitory control in a final sample of healthy individuals (N = 53), while exploring the underlying neurophysiological mechanism.

Method

Participants were randomly divided into two groups: one receiving SMR neurofeedback training to enhance sensorimotor activity within the 12-15 Hz frequency range, and the other receiving sham feedback. Inhibition performance and neural correlates were evaluated with a Go-NoGo task before (T0) and after (T1) 10 neurofeedback sessions using event-related potentials. Data were analyzed via ANOVAs and regression analyses.

Results

Compared to placebo, the active group demonstrated higher absolute SMR power (p = 0.040) and improvements in inhibitory control, including faster response times and fewer inhibition errors (p < 0.001, d = 6.06), associated with a larger NoGoP3d amplitude (p < 0.001, d = 3.35). A positive correlation between the increase in SMR power and the rise in NoGoP3d amplitude (β=0.46, p = 0.015) explains 21 % of the observed variance.

Conclusions

Uptraining SMR power is linked to heightened utilization of neural resources for executing optimal inhibition responses. These results uphold its effectiveness in cognitive rehabilitation.

Do Miniature Eye Movements Affect Neurofeedback Training Performance? A Combined EEG-Eye Tracking Study

EEG-based neurofeedback is a prominent method to modulate one's own brain activity in a desired direction. However, the EEG signal can be disturbed by artifacts, e.g., eye movements, which can consequently confound the neurofeedback performance. Involuntary miniature eye movements can be hardly detected by conventional EEG correction methods such as recording the electro-oculogram (EOG) and subtracting EOG activity from the EEG signal. However, such miniature eye movements can influence EEG activity, especially in the Gamma frequency range, enormously. In the present study, we investigated whether power in different EEG frequencies can be effectively modulated by self-control of brain signals during neurofeedback training and/or whether changes in EEG power are provoked by miniature eye movements during the training. To this end, 24 participants performed one session of SMR and one session of Gamma neurofeedback training. Additionally, in each training session sham feedback was performed. An eye tracker was used to detect miniature eye movements (< 1°) during neurofeedback training. About two thirds of the participants were able to increase their SMR power over the course of NF training, while one third was able to increase Gamma power. Generally, miniature eye movements induced a strong Gamma power increase. The number of eye movements also increased numerically over the course of the NF training. However, we did not find a significant relationship with the NF training performance. This is a first indication that miniature saccades do not affect NF training performance, but should not be neglected during NF training. Our results have to be confirmed in future studies.

A Scoping Review of the Effect of EEG Neurofeedback on Pain Complaints in Adults with Chronic Pain

Background and Aim: Non-pharmacological treatments such as electroencephalogram (EEG) neurofeedback have become more important in multidisciplinary approaches to treat chronic pain. The aim of this scoping review is to identify the literature on the effects of EEG neurofeedback in reducing pain complaints in adult chronic-pain patients and to elaborate on the neurophysiological rationale for using specific frequency bands as targets for EEG neurofeedback. Methods: A pre-registered scoping review was set up and reported following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) extension for Scoping Reviews (PRISMA-ScR). The data were collected by searching for studies published between 1985 and January 2023 in PubMed, EMBASE, and PsycINFO. Results: Thirty-two studies on various types of chronic pain were included. The intervention was well-tolerated. Approximately half of the studies used a protocol that reinforced alpha or sensorimotor rhythms and suppressed theta or beta activity. However, the underlying neurophysiological rationale behind these specific frequency bands remains unclear. Conclusions: There are indications that neurofeedback in patients with chronic pain probably has short-term analgesic effects; however, the long-term effects are less clear. In order to draw more stable conclusions on the effectiveness of neurofeedback in chronic pain, additional research on the neurophysiological mechanisms of targeted frequency bands is definitely worthwhile. Several recommendations for setting up and evaluating the effect of neurofeedback protocols are suggested.

Analyzing and computing humans by means of the brain using Brain-Computer Interfaces - understanding the user - previous evidence, self-relevance and the user's self-concept as potential superordinate human factors of relevance

Brain-computer interfaces (BCIs) are well-known instances of how technology can convert a user's brain activity taken from non-invasive electroencephalography (EEG) into computer commands for the purpose of computer-assisted communication and interaction. However, not all users are attaining the accuracy required to use a BCI consistently, despite advancements in technology. Accordingly, previous research suggests that human factors could be responsible for the variance in BCI performance among users. Therefore, the user's internal mental states and traits including motivation, affect or cognition, personality traits, or the user's satisfaction, beliefs or trust in the technology have been investigated. Going a step further, this manuscript aims to discuss which human factors could be potential superordinate factors that influence BCI performance, implicitly, explicitly as well as inter- and intraindividually. Based on the results of previous studies that used comparable protocols to examine the motivational, affective, cognitive state or personality traits of healthy and vulnerable EEG-BCI users within and across well-investigated BCIs (P300-BCIs or SMR-BCIs, respectively), it is proposed that the self-relevance of tasks and stimuli and the user's self-concept provide a huge potential for BCI applications. As potential key human factors self-relevance and the user's self-concept (self-referential knowledge and beliefs about one's self) guide information processing and modulate the user's motivation, attention, or feelings of ownership, agency, and autonomy. Changes in the self-relevance of tasks and stimuli as well as self-referential processing related to one's self (self-concept) trigger changes in neurophysiological activity in specific brain networks relevant to BCI. Accordingly, concrete examples will be provided to discuss how past and future research could incorporate self-relevance and the user's self-concept in the BCI setting - including paradigms, user instructions, and training sessions.

Effect of a single session of sensorimotor rhythm neurofeedback training on the putting performance of professional golfers

Sensorimotor rhythm (SMR) activity has been associated with automaticity and flow in motor execution. Studies have revealed that neurofeedback training (NFT) of the SMR can improve sports performance; however, few studies have adequately explored the effects of a single session of such NFT or examined the possible mechanisms underlying these effects on sports performance. This study recruited 44 professional golfers to address these gaps in the literature. A crossover design was employed to determine the order of the participation in the NFT and no-training control conditions. The participants were asked to perform 60 10-foot putts while electroencephalograms (EEGs) were recorded before and after the tasks. In pre-and post-tests, visual analog scales were used to assess the psychological states associated with SMR activities including the levels of attention engagement, conscious motor control, and physical relaxation. The results revealed that a single NFT session effectively increased SMR power and improved putting performance compared with the control condition. The subjective assessments also revealed that the participants reported lower attention engagement, less conscious control of the motor details and were more relaxed in the putting task, suggesting that SMR NFT promoted effortless and quiescent mental states during motor preparation for a putting task. This study aligns with theoretical hypotheses and extends current knowledge by revealing that a single session of SMR NFT can effectively enhance SMR power and improve putting performance in professional golfers. It also provides preliminary evidence of the possible underlying mechanisms that drive the effect of SMR NFT on putting performances.

A new EEG neurofeedback training approach in sports: the effects function-specific instruction of Mu rhythm and visuomotor skill performance

Introduction

Achieving optimal visuomotor performance in precision sports relies on maintaining an optimal psychological state during motor preparation. To uncover the optimal psychological state, extensive EEG studies have established a link between the Mu rhythm (8-13 Hz at Cz) and cognitive resource allocation during visuomotor tasks (i.e., golf or shooting). In addition, the new approach in EEG neurofeedback training (NFT), called the function-specific instruction (FSI) approach, for sports involves providing function-directed verbal instructions to assist individuals to control specific EEG parameters and align them with targeted brain activity features. While this approach was initially hypothesized to aid individuals in attaining a particular mental state during NFT, the impact of EEG-NFT involving Mu rhythm on visuomotor performance, especially when contrasting the traditional instruction (TI) approach with the FSI approach, underscores the necessity for additional exploration. Hence, the objective of this study is to investigate the impact of the FSI approach on modulating Mu rhythm through EEG-NFT in the context of visuomotor performance.

Methods

Thirty novice participants were recruited and divided into three groups: function-specific instruction (FSI, four females, six males; mean age = 27.00 ± 7.13), traditional instruction (TI, five females, five males; mean age = 27.00 ± 3.88), and sham control (SC, five females, five males; mean age = 27.80 ± 5.34). These groups engaged in a single-session EEG-NFT and performed golf putting tasks both before and after the EEG-NFT.

Results

The results showed that within the FSI group, single-session NFT with augmented Mu power led to a significant decrease in putting performance (p = 0.013). Furthermore, we noted a marginal significance indicating a slight increase in Mu power and a reduction in the subjective sensation of action control following EEG-NFT (p = 0.119). While there was a positive correlation between Mu power and mean radial error in golf putting performance (p = 0.043), it is important to interpret this relationship cautiously in the context of reduced accuracy in golf putting.

Discussion

The findings emphasize the necessity for extended investigation to attain a more profound comprehension of the nuanced significance of Mu power in visuomotor performance. The study highlights the potential effectiveness of the FSI approach in EEG-NFT and in enhancing visuomotor performance, but it also emphasizes the potential impact of skill level and attentional control, particularly in complex visuomotor tasks.

Decreased beta 1 (12-15 Hertz) power modulates the transfer of suicidal ideation to suicide in major depressive disorder

BACKGROUND

Suicide prevention for major depressive disorder (MDD) is a worldwide challenge, especially for suicide attempt (SA). Viewing suicide as a state rather than a lifetime event provided new perspectives on suicide research.

OBJECTIVE

This study aimed to verify and complement SAs biomarkers of MDD with a recent SA sample.

METHODS

This study included 189 participants (60 healthy controls; 47 MDD patients with non-suicide (MDD-NSs), 40 MDD patients with suicide ideation (MDD-SIs) and 42 MDD patients with SA (MDD-SAs)). MDD patients with an acute SA time was determined to be within 1 week since the last SA. SUICIDALITY Part in MINI was applied to evaluate suicidality. Absolute powers in 14 frequency bands were extracted from subject's resting-state electroencephalography data and compared within four groups. The relationship among suicidality, the number of SA and powers in significant frequency bands were investigated.

RESULTS

MDD-SIs had increased powers in delta, theta, alpha and beta band on the right frontocentral channels compared to MDD-NSs, while MDD-SAs had decreased powers in delta, beta and gamma bands on widely the right frontocentral and parietooccipital channels compared to MDD-SIs. Beta 1 power was the lowest in MDD-SAs and was modulated by the number of SA. The correlation between suicidality and beta 1 power was negative in MDD-SAs and positive in MDD-SIs.

CONCLUSION

Reduced beta 1 (12-15 Hz) power could be essential in promoting suicidal behaviour in MDD. Research on recent SA samples contributes to a better understanding of suicide mechanisms and preventing suicidal behaviour in MDD.

The efficacy of electroencephalography neurofeedback for enhancing episodic memory in healthy and clinical participants: A systematic qualitative review and meta-analysis

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.

The Effect of Neurofeedback Training on Executive Control Network of Attention and Dart-Throwing Performance in Individuals with Trait Anxiety

This study aimed to investigate the effect of neurofeedback training on the executive control network of attention and dart-throwing skill performance in individuals with trait anxiety. Twenty girls (24.65 [Formula: see text] 2.83 years) participated in this study. They were divided into neurofeedback and control training groups. All participants practiced 14 sessions. The neurofeedback group performed neurofeedback training (increasing SMR wave, decreasing theta, and increasing alpha) and dart-throwing exercise, and the control group only completed the dart-throwing exercise. The post-test, including Attentional Networks Test (ANT) and dart-throwing, was conducted 48 h after the last training session. The results revealed a significant difference in the performance of the executive control network and dart-throwing skill between the neurofeedback and the control training group. In general, these findings support the effect of neurofeedback training on the neural mechanisms of the executive control network of attention, and performance in dart-throwing skill improves by improving attentional performance processes.

Neurofeedback training and motor learning: the enhanced sensorimotor rhythm protocol is better or the suppressed alpha or the suppressed mu?

A large number of previous studies have examined how different neurofeedback-based techniques may influence motor learning. However, only a few studies attempted to compare the effects of these different techniques on motor learning. Therefore, the present study attempts to examine the effects of neurofeedback training on motor learning in novice golfers, using three protocols, namely enhanced sensorimotor rhythm (SMR) at Cz, suppressed alpha waves at Fz, and suppressed mu waves at Cz. The participants were 64 adults (32 females; mean age = 22.31 ± 2.25 years). The study consisted of a pretest stage (day 1), intervention (6 sessions, over two weeks, 3 sessions per week), short-term retention (one day after intervention), and long-term retention (two weeks after intervention); in the pretest and short-term and long-term retention, motor performance for golf putting (12 trials) as well as amplitudes of SMR wave at Cz, alpha at Fz, and Mu at Cz were recorded. During each intervention session, the participants in three neurofeedback groups and a sham group first performed neurofeedback training (enhanced SMR at Cz, suppressed alpha at Fz, and suppressed Mu at Cz) for 20 min. Then, the participants in all groups performed three blocks of 12 trials consisting of golf putting training. The results indicated no difference between the sham and the experimental groups in the acquisition stage, as individuals in all groups experienced similar improvement in putting accuracy. However, in the short-term retention, all the three neurofeedback groups outperformed the sham group, although in the long-term retention, only the SMR group and the Alpha group showed a better performance than the sham group while the Mu group did not exhibit a notably better performance than the sham group. Our results also showed significant variations in the amplitudes of the SMR, alpha, and mu waves depending on the neurofeedback intervention provided, while no significant variation was observed in the sham group. Based on these results, it is recommended that coaches should make further use of enhanced SMR at Cz or suppressed alpha at Fz as their neurofeedback interventions to facilitate longer-term motor learning in golfers.

Magnetic resonance spectroscopy investigation in the right human hippocampus following spinal cord injury

Objective

Preclinical studies have shown that cognitive impairments following spinal cord injury (SCI), such as impaired spatial memory, are linked to inflammation, neurodegeneration, and reduced neurogenesis in the right hippocampus. This cross-sectional study aims to characterize metabolic and macrostructural changes in the right hippocampus and their association to cognitive function in traumatic SCI patients.

Methods

Within this cross-sectional study, cognitive function was assessed in 28 chronic traumatic SCI patients and 18 age-, sex-, and education-matched healthy controls by a visuospatial and verbal memory test. A magnetic resonance spectroscopy (MRS) and structural MRI protocol was performed in the right hippocampus of both groups to quantify metabolic concentrations and hippocampal volume, respectively. Group comparisons investigated changes between SCI patients and healthy controls and correlation analyses investigated their relationship to memory performance.

Results

Memory performance was similar in SCI patients and healthy controls. The quality of the recorded MR spectra was excellent in comparison to the best-practice reports for the hippocampus. Metabolite concentrations and volume of the hippocampus measured based on MRS and MRI were not different between two groups. Memory performance in SCI patients and healthy controls was not correlated with metabolic or structural measures.

Conclusion

This study suggests that the hippocampus may not be pathologically affected at a functional, metabolic, and macrostructural level in chronic SCI. This points toward the absence of significant and clinically relevant trauma-induced neurodegeneration in the hippocampus.

QEEG markers of superior shooting performance in skilled marksmen: An investigation of cortical activity on psychomotor efficiency hypothesis

For elite performers, psychomotor behavior's success or failure can be traced to differences in brain dynamics. The psychomotor efficiency hypothesis suggests refined cortical activity through 1) selective activation of task-relevant processes and 2) inhibition of non-essential processes. The use of electroencephalography (EEG) has been applied to investigate psychomotor performance's neural processes. The EEG markers that reflect an elevation of psychomotor efficiency include left temporal alpha (T3 alpha), frontal midline theta (Fm theta), sensorimotor rhythm (SMR), and the coherence between frontal and left temporal regions. However, the relationship between elite performers' task-relevant and non-essential neural processes is still not well understood. Therefore, this study aimed to explore how each task-relevant and inhibition of non-essential processes contribute to superior psychomotor behavior. Thirty-five highly skilled marksmen were recruited to perform 30 shots in the shooting task while the EEG was recorded. The marksmen were divided into two groups (superior & inferior) based on a median split of shooting performance. The superior group exhibited higher accuracy and precision, with a reduction in movement jerk. EEG measures revealed that the superior group exhibited higher SMR before the trigger pull than the inferior group. In addition, the superior group demonstrated reduced Fz-T3 coherence in their bull's eye shots than the missed shots. These results suggest that the superior group exhibited less effortful engagement of task-relevant processes and lower interference from non-essential cortical regions than the inferior group. The study's overall findings support the psychomotor efficiency hypothesis. When comparing highly skilled performers, the slight differences in brain dynamics ultimately contribute to the success or failure of psychomotor performance.

Collaborative neural processes predict successful cognitive-motor performance

Psychomotor efficiency is achieved by expert performers who exhibit refined attentional strategies and efficient motor program execution. Further understanding of the psychomotor efficiency hypothesis requires examination of the co-activation of key electroencephalographic (EEG) indices, including frontal theta (Fθ) power, left temporal alpha (T3α) power, the sensory-motor rhythm (SMR), and frontocentral alpha power (FCα). This study examined the relationship between these selected neural processes and the odds of successful cognitive-motor performance. EEG indices of successful and failed putts observed in twenty-seven skilled golfers were subjected to mixed-effects logistic regression analysis. The results revealed that concurrent elevations of Fθ and T3α were associated with increased odds of successful performance. The co-activation from motoric processes indicated by SMR and FCα also elevated the odds. Overall, the findings emphasize that refined attention allocation and effective motor program processing are essential cognitive features of superior cognitive-motor performance for skilled golfers.

Exploring the Effects of EEG-Based Alpha Neurofeedback on Working Memory Capacity in Healthy Participants

Neurofeedback, an operant conditioning neuromodulation technique, uses information from brain activities in real-time via brain-computer interface (BCI) technology. This technique has been utilized to enhance the cognitive abilities, including working memory performance, of human beings. The aims of this study are to investigate how alpha neurofeedback can improve working memory performance in healthy participants and to explore the underlying neural mechanisms in a working memory task before and after neurofeedback. Thirty-six participants divided into the NFT group and the control group participated in this study. This study was not blinded, and both the participants and the researcher were aware of their group assignments. Increasing power in the alpha EEG band was used as a neurofeedback in the eyes-open condition only in the NFT group. The data were collected before and after neurofeedback while they were performing the N-back memory task (N = 1 and N = 2). Both groups showed improvement in their working memory performance. There was an enhancement in the power of their frontal alpha and beta activities with increased working memory load (i.e., 2-back). The experimental group showed improvements in their functional connections between different brain regions at the theta level. This effect was absent in the control group. Furthermore, brain hemispheric lateralization was found during the N-back task, and there were more intra-hemisphere connections than inter-hemisphere connections of the brain. These results suggest that healthy participants can benefit from neurofeedback and from having their brain networks changed after the training.

The effects of first-dose methylphenidate on the neural signatures of visual selective attention in children with attention-deficit/hyperactivity disorder

Although methylphenidate (MPH) has been shown to significantly improve selective attention in children with attention-deficit/hyperactivity disorder (ADHD), the neural mechanism of this effect remains unclear. We investigated the effects of first-dose MPH on the neural signatures of visual selective attention in children with ADHD. We measured the impact of first-dose MPH on electrophysiological indexes from eighteen children with ADHD (8.9-15.2 years; 15 boys) while they performed a visual search task. MPH was administered in a double-blind placebo-controlled crossover design. MPH led to decreases in behavioral error rates and reaction times. For the electrophysiological indexes, MPH significantly increased the target-elicited N2pc amplitude and posterior P3 amplitude during the selective attention process. The trial-based correlation analysis revealed that the enhanced N2pc (more negative) and P3 (more positive) promoted the behavioral response speed for children with ADHD. The lower individual P3 amplitude was associated with higher severity of inattention symptoms. The severer inattention symptoms were related to weaker MPH effect on N2pc amplitude. These findings suggest that N2pc and P3 are closely related to the mechanism of MPH in the ADHD treatment.

Both Sensorimotor Rhythm Neurofeedback and Self-Controlled Practice Enhance Motor Learning and Performance in Novice Golfers

A major concern voiced by motor behavior scientists is to find useful practice techniques that can be effective in improving motor learning and performance. Neurofeedback and self-controlled practice are among the techniques that have recently drawn attention from specialists in this area. The present study examined the additive and individual effects of sensorimotor rhythm (SMR) neurofeedback as well as self-controlled practice on motor learning and performance in novice golfers. In this semi-empirical study, forty adults (20 females, Meanage = 26.10, SD = 5.56 years) were conveniently selected and randomly assigned to four groups: (1) neurofeedback/self-controlled practice, (2) neurofeedback/yoked practice, (3) sham/self-controlled practice, and (4) sham/yoked practice. The participants performed golf putting task in four stages, namely pretest (12 trials), intervention (one day after pretest; 6 sessions, 36 trails each), post-test (one day after intervention; 12 trials), and follow-up (two weeks after interventions; 12 trials). In addition, the participants had their EEG (SMR wave in Cz point) recorded during pretest, post-test, and follow-up. The results indicated that, although no additive effect was observed for the two practices during different stages of the experiment (p > 0.05), in acquisition and post-test stages, SMR neurofeedback and self-controlled practice independently facilitated golf putting (p ≤ 0.05). However, in the follow-up test, only the neurofeedback practice maintained its positive effects (p ≤ 0.05). The results also showed that participation in SMR neurofeedback practice can enhance the power of the SMR wave (p ≤ 0.05), regardless of the type of the self-controlled practice used. In sum, the two practice techniques seem to be independently effective in facilitating motor learning in instructional settings, particularly for golfers.

Assessment of the capacity to modulate brain signals in a home-based SMR neurofeedback training setting

Electroencephalogram (EEG)-based neurofeedback (NF) is mainly used in clinical settings as a therapeutic intervention or to optimize performance in healthy individuals. Home-based NF systems are available and might facilitate general access to NF training, especially when repeated training sessions are necessary. However, it remains an open question whether NF training at home is possible without remote monitoring. In the present study, we assessed the capacity of healthy individuals to modulate their own EEG activity when using a home-based NF training system in a comparable manner as if participants had purchased a commercially available NF system. Participants' face-to-face contact with experimenters was reduced to a minimum, and instructions were provided only in the form of written information or videos. Initially, 38 participants performed 9 sessions of sensorimotor rhythm (SMR) (12-15 Hz) based NF training (three generalization sessions, six training sessions). An active control group (n = 19) received feedback on random EEG frequencies. Because of technical problems, bad EEG data quality, or non-compliance, 21 participants had to be excluded from the final data analysis, providing first evidence for the difficulties of non-supervised home-based NF training. In this study, participants were not able to modulate their own brain activity in a desired direction during NF training. Our results indicate that personal interaction with a NF expert might be of relevance and that remote supervision of the training data and more direct communication with the NF users are necessary to enable successful NF training performance. We provide suggestions for the development and implementation of home-based NF systems.

Attention neuroenhancement through tDCS or neurofeedback: a randomized, single-blind, controlled trial

Neurofeedback and transcranial Direct Current Stimulation (tDCS) are promising techniques for neuroenhancement of attentional performance. As far as we know no study compared both techniques on attentional performance in healthy participants. We compared tDCS and neurofeedback in a randomized, single-blind, controlled experiment assessing both behavioral (accuracy and time reaction) and electrophysiological (N1, P1, and P3 components) data of participants responding to the Attention Network Task (ANT). Eighty volunteers volunteered for this study. We adopted standard protocols for both techniques, i.e., a Sensorimotor Rhythm (SMR) protocol for neurofeedback and the right DLPFC anodal stimulation for tDCS, applied over nine sessions (two weeks). We did not find significant differences between treatment groups on ANT, neither at the behavioral nor at the electrophysiological levels. However, we found that participants from both neuromodulation groups, irrespective of if active or sham, reported attentional improvements in response to the treatment on a subjective scale. Our study adds another null result to the neuromodulation literature, showing that neurofeedback and tDCS effects are more complex than previously suggested and associated with placebo effect. More studies in neuroenhancement literature are necessary to fully comprehend neuromodulation mechanisms.

Psychophysiological Responses of Cut Flower Fragrances as an Olfactory Stimulation by Measurement of Electroencephalogram in Adults

Horticultural therapy (HT) is green care that can help improve and recover the health of modern people living in cities through natural experiences. Many studies have been conducted to determine HT's therapeutic effects and underlying mechanisms, but investigation for developing readily applicable clinical techniques is insufficient. We aimed to investigate adults' brain activity and emotional state during flower arrangement (FA) with different flowers in an HT program. We recruited thirty adults and used a randomized cross-over study method to set them to participate in five FA tasks at 90-s intervals. While performing FA tasks, the participants' prefrontal cortex brain waves were measured by a wireless electroencephalography device and their emotional states between FA tasks were measured by questionnaires. Results showed that each FA task resulted in a different attention level of the participants. The participants showed the highest attention level during FA with stocks and carnations, while FA with lilies showed the lowest attention level among the five FA tasks. Instead, the participants showed the highest arousal, tension, and anxiety for emotional states during FA with lilies. Therefore, this study confirmed the differences in attention level and emotional changes according to flower types for using clinical techniques of HT for various clients.

Triathletes are experts in self-regulating physical activity - But what about self-regulating neural activity?

Regular exercise improves cognitive control abilities and successful self-regulation of physical activity. However, it is not clear whether exercising also improves the ability to self-regulate one's own brain activity. We investigated this in 26 triathletes and 25 control participants who did not exercise regularly. Within each group half of the participants performed one session of sensorimotor rhythm (SMR, 12-15 Hz) upregulation neurofeedback training, the other half received a sham neurofeedback training. The neurofeedback training session took about 45 min. In a separate session, participants underwent structural magnetic resonance imaging (MRI) to investigate possible differences in brain structure between triathletes and controls. Triathletes and controls were able to voluntarily upregulate their SMR activity during neurofeedback when receiving real feedback. Triathletes showed a stronger increase in SMR activity in the second half of the training compared to controls, suggesting that triathletes are able to self-regulate their own brain activity over a longer period of time. Further, triathletes and controls showed differences in brain structure as reflected by larger gray and white matter volumes in the inferior frontal gyrus and insula compared to controls. These brain areas are generally involved in cognitive control mechanisms. Our results provide new evidence regarding self-regulation abilities of people who exercise regularly and might impact the practical application of neurofeedback.

Neurofeedback and neural self-regulation: a new perspective based on allostasis

The field of neurofeedback training (NFT) has seen growing interest and an expansion of scope, resulting in a steadily increasing number of publications addressing different aspects of NFT. This development has been accompanied by a debate about the underlying mechanisms and expected outcomes. Recent developments in the understanding of psychophysiological regulation have cast doubt on the validity of control systems theory, the principal framework traditionally used to characterize NFT. The present article reviews the theoretical and empirical aspects of NFT and proposes a predictive framework based on the concept of allostasis. Specifically, we conceptualize NFT as an adaptation to changing contingencies. In an allostasis four-stage model, NFT involves (a) perceiving relations between demands and set-points, (b) learning to apply collected patterns (experience) to predict future output, (c) determining efficient set-points, and (d) adapting brain activity to the desired ("set") state. This model also identifies boundaries for what changes can be expected from a neurofeedback intervention and outlines a time frame for such changes to occur.

Effects of virtual reality-based feedback on neurofeedback training performance—A sham-controlled study

Electroencephalography-neurofeedback (EEG-NF) has become a valuable tool in the field of psychology, e.g., to improve cognitive function. Nevertheless, a large percentage of NF users seem to be unable to control their own brain activation. Therefore, the aim of this study was to examine whether a different kind of visual feedback could positively influence NF performance after one training session. Virtual reality (VR) seems to have beneficial training effects and has already been reported to increase motivational training aspects. In the present study, we tested 61 young healthy adults (mean age: 23.48 years; 28 female) to investigate, whether 3D VR-based NF training has a more beneficial effect on the sensorimotor rhythm (SMR, 12–15 Hz) power increase than a mere 2D conventional NF paradigm. In the 3D group, participants had to roll a ball along a predefined path in an immersive virtual environment, whereas the 2D group had to increase the height of a bar. Both paradigms were presented using VR goggles. Participants completed one baseline and six feedback runs with 3 min each, in which they should try to increase SMR power over Cz. Half of the participants received real feedback whereas the other half received sham feedback. Participants receiving 3D VR-based feedback showed a linear increase in SMR power over the feedback runs within one training session. This was the case for the real as well as for the sham 3D feedback group and might be related to more general VR-related effects. The 2D group receiving the conventional bar feedback showed no changes in SMR power over the feedback runs. The present study underlines that the visual feedback modality has differential effects on the NF training performance and that 3D VR-based feedback has advantages over conventional 2D feedback.

Brain-Computer Interface Training Based on Brain Activity Can Induce Motor Recovery in Patients With Stroke: A Meta-Analysis

BACKGROUND

Brain-computer interface (BCI) is a procedure involving brain activity in which neural status is provided to the participants for self-regulation. The current review aims to evaluate the effect sizes of clinical studies investigating the use of BCI-based rehabilitation interventions in restoring upper extremity function and effective methods to detect brain activity for motor recovery.

METHODS

A computerized search of MEDLINE, CENTRAL, Web of Science, and PEDro was performed to identify relevant articles. We selected clinical trials that used BCI-based training for post-stroke patients and provided motor assessment scores before and after the intervention. The pooled standardized mean differences of BCI-based training were calculated using the random-effects model.

RESULTS

We initially identified 655 potentially relevant articles; finally, 16 articles fulfilled the inclusion criteria, involving 382 participants. A significant effect of neurofeedback intervention for the paretic upper limb was observed (standardized mean difference = .48, [.16-.80], P = .006). However, the effect estimates were moderately heterogeneous among the studies (I² = 45%, P = .03). Subgroup analysis of the method of measurement of brain activity indicated the effectiveness of the algorithm focusing on sensorimotor rhythm.

CONCLUSION

This meta-analysis suggested that BCI-based training was superior to conventional interventions for motor recovery of the upper limbs in patients with stroke. However, the results are not conclusive because of a high risk of bias and a large degree of heterogeneity due to the differences in the BCI interventions and the participants; therefore, further studies involving larger cohorts are required to confirm these results.

EEG-heart rate connectivity changes after sensorimotor rhythm neurofeedback training: Ancillary study

OBJECTIVES

Neurofeedback can induce long-term changes in brain functional connectivity, but its influence on the connectivity between different physiological systems is unknown. The present paper is an ancillary study of a previous paper that confirmed the effect of neurofeedback on brain connectivity associated with chronic pain. We analysed the influence of neurofeedback on the connectivity between the electroencephalograph (EEG) and heart rate (HR).

METHODS

Seventeen patients diagnosed with fibromyalgia were divided into three groups: good sensorimotor rhythm (SMR) training responders (n = 4), bad SMR responders (n = 5) and fake training (SHAM, n = 8). Training consisted of six sessions in which participants learned to synchronize and desynchronize SMR power. Before the first training (pre-resting state) and sixth training (post-resting state) session, open-eye resting-state EEG and electrocardiograph signals were recorded.

RESULTS

Good responders reduced pain ratings after SMR neurofeedback training. This improvement in fibromyalgia symptoms was associated with a reduction of the connectivity between the central area and HR, between central and frontal areas, within the central area itself, and between central and occipital areas. The sham group and poor responders experienced no changes in their fibromyalgia symptoms.

CONCLUSIONS

Our results provide new evidence that neurofeedback is a promising tool that can be used to treat of chronic pain syndromes and to obtain a better understanding of the interactions between physiological networks. These findings are preliminary, but they may pave the way for future studies that are more methodologically robust. In addition, new research questions are raised: what is the role of the central-peripheral network in chronic pain and what is the effect of neurofeedback on this network.

Neurofeedback Training Based on Motor Imagery Strategies Increases EEG Complexity in Elderly Population

Neurofeedback training (NFT) has shown promising results in recent years as a tool to address the effects of age-related cognitive decline in the elderly. Since previous studies have linked reduced complexity of electroencephalography (EEG) signal to the process of cognitive decline, we propose the use of non-linear methods to characterise changes in EEG complexity induced by NFT. In this study, we analyse the pre- and post-training EEG from 11 elderly subjects who performed an NFT based on motor imagery (MI-NFT). Spectral changes were studied using relative power (RP) from classical frequency bands (delta, theta, alpha, and beta), whilst multiscale entropy (MSE) was applied to assess EEG-induced complexity changes. Furthermore, we analysed the subject's scores from Luria tests performed before and after MI-NFT. We found that MI-NFT induced a power shift towards rapid frequencies, as well as an increase of EEG complexity in all channels, except for C3. These improvements were most evident in frontal channels. Moreover, results from cognitive tests showed significant enhancement in intellectual and memory functions. Therefore, our findings suggest the usefulness of MI-NFT to improve cognitive functions in the elderly and encourage future studies to use MSE as a metric to characterise EEG changes induced by MI-NFT.

Clinical Findings in SMR Neurofeedback Protocol Training in Women with Fibromyalgia Syndrome

Fibromyalgia is related to central sensitization syndrome (CSS) and is associated with chronic pain and a decrease in general health. The aim of this study was to explore how changes in brain patterns of female fibromyalgia patients are shaped by neurofeedback therapy and how it affects pain perception and general health. A quasi-experimental study with pre- and post-tests was carried out with 37 female fibromyalgia patients referred by the Pain Unit of the National Health Service of Spain. The method involved applying a sensorimotor rhythm (SMR) protocol to monitor changes in brain waves under different conditions, taking pre-/post-test measurements of perceived pain, general health and the impact on fibromyalgia. Measures included the Fibromyalgia Impact Questionnaire Revised (FIQR), the Visual Analogue Scale (VAS), the General Health Questionnaire (GHQ-28) and EEG (SMR, theta waves). During therapy, the SMR/theta wave ratio increased significantly and after application of therapy, significant results were observed for the FIQR, VAS and GHQ-28. In conclusion, neurofeedback therapy increases the SMR/theta wave ratio in fibromyalgia, helping to maintain a balance between brain functions. This is associated with the activation of inhibitory processes, which is related to the perceived improvement of pain in fibromyalgia patients.

The Effect of Kendo’s Chudan-no-kamae and Three Striking Movements on Changes in Brainwaves Related to Concentration Index

OBJECTIVES This study was conducted to figure out the effects of kendo training on the activity of brainwaves by analyzing changes in brainwaves during chudan-no-kamae and three-movement-striking, which are basic movements of kendo, in elementary school students who undergo kendo training and comparing left and right side brainwave activities to find out differences.METHODS This study was conducted with 29 male elementary school students living in K City who were experts in kendo with a career as an athlete or a kendo training period not shorter than six months. The brainwave activity was measured by measuring and analyzing brainwaves at eight regions at the prefrontal lobe, the frontal lobe, the temporal lobe, and the occipital lobe using brainwave measuring equipment. Brainwaves were measured for 5 minutes in a sitting position in a stable state and were also measured for 5 minutes after 15 minutes of the chudan-no-kamae movement, which is aiming at the opponent with the point of the sword while moving along eight moving lines of the opponents, and for 5 minutes after 15 minutes of three striking movements.RESULTS Alpha waves showed higher brainwave activity during the stable state than during the kendo movements (three striking movements, chudan-no-kamae) while SMR, M-beta, and H-beta showed higher brainwave activity after kendo movements than during the resting state. The asymmetry between the left and right sides increased after the movements compared to during the resting state.CONCLUSIONS These results are considered attributable to kendo training that partly increased their concentration thereby increasing brainwave activity. However, it is unclear that kendo training will be helpful for concentration through physical activities and brain activity in this study. Therefore, further study should be conducted with the measurement of factors related to emotional aspects, concentration, and brainwaves according to kendo training.

MRI correlates of cognitive improvement after home-based EEG neurofeedback training in patients with multiple sclerosis: a pilot study

OBJECTIVE

Neurofeedback training may improve cognitive function in patients with neurological disorders. However, the underlying cerebral mechanisms of such improvements are poorly understood. Therefore, we aimed to investigate MRI correlates of cognitive improvement after EEG-based neurofeedback training in patients with MS (pwMS).

METHODS

Fourteen pwMS underwent ten neurofeedback training sessions within 3-4 weeks at home using a tele-rehabilitation system. Half of the pwMS (N = 7, responders) learned to self-regulate sensorimotor rhythm (SMR, 12-15 Hz) by visual feedback and improved cognitively after training, whereas the remainder (non-responders, n = 7) did not. Diffusion-tensor imaging and resting-state fMRI of the brain was performed before and after training. We analyzed fractional anisotropy (FA) and functional connectivity (FC) of the default-mode, sensorimotor (SMN) and salience network (SAL).

RESULTS

At baseline, responders and non-responders were comparable regarding sex, age, education, disease duration, physical and cognitive impairment, and MRI parameters. After training, compared to non-responders, responders showed increased FA and FC within the SAL and SMN. Cognitive improvement correlated with increased FC in SAL and a correlation trend with increased FA was observed.

CONCLUSIONS

This exploratory study suggests that successful neurofeedback training may not only lead to cognitive improvement, but also to increases in brain microstructure and functional connectivity.

Comparison of Biofeedback and Combined Interventions on Athlete's Performance

The aim of this study was the comparison of neurofeedback and biofeedback as a combination, against biofeedback intervention alone on athletic performance. 45 novice basketball players were allocated into three groups and assigned accordingly, two experimental and one control group. The experimental group 1 received 24 biofeedback sessions only, experimental group 2 received 24 biofeedback and neurofeedback sessions combined, whereas the control group didn't receive any form of intervention. Athletic performance scales were used before and after each intervention and multivariate analysis of covariance was used to compare the two groups. Results showed that in comparison to the control group, the athletic performance scales scores in both experimental groups were significantly increased. Furthermore, in experimental group 2 (combined method), we noticed a significantly greater improvement in performance levels than experimental group 1. We concluded that neurofeedback and biofeedback interventions combined, can be used as an effective method to enhance athletic performance.

The Effects of Neurofeedback on Aging-Associated Cognitive Decline: A Systematic Review

For more than a decade, neurofeedback interventions have been applied with the goal of improving cognitive functions in older adults. Some of these studies have been reviewed, but only in combination with experiments conducted in young adults or with studies seeking to modify functions not related to cognition. The purpose of the present review is to assess whether neurofeedback interventions benefit cognition in elderly adults. We included all neurofeedback studies conducted in older adults, whether healthy or affected by a clinical condition, that attempted to ameliorate any domain of cognition, with no restrictions by publication date. Fourteen studies were eligible for this review. Neurofeedback improved memory in healthy and unhealthy participants mainly when the theta and sensorimotor rhythm (SMR) frequencies were trained. In addition, other cognitive domains benefited from this intervention. Conversely, neurofeedback had no effect on attention processes. Although different studies used markedly different methods, almost all of them reported positive effects of neurofeedback in at least one cognitive domain. New interventions under consideration should be tested using placebo-controlled, double-blind experimental designs with follow-up evaluations.

Differential Effects of Up- and Down-Regulation of SMR Coherence on EEG Activity and Memory Performance: A Neurofeedback Training Study

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.

Individual variation in alpha neurofeedback training efficacy predicts pain modulation

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Sensorimotor alpha neurofeedback training effect on pain perception was assessed.

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Neurofeedback training decreased the sensory-discriminative aspect of pain.

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Neurofeedback training increased the affective-motivational aspect of pain.

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Pain modulation by neurofeedback training was dependent upon the training efficacy.

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Neurofeedback training efficacy predicted sensory-discriminative pain modulation.

Studies have shown an association between sensorimotor α-oscillation and pain perception. It suggests the potential use of neurofeedback (NFB) training for pain modulation through modifying sensorimotor α-oscillation. Here, a single-session NFB training protocol targeted on increasing sensorimotor α-oscillations was applied to forty-five healthy participants. Pain thresholds to nociceptive laser stimulations and pain ratings (intensity and unpleasantness) to identical laser painful stimulations were assessed immediately before and after NFB training. Participants had larger pain thresholds, but rated the identical painful laser stimulation as more unpleasant after NFB training. These pain measurements were further compared between participants with high or low NFB training efficacy that was quantified as the regression slope of α-oscillation throughout the ten training blocks. A significant increase in pain thresholds was observed among participants with high-efficacy; whereas a significant increase in pain ratings was observed among participants with low-efficacy. These results suggested that NFB training decreased the sensory-discriminative aspect of pain, but increased the affective-motivational aspect of pain, whereas both pain modulations were dependent upon the NFB training efficacy. Importantly, correlation analysis across all participants revealed that a greater NFB training efficacy predicted a greater increase in pain thresholds particularly at hand contralateral to NFB target site, but no significant correlation was observed between NFB training efficacy and modulation on pain ratings. It thus provided causal evidence for a link between sensorimotor α-oscillation and the sensory-discriminative aspect of pain, and highlighted the need for personalized neurofeedback for the benefits on pain modulation at the individual level. Future studies can adopt a double-blind sham-controlled protocol to validate NFB training induced pain modulation.

Preventing relapse in alcohol disorder with EEG-neurofeedback as a neuromodulation technique: A review and new insights regarding its application

Alcohol Use Disorder (AUD) has a disconcertingly high relapse rate (70-80% within a year following withdrawal). Preventing relapse or minimizing its extent is hence a challenging goal for long-term successful management of AUD. New perspectives that rely on diverse neuromodulation tools have been developed in this regard as care supports. This paper focuses on electroencephalogram-neurofeedback (EEG-NF), which is a tool that has experienced renewed interest in both clinical and research areas. We review the literature on EEG-based neurofeedback studies investigating the efficacy in AUD and including at least 10 neurofeedback training sessions. As neurofeedback is a form of biofeedback in which a measure of brain activity is provided as feedback in real-time to a subject, the high degree of temporal resolution of the EEG interface supports optimal learning. By offering a wide range of brain oscillation targets (alpha, beta, theta, delta, gamma, and SMR) the EEG-NF procedure increases the scope of possible investigations through a multitude of experimental protocols that can be considered to reinforce or inhibit specific forms of EEG activity associated with AUD-related cognitive impairments. The present review provides an overview of the EEG-NF protocols that have been used in AUD and it highlights the current paucity of robust evidence. Within this framework, this review presents the arguments in favor of the application of EEG-NF as an add-on tool in the management of alcohol disorders to enhance the cognitive abilities required to maintain abstinence more specifically, with a focus on inhibition and attentional skills.

SMR/Theta Neurofeedback Training Improves Cognitive Performance and EEG Activity in Elderly With Mild Cognitive Impairment: A Pilot Study

Background: Neurofeedback (NF) training, as a method of self-regulation of brain activity, may be beneficial in elderly patients with mild cognitive impairment (MCI). In this pilot study, we investigated whether a sensorimotor (SMR)/theta NF training could improve cognitive performance and brain electrical activity in elderly patients with MCI. Methods: Twenty elderly patients with MCI were assigned to 20 consecutive sessions of sensorimotor (SMR)/theta NF training, during 10 weeks, on a basis of two sessions each week. Neuropsychological assessments and questionnaires, as well as electroencephalogram (EEG), were performed and compared between baseline (T0), after the last NF training session at 10 weeks (T1), and 1-month follow-up (T2). Results: Repeated measures ANOVA revealed that from baseline to post-intervention, participants showed significant improvement in the Montreal cognitive assessment (MoCa, F = 4.78; p = 0.012), the delayed recall of the Rey auditory verbal learning test (RAVLT, F = 3.675; p = 0.032), the Forward digit span (F = 13.82; p < 0.0001), the Anxiety Goldberg Scale (F = 4.54; p = 0.015), the Wechsler Adult Intelligence Score-Fourth Edition (WAIS-IV; F = 24.75; p < 0.0001), and the Mac Nair score (F = 4.47; p = 0.016). EEG theta power (F = 4.44; p = 0.016) and alpha power (F = 3.84; p = 0.027) during eyes-closed resting-state significantly increased after the NF training and showed sustained improvement at a 1-month follow-up. Conclusion: Our results suggest that NF training could be effective to reduce cognitive deficits in elderly patients with MCI and improve their EEG activity. If these findings are confirmed by randomized controlled studies with larger samples of patients, NF could be seen as a useful non-invasive, non-pharmacological tool for preventing further decline, rehabilitation of cognitive function in the elderly. Clinical Trial Registration: This pilot study was a preliminary step before the trial registered in www.ClinicalTrials.gov, under the number of NCT03526692.

Effects of a single session of SMR neurofeedback training on anxiety and cortisol levels

OBJECTIVES

According to some studies, a putatively calming effect of EEG neurofeedback training could be useful as a therapeutic tool in psychiatric practice. With the aim of elucidating this possibility, we tested the efficacy of a single session of ↑sensorimotor (SMR)/↓theta neurofeedback training for mood improvement in 32 healthy men, taking into account trainability, independence and interpretability of the results.

METHODS

A pre-post design, with the following dependent variables, was applied: (i) psychometric measures of mood with regards to anxiety, depression, and anger (Profile of Mood State, POMS, and State Trait Anxiety Inventory, STAI); (ii) biological measures (salivary levels of cortisol); (iii) neurophysiological measures (EEG frequency band power analysis). In accordance with general recommendations for research in neurofeedback, a control group receiving sham neurofeedback was included.

RESULTS

Anxiety levels decreased after the real neurofeedback and increased after the sham neurofeedback (P<0.01, size effect 0.9 for comparison between groups). Cortisol decreased after the experiment in both groups, though with significantly more pronounced effects in the desired direction after the real neurofeedback (P<0.04; size effect 0.7). The group receiving real neurofeedback significantly enhanced their SMR band (P<0.004; size effect 0.88), without changes in the theta band. The group receiving sham neurofeedback did not show any EEG changes.

CONCLUSIONS

The improvement observed in anxiety was greater in the experimental group than in the sham group, confirmed by both subjective (psychometric) measures and objective (biological) measures. This was demonstrated to be associated with the real neurofeedback, though a nonspecific (placebo) effect likely also contributed.

Alpha down-regulation neurofeedback training effects on implicit motor learning and consolidation

OBJECTIVE

Implicit motor learning, which is a non-conscious form of learning characterized by motor performance improvement with practice, plays an essential role in various daily activities. Earlier study using neurofeedback training (NFT), a type of brain-computer interaction that enables the user to learn self-regulating his/her own brain activity, demonstrated that down-regulating alpha over primary motor cortex by NFT could immediately facilitate the implicit motor learning in a relatively simple motor task. However, detailed effects on EEG and implicit motor learning due to NFT especially in a more complex motor task are still unclear.

APPROACH

We designed a single-blind sham-controlled between-subject study to examine whether alpha down-regulation NFT could facilitate implicit motor learning and also its consolidation in a more difficult and motor predominant task. At left primary motor cortex (C3) in two days, the alpha NFT group received alpha down-regulation training through auditory feedback while the sham-control group received random beta NFT. At the end of NFT, all participants performed the continuous tracking task with their dominant (right) hand to evaluate the implicit motor learning immediately. Finally, the continuous tracking task was performed again on the next day to assess consolidation effects.

MAIN RESULTS

The alpha NFT group successfully decreased alpha amplitude during NFT, whereas the sham-control group maintained alpha at a relatively stable level. There was unfortunately no statistical evidence proving that the alpha NFT group significantly enhanced the implicit motor learning at the end of NFT and the consolidation on the next day compared to the sham-control group. Nevertheless, a significant correlation was found between the alpha change trend during NFT and the implicit motor learning for all participants, suggesting that faster alpha down-regulation was associated with better implicit motor learning.

SIGNIFICANCE

The findings suggested a close link between implicit motor learning and alpha change induced by NFT.

Train Your Brain? Can We Really Selectively Train Specific EEG Frequencies With Neurofeedback Training

Neurofeedback (NFB) is an operant conditioning procedure whereby an individual learns to self-regulate the electrical activity of his/her brain. Initially developed as a treatment intervention for pathologies with underlying EEG dysfunctions, NFB is also used as a training tool to enhance specific cognitive states required in high-performance situations. The original idea behind the NFB training effect is that the changes should only be circumscribed to the trained EEG frequencies. The EEG frequencies which are not used as feedback frequencies should be independent and not affected by the neurofeedback training. Despite the success of sensorimotor rhythm NFB training in cognitive performance enhancement, it remains unclear whether all participants can intentionally modify the power densities of specifically selected electroencephalographic (EEG) frequencies. In the present study, participants were randomly assigned to either a control heart rate variability (HRV) biofeedback (HRV) training group or a combination of HRV biofeedback and neurofeedback (HRV/NFB) training group. This randomized mixed design experiment consisted of two introductory theoretical lessons and a training period of 6 weeks. We investigated the evolution of the different EEG frequency bands of our two experimental groups across and within session. All the participants exhibited EEG changes across and within session. However, within the HRV/NFB training group, untrained EEG frequencies have been significantly modified, unlike some of the trained frequencies. Moreover, EEG activity was modified in both the HRV group and the HRV/NFB groups. Hence, the EEG changes were not only circumscribed to the trained frequency bands or to the training modality.

EEG Neurofeedback Is Under Strong Control of Psychosocial Factors

Recently, a deep impact of psychosocial effects on the outcomes of neurofeedback training was suggested. Previous findings point out an association between locus of control in dealing with technology and the individual ability to up-regulate the sensorimotor rhythm (12–15 Hz) in the EEG. Since the antecedents of locus of control in dealing with technology differ between males and females, we have investigated the effect of sex of participant and experimenter on the outcomes of neurofeedback training. Mindfulness and SMR baseline power also were assessed as possible confounding variables. Undergraduate psychology students (n = 142) took part in a single session of neurofeedback training conducted by either male or female experimenters. Male participants as well as those female participants instructed by male experimenters were able to upregulate SMR, while female participants trained by female experimenters were not. A strong positive correlation between training outcomes and locus of control in dealing with technology was observed only in the female participants trained by female experimenters. These results are suggestive about the impact of psychosocial factors—particularly gender-related effects—on neurofeedback training outcomes and the urgent need to document it in neurofeedback studies.

Self-regulation of brain activity and its effect on cognitive function in patients with multiple sclerosis - First insights from an interventional study using neurofeedback

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.

Comparison of effects between SMR/delta-ratio and beta1/theta-ratio neurofeedback training for older adults with Mild Cognitive Impairment: a protocol for a randomized controlled trial

Background

Older adults with Mild Cognitive Impairment (MCI) are at high risk of progressing to Alzheimer’s disease (AD). Slowing down the effect of dementia by enhancing brain plasticity represents one of the most prominent challenges. Neurofeedback (NF) has shown promising results in improving working memory but has never been evaluated in people with MCI. We aim to examine whether NF training can decrease cognitive disorders, targeting memory, attention functions and brain electrical activity in elderly patients with MCI.

Methods

In this single-blind, randomized controlled trial (RCT) protocol, we will investigate the effects of two NF training protocols on cognitive performances and on brain electrical activity. Sixty MCI patients will be assigned either to an intervention program or to psycho-pedagogical care as a control condition. Participants in the intervention group will attend 30 sessions of sensorimotor/delta-ratio NF training or beta1/theta-ratio NF training. Neuropsychological assessment, questionnaires and electroencephalography (EEG) assessment parameters will be used as dependent variables in three periods: at baseline (T0), immediately after the last NF training session at 4 months (T1) and at 3-month follow-up (T2). The primary outcome will be the change in attention measured with the Trail Making Test B. Secondary outcome will be the changes in cognitive performance and in EEG activities.

Discussion

If the results of our study show improvement in cognitive performances of older adults with MCI, this non-invasive, low-cost technique may deserve better consideration as a therapeutic intervention to delay cognitive decline and dementia. Consequently, research in NF will need to review and develop the rigor of its application in gerontology.

Trial registration

ClinicalTrials.gov, ID: NCT03526692. Registered on 16 May 2018.

Electronic supplementary material

The online version of this article (10.1186/s13063-018-3170-x) contains supplementary material, which is available to authorized users.

SMR Neurofeedback Training Facilitates Working Memory Performance in Healthy Older Adults: A Behavioral and EEG Study

Cognitive aging has become a major concern because life expectancy has increased and elderly populations are socially and economically active. Neurofeedback is a technique of neuromodulation through operant conditioning paradigm that uses a computer interface to provide real-time information about brain activity to increase individual self-perception and assist in modulation. The sensorimotor rhythm (SMR) training protocol is known to enhance attention and has been applied to improve cognitive performance, primarily for attention and memory gains. The aim of this study is to test if the SMR protocol can improve working memory performance in an aging population and consequently favor cognitive reserve. Seventeen older adults (12 females) took part in a randomized placebo-controlled study. They completed a visual working memory test, Delayed Matching to Sample Task (DMTS), before and after the SMR neurofeedback protocol in order to compare their visual working memory performance. Moreover, a 19-channels EEG was collected while they perform the DMTS pre- and post-training. The experimental group showed an improvement in their working memory performance after the training with similar activation power, mainly in theta and beta frequency band at frontal and alpha at temporal regions. The sham group showed some variations in the score of working memory after the training, but were not statistically significant and their power spectrum demonstrate enhancement in alpha and beta band frontal and temporal. The group that did not receive neurofeedback training did not show a change in their working memory performance, neither in their EEG spectrum. The results suggest that neurofeedback can benefit brain reserve in an aging population because individuals enhanced their working memory performance after training and have their EEG activation changed according to expected in working memory tasks.