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Askovic M, Soh N, Elhindi J, Harris AW. Neurofeedback for post-traumatic stress disorder: systematic review and meta-analysis of clinical and neurophysiological outcomes. Eur J Psychotraumatol 2023; 14:2257435. [PMID: 37732560 PMCID: PMC10515677 DOI: 10.1080/20008066.2023.2257435] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 07/22/2023] [Indexed: 09/22/2023] Open
Abstract
Background: Posttraumatic stress disorder (PTSD) is a debilitating condition affecting millions of people worldwide. Existing treatments often fail to address the complexity of its symptoms and functional impairments resulting from severe and prolonged trauma. Electroencephalographic Neurofeedback (NFB) has emerged as a promising treatment that aims to reduce the symptoms of PTSD by modulating brain activity.Objective: We conducted a systematic review and meta-analysis of ten clinical trials to answer the question: how effective is NFB in addressing PTSD and other associated symptoms across different trauma populations, and are these improvements related to neurophysiological changes?Method: The review followed the Preferred Reporting Items for Systematic Reviews and Meta analyses guidelines. We considered all published and unpublished randomised controlled trials (RCTs) and non-randomised studies of interventions (NRSIs) involving adults with PTSD as a primary diagnosis without exclusion by type of trauma, co-morbid diagnosis, locality, or sex. Ten controlled studies were included; seven RCTs and three NRSIs with a total number of participants n = 293 (128 male). Only RCTs were included in the meta-analysis (215 participants; 88 male).Results: All included studies showed an advantage of NFB over control conditions in reducing symptoms of PTSD, with indications of improvement in symptoms of anxiety and depression and related neurophysiological changes. Meta-analysis of the pooled data shows a significant reduction in PTSD symptoms post-treatment SMD of -1.76 (95% CI -2.69, -0.83), and the mean remission rate was higher in the NFB group (79.3%) compared to the control group (24.4%). However, the studies reviewed were mostly small, with heterogeneous populations and varied quality.Conclusions: The effect of NFB on the symptoms of PTSD was moderate and mechanistic evidence suggested that NFB leads to therapeutic changes in brain functioning. Future research should focus on more rigorous methodological designs, expanded sample size and longer follow-up.
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Affiliation(s)
- Mirjana Askovic
- New South Wales Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS), Sydney, NSW, Australia
- Specialty of Psychiatry, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
- Brain Dynamics Centre, Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia
| | - Nerissa Soh
- Specialty of Psychiatry, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - James Elhindi
- Research and Education Network, Western Sydney Local Health District, Sydney, NSW, Australia
| | - Anthony W.F. Harris
- Specialty of Psychiatry, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
- Brain Dynamics Centre, Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia
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Makale MT, Abbasi S, Nybo C, Keifer J, Christman L, Fairchild JK, Yesavage J, Blum K, Gold MS, Baron D, Cadet JL, Elman I, Dennen CA, Murphy KT. Personalized repetitive transcranial magnetic stimulation (prtms®) for post-traumatic stress disorder (ptsd) in military combat veterans. Heliyon 2023; 9:e18943. [PMID: 37609394 PMCID: PMC10440537 DOI: 10.1016/j.heliyon.2023.e18943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 07/31/2023] [Accepted: 08/03/2023] [Indexed: 08/24/2023] Open
Abstract
Emerging data suggest that post-traumatic stress disorder (PTSD) arises from disrupted brain default mode network (DMN) activity manifested by dysregulated encephalogram (EEG) alpha oscillations. Hence, we pursued the treatment of combat veterans with PTSD (n = 185) using an expanded form of repetitive transcranial magnetic stimulation (rTMS) termed personalized-rTMS (PrTMS). In this treatment methodology spectral EEG based guidance is used to iteratively optimize symptom resolution via (1) stimulation of multiple motor sensory and frontal cortical sites at reduced power, and (2) adjustments of cortical treatment loci and stimulus frequency during treatment progression based on a proprietary frequency algorithm (PeakLogic, Inc. San Diego) identifying stimulation frequency in the DMN elements of the alpha oscillatory band. Following 4 - 6 weeks of PrTMS® therapy in addition to routine PTSD therapy, veterans exhibited significant clinical improvement accompanied by increased cortical alpha center frequency and alpha oscillatory synchronization. Full resolution of PTSD symptoms was attained in over 50% of patients. These data support DMN involvement in PTSD pathophysiology and suggest a role in therapeutic outcomes. Prospective, sham controlled PrTMS® trials may be warranted to validate our clinical findings and to examine the contribution of DMN targeting for novel preventive, diagnostic, and therapeutic strategies tailored to the unique needs of individual patients with both combat and non-combat PTSD.
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Affiliation(s)
- Milan T. Makale
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA, 92093, USA
| | - Shaghayegh Abbasi
- Department of Electrical Engineering, University of Portland, Portland, OR, 97203, USA
| | - Chad Nybo
- CrossTx Inc., Bozeman, MT, 59715, USA
| | | | | | - J. Kaci Fairchild
- Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94305, USA
- Sierra Pacific Mental Illness Research, Education, and Clinical Center, VA Medical Center, Palo Alto, CA, 94304, USA
| | - Jerome Yesavage
- Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94305, USA
| | - Kenneth Blum
- Division of Addiction Research & Education, Center for Sports, Exercise & Global Mental Health, Western University Health Sciences, Pomona, USA
- Department of Clinical Psychology and Addiction, Institute of Psychology, Faculty of Education and Psychology, Eötvös Loránd University, Hungary
- Department of Psychiatry, Wright University, Boonshoft School of Medicine, Dayton, OH, USA
- Department of Molecular Biology and Adelson School of Medicine, Ariel University, Ariel, Israel
| | - Mark S. Gold
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - David Baron
- Division of Addiction Research & Education, Center for Sports, Exercise & Global Mental Health, Western University Health Sciences, Pomona, USA
| | - Jean Lud Cadet
- Molecular Neuropsychiatry Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | - Igor Elman
- Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA
| | - Catherine A. Dennen
- Department of Family Medicine, Jefferson Health Northeast, Philadelphia, PA, USA
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Saibene A, Caglioni M, Corchs S, Gasparini F. EEG-Based BCIs on Motor Imagery Paradigm Using Wearable Technologies: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2023; 23:2798. [PMID: 36905004 PMCID: PMC10007053 DOI: 10.3390/s23052798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/21/2023] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
In recent decades, the automatic recognition and interpretation of brain waves acquired by electroencephalographic (EEG) technologies have undergone remarkable growth, leading to a consequent rapid development of brain-computer interfaces (BCIs). EEG-based BCIs are non-invasive systems that allow communication between a human being and an external device interpreting brain activity directly. Thanks to the advances in neurotechnologies, and especially in the field of wearable devices, BCIs are now also employed outside medical and clinical applications. Within this context, this paper proposes a systematic review of EEG-based BCIs, focusing on one of the most promising paradigms based on motor imagery (MI) and limiting the analysis to applications that adopt wearable devices. This review aims to evaluate the maturity levels of these systems, both from the technological and computational points of view. The selection of papers has been performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), leading to 84 publications considered in the last ten years (from 2012 to 2022). Besides technological and computational aspects, this review also aims to systematically list experimental paradigms and available datasets in order to identify benchmarks and guidelines for the development of new applications and computational models.
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Affiliation(s)
- Aurora Saibene
- Department of Informatics, Systems and Communication, University of Milano-Bicocca, Viale Sarca 336, 20126 Milano, Italy
- NeuroMI, Milan Center for Neuroscience, Piazza dell’Ateneo Nuovo 1, 20126 Milano, Italy
| | - Mirko Caglioni
- Department of Informatics, Systems and Communication, University of Milano-Bicocca, Viale Sarca 336, 20126 Milano, Italy
| | - Silvia Corchs
- NeuroMI, Milan Center for Neuroscience, Piazza dell’Ateneo Nuovo 1, 20126 Milano, Italy
- Department of Theoretical and Applied Sciences, University of Insubria, Via J. H. Dunant 3, 21100 Varese, Italy
| | - Francesca Gasparini
- Department of Informatics, Systems and Communication, University of Milano-Bicocca, Viale Sarca 336, 20126 Milano, Italy
- NeuroMI, Milan Center for Neuroscience, Piazza dell’Ateneo Nuovo 1, 20126 Milano, Italy
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Dorokhov VB, Runnova A, Tkachenko ON, Taranov AO, Arseniev GN, Kiselev A, Selskii A, Orlova A, Zhuravlev M. Analysis two types of K complexes on the human EEG based on classical continuous wavelet transform. CHAOS (WOODBURY, N.Y.) 2023; 33:031102. [PMID: 37003802 DOI: 10.1063/5.0143284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 02/20/2023] [Indexed: 06/19/2023]
Abstract
In our work, we compare EEG time-frequency features for two types of K-complexes detected in volunteers performing the monotonous psychomotor test with their eyes closed. Type I K-complexes preceded spontaneous awakenings, while after type II K-complexes, subjects continued to sleep at least for 10 s after. The total number of K-complexes in the group of 18 volunteers was 646, of which of which type I K-complexes was 150 and type II K-complexes was 496. Time-frequency analysis was performed using continuous wavelet transform. EEG wavelet spectral power was averaged upon several brain zones for each of the classical frequency ranges (slow wave, δ, θ, α, β1, β2, γ bands). The low-frequency oscillatory activity ( δ-band) preceding type I K-complexes was asymmetrical and most prominent in the left hemisphere. Statistically significant differences were obtained by averaging over the left and right hemispheres, as well as projections of the motor area of the brain, p<0.05. The maximal differences between the types I and II of K-complexes were demonstrated in δ-, θ-bands in the occipital and posterior temporal regions. The high amplitude of the motor cortex projection response in β2-band, [20;30] Hz, related to the sensory-motor modality of task in monotonous psychomotor test. The δ-oscillatory activity preceding type I K-complexes was asymmetrical and most prominent in the left hemisphere may be due to the important role of the left hemisphere in spontaneous awakening from sleep during monotonous work, which is an interesting issue for future research.
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Affiliation(s)
- V B Dorokhov
- Laboratory of Sleep/Wake Neurobiology, Institute of Higher Nervous Activity and Neurophysiology of the Russian Academy of Sciences, 117865 Moscow, Russia
| | - A Runnova
- Center for Coordination of Fundamental Scientific Activities, National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia
| | - O N Tkachenko
- Laboratory of Sleep/Wake Neurobiology, Institute of Higher Nervous Activity and Neurophysiology of the Russian Academy of Sciences, 117865 Moscow, Russia
| | - A O Taranov
- Laboratory of Sleep/Wake Neurobiology, Institute of Higher Nervous Activity and Neurophysiology of the Russian Academy of Sciences, 117865 Moscow, Russia
| | - G N Arseniev
- Laboratory of Sleep/Wake Neurobiology, Institute of Higher Nervous Activity and Neurophysiology of the Russian Academy of Sciences, 117865 Moscow, Russia
| | - A Kiselev
- Center for Coordination of Fundamental Scientific Activities, National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia
| | - A Selskii
- Institute of Physics, Saratov State University, 410012 Saratov, Russia
| | - A Orlova
- Center for Coordination of Fundamental Scientific Activities, National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia
| | - M Zhuravlev
- Center for Coordination of Fundamental Scientific Activities, National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia
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Lieberman JM, Rabellino D, Densmore M, Frewen PA, Steyrl D, Scharnowski F, Théberge J, Neufeld RWJ, Schmahl C, Jetly R, Narikuzhy S, Lanius RA, Nicholson AA. Posterior cingulate cortex targeted real-time fMRI neurofeedback recalibrates functional connectivity with the amygdala, posterior insula, and default-mode network in PTSD. Brain Behav 2023; 13:e2883. [PMID: 36791212 PMCID: PMC10013955 DOI: 10.1002/brb3.2883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/07/2022] [Accepted: 12/12/2022] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Alterations within large-scale brain networks-namely, the default mode (DMN) and salience networks (SN)-are present among individuals with posttraumatic stress disorder (PTSD). Previous real-time functional magnetic resonance imaging (fMRI) and electroencephalography neurofeedback studies suggest that regulating posterior cingulate cortex (PCC; the primary hub of the posterior DMN) activity may reduce PTSD symptoms and recalibrate altered network dynamics. However, PCC connectivity to the DMN and SN during PCC-targeted fMRI neurofeedback remains unexamined and may help to elucidate neurophysiological mechanisms through which these symptom improvements may occur. METHODS Using a trauma/emotion provocation paradigm, we investigated psychophysiological interactions over a single session of neurofeedback among PTSD (n = 14) and healthy control (n = 15) participants. We compared PCC functional connectivity between regulate (in which participants downregulated PCC activity) and view (in which participants did not exert regulatory control) conditions across the whole-brain as well as in a priori specified regions-of-interest. RESULTS During regulate as compared to view conditions, only the PTSD group showed significant PCC connectivity with anterior DMN (dmPFC, vmPFC) and SN (posterior insula) regions, whereas both groups displayed PCC connectivity with other posterior DMN areas (precuneus/cuneus). Additionally, as compared with controls, the PTSD group showed significantly greater PCC connectivity with the SN (amygdala) during regulate as compared to view conditions. Moreover, linear regression analyses revealed that during regulate as compared to view conditions, PCC connectivity to DMN and SN regions was positively correlated to psychiatric symptoms across all participants. CONCLUSION In summary, observations of PCC connectivity to the DMN and SN provide emerging evidence of neural mechanisms underlying PCC-targeted fMRI neurofeedback among individuals with PTSD. This supports the use of PCC-targeted neurofeedback as a means by which to recalibrate PTSD-associated alterations in neural connectivity within the DMN and SN, which together, may help to facilitate improved emotion regulation abilities in PTSD.
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Affiliation(s)
- Jonathan M Lieberman
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Imaging, Lawson Health Research Institute, London, Ontario, Canada
| | - Daniela Rabellino
- Imaging, Lawson Health Research Institute, London, Ontario, Canada.,Department of Neuroscience, Western University, London, Ontario, Canada
| | - Maria Densmore
- Imaging, Lawson Health Research Institute, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada
| | - Paul A Frewen
- Department of Neuroscience, Western University, London, Ontario, Canada.,Department of Psychology, Western University, London, Ontario, Canada
| | - David Steyrl
- Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Vienna, Austria
| | - Frank Scharnowski
- Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Vienna, Austria
| | - Jean Théberge
- Imaging, Lawson Health Research Institute, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada.,Department of Medical Biophysics, Western University, London, Ontario, Canada.,Department of Diagnostic Imaging, St. Joseph's Healthcare, London, Ontario, Canada
| | - Richard W J Neufeld
- Department of Neuroscience, Western University, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada.,Department of Psychology, Western University, London, Ontario, Canada.,Department of Psychology, University of British Columbia, Okanagan, Kelowna, British Columbia, Canada
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Heidelberg University, Heidelberg, Germany
| | - Rakesh Jetly
- The Institute of Mental Health Research, University of Ottawa, Royal Ottawa Hospital, Ontario, Canada
| | - Sandhya Narikuzhy
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Ruth A Lanius
- Imaging, Lawson Health Research Institute, London, Ontario, Canada.,Department of Neuroscience, Western University, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada.,Homewood Research Institute, Guelph, Ontario, Canada
| | - Andrew A Nicholson
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Vienna, Austria.,Department of Medical Biophysics, Western University, London, Ontario, Canada.,The Institute of Mental Health Research, University of Ottawa, Royal Ottawa Hospital, Ontario, Canada.,Homewood Research Institute, Guelph, Ontario, Canada.,Atlas Institute for Veterans and Families, Ottawa, Ontario, Canada.,School of Psychology, University of Ottawa, Ottawa, Canada
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6
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Mostajo-Radji MA. A Latin American perspective on neurodiplomacy. FRONTIERS IN MEDICAL TECHNOLOGY 2023; 4:1005043. [PMID: 36712171 PMCID: PMC9880232 DOI: 10.3389/fmedt.2022.1005043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 12/08/2022] [Indexed: 01/15/2023] Open
Affiliation(s)
- Mohammed A. Mostajo-Radji
- UCSC Genomics Institute, University of California Santa Cruz, Santa Cruz, CA, United States,Live Cell Biotechnology Discovery Lab, University of California Santa Cruz, Santa Cruz, CA, United States,Correspondence: Mohammed A. Mostajo-Radji
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Shaw SB, Nicholson AA, Ros T, Harricharan S, Terpou B, Densmore M, Theberge J, Frewen P, Lanius RA. Increased top-down control of emotions during symptom provocation working memory tasks following a RCT of alpha-down neurofeedback in PTSD. Neuroimage Clin 2023; 37:103313. [PMID: 36669352 PMCID: PMC9868881 DOI: 10.1016/j.nicl.2023.103313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 12/31/2022] [Accepted: 01/02/2023] [Indexed: 01/05/2023]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) has been found to be associated with emotion under-modulation from the prefrontal cortex and a breakdown of the top-down control of cognition and emotion. Novel adjunct therapies such as neurofeedback (NFB) have been shown to normalize aberrant neural circuits that underlie PTSD psychopathology at rest. However, little evidence exists for NFB-linked neural improvements under emotionally relevant cognitive load. The current study sought to address this gap by examining the effects of alpha-down NFB in the context of an emotional n-back task. METHODS We conducted a 20-week double-blind randomized, sham-controlled trial of alpha-down NFB and collected neuroimaging data before and after the NFB protocol. Participants performed an emotional 1-back and 2-back working memory task, with interleaved trauma-neutral and trauma-relevant cues in the fMRI scanner. Data from 35 participants with a primary diagnosis of PTSD were analyzed in this study (n = 18 in the experimental group undergoing alpha-down NFB, n = 17 in the sham-control group). RESULTS Firstly, within-group analyses showed clinically significant reductions in PTSD symptom severity scores at the post-intervention timepoint and 3-month follow-up for the experimental group, and not for the sham-control group. The neuroimaging analyses revealed that alpha-down NFB enhanced engagement of top-down cognitive and emotional control centers, such as the dorsolateral prefrontal cortex (dlPFC), and improved integration of the anterior and posterior parts of the default mode network (DMN). Finally, our results also indicate that increased alpha-down NFB performance correlated with increased activity in brain regions involved in top-down control and bodily consciousness/embodied processing of self (TPJ and posterior insula). CONCLUSION This is the first study to provide mechanistic insights into how NFB may normalize dysfunctional brain activity and connectivity in PTSD under cognitive load with simultaneous symptom provocation, adding to a growing body of evidence supporting the therapeutic neuromodulatory effects of NFB. This preliminary study highlights the benefits of alpha-down NFB training as an adjunctive therapy for PTSD and warrants further investigation into its therapeutic effects on cognitive and emotion control in those with PTSD.
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Affiliation(s)
- Saurabh Bhaskar Shaw
- Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Vector Institute, Toronto, Ontario, Canada; Homewood Research Institute (HRI), Guelph, Ontario, Canada.
| | - Andrew A Nicholson
- School of Psychology, University of Ottawa, Canada; Atlas Institute for Veterans and Families, Royal Ottawa Hospital, Canada; Department of Psychiatry and Behavioral Neuroscience, McMaster University, Hamilton, Ontario, Canada; Department of Medical Biophysics, Western University, London, Ontario, Canada
| | - Tomas Ros
- Departments of Neuroscience and Psychiatry, University of Geneva, Geneva, Switzerland
| | - Sherain Harricharan
- Homewood Research Institute (HRI), Guelph, Ontario, Canada; Department of Psychiatry and Behavioral Neuroscience, McMaster University, Hamilton, Ontario, Canada; St. Joseph's Healthcare, Hamilton, Ontario, Canada
| | - Braeden Terpou
- Homewood Research Institute (HRI), Guelph, Ontario, Canada; Department of Psychiatry and Behavioral Neuroscience, McMaster University, Hamilton, Ontario, Canada
| | - Maria Densmore
- Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada
| | - Jean Theberge
- Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Department of Medical Biophysics, Western University, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; Department of Diagnostic Imaging, St. Joseph's Healthcare, London, Ontario, Canada
| | - Paul Frewen
- Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Ruth A Lanius
- Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Homewood Research Institute (HRI), Guelph, Ontario, Canada; St. Joseph's Healthcare, Hamilton, Ontario, Canada.
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8
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Hong J, Park JH. Efficacy of Neuro-Feedback Training for PTSD Symptoms: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13096. [PMID: 36293673 PMCID: PMC9603735 DOI: 10.3390/ijerph192013096] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/07/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
If the negative emotions experienced in life become trauma, they affect daily life. Neuro-feedback technology has recently been introduced as a treatment, but many different neuro-feedback protocols and methods exits. This study conducted a meta-analysis of neuro-feedback training for post-traumatic stress disorder (PTSD) symptoms to evaluate the effects of functional magnetic resonance imaging (fMRI) and electroencephalogram (EEG)-based neuro-feedback training. A search of PubMed, the Cochrane Library, Web of Science, Science Direct, and ClinicalTrials.gov was conducted from January 2011 to December 2021. The studies' quality was assessed using the Cochrane risk of bias tool and publication bias was assessed by Egger's regression test. Seven studies that met the inclusion criteria were used for the systematic review and meta-analysis. EEG was more effective than fMRI for PTSD symptoms, and the effect on PTSD symptoms was higher than on anxiety and depression. There was no difference in the effectiveness of the training sessions. Our findings showed that EEG-based neuro-feedback training was more helpful for training PTSD symptoms. Additionally, the methods were also shown to be valid for evaluating clinical PTSD diagnoses. Further research is needed to establish a gold standard protocol for the EEG-based neuro-feedback training (EEG-NFT) method for PTSD symptoms.
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Affiliation(s)
- Jian Hong
- Department of ICT Convergence, The Graduate School, Soonchunhyang University, Asan 31538, Korea
| | - Jin-Hyuck Park
- Department of Occupational Therapy, Soonchunhyang University, Asan 31538, Korea
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Korik A, McCreadie K, McShane N, Du Bois N, Khodadadzadeh M, Stow J, McElligott J, Carroll Á, Coyle D. Competing at the Cybathlon championship for people with disabilities: long-term motor imagery brain-computer interface training of a cybathlete who has tetraplegia. J Neuroeng Rehabil 2022; 19:95. [PMID: 36068570 PMCID: PMC9446658 DOI: 10.1186/s12984-022-01073-9] [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: 10/14/2021] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background The brain–computer interface (BCI) race at the Cybathlon championship, for people with disabilities, challenges teams (BCI researchers, developers and pilots with spinal cord injury) to control an avatar on a virtual racetrack without movement. Here we describe the training regime and results of the Ulster University BCI Team pilot who has tetraplegia and was trained to use an electroencephalography (EEG)-based BCI intermittently over 10 years, to compete in three Cybathlon events. Methods A multi-class, multiple binary classifier framework was used to decode three kinesthetically imagined movements (motor imagery of left arm, right arm, and feet), and relaxed state. Three game paradigms were used for training i.e., NeuroSensi, Triad, and Cybathlon Race: BrainDriver. An evaluation of the pilot’s performance is presented for two Cybathlon competition training periods—spanning 20 sessions over 5 weeks prior to the 2019 competition, and 25 sessions over 5 weeks in the run up to the 2020 competition. Results Having participated in BCI training in 2009 and competed in Cybathlon 2016, the experienced pilot achieved high two-class accuracy on all class pairs when training began in 2019 (decoding accuracy > 90%, resulting in efficient NeuroSensi and Triad game control). The BrainDriver performance (i.e., Cybathlon race completion time) improved significantly during the training period, leading up to the competition day, ranging from 274–156 s (255 ± 24 s to 191 ± 14 s mean ± std), over 17 days (10 sessions) in 2019, and from 230–168 s (214 ± 14 s to 181 ± 4 s), over 18 days (13 sessions) in 2020. However, on both competition occasions, towards the race date, the performance deteriorated significantly. Conclusions The training regime and framework applied were highly effective in achieving competitive race completion times. The BCI framework did not cope with significant deviation in electroencephalography (EEG) observed in the sessions occurring shortly before and during the race day. Changes in cognitive state as a result of stress, arousal level, and fatigue, associated with the competition challenge and performance pressure, were likely contributing factors to the non-stationary effects that resulted in the BCI and pilot achieving suboptimal performance on race day. Trial registration not registered Supplementary Information The online version contains supplementary material available at 10.1186/s12984-022-01073-9.
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Affiliation(s)
- Attila Korik
- Intelligent Systems Research Centre, Ulster University, Derry, UK.
| | - Karl McCreadie
- Intelligent Systems Research Centre, Ulster University, Derry, UK
| | - Niall McShane
- Intelligent Systems Research Centre, Ulster University, Derry, UK
| | - Naomi Du Bois
- Intelligent Systems Research Centre, Ulster University, Derry, UK
| | | | - Jacqui Stow
- National Rehabilitation Hospital of Ireland, Dun Laoghaire, Ireland
| | | | - Áine Carroll
- National Rehabilitation Hospital of Ireland, Dun Laoghaire, Ireland.,University College Dublin, Dublin, Ireland
| | - Damien Coyle
- Intelligent Systems Research Centre, Ulster University, Derry, UK
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10
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du Bois N, Bigirimana A, Korik A, Kéthina LG, Rutembesa E, Mutabaruka J, Mutesa L, Prasad G, Jansen S, Coyle D. Electroencephalography and psychological assessment datasets to determine the efficacy of a low-cost, wearable neurotechnology intervention for reducing Post-Traumatic Stress Disorder symptom severity. Data Brief 2022; 42:108066. [PMID: 35434211 PMCID: PMC9011039 DOI: 10.1016/j.dib.2022.108066] [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: 03/01/2022] [Revised: 03/11/2022] [Accepted: 03/14/2022] [Indexed: 11/29/2022] Open
Abstract
The datasets described here comprise electroencephalography (EEG) data and psychometric data freely available on data.mendeley.com. The EEG data is available in .mat formatted files containing the EEG signal values structured in two-dimensional (2D) matrices, with channel data and trigger information in rows, and samples in columns (having a sampling rate of 250Hz). Twenty-nine female survivors of the 1994 genocide against the Tutsi in Rwanda, underwent a psychological assessment before and after an intervention aimed at reducing Post-Traumatic Stress Disorder (PTSD) symptom severity. Three measures of trauma and four measures of wellbeing were assessed using empirically validated standardised assessments. The pre- and post- intervention psychometric data were analysed using non-parametric statistical methods and the post-intervention data were further evaluated according to diagnostic assessment rules to determine clinically relevant improvements for each group. The participants were assigned to a control group (CG, n = 9), a motor-imagery group (MI, n = 10), and a neurofeedback group (NF, n = 10). Participants in the latter two groups received Brain-Computer Interface (BCI) based training as a treatment intervention over a sixteen-day period, between the pre- and post- clinical interviews. The training involved presenting feedback visually via a videogame, based on real-time analysis of the EEG recorded data during the BCI-based treatment session. Participants were asked to regulate (NF) or intentionally modulate (MI) brain activity to affect/control the game.
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Gupta S, Goel L, Singh A, Agarwal AK, Singh RK. TOXGB: Teamwork Optimization Based XGBoost model for early identification of post-traumatic stress disorder. Cogn Neurodyn 2022; 16:833-846. [PMID: 35018201 PMCID: PMC8734551 DOI: 10.1007/s11571-021-09771-1] [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: 10/23/2021] [Revised: 11/25/2021] [Accepted: 12/13/2021] [Indexed: 11/03/2022] Open
Abstract
Post-traumatic stress (PTSD) is considered a clinical issue that influences numerous people from diverse trades all over the world. Numerous research scholars recorded diverse complexities to estimate the severity of the PTSD symptoms in the patients. But diagnosing PTSD and obtaining accurate diagnosing techniques becomes a more complicated task. Therefore, this paper develops a speech based post-traumatic stress disorder monitoring method and the significant objective of the proposed method is to determine if the patients are affected by PTSD. The proposed approach utilizes three different steps: pre-processing or pre-emphasis, feature extraction as well as classification to evaluate the patients affected by PTSD or not. The input speech signal is initially provided to the pre-processing phase where the speech gets segmented into frames. The speech frame is then extracted and classified using XGBoost based Teamwork optimization (XGB-TWO) algorithm. In addition to this, we utilized two different types of datasets namely TIMIT and FEMH to evaluate and classify the PSTD from the speech signals. Furthermore, based on the evaluation of the proposed model to diagnose PTSD patients, various evaluation metrics namely accuracy, specificity, sensitivity, and recall are evaluated. Finally, the experimental investigation and comparative analysis are carried out and the evaluation results demonstrated that the accuracy rate achieved for the proposed technique is 98.25%.
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Affiliation(s)
- Sonam Gupta
- Department of Computer Science and Engineering, Ajay Kumar Garg Engineering College, Ghaziabad, India
| | - Lipika Goel
- Department of Computer Science and Engineering, Gokaraju Rangaraju Institute of Engineering and Technology, Hyderabad, India
| | - Arjun Singh
- Department of Computer and Communication Engineering, Manipal University Jaipur, Rajasthan, India
| | - Abhay Kumar Agarwal
- Department of Computer Science and Engineering, Kamla Nehru Institute of Technology, Sultanpur, India
| | - Raushan Kumar Singh
- Department of Computer Science and Engineering, Kamla Nehru Institute of Technology, Sultanpur, India
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