Neurocognitive Enhancement Effects of Combined Mindfulness-Neurofeedback Training in Sport

Modest Effects of Neurofeedback-Assisted Meditation Using a Wearable Device on Stress Reduction: A Randomized, Double-Blind, and Controlled Study

BACKGROUND

To evaluate the therapeutic effectiveness and safety of a neurofeedback wearable device for stress reduction.

METHODS

A randomized, double-blind, controlled study was designed. Participants had psychological stress with depression or sleep disturbances. They practiced either neurofeedback-assisted meditation (n = 20; female, 15 [75.0%]; age, 49.40 ± 11.76 years) or neurofeedback non-assisted meditation (n = 18; female, 11 [61.1%]; age, 48.67 ± 12.90 years) for 12 minutes twice a day for two weeks. Outcome variables were self-reported questionnaires, including the Korean version of the Perceived Stress Scale, Beck Depression Inventory-II, Insomnia Severity Index, Pittsburgh Sleep Quality Index, and State Trait Anxiety Index, quantitative electroencephalography (qEEG), and blood tests. Satisfaction with device use was measured at the final visit.

RESULTS

The experimental group had a significant change in PSS score after two weeks of intervention compared with the control group (6.45 ± 0.95 vs. 3.00 ± 5.54, P = 0.037). State anxiety tended to have a greater effect in the experimental group than in the control group (P = 0.078). Depressive mood and sleep also improved in each group, with no significant difference between the two groups. There were no significant differences in stress-related physiological parameters, such as stress hormones or qEEG, between the two groups. Subjective device satisfaction was significantly higher in the experimental group than in the control group (P = 0.008).

CONCLUSION

Neurofeedback-assisted meditation using a wearable device can help improve subjective stress reduction compared with non-assisted meditation. These results support neurofeedback as an effective adjunct to meditation for relieving stress.

TRIAL REGISTRATION

Clinical Research Information Service Identifier: KCT0007413.

Digitally Assisted Mindfulness in Training Self-Regulation Skills for Sustainable Mental Health: A Systematic Review

The onset of the COVID-19 pandemic has led to an increased demand for mental health interventions, with a special focus on digitally assisted ones. Self-regulation describes a set of meta-skills that enable one to take control over his/her mental health and it is recognized as a vital indicator of well-being. Mindfulness training is a promising training strategy for promoting self-regulation, behavioral change, and mental well-being. A growing body of research outlines that smart technologies are ready to revolutionize the way mental health training programs take place. Artificial intelligence (AI); extended reality (XR) including virtual reality (VR), augmented reality (AR), and mixed reality (MR); as well as the advancements in brain computer interfaces (BCIs) are ready to transform these mental health training programs. Mindfulness-based interventions assisted by smart technologies for mental, emotional, and behavioral regulation seem to be a crucial yet under-investigated issue. The current systematic review paper aims to explore whether and how smart technologies can assist mindfulness training for the development of self-regulation skills among people at risk of mental health issues as well as populations with various clinical characteristics. The PRISMA 2020 methodology was utilized to respond to the objectives and research questions using a total of sixty-six experimental studies that met the inclusion criteria. The results showed that digitally assisted mindfulness interventions supported by smart technologies, including AI-based applications, chatbots, virtual coaches, immersive technologies, and brain-sensing headbands, can effectively assist trainees in developing a wide range of cognitive, emotional, and behavioral self-regulation skills, leading to a greater satisfaction of their psychological needs, and thus mental wellness. These results may provide positive feedback for developing smarter and more inclusive training environments, with a special focus on people with special training needs or disabilities.

Neurofeedback as neuroempowerment technique for affective regulation and interoceptive awareness in adolescence: preliminary considerations applied to a psychogenic pseudosyncope case

Revisions of classical models of acute stress response spectrum and defence cascade process might represent a valuable background for the interpretation of the link between affective reactions, traumatic experiences, and Psychogenic pseudosyncope (PPS) events in childhood and across the lifespan. Indeed, associations between subjective emotional life, early exposure to distressing and/or traumatic events, and PPS have fuelled a debate on potential causes of occurrence and recurrence of such a peculiar clinical manifestation. At the same time, such background suggests that empowering stress management and affective regulation skills could be the target for neurorehabilitation interventions aiming at reducing the severity of symptomatology and/or improving awareness and management of pseudosyncopal spells. Specifically, neuro/biofeedback-based empowerment of self-regulation skills, associated to an increased interoceptive increased awareness, could be a promising complement to classical psychological therapies. Starting from the presentation of a paediatric PPS clinical case, the present work discusses the relevance of assessing affective appraisal and autonomic reactivity in individuals suffering from PPS episodes and introduces a novel potential neuroempowerment protocol aimed at improving self-regulation and stress management skills in adolescence based on a combined neurofeedback and embodied-awareness intervention. By capitalizing available evidence of the effects of neuromodulation and embodied practices on self-awareness/regulation across the life-span, the proposed protocol is based on neurofeedback-supported affective management training, as well as both contemplative and informal awareness exercises devised to be appealing and challenging even for younger patients.

Psychological Skills Training for Athletes in Sports: Web of Science Bibliometric Analysis

Psychological Skill Training (PST) for optimal performance in sports has received extensive attention from athletes, coaches, and experts, and numerous studies have been conducted, but despite this interest, it has not been the subject of any bibliographic analysis. The analysis covered 405 articles and reviews that were located in the Thomson Reuters Web of Science (Core CollectionTM) between 1992 and 2021. These papers were published by 1048 authors from 543 different universities across 54 countries in 107 different journals. The fundamental bibliometric calculations and co-word networks were completed. As a result, the following thematic elements were grouped into four clusters: (1) PST for stress, mental toughness, and coping, (2) PST for anxiety, motivation, self-confidence, and self-efficacy, (3) PST for flow and mindfulness, and (4) PST for emotions. From the results of this study, it was confirmed that the topic of PST is converging toward the best performance, with various approaches, such as stress management, anxiety control, and coping as techniques for PST. Furthermore, mindfulness and positive psychology studies emphasize athletes' quality of life, so coaches and experts should pay more attention to improving athletes' quality of life in future research.

Effects of dual-task training in patients with post-stroke cognitive impairment: A randomized controlled trial

Background

Evidence for the efficacy of cognitive-motor dual-task (CMDT) training in patients with post-stroke cognitive impairment (PSCI) and no dementia is still lacking. More importantly, although some studies on the cognitive effect of CMDT training show an improvement in cognitive performance, the results are still controversial, and the intervention mechanism of CMDT training on cognitive function improvement is not clear. The main purpose of this study was to analyze the effects of CMDT training on cognitive function, neuron electrophysiology, and frontal lobe hemodynamics in patients with PSCI.

Methods

Here we tested the effects of CMDT training on cognitive function in PSCI patients. Forty subjects who met the criteria of PSCI were randomly assigned to control and experimental groups. CMDT training or cognitive task (CT) training was administered to each patient in the experimental and control groups, respectively. All subjects performed Mini-mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scale before and after the intervention, and the event-related potentials (ERP) and functional near-infrared spectroscopy (fNIRS) were used to evaluate the changes in neuron electrophysiology and hemodynamics.

Results

Forty patients were randomized across Beijing Rehabilitation Hospital Capital Medical University in Beijing. At the end of the intervention, 33 subjects completed the experimental process. The CMDT group showed significant improvement in the MMSE (P = 0.01) and MoCA (P = 0.024) relative to the CT group. The results of ERP and fNIRS showed that CMDT training could shorten the latency of P300 (P = 0.001) and the peak time of oxygenated hemoglobin (P = 0.004). The results showed that CMDT training shortened the response time of central neurons and significantly increased the rate of oxygen supply to the frontal lobe.

Conclusion

CMDT training in patients with PSCI improved global cognitive function, which was supported by the improved neural efficiency of associated brain areas.

Clinical trial registration

http://www.chictr.org.cn, identifier ChiCTR2000034862.

The Effect of Neurofeedback on the Reaction Time and Cognitive Performance of Athletes: A Systematic Review and Meta-Analysis

Our study evaluated the effect of training with neurofeedback (NFB) in improving athletes' reaction time and decision-making. A computerized search in PubMed, PsycINFO, Scielo, Web of Science, EMBASE, Scopus, BVS, and Cochrane databases was performed to identify studies published from 2011 to June 2021. The protocol was registered in PROSPERO. The quality of studies that was peer-reviewed and included was assessed using the Review Manager tool, Cochrane Risk of Bias, and design and reporting quality according to the CRED-nf checklist. Standard mean differences and 95% confidence intervals (CIs) were calculated and combined using a random-effects model. A total of 07 randomized controlled trials (RCTs) (173 athletes) met the inclusion criteria. Significant effects of NFB in the experimental group in relation to reaction time were found, indicating an improvement in sports performance [standardized mean difference (SMD) = −1.08; 95% CI = (−1.90, −0.25), p = 0.0009] and cognitive performance vs. decision-making with moderate effect [SMD = 1.12; 95% CI = (−0.40, 1.85), p = 0.0001]. However, the control group had a very small effect on cognitive performance [SMD = 0.19; 95% CI = (−0.20, 0.59), p = 0.086]. NFB could improve athletes' reaction time and decision-making, effectively increasing their performance in the sports field. Future studies should focus on standardized protocols for NFB training.

Mindfulness Practice with a Brain-Sensing Device Improved Cognitive Functioning of Elementary School Children: An Exploratory Pilot Study

This is the first pilot study with children that has assessed the effects of a brain-computer interface-assisted mindfulness program on neural mechanisms and associated cognitive performance. The participants were 31 children aged 9-10 years who were randomly assigned to either an eight-session mindfulness training with EEG-feedback or a passive control group. Mindfulness-related brain activity was measured during the training, while cognitive tests and resting-state brain activity were measured pre- and post-test. The within-group measurement of calm/focused brain states and mind-wandering revealed a significant linear change. Significant positive changes were detected in children's inhibition, information processing, and resting-state brain activity (alpha, theta) compared to the control group. Elevated baseline alpha activity was associated with less reactivity in reaction time on a cognitive test. Our exploratory findings show some preliminary support for a potential executive function-enhancing effect of mindfulness supplemented with EEG-feedback, which may have some important implications for children's self-regulated learning and academic achievement.

Evaluating deep learning EEG-based mental stress classification in adolescents with autism for breathing entrainment BCI

Mental stress is a major individual and societal burden and one of the main contributing factors that lead to pathologies such as depression, anxiety disorders, heart attacks, and strokes. Given that anxiety disorders are one of the most common comorbidities in youth with autism spectrum disorder (ASD), this population is particularly vulnerable to mental stress, severely limiting overall quality of life. To prevent this, early stress quantification with machine learning (ML) and effective anxiety mitigation with non-pharmacological interventions are essential. This study aims to investigate the feasibility of exploiting electroencephalography (EEG) signals for stress assessment by comparing several ML classifiers, namely support vector machine (SVM) and deep learning methods. We trained a total of eleven subject-dependent models-four with conventional brain-computer interface (BCI) methods and seven with deep learning approaches-on the EEG of neurotypical (n=5) and ASD (n=8) participants performing alternating blocks of mental arithmetic stress induction, guided and unguided breathing. Our results show that a multiclass two-layer LSTM RNN deep learning classifier is capable of identifying mental stress from ongoing EEG with an overall accuracy of 93.27%. Our study is the first to successfully apply an LSTM RNN classifier to identify stress states from EEG in both ASD and neurotypical adolescents, and offers promise for an EEG-based BCI for the real-time assessment and mitigation of mental stress through a closed-loop adaptation of respiration entrainment.

Alterations of Regional Homogeneity and Functional Connectivity Following Short-Term Mindfulness Meditation in Healthy Volunteers

Mindfulness is described as the non-judgmental awareness of experiences in the present moment. The sustained practice of mindfulness may also have beneficial effects on an individual's well-being. For instance, mindfulness meditation is an effective approach for improving emotion regulation. Specifically, the early stage of mindfulness meditation training enhances emotional monitoring systems related to attention regulation and executive function. Reduced activity in the default mode network (DMN) would probably be observed corresponding to the attenuated mind wandering. In the present study, we hypothesized that alterations in functional activity in the frontal-parietal cortex and DMN may be induced by short-term mindfulness meditation. In this study, before and after 8 weeks of weekly Mindfulness-Based Stress Reduction (MBSR) training, healthy participants were evaluated using a mindfulness questionnaire and an affect schedule, as well as via resting-state functional magnetic resonance imaging. Sixteen right-handed non-meditators were enrolled. Another 16 demographically matched healthy adults without any meditation experience were recruited as controls. Pre- and post-MBSR assessments were compared. Increased regional homogeneity in the right superior parietal lobule and left postcentral gyrus (PoCG), as well as altered functional connectivity in PoCG-related networks, were observed post-MBSR. The mindfulness questionnaire scores also improved and negative affect was significantly decreased after MBSR. Together with reduced involvement of the posterior brain, our results suggest a tendency toward stronger involvement of the parietal cortex in mindfulness beginners. This study provides novel evidence regarding the optimization of emotional processing with short-term mindfulness meditation.

Efficacy of a Neurofeedback Training on Attention and Driving Performance: Physiological and Behavioral Measures

Increased attention and lower stress levels are associated with more functional and safe driving behavior, since they contribute to reduce distractibility and risk-taking at the wheel. Previous neuroscience research highlighted that NeuroFeedback (NF) training mediated by wearable devices could be effective in terms of neurocognitive strengthening and attention regulation with a direct effect on driving attentional performance. Thus, this research aims to test the effectiveness of a NF protocol on a sample of drivers, to observe its impact on attentional skills and psychophysiological levels of stress involved in driving behavior. 50 participants were randomly assigned to the experimental and active control group. The experimental condition consisted of a 21-day mindfulness NF training with incremental duration sessions. A pre- (t0) and post-treatment (t1) assessment included behavioral, psychometric, neuropsychological, and psychophysiological autonomic measures. Specifically, the Driver Behavior Questionnaire (DBQ) and the Active Box (AB) device were used to evaluate the everyday driving behavior. Results underlined an improvement in driving behavior performance and a decrease of violations at the wheel of the experimental group (EXPg) at t1 measured, respectively by AB and DBQ. About the autonomic and neuropsychological measure, an increase in heart rate (HR) and an increased accuracy at the Stroop Task were detected: a specific increase of Stroop-related HR was found for the EXPg at t1. Also, reduced reaction times were found in the Multiple Features Target Cancellation for the EXPg at t1. Overall, the EXPg displayed a physiological, behavioral and neuropsychological increased efficiency related to attention as well as a driving-related behavioral improvement after NF training.