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EEG-Neurofeedback as a Potential Therapeutic Approach for Cognitive Deficits in Patients with Dementia, Multiple Sclerosis, Stroke and Traumatic Brain Injury. Life (Basel) 2023; 13:life13020365. [PMID: 36836721 PMCID: PMC9966294 DOI: 10.3390/life13020365] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/21/2023] [Accepted: 01/25/2023] [Indexed: 01/31/2023] Open
Abstract
Memory deficits are common in patients with dementia, such as Alzheimer's disease, but also in patients with other neurological and psychiatric disorders, such as brain injury, multiple sclerosis, ischemic stroke and schizophrenia. Memory loss affects patients' functionality and, by extension, their quality of life. Non-invasive brain training methods, such as EEG neurofeedback, are used to address cognitive deficits and behavioral changes in dementia and other neurological disorders by training patients to alter their brain activity via operant activity. In this review paper, we analyze various protocols of EEG neurofeedback in memory rehabilitation in patients with dementia, multiple sclerosis, strokes and traumatic brain injury. The results from the studies show the effectiveness of the ΕΕG-NFB method in improving at least one cognitive domain, regardless of the number of sessions or the type of protocol applied. In future research, it is important to address methodological weaknesses in the application of the method, its long-term effects as well as ethical issues.
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Yang B, Huang Y, Li Z, Hu X. Management of Post-stroke Depression (PSD) by Electroencephalography for Effective Rehabilitation. ENGINEERED REGENERATION 2022. [DOI: 10.1016/j.engreg.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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Lambert-Beaudet F, Journault WG, Rudziavic Provençal A, Bastien CH. Neurofeedback for insomnia: Current state of research. World J Psychiatry 2021; 11:897-914. [PMID: 34733650 PMCID: PMC8546766 DOI: 10.5498/wjp.v11.i10.897] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 05/18/2021] [Accepted: 08/27/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Chronic insomnia affects about 6%-13% of the Canadian population. Although treatments already exist, they each have their own issues. Neurofeedback is a neuromodulation technique that specifically targets abnormal brain activity and is gaining attention as a possible insomnia treatment.
AIM To review the latest studies pertaining to the use of neurofeedback in the treatment of insomnia.
METHODS In this non-systematic review, only experimental studies assessing the effects of neurofeedback on patients with insomnia were targeted across four bibliographic databases.
RESULTS A total of 12 studies were retained. All neurofeedback studies included in this study showed a clear improvement of subjective sleep. However, data concerning objective improvement are contradictory. Most studies regarding surface and z-score neurofeedback show that neurofeedback targeting the sensorimotor rhythm in the sensorimotor cortex may help improve subjective sleep. A placebo effect seems also to be present in some studies. Several limitations were present in each study.
CONCLUSION While studies concerning neurofeedback as a treatment for insomnia are encouraging, many methodological barriers remain to be resolved to prove its efficacy unequivocally. More studies using robust design parameters, as well as the replication of existing studies, are necessary to support neurofeedback as an effective treatment for insomnia.
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Affiliation(s)
| | | | | | - Célyne H Bastien
- Department of Psychology, School of Psychology Laval University, Québec G1V0A6, Canada
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Białkowska J, Mroczkowska D, Wickland-Białkowska M. The use of EEG biofeedback to improve memory, concentration, attention and reduce emotional tension. REHABILITACJA MEDYCZNA 2019. [DOI: 10.5604/01.3001.0013.5097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Biofeedback is a method of giving patients computerised feedback signals about changes in the physiological state of their body. This allows them to learn how to consciously modify functions not controlled consciously. This method allows active and conscious involvement of the patient in controlling their own physiological processes. The therapy aims to regulate the frequency of human brain waves. The human brain produces different ranges of waves that are characteristic of different types of human activity, a mechanism used in this method. The use of this method in routine rehabilitation with a specifically designed computer programme provides physicians, physiotherapists, neuropsychologists and speech therapists with a new tool for treatment, opportunities for improvement in treatment, and helps them better plan and develop treatment strategies using Evidence-Based Medicine. The aim of the work is to discuss how EEG Biofeedback software can be applied in neurorehabilitation and to discuss the use of EEG Biofeedback software in order to improve memory, concentration, attention, reduce emotional tension, increase resistance to stress, improve self-control, self-esteem and relaxation.
Key words
EEG biofeedback, neurorehabilitation, computer software in rehabilitation
Article received: 14.01.2019; Accepted: 17.09.2019
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Affiliation(s)
- Joanna Białkowska
- Department of Public Health, Faculty of Health Sciences, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Clinical University Hospital in Olsztyn, Poland / Wydział Nauk o Zdrowiu, Collegium Medicum. Uniwersytet Warmińsko-Mazurski w Olsztynie
| | - Dorota Mroczkowska
- Department of Public Health, Faculty of Health Sciences, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Clinical University Hospital in Olsztyn, Poland / Wydział Nauk o Zdrowiu, Collegium Medicum. Uniwersytet Warmińsko-Mazurski w Olsztynie
| | - Martyna Wickland-Białkowska
- Voivodeship Specialist Children’s Hospital in Olsztyn, Poland / Wojewódzki Specjalistyczny Szpital Dziecięcy w Olsztynie
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Wang T, Mantini D, Gillebert CR. The potential of real-time fMRI neurofeedback for stroke rehabilitation: A systematic review. Cortex 2017; 107:148-165. [PMID: 28992948 PMCID: PMC6182108 DOI: 10.1016/j.cortex.2017.09.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 08/02/2017] [Accepted: 09/07/2017] [Indexed: 12/17/2022]
Abstract
Real-time functional magnetic resonance imaging (rt-fMRI) neurofeedback aids the modulation of neural functions by training self-regulation of brain activity through operant conditioning. This technique has been applied to treat several neurodevelopmental and neuropsychiatric disorders, but its effectiveness for stroke rehabilitation has not been examined yet. Here, we systematically review the effectiveness of rt-fMRI neurofeedback training in modulating motor and cognitive processes that are often impaired after stroke. Based on predefined search criteria, we selected and examined 33 rt-fMRI neurofeedback studies, including 651 healthy individuals and 15 stroke patients in total. The results of our systematic review suggest that rt-fMRI neurofeedback training can lead to a learned modulation of brain signals, with associated changes at both the neural and the behavioural level. However, more research is needed to establish how its use can be optimized in the context of stroke rehabilitation.
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Affiliation(s)
- Tianlu Wang
- Department of Brain & Cognition, University of Leuven, Leuven, Belgium
| | - Dante Mantini
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom; Research Center for Movement Control and Neuroplasticity, University of Leuven, Leuven, Belgium; Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Celine R Gillebert
- Department of Brain & Cognition, University of Leuven, Leuven, Belgium; Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom.
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Neurofeedback as a form of cognitive rehabilitation therapy following stroke: A systematic review. PLoS One 2017; 12:e0177290. [PMID: 28510578 PMCID: PMC5433697 DOI: 10.1371/journal.pone.0177290] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Accepted: 04/25/2017] [Indexed: 11/19/2022] Open
Abstract
Neurofeedback therapy (NFT) has been used within a number of populations however it has not been applied or thoroughly examined as a form of cognitive rehabilitation within a stroke population. Objectives for this systematic review included: i) identifying how NFT is utilized to treat cognitive deficits following stroke, ii) examining the strength and quality of evidence to support the use of NFT as a form of cognitive rehabilitation therapy (CRT) and iii) providing recommendations for future investigations. Searches were conducted using OVID (Medline, Health Star, Embase + Embase Classic) and PubMed databases. Additional searches were completed using the Cochrane Reviews library database, Google Scholar, the University of Toronto online library catalogue, ClinicalTrials.gov website and select journals. Searches were completed Feb/March 2015 and updated in June/July/Aug 2015. Eight studies were eligible for inclusion in this review. Studies were eligible for inclusion if they: i) were specific to a stroke population, ii) delivered CRT via a NFT protocol, iii) included participants who were affected by a cognitive deficit(s) following stroke (i.e. memory loss, loss of executive function, speech impairment etc.). NFT protocols were highly specific and varied within each study. The majority of studies identified improvements in participant cognitive deficits following the initiation of therapy. Reviewers assessed study quality using the Downs and Black Checklist for Measuring Study Quality tool; limited study quality and strength of evidence restricted generalizability of conclusions regarding the use of this therapy to the greater stroke population. Progression in this field requires further inquiry to strengthen methodology quality and study design. Future investigations should aim to standardize NFT protocols in an effort to understand the dose-response relationship between NFT and improvements in functional outcome. Future investigations should also place a large emphasis on long-term participant follow-up.
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Kober SE, Schweiger D, Reichert JL, Neuper C, Wood G. Upper Alpha Based Neurofeedback Training in Chronic Stroke: Brain Plasticity Processes and Cognitive Effects. Appl Psychophysiol Biofeedback 2017; 42:69-83. [PMID: 28197747 PMCID: PMC5344963 DOI: 10.1007/s10484-017-9353-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
In the present study, we investigated the effects of upper alpha based neurofeedback (NF) training on electrical brain activity and cognitive functions in stroke survivors. Therefore, two single chronic stroke patients with memory deficits (subject A with a bilateral subarachnoid hemorrhage; subject B with an ischemic stroke in the left arteria cerebri media) and a healthy elderly control group (N = 24) received up to ten NF training sessions. To evaluate NF training effects, all participants performed multichannel electroencephalogram (EEG) resting measurements and a neuropsychological test battery assessing different cognitive functions before and after NF training. Stroke patients showed improvements in memory functions after successful NF training compared to the pre-assessment. Subject B had a pathological delta (0.5-4 Hz) and upper alpha (10-12 Hz) power maximum over the unaffected hemisphere before NF training. After NF training, he showed a more bilateral and "normalized" topographical distribution of these EEG frequencies. Healthy participants as well as subject A did not show any abnormalities in EEG topography before the start of NF training. Consequently, no changes in the topographical distribution of EEG activity were observed in these participants when comparing the pre- and post-assessment. Hence, our results show that upper alpha based NF training had on the one hand positive effects on memory functions, and on the other hand led to cortical "normalization" in a stroke patient with pathological brain activation patterns, which underlines the potential usefulness of NF as neurological rehabilitation tool.
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Affiliation(s)
- Silvia Erika Kober
- Department of Psychology, University of Graz, Universitaetsplatz 2/III, 8010 Graz, Austria
- BioTechMed-Graz, Mozartgasse 12/II, Graz, 8010 Austria
| | - Daniela Schweiger
- Department of Psychology, University of Graz, Universitaetsplatz 2/III, 8010 Graz, Austria
| | | | - Christa Neuper
- Department of Psychology, University of Graz, Universitaetsplatz 2/III, 8010 Graz, Austria
- BioTechMed-Graz, Mozartgasse 12/II, Graz, 8010 Austria
- Institute of Neural Engineering, Laboratory of Brain-Computer Interfaces, Graz University of Technology, Stremayrgasse 16, Graz, 8010 Austria
| | - Guilherme Wood
- Department of Psychology, University of Graz, Universitaetsplatz 2/III, 8010 Graz, Austria
- BioTechMed-Graz, Mozartgasse 12/II, Graz, 8010 Austria
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Reichert JL, Kober SE, Schweiger D, Grieshofer P, Neuper C, Wood G. Shutting Down Sensorimotor Interferences after Stroke: A Proof-of-Principle SMR Neurofeedback Study. Front Hum Neurosci 2016; 10:348. [PMID: 27471456 PMCID: PMC4945651 DOI: 10.3389/fnhum.2016.00348] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 06/24/2016] [Indexed: 11/13/2022] Open
Abstract
Introduction: Neurofeedback training aims at learning self-regulation of brain activity underlying cognitive, emotional or physiological functions. Despite of promising investigations on neurofeedback as a tool for cognitive rehabilitation in neurological diseases, such as after stroke, there is still a lack of research on feasibility and efficiency of neurofeedback in this field. Methods: The present study aimed at investigating behavioral and electrophysiological effects of 10 sessions of sensorimotor rhythm (SMR) neurofeedback in a 74-years-old stroke patient (UG20). Based on previous results in healthy young participants, we hypothesized that SMR neurofeedback leads to a decrease in sensorimotor interferences and improved stimulus processing, reflected by changes in event-related potentials (ERPs) and electrophysiological coherence. To assess whether UG20 benefited from the training as much as healthy persons of a similar age, a healthy control group of N = 10 elderly persons was trained as well. Before and after neurofeedback training, participants took part in a multichannel electroencephalography measurement conducted during a non-verbal and a verbal learning task. Results: Both UG20 and the healthy controls were able to regulate their SMR activity during neurofeedback training. Moreover, in a non-verbal learning task, changes in ERPs and coherence were observed after training: UG20 showed a better performance in the non-verbal learning task and a higher P3 amplitude after training than before, and coherence between central and parietal electrodes decreased after training. The control group also showed a behavioral improvement in the non-verbal learning task and tendencies for higher P3 amplitudes and decreased central-parietal coherence after training. Single-case analyses indicated that the changes observed in UG20 were not smaller than the changes in healthy controls. Conclusion: Neurofeedback can be successfully applied in a stroke patient and in healthy elderly persons. We suggest that SMR neurofeedback leads to a shutting-down of sensorimotor interferences which benefits semantic encoding and retrieval.
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Affiliation(s)
- Johanna L Reichert
- Institute of Psychology, University of GrazGraz, Austria; BioTechMed GrazGraz, Austria
| | - Silvia E Kober
- Institute of Psychology, University of GrazGraz, Austria; BioTechMed GrazGraz, Austria
| | | | | | - Christa Neuper
- Institute of Psychology, University of Graz Graz, Austria
| | - Guilherme Wood
- Institute of Psychology, University of Graz Graz, Austria
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Kober SE, Schweiger D, Witte M, Reichert JL, Grieshofer P, Neuper C, Wood G. Specific effects of EEG based neurofeedback training on memory functions in post-stroke victims. J Neuroeng Rehabil 2015; 12:107. [PMID: 26625906 PMCID: PMC4666277 DOI: 10.1186/s12984-015-0105-6] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 11/24/2015] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Using EEG based neurofeedback (NF), the activity of the brain is modulated directly and, therefore, the cortical substrates of cognitive functions themselves. In the present study, we investigated the ability of stroke patients to control their own brain activity via NF and evaluated specific effects of different NF protocols on cognition, in particular recovery of memory. METHODS N = 17 stroke patients received up to ten sessions of either SMR (N = 11, 12-15 Hz) or Upper Alpha (N = 6, e.g. 10-12 Hz) NF training. N = 7 stroke patients received treatment as usual as control condition. Furthermore, N = 40 healthy controls performed NF training as well. To evaluate the NF training outcome, a test battery assessing different cognitive functions was performed before and after NF training. RESULTS About 70 % of both patients and controls achieved distinct gains in NF performance leading to improvements in verbal short- and long-term memory, independent of the used NF protocol. The SMR patient group showed specific improvements in visuo-spatial short-term memory performance, whereas the Upper Alpha patient group specifically improved their working memory performance. NF training effects were even stronger than effects of traditional cognitive training methods in stroke patients. NF training showed no effects on other cognitive functions than memory. CONCLUSIONS Post-stroke victims with memory deficits could benefit from NF training as much as healthy controls. The used NF training protocols (SMR, Upper Alpha) had specific as well as unspecific effects on memory. Hence, NF might offer an effective cognitive rehabilitation tool improving memory deficits of stroke survivors.
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Affiliation(s)
- Silvia Erika Kober
- Department of Psychology, University of Graz, Universitaetsplatz 2/III, Graz, 8010, Austria.
- BioTechMed-Graz, Graz, Austria.
| | - Daniela Schweiger
- Department of Psychology, University of Graz, Universitaetsplatz 2/III, Graz, 8010, Austria.
| | - Matthias Witte
- Department of Psychology, University of Graz, Universitaetsplatz 2/III, Graz, 8010, Austria.
| | - Johanna Louise Reichert
- Department of Psychology, University of Graz, Universitaetsplatz 2/III, Graz, 8010, Austria.
| | | | - Christa Neuper
- Department of Psychology, University of Graz, Universitaetsplatz 2/III, Graz, 8010, Austria.
- BioTechMed-Graz, Graz, Austria.
- Laboratory of Brain-Computer Interfaces, Institute for Knowledge Discovery, Graz University of Technology, Graz, Austria.
| | - Guilherme Wood
- Department of Psychology, University of Graz, Universitaetsplatz 2/III, Graz, 8010, Austria.
- BioTechMed-Graz, Graz, Austria.
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Mroczkowska D, Białkowska J, Rakowska A. Neurofeedback as supportive therapy after stroke. Case report. POSTEPY PSYCHIATRII I NEUROLOGII 2014. [DOI: 10.1016/j.pin.2014.09.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sherlin LH, Larson NC, Sherlin RM. Developing a Performance Brain Training™ Approach for Baseball: A Process Analysis with Descriptive Data. Appl Psychophysiol Biofeedback 2012; 38:29-44. [DOI: 10.1007/s10484-012-9205-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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