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Marcu GM, Dumbravă A, Băcilă IC, Szekely-Copîndean RD, Zăgrean AM. Increasing Value and Reducing Waste of Research on Neurofeedback Effects in Post-traumatic Stress Disorder: A State-of-the-Art-Review. Appl Psychophysiol Biofeedback 2024; 49:23-45. [PMID: 38151684 DOI: 10.1007/s10484-023-09610-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
Post-Traumatic Stress Disorder (PTSD) is often considered challenging to treat due to factors that contribute to its complexity. In the last decade, more attention has been paid to non-pharmacological or non-psychological therapies for PTSD, including neurofeedback (NFB). NFB is a promising non-invasive technique targeting specific brainwave patterns associated with psychiatric symptomatology. By learning to regulate brain activity in a closed-loop paradigm, individuals can improve their functionality while reducing symptom severity. However, owing to its lax regulation and heterogeneous legal status across different countries, the degree to which it has scientific support as a psychiatric treatment remains controversial. In this state-of-the-art review, we searched PubMed, Cochrane Central, Web of Science, Scopus, and MEDLINE and identified meta-analyses and systematic reviews exploring the efficacy of NFB for PTSD. We included seven systematic reviews, out of which three included meta-analyses (32 studies and 669 participants) that targeted NFB as an intervention while addressing a single condition-PTSD. We used the MeaSurement Tool to Assess systematic Reviews (AMSTAR) 2 and the criteria described by Cristea and Naudet (Behav Res Therapy 123:103479, 2019, https://doi.org/10.1016/j.brat.2019.103479 ) to identify sources of research waste and increasing value in biomedical research. The seven assessed reviews had an overall extremely poor quality score (5 critically low, one low, one moderate, and none high) and multiple sources of waste while opening opportunities for increasing value in the NFB literature. Our research shows that it remains unclear whether NFB training is significantly beneficial in treating PTSD. The quality of the investigated literature is low and maintains a persistent uncertainty over numerous points, which are highly important for deciding whether an intervention has clinical efficacy. Just as importantly, none of the reviews we appraised explored the statistical power, referred to open data of the included studies, or adjusted their pooled effect sizes for publication bias and risk of bias. Based on the obtained results, we identified some recurrent sources of waste (such as a lack of research decisions based on sound questions or using an appropriate methodology in a fully transparent, unbiased, and useable manner) and proposed some directions for increasing value (homogeneity and consensus) in designing and reporting research on NFB interventions in PTSD.
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Affiliation(s)
- Gabriela Mariana Marcu
- Division of Physiology and Neuroscience, Department of Functional Sciences, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
- Department of Psychology, "Lucian Blaga" University of Sibiu, Sibiu, Romania.
| | - Andrei Dumbravă
- George I.M. Georgescu Institute of Cardiovascular Diseases, Iaşi, Romania
- Alexandru Ioan Cuza University Iaşi, Iaşi, Romania
| | - Ionuţ-Ciprian Băcilă
- Scientific Research Group in Neuroscience "Dr. Gheorghe Preda" Clinical Psychiatry Hospital, Sibiu, Romania
- Faculty of Medicine, "Lucian Blaga" University of Sibiu Romania, Sibiu, Romania
| | - Raluca Diana Szekely-Copîndean
- Scientific Research Group in Neuroscience "Dr. Gheorghe Preda" Clinical Psychiatry Hospital, Sibiu, Romania
- Department of Social and Human Research, Romanian Academy - Cluj-Napoca Branch, Cluj-Napoca, Romania
| | - Ana-Maria Zăgrean
- Division of Physiology and Neuroscience, Department of Functional Sciences, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
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Kober SE, Buchrieser F, Wood G. Neurofeedback on twitter: Evaluation of the scientific credibility and communication about the technique. Heliyon 2023; 9:e18931. [PMID: 37600360 PMCID: PMC10432958 DOI: 10.1016/j.heliyon.2023.e18931] [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: 02/24/2023] [Revised: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 08/22/2023] Open
Abstract
Neurofeedback is a popular technique to induce neuroplasticity with a controversial reputation. The public discourse on neurofeedback, as a therapeutic and neuroenhancement technique, encompasses scientific communication, therapeutic expectations and outcomes, as well as complementary and alternative practices. We investigated twitter publications from 2010 to 2022 on the keyword "neurofeedback". A total of over 138 k tweets were obtained, which originated from over 42 k different users. The communication flow in the neurofeedback community is mainly unidirectional and non-interactive. Analysis of hashtags revealed application fields, therapy provider and neuroenhancement to be the most popular contents in neurofeedback communication. A group of 1221 productive users was identified, in which clinicians, entrepreneurs, broadcasters, and scientists contribute. We identified reactions to critical publications in the twitter traffic and an increase in the number of tweets by academic users which suggest an increase in the interest on the scientific credibility of neurofeedback. More intense scientific communication on neurofeedback in twitter may contribute to promote a more realistic view on challenges and advances regarding good scientific practice of neurofeedback.
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Kalokairinou L, Specker Sullivan L, Wexler A. Neurofeedback as placebo: a case of unintentional deception? JOURNAL OF MEDICAL ETHICS 2022; 48:1037-1042. [PMID: 34521768 PMCID: PMC9205641 DOI: 10.1136/medethics-2021-107435] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 08/18/2021] [Indexed: 05/27/2023]
Abstract
The use of placebo in clinical practice has been the topic of extensive debate in the bioethics literature, with much scholarship focusing on concerns regarding deception. While considerations of placebo without deception have largely centred on open-label placebo, this paper considers a different kind of ethical quandary regarding placebo without an intent to deceive-one where the provider believes a treatment is effective due to a direct physiological mechanism, even though that belief may not be supported by rigorous scientific evidence. This is often the case with complementary and alternative medicine (CAM) techniques and also with some mainstream therapies that have not proven to be better than sham. Using one such CAM technique as a case study-electroencephalography (EEG) neurofeedback for attention-deficit/hyperactivity disorder (ADHD)-this paper explores the ethics of providing therapies that may have some beneficial effect, although one that is likely due to placebo effect. First, we provide background on EEG neurofeedback for ADHD and its evidence base, showing how it has proven to be equivalent to-but not better than-sham neurofeedback. Subsequently, we explore whether offering therapies that are claimed to work via specific physical pathways, but may actually work due to the placebo effect, constitute deception. We suggest that this practice may constitute unintentional deception regarding mechanism of action. Ultimately, we argue that providers have increased information provision obligations when offering treatments that diverge from standard of care and we make recommendations for mitigating unintentional deception.
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Affiliation(s)
- Louiza Kalokairinou
- Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Anna Wexler
- Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Perez TM, Glue P, Adhia DB, Navid MS, Zeng J, Dillingham P, Smith M, Niazi IK, Young CK, De Ridder D. Infraslow closed-loop brain training for anxiety and depression (ISAD): a protocol for a randomized, double-blind, sham-controlled pilot trial in adult females with internalizing disorders. Trials 2022; 23:949. [PMID: 36397122 PMCID: PMC9670077 DOI: 10.1186/s13063-022-06863-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 10/22/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The core intrinsic connectivity networks (core-ICNs), encompassing the default-mode network (DMN), salience network (SN) and central executive network (CEN), have been shown to be dysfunctional in individuals with internalizing disorders (IDs, e.g. major depressive disorder, MDD; generalized anxiety disorder, GAD; social anxiety disorder, SOC). As such, source-localized, closed-loop brain training of electrophysiological signals, also known as standardized low-resolution electromagnetic tomography (sLORETA) neurofeedback (NFB), targeting key cortical nodes within these networks has the potential to reduce symptoms associated with IDs and restore normal core ICN function. We intend to conduct a randomized, double-blind (participant and assessor), sham-controlled, parallel-group (3-arm) trial of sLORETA infraslow (<0.1 Hz) fluctuation neurofeedback (sLORETA ISF-NFB) 3 times per week over 4 weeks in participants (n=60) with IDs. Our primary objectives will be to examine patient-reported outcomes (PROs) and neurophysiological measures to (1) compare the potential effects of sham ISF-NFB to either genuine 1-region ISF-NFB or genuine 2-region ISF-NFB, and (2) assess for potential associations between changes in PRO scores and modifications of electroencephalographic (EEG) activity/connectivity within/between the trained regions of interest (ROIs). As part of an exploratory analysis, we will investigate the effects of additional training sessions and the potential for the potentiation of the effects over time. METHODS We will randomly assign participants who meet the criteria for MDD, GAD, and/or SOC per the MINI (Mini International Neuropsychiatric Interview for DSM-5) to one of three groups: (1) 12 sessions of posterior cingulate cortex (PCC) ISF-NFB up-training (n=15), (2) 12 sessions of concurrent PCC ISF up-training and dorsal anterior cingulate cortex (dACC) ISF-NFB down-training (n=15), or (3) 6 sessions of yoked-sham training followed by 6 sessions genuine ISF-NFB (n=30). Transdiagnostic PROs (Hospital Anxiety and Depression Scale, HADS; Inventory of Depression and Anxiety Symptoms - Second Version, IDAS-II; Multidimensional Emotional Disorder Inventory, MEDI; Intolerance of Uncertainty Scale - Short Form, IUS-12; Repetitive Thinking Questionnaire, RTQ-10) as well as resting-state neurophysiological measures (full-band EEG and ECG) will be collected from all subjects during two baseline sessions (approximately 1 week apart) then at post 6 sessions, post 12 sessions, and follow-up (1 month later). We will employ Bayesian methods in R and advanced source-localisation software (i.e. exact low-resolution brain electromagnetic tomography; eLORETA) in our analysis. DISCUSSION This protocol will outline the rationale and research methodology for a clinical pilot trial of sLORETA ISF-NFB targeting key nodes within the core-ICNs in a female ID population with the primary aims being to assess its potential efficacy via transdiagnostic PROs and relevant neurophysiological measures. TRIAL REGISTRATION Our study was prospectively registered with the Australia New Zealand Clinical Trials Registry (ANZCTR; Trial ID: ACTRN12619001428156). Registered on October 15, 2019.
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Affiliation(s)
- Tyson M Perez
- Department of Surgical Sciences, University of Otago, Dunedin, New Zealand.
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand.
| | - Paul Glue
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand
| | - Divya B Adhia
- Department of Surgical Sciences, University of Otago, Dunedin, New Zealand
| | - Muhammad S Navid
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland, New Zealand
- Donders Institute for Brain, Cognition and Behaviour, Radbout University Medical Center, Nijmegen, The Netherlands
| | - Jiaxu Zeng
- Department of Preventative & Social Medicine, Otago Medical School-Dunedin Campus, University of Otago, Dunedin, New Zealand
| | - Peter Dillingham
- Coastal People Southern Skies Centre of Research Excellence, Department of Mathematics & Statistics, University of Otago, Dunedin, New Zealand
| | - Mark Smith
- Neurofeedback Therapy Services of New York, New York, USA
| | - Imran K Niazi
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland, New Zealand
| | - Calvin K Young
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Dirk De Ridder
- Department of Surgical Sciences, University of Otago, Dunedin, New Zealand
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Attention neuroenhancement through tDCS or neurofeedback: a randomized, single-blind, controlled trial. Sci Rep 2022; 12:17613. [PMID: 36266396 PMCID: PMC9584934 DOI: 10.1038/s41598-022-22245-6] [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: 03/15/2022] [Accepted: 10/12/2022] [Indexed: 01/13/2023] Open
Abstract
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.
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Du B, Cheng X, Duan Y, Ning H. fMRI Brain Decoding and Its Applications in Brain-Computer Interface: A Survey. Brain Sci 2022; 12:228. [PMID: 35203991 PMCID: PMC8869956 DOI: 10.3390/brainsci12020228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/29/2022] [Accepted: 01/30/2022] [Indexed: 11/25/2022] Open
Abstract
Brain neural activity decoding is an important branch of neuroscience research and a key technology for the brain-computer interface (BCI). Researchers initially developed simple linear models and machine learning algorithms to classify and recognize brain activities. With the great success of deep learning on image recognition and generation, deep neural networks (DNN) have been engaged in reconstructing visual stimuli from human brain activity via functional magnetic resonance imaging (fMRI). In this paper, we reviewed the brain activity decoding models based on machine learning and deep learning algorithms. Specifically, we focused on current brain activity decoding models with high attention: variational auto-encoder (VAE), generative confrontation network (GAN), and the graph convolutional network (GCN). Furthermore, brain neural-activity-decoding-enabled fMRI-based BCI applications in mental and psychological disease treatment are presented to illustrate the positive correlation between brain decoding and BCI. Finally, existing challenges and future research directions are addressed.
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Affiliation(s)
- Bing Du
- School of Computer and Communication Engineering, University of Science and Technology Beijing, Beijing 100083, China; (B.D.); (X.C.)
| | - Xiaomu Cheng
- School of Computer and Communication Engineering, University of Science and Technology Beijing, Beijing 100083, China; (B.D.); (X.C.)
| | - Yiping Duan
- Department of Electronic Engineering, Tsinghua University, Beijing 100084, China;
| | - Huansheng Ning
- School of Computer and Communication Engineering, University of Science and Technology Beijing, Beijing 100083, China; (B.D.); (X.C.)
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Neurofeedback for cognitive enhancement and intervention and brain plasticity. Rev Neurol (Paris) 2021; 177:1133-1144. [PMID: 34674879 DOI: 10.1016/j.neurol.2021.08.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 08/27/2021] [Indexed: 12/18/2022]
Abstract
In recent years, neurofeedback has been used as a cognitive training tool to improve brain functions for clinical or recreational purposes. It is based on providing participants with feedback about their brain activity and training them to control it, initiating directional changes. The overarching hypothesis behind this method is that this control results in an enhancement of the cognitive abilities associated with this brain activity, and triggers specific structural and functional changes in the brain, promoted by learning and neuronal plasticity effects. Here, we review the general methodological principles behind neurofeedback and we describe its behavioural benefits in clinical and experimental contexts. We review the non-specific effects of neurofeedback on the reinforcement learning striato-frontal networks as well as the more specific changes in the cortical networks on which the neurofeedback control is exerted. Last, we analyse the current challenges faces by neurofeedback studies, including the quantification of the temporal dynamics of neurofeedback effects, the generalisation of its behavioural outcomes to everyday life situations, the design of appropriate controls to disambiguate placebo from true neurofeedback effects and the development of more advanced cortical signal processing to achieve a finer-grained real-time modelling of cognitive functions.
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Rubia K, Westwood S, Aggensteiner PM, Brandeis D. Neurotherapeutics for Attention Deficit/Hyperactivity Disorder (ADHD): A Review. Cells 2021; 10:2156. [PMID: 34440925 PMCID: PMC8394071 DOI: 10.3390/cells10082156] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/07/2021] [Accepted: 08/18/2021] [Indexed: 01/19/2023] Open
Abstract
This review focuses on the evidence for neurotherapeutics for attention deficit/hyperactivity disorder (ADHD). EEG-neurofeedback has been tested for about 45 years, with the latest meta-analyses of randomised controlled trials (RCT) showing small/medium effects compared to non-active controls only. Three small studies piloted neurofeedback of frontal activations in ADHD using functional magnetic resonance imaging or near-infrared spectroscopy, finding no superior effects over control conditions. Brain stimulation has been applied to ADHD using mostly repetitive transcranial magnetic and direct current stimulation (rTMS/tDCS). rTMS has shown mostly negative findings on improving cognition or symptoms. Meta-analyses of tDCS studies targeting mostly the dorsolateral prefrontal cortex show small effects on cognitive improvements with only two out of three studies showing clinical improvements. Trigeminal nerve stimulation has been shown to improve ADHD symptoms with medium effect in one RCT. Modern neurotherapeutics are attractive due to their relative safety and potential neuroplastic effects. However, they need to be thoroughly tested for clinical and cognitive efficacy across settings and beyond core symptoms and for their potential for individualised treatment.
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Affiliation(s)
- Katya Rubia
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neurosciences, King’s College London, De Crespigny Park, London SE5 8AF, UK;
- Department of Social Genetics and Developmental Psychiatry, Institute of Psychiatry, Psychology & Neurosciences, King’s College London, De Crespigny Park, London SE5 8AF, UK
- Department of Child & Adolescent Psychiatry, Transcampus, Dresden University, 01307 Dresden, Germany
| | - Samuel Westwood
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neurosciences, King’s College London, De Crespigny Park, London SE5 8AF, UK;
- Department of Social Genetics and Developmental Psychiatry, Institute of Psychiatry, Psychology & Neurosciences, King’s College London, De Crespigny Park, London SE5 8AF, UK
- Department of Psychology, Wolverhampton University, Wolverhampton WV1 1LY, UK
| | - Pascal-M. Aggensteiner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, 68159 Mannheim, Germany; (P.-M.A.); (D.B.)
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, 68159 Mannheim, Germany; (P.-M.A.); (D.B.)
- Department of Child and Adolescent Psychiatry and Psychotherapy, Hospital of Psychiatry, Psychiatric Hospital University, University of Zürich, 8032 Zürich, Switzerland
- Neuroscience Center Zürich, Swiss Federal Institute of Technology and University of Zürich, 8057 Zürich, Switzerland
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Nagappan A, Kalokairinou L, Wexler A. Ethical and Legal Considerations of Alternative Neurotherapies. AJOB Neurosci 2021; 12:257-269. [PMID: 33759705 DOI: 10.1080/21507740.2021.1896601] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Neurotherapies for diagnostics and treatment-such as electroencephalography (EEG) neurofeedback, single-photon emission computerized tomography (SPECT) imaging for neuropsychiatric evaluation, and off-label/experimental uses of brain stimulation-are continuously being offered to the public outside mainstream healthcare settings. Because these neurotherapies share many key features of complementary and alternative medicine (CAM) techniques-and meet the definition of CAM as set out in Kaptchuk and Eisenberg-here we refer to them as "alternative neurotherapies." By explicitly linking these alternative neurotherapy practices under a common conceptual framework, this paper draws attention to, and critically considers, the cross-cutting ethical and legal issues related to the provision of these services. The first section of this paper provides an updated empirical overview of uses of SPECT neuropsychiatric evaluations, EEG neurofeedback, and experimental/off-label forms of brain stimulation. Next, drawing on CAM bioethics scholarship, we highlight the pertinent ethical issues in the alternative neurotherapy context, including the truthful representation of evidence base, marketing to vulnerable populations, potential harms, provider competency, and conflicts of interest. Finally, we consider the principal legal issues at stake for the provision of alternative neurotherapies in the U.S., namely those related to licensing and scope-of-practice considerations. We conclude with recommendations for future research in this domain.
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Schmidt J, Martin A. The Influence of Physiological and Psychological Learning Mechanisms in Neurofeedback vs. Mental Imagery Against Binge Eating. Appl Psychophysiol Biofeedback 2020; 45:293-305. [PMID: 32990891 PMCID: PMC7644525 DOI: 10.1007/s10484-020-09486-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2020] [Indexed: 11/29/2022]
Abstract
In biofeedback research, the debate on physiological versus psychological learning has a long tradition and is still relevant today, regarding new developments of biofeedback for behavior modification. Analyzing the role of these learning mechanisms may help improving the protocols and answer the question, whether feedback of physiological functions is necessary to modify a target behavior. We explored the presence and impact of physiological (EEG changes) versus psychological learning (changes in somatic self-efficacy) in a recently developed EEG neurofeedback protocol for binge eating. The protocol targets a reduction of food-cue induced cortical arousal through regulation of EEG high beta activity. In an experimental study accompanying a randomized controlled trial, pre and post treatment EEG measurements were analyzed in a neurofeedback group (n = 18) and an active mental imagery control group without physiological feedback (n = 18). Physiological learning in terms of EEG high beta reduction only occurred in the neurofeedback group. Post treatment, participants with successfully reduced binge eating episodes (≥ 50% reduction) showed lower EEG high beta activity than unsuccessful participants (p = .02) after neurofeedback, but not after mental imagery. Further, lower EEG high beta activity at post-treatment predicted fewer binge eating episodes in neurofeedback only. In mental imagery, somatic self-efficacy predicted treatment success instead of EEG activity. Altogether, the results indicate that physiological changes serve as a specific treatment mechanism in neurofeedback against binge eating. Reducing cortical arousal may improve eating behaviors and corresponding neurofeedback techniques should therefore be considered in future treatments.
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Affiliation(s)
- Jennifer Schmidt
- HSD Hochschule Döpfer University of Applied Sciences, Waidmarkt 3 & 9, 50676, Cologne, Germany.
| | - Alexandra Martin
- Clinical Psychology and Psychotherapy, University of Wuppertal, Wuppertal, Germany
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Roy R, de la Vega R, Jensen MP, Miró J. Neurofeedback for Pain Management: A Systematic Review. Front Neurosci 2020; 14:671. [PMID: 32765208 PMCID: PMC7378966 DOI: 10.3389/fnins.2020.00671] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 06/02/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Chronic pain is a significant global health issue. For most individuals with chronic pain, biomedical treatments do not provide adequate relief. Given the evidence that neurophysiological abnormalities are associated with pain, it is reasonable to consider treatments that target these factors, such as neurofeedback (NF). The primary objectives of this review were to summarize the current state of knowledge regarding: (1) the different types of NF and NF protocols that have been evaluated for pain management; (2) the evidence supporting each NF type and protocol; (3) if targeted brain activity changes occur with NF training; and (4) if such brain activity change is associated with improvements on treatment outcomes. Methods: Inclusion criteria were intentionally broad to encompass every empirical study using NF in relation to pain. We considered all kinds of NF, including both electroencephalogram- (EEG-) and functional magnetic resonance imagining- (fMRI-) based. We searched the following databases from inception through September 2019: Pubmed, Ovid, Embase, Web of Science, PsycINFO. The search strategy consisted of a combination of key terms referring to all NF types and pain conditions (e.g., neurofeedback, rt-fMRI-NF, BOLD, pain, migraine). Results: A total of 6,552 citations were retrieved; 24 of these that were included in the review. Most of the studies were of moderate quality, included a control condition and but did not include a follow-up. They focused on studying pain intensity (83%), pain frequency, and other variables (fatigue, sleep, depression) in samples of adults (n = 7-71) with headaches, fibromyalgia and other pain conditions. Most studies (79%) used EEG-based NF. A wide variety of NF types and protocols have been used for pain management aiming to either increase, decrease or regulate brain activity in certain areas theoretically associated with pain. Conclusions: Given the generally positive results in the studies reviewed, the findings indicate that NF procedures have the potential for reducing pain and improving other related outcomes in individuals with chronic pain. However, the current evidence does not provide definitive conclusions or allow for reliable recommendations on which protocols or methods of administration may be the most effective. These findings support the need for continued - but higher quality - research in this area.
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Affiliation(s)
- Rubén Roy
- Universitat Rovira i Virgili, Unit for the Study and Treatment of Pain–ALGOS, Department of Psychology, Research Center for Behavior Assessment (CRAMC), Tarragona, Spain
| | - Rocío de la Vega
- Center for Child Health, Behavior and Development, Children's Research Institute, Seattle, WA, United States
| | - Mark P. Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, United States
| | - Jordi Miró
- Universitat Rovira i Virgili, Unit for the Study and Treatment of Pain–ALGOS, Department of Psychology, Research Center for Behavior Assessment (CRAMC), Tarragona, Spain
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Towards a Pragmatic Approach to a Psychophysiological Unit of Analysis for Mental and Brain Disorders: An EEG-Copeia for Neurofeedback. Appl Psychophysiol Biofeedback 2020; 44:151-172. [PMID: 31098793 DOI: 10.1007/s10484-019-09440-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This article proposes what we call an "EEG-Copeia" for neurofeedback, like the "Pharmacopeia" for psychopharmacology. This paper proposes to define an "EEG-Copeia" as an organized list of scientifically validated EEG markers, characterized by a specific association with an identified cognitive process, that define a psychophysiological unit of analysis useful for mental or brain disorder evaluation and treatment. A characteristic of EEG neurofeedback for mental and brain disorders is that it targets a EEG markers related to a supposed cognitive process, whereas conventional treatments target clinical manifestations. This could explain why EEG neurofeedback studies encounter difficulty in achieving reproducibility and validation. The present paper suggests that a first step to optimize EEG neurofeedback protocols and future research is to target a valid EEG marker. The specificity of the cognitive skills trained and learned during real time feedback of the EEG marker could be enhanced and both the reliability of neurofeedback training and the therapeutic impact optimized. However, several of the most well-known EEG markers have seldom been applied for neurofeedback. Moreover, we lack a reliable and valid EEG targets library for further RCT to evaluate the efficacy of neurofeedback in mental and brain disorders. With the present manuscript, our aim is to foster dialogues between cognitive neuroscience and EEG neurofeedback according to a psychophysiological perspective. The primary objective of this review was to identify the most robust EEG target. EEG markers linked with one or several clearly identified cognitive-related processes will be identified. The secondary objective was to organize these EEG markers and related cognitive process in a psychophysiological unit of analysis matrix inspired by the Research Domain Criteria (RDoC) project.
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Ros T, Enriquez-Geppert S, Zotev V, Young KD, Wood G, Whitfield-Gabrieli S, Wan F, Vuilleumier P, Vialatte F, Van De Ville D, Todder D, Surmeli T, Sulzer JS, Strehl U, Sterman MB, Steiner NJ, Sorger B, Soekadar SR, Sitaram R, Sherlin LH, Schönenberg M, Scharnowski F, Schabus M, Rubia K, Rosa A, Reiner M, Pineda JA, Paret C, Ossadtchi A, Nicholson AA, Nan W, Minguez J, Micoulaud-Franchi JA, Mehler DMA, Lührs M, Lubar J, Lotte F, Linden DEJ, Lewis-Peacock JA, Lebedev MA, Lanius RA, Kübler A, Kranczioch C, Koush Y, Konicar L, Kohl SH, Kober SE, Klados MA, Jeunet C, Janssen TWP, Huster RJ, Hoedlmoser K, Hirshberg LM, Heunis S, Hendler T, Hampson M, Guggisberg AG, Guggenberger R, Gruzelier JH, Göbel RW, Gninenko N, Gharabaghi A, Frewen P, Fovet T, Fernández T, Escolano C, Ehlis AC, Drechsler R, Christopher deCharms R, Debener S, De Ridder D, Davelaar EJ, Congedo M, Cavazza M, Breteler MHM, Brandeis D, Bodurka J, Birbaumer N, Bazanova OM, Barth B, Bamidis PD, Auer T, Arns M, Thibault RT. Consensus on the reporting and experimental design of clinical and cognitive-behavioural neurofeedback studies (CRED-nf checklist). Brain 2020; 143:1674-1685. [PMID: 32176800 PMCID: PMC7296848 DOI: 10.1093/brain/awaa009] [Citation(s) in RCA: 160] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 10/10/2019] [Accepted: 10/28/2020] [Indexed: 02/02/2023] Open
Abstract
Neurofeedback has begun to attract the attention and scrutiny of the scientific and medical mainstream. Here, neurofeedback researchers present a consensus-derived checklist that aims to improve the reporting and experimental design standards in the field.
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Affiliation(s)
- Tomas Ros
- Departments of Neuroscience and Psychiatry, University of Geneva; Campus Biotech, Geneva, Switzerland
| | - Stefanie Enriquez-Geppert
- Department of Clinical Neuropsychology, University of Groningen, Groningen, The Netherlands
- Department of Biomedical Sciences of Cells & Systems, University Medical Center Groningen, Groningen, The Netherlands
| | - Vadim Zotev
- Laureate Institute for Brain Research, Tulsa, Oklahoma, USA
| | - Kymberly D Young
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Guilherme Wood
- Institute of Psychology, University of Graz, Graz, Austria
| | - Susan Whitfield-Gabrieli
- Massachusetts Institute of Technology, Cambridge, MA, USA
- Northeastern University, Boston, MA, USA
| | - Feng Wan
- Department of Electrical and Computer Engineering, Faculty of Science and Technology, University of Macau, Macau, China
| | | | | | - Dimitri Van De Ville
- Institute of Bioengineering, Center for Neuroprosthetics, École Polytechnique Fédérale de Lausanne (EPFL); Campus Biotech, Geneva, Switzerland
| | - Doron Todder
- Faculty of Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Beer-Sheva Mental Health Center, Israel Ministry of Health, Beer-Sheva, Israel
| | - Tanju Surmeli
- Living Health Center for Research and Education, Istanbul, Turkey
| | - James S Sulzer
- Department of Mechanical Engineering, University of Texas at Austin, Austin, TX, USA
| | - Ute Strehl
- Institute for Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
| | - Maurice Barry Sterman
- Neurobiology and Biobehavioral Psychiatry, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Naomi J Steiner
- Boston University School of Medicine, Department of Pediatrics, Boston, MA, USA
| | - Bettina Sorger
- Department of Cognitive Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Surjo R Soekadar
- Clinical Neurotechnology Laboratory, Neuroscience Research Center (NWFZ), Department of Psychiatry and Psychotherapy (CCM), Charité - University Medicine Berlin, Berlin, Germany
| | - Ranganatha Sitaram
- Institute of Biological and Medical Engineering, Pontificia Universidad Católica de Chile, Macul, Santiago, Chile
| | | | | | - Frank Scharnowski
- Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, Vienna, Austria
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zürich, Zürich, Switzerland
| | - Manuel Schabus
- University of Salzburg, Centre for Cognitive Neuroscience and Department of Psychology, Salzburg, Austria
| | - Katya Rubia
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | | | - Miriam Reiner
- Technion, Israel Institute of Technology, Haifa, Israel
| | - Jaime A Pineda
- Cognitive Science Department, University of California, San Diego, CA, USA
| | - Christian Paret
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Germany
| | - Alexei Ossadtchi
- National Research University Higher School of Economics, Moscow, Russia
| | - Andrew A Nicholson
- Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, Vienna, Austria
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zürich, Zürich, Switzerland
| | - Wenya Nan
- Department of Psychology, Shanghai Normal University, Shanghai, China
| | | | | | - David M A Mehler
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Michael Lührs
- Department of Cognitive Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Joel Lubar
- Department of Psychology, University of Tennessee, Knoxville, USA
| | - Fabien Lotte
- Inria Bordeaux Sud-Ouest/LaBRI University of Bordeaux - CNRS-Bordeaux INP, Bordeaux, France
| | - David E J Linden
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | | | - Mikhail A Lebedev
- Center for Bioelectric Interfaces of the Institute for Cognitive Neuroscience, National Research University Higher School of Economics, Moscow, Russia
- Department of Information and Internet Technologies of Digital Health Institute; I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Duke Center for Neuroengineering, Duke University, Durham, NC, USA
| | - Ruth A Lanius
- Department of Psychiatry, Western University, London, Ontario, Canada
| | - Andrea Kübler
- Department of Psychology I, Psychological Intervention, Behavior Analysis and Regulation of Behavior, University of Würzburg
| | - Cornelia Kranczioch
- Neuropsychology Lab, Department of Psychology, University of Oldenburg, Oldenberg, Germany
| | - Yury Koush
- Magnetic Resonance Research Center (MRRC), Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT, USA
| | - Lilian Konicar
- Medical University of Vienna, Department of Child and Adolescent Psychiatry, Vienna, Austria
| | - Simon H Kohl
- JARA-Institute Molecular neuroscience and neuroimaging (INM-11), Jülich Research Centre, Jülich, Germany
| | | | - Manousos A Klados
- Department of Psychology, The University of Sheffield International Faculty, City College, Thessaloniki, Greece
| | - Camille Jeunet
- CLLE Lab, CNRS, Université Toulouse Jean Jaurès, Toulouse, France
| | - T W P Janssen
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Rene J Huster
- Multimodal imaging and Cognitive Control Lab, Department of Psychology, University of Olso, Norway
| | - Kerstin Hoedlmoser
- University of Salzburg, Centre for Cognitive Neuroscience and Department of Psychology, Salzburg, Austria
| | | | - Stephan Heunis
- Electrical Engineering Department, Eindhoven University of Technology, The Netherlands
| | - Talma Hendler
- Sagol Brain Institute, Wohl Institute for Advanced Imaging, Sourasky Medical Center, Tel Aviv, Israel
| | - Michelle Hampson
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Adrian G Guggisberg
- Division of Neurorehabilitation, Department of Clinical Neurosciences, University Hospital Geneva, Geneva, Switzerland
| | - Robert Guggenberger
- Division of Functional and Restorative Neurosurgery, University of Tübingen, Tübingen, Germany
| | - John H Gruzelier
- Department of Psychology, Goldsmiths, University of London, London, UK
| | - Rainer W Göbel
- Department of Cognitive Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Nicolas Gninenko
- Institute of Bioengineering, Center for Neuroprosthetics, École Polytechnique Fédérale de Lausanne (EPFL); Campus Biotech, Geneva, Switzerland
| | - Alireza Gharabaghi
- Division of Functional and Restorative Neurosurgery, University of Tübingen, Tübingen, Germany
| | - Paul Frewen
- Department of Psychiatry, Western University, London, Ontario, Canada
| | - Thomas Fovet
- Univ. Lille, INSERM U1172, CHU LILLE, Centre Lille Neuroscience & Cognition, Pôle de Psychiatrie, F-59000, Lille, France
| | - Thalía Fernández
- UNAM Institute of Neurobiology, National Autonomous University of Mexico, Juriquilla, Mexico
| | | | - Ann-Christine Ehlis
- Psychophysiology and Optical Imaging, Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Renate Drechsler
- Department of Child and Adolescent, Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zürich, Zürich, Switzerland
| | | | - Stefan Debener
- Neuropsychology Lab, Department of Psychology, University of Oldenburg, Oldenberg, Germany
| | - Dirk De Ridder
- Department of Surgery, Section of Neurosurgery, University of Otago, Dunedin, New Zealand
| | - Eddy J Davelaar
- Department of Psychological Sciences Birkbeck, University of London, Bloomsbury, London, UK
| | - Marco Congedo
- GIPSA-lab, CNRS, University Grenoble Alpes, Grenoble-INP, Grenoble, France
| | - Marc Cavazza
- School of Computing and Mathematical Sciences, University of Greenwich, London, UK
| | - Marinus H M Breteler
- Radboud University Nijmegen, Department of Clinical Psychology, Nijmegen, The Netherlands
| | - Daniel Brandeis
- Department of Child and Adolescent, Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zürich, Zürich, Switzerland
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Jerzy Bodurka
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Niels Birbaumer
- Institute for Medical Psychology and Behavioural Neurobiology, University of Tübingen, Tübingen, Germany
| | - Olga M Bazanova
- State Research Institute of Physiology and Basic Medicine, Novosibirsk, Russia
| | - Beatrix Barth
- Psychophysiology and Optical Imaging, Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | | | - Tibor Auer
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Martijn Arns
- Brainclinics Foundation, Research Institute Brainclinics, Nijmegen, The Netherlands
| | - Robert T Thibault
- School of Psychological Science, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
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Wexler A, Nagappan A, Kopyto D, Choi R. Neuroenhancement for sale: assessing the website claims of neurofeedback providers in the United States. JOURNAL OF COGNITIVE ENHANCEMENT 2020; 4:379-388. [PMID: 34164596 DOI: 10.1007/s41465-020-00170-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Although electroencephalographic (EEG) neurofeedback is a technique that has been in existence for many decades, it has remained controversial, largely due to questions about efficacy. Yet neurofeedback is being widely offered to the public, often at great expense. To date, however, there has not been empirical data on which providers are utilizing neurofeedback, what they are offering it for, and how they are advertising the technique. The present study aimed to fill that gap by systematically analyzing the websites of neurofeedback practitioners in the United States. To that end, we obtained data from four directories of neurofeedback providers, extracting practitioner names, geographical locations, professional training, and website URLs. Only websites offering neurofeedback services (N=371) were included in the next step, wherein two coders independently coded the websites based on a codebook developed from preliminary analyses. We found that nearly all websites (97.0%) contained claims about at least one clinical indication, most commonly anxiety, ADHD/ADD, and depression; however, only 36.0% of providers had either a medical degree (MD) or a doctoral-level degree in psychology. The majority of websites advertised neurofeedback for cognitive (90.0%) or performance (67.9%) enhancement, and roughly three-quarters utilized language related to complementary and alternative medicine (CAM). In sum, there is a considerable divergence between the scientific literature on neurofeedback and the marketing of neurofeedback services to the general public, raising concerns regarding the misrepresentation of services and misleading advertising claims.
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Affiliation(s)
- Anna Wexler
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania
| | - Ashwini Nagappan
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania
| | - Deena Kopyto
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania
| | - Rebekah Choi
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania
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Murovec N, Heilinger A, Xu R, Ortner R, Spataro R, La Bella V, Miao Y, Jin J, Chatelle C, Laureys S, Allison BZ, Guger C. Effects of a Vibro-Tactile P300 Based Brain-Computer Interface on the Coma Recovery Scale-Revised in Patients With Disorders of Consciousness. Front Neurosci 2020; 14:294. [PMID: 32327970 PMCID: PMC7161577 DOI: 10.3389/fnins.2020.00294] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 03/13/2020] [Indexed: 11/22/2022] Open
Abstract
Persons diagnosed with disorders of consciousness (DOC) typically suffer from motor and cognitive disabilities. Recent research has shown that non-invasive brain-computer interface (BCI) technology could help assess these patients' cognitive functions and command following abilities. 20 DOC patients participated in the study and performed 10 vibro-tactile P300 BCI sessions over 10 days with 8-12 runs each day. Vibrotactile tactors were placed on the each patient's left and right wrists and one foot. Patients were instructed, via earbuds, to concentrate and silently count vibrotactile pulses on either their left or right wrist that presented a target stimulus and to ignore the others. Changes of the BCI classification accuracy were investigated over the 10 days. In addition, the Coma Recovery Scale-Revised (CRS-R) score was measured before and after the 10 vibro-tactile P300 sessions. In the first run, 10 patients had a classification accuracy above chance level (>12.5%). In the best run, every patient reached an accuracy ≥60%. The grand average accuracy in the first session for all patients was 40%. In the best session, the grand average accuracy was 88% and the median accuracy across all sessions was 21%. The CRS-R scores compared before and after 10 VT3 sessions for all 20 patients, are showing significant improvement (p = 0.024). Twelve of the twenty patients showed an improvement of 1 to 7 points in the CRS-R score after the VT3 BCI sessions (mean: 2.6). Six patients did not show a change of the CRS-R and two patients showed a decline in the score by 1 point. Every patient achieved at least 60% accuracy at least once, which indicates successful command following. This shows the importance of repeated measures when DOC patients are assessed. The improvement of the CRS-R score after the 10 VT3 sessions is an important issue for future experiments to test the possible therapeutic applications of vibro-tactile and related BCIs with a larger patient group.
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Affiliation(s)
- Nensi Murovec
- g. tec Medical Engineering GmbH, Schiedlberg, Austria
- Guger Technologies OG, Graz, Austria
| | | | - Ren Xu
- Guger Technologies OG, Graz, Austria
| | - Rupert Ortner
- g. tec Medical Engineering Spain S.L., Barcelona, Spain
| | - Rossella Spataro
- g. tec Medical Engineering GmbH, Schiedlberg, Austria
- IRCCS Centro Neurolesi Bonino Pulejo, Palermo, Italy
| | - Vincenzo La Bella
- ALS Clinical Research Center, Bi.N.D., University of Palermo, Palermo, Italy
| | - Yangyang Miao
- Department of Automation, East China University of Science and Technology, Shanghai, China
| | - Jing Jin
- Department of Automation, East China University of Science and Technology, Shanghai, China
| | - Camille Chatelle
- GIGA Consciousness, Coma Science Group, University of Liège, Liège, Belgium
| | - Steven Laureys
- GIGA Consciousness, Coma Science Group, University of Liège, Liège, Belgium
- French Association of Locked-in Syndrome (ALIS), Paris, France
| | - Brendan Z. Allison
- Department of Cognitive Science, University of California, San Diego, La Jolla, CA, United States
| | - Christoph Guger
- g. tec Medical Engineering GmbH, Schiedlberg, Austria
- Guger Technologies OG, Graz, Austria
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Neurofeedback: A challenge for integrative clinical neurophysiological studies. Neurophysiol Clin 2020; 50:1-3. [PMID: 32007382 DOI: 10.1016/j.neucli.2020.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 01/10/2020] [Indexed: 01/03/2023] Open
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Current progress in real-time functional magnetic resonance-based neurofeedback: Methodological challenges and achievements. Neuroimage 2019; 202:116107. [DOI: 10.1016/j.neuroimage.2019.116107] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 07/26/2019] [Accepted: 08/16/2019] [Indexed: 12/21/2022] Open
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Affiliation(s)
- Manuel Schabus
- Laboratory for Sleep, Cognition and Consciousness Research, Department of Psychology, University of Salzburg, Austria.,Centre for Cognitive Neuroscience Salzburg (CCNS), University of Salzburg, Austria
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Lovato N, Miller CB, Gordon CJ, Grunstein RR, Lack L. The efficacy of biofeedback for the treatment of insomnia: a critical review. Sleep Med 2018; 56:192-200. [PMID: 30846410 DOI: 10.1016/j.sleep.2018.12.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 11/26/2018] [Accepted: 12/03/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND The popularity of biofeedback as a non-pharmacological treatment option for insomnia has increased in recent times despite inconsistent empirical evidence for its therapeutic efficacy. OBJECTIVE The purpose of the current review was to systematically assess the efficacy of using biofeedback to treat insomnia. METHODS AND RESULTS A search of electronic databases (PubMED, MEDLINE, OvidSP, Ovid EMBASE, PsychInfo, The Cochrane Library including Cochrane Reviews), clinical trials databases and registries (Clinical Trials Database [US], Australian New Zealand Clinical Trials Registry [ANZCTR]) and online journal (eg, SLEEP, Sleep Medicine) identified 92 studies. Of these, 50 publications were descriptive or review papers about use of biofeedback for the treatment of insomnia, while an additional 37 did not meet the detailed inclusion criteria (ie not original research, participants do not meet the diagnostic criteria for insomnia). Six full-text articles met inclusion criteria and were included in this review. Methodological flaws including poor study design (small sample size, lack of control group) limit the validity of the body of work in this field to date and fail adequately to account for other unspecified factors likely to drive the observed changes, such as care and attention of those administering the treatment, as well as the expectations and motivations of the patient. CONCLUSION There is an urgent need for future studies to clarify the role of unspecific placebo effects when reporting biofeedback effects for the treatment of insomnia.
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Affiliation(s)
- Nicole Lovato
- Adelaide Institute for Sleep Health, A Flinders Centre of Research Excellence, Flinders University of South Australia, Australia; CRC for Alertness, Safety and Productivity, Melbourne, VIC, Australia.
| | | | - Christopher J Gordon
- CRC for Alertness, Safety and Productivity, Melbourne, VIC, Australia; CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, NSW, Australia; Sydney Nursing School, The University of Sydney, Sydney, NSW, Australia
| | - Ronald R Grunstein
- CRC for Alertness, Safety and Productivity, Melbourne, VIC, Australia; CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, NSW, Australia; Department of Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Leon Lack
- Adelaide Institute for Sleep Health, A Flinders Centre of Research Excellence, Flinders University of South Australia, Australia; School of Psychology, Flinders University of South Australia, Australia
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Mind-Reading or Misleading? Assessing Direct-to-Consumer Electroencephalography (EEG) Devices Marketed for Wellness and Their Ethical and Regulatory Implications. JOURNAL OF COGNITIVE ENHANCEMENT 2018. [DOI: 10.1007/s41465-018-0091-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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