1
|
Tosti B, Corrado S, Mancone S, Di Libero T, Rodio A, Andrade A, Diotaiuti P. Integrated use of biofeedback and neurofeedback techniques in treating pathological conditions and improving performance: a narrative review. Front Neurosci 2024; 18:1358481. [PMID: 38567285 PMCID: PMC10985214 DOI: 10.3389/fnins.2024.1358481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/01/2024] [Indexed: 04/04/2024] Open
Abstract
In recent years, the scientific community has begun tо explore the efficacy оf an integrated neurofeedback + biofeedback approach іn various conditions, both pathological and non-pathological. Although several studies have contributed valuable insights into its potential benefits, this review aims tо further investigate its effectiveness by synthesizing current findings and identifying areas for future research. Our goal іs tо provide a comprehensive overview that may highlight gaps іn the existing literature and propose directions for subsequent studies. The search for articles was conducted on the digital databases PubMed, Scopus, and Web of Science. Studies to have used the integrated neurofeedback + biofeedback approach published between 2014 and 2023 and reviews to have analyzed the efficacy of neurofeedback and biofeedback, separately, related to the same time interval and topics were selected. The search identified five studies compatible with the objectives of the review, related to several conditions: nicotine addiction, sports performance, Autism Spectrum Disorder (ASD), and Attention Deficit Hyperactivity Disorder (ADHD). The integrated neurofeedback + biofeedback approach has been shown to be effective in improving several aspects of these conditions, such as a reduction in the presence of psychiatric symptoms, anxiety, depression, and withdrawal symptoms and an increase in self-esteem in smokers; improvements in communication, imitation, social/cognitive awareness, and social behavior in ASD subjects; improvements in attention, alertness, and reaction time in sports champions; and improvements in attention and inhibitory control in ADHD subjects. Further research, characterized by greater methodological rigor, is therefore needed to determine the effectiveness of this method and the superiority, if any, of this type of training over the single administration of either. This review іs intended tо serve as a catalyst for future research, signaling promising directions for the advancement оf biofeedback and neurofeedback methodologies.
Collapse
Affiliation(s)
- Beatrice Tosti
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Lazio, Italy
| | - Stefano Corrado
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Lazio, Italy
| | - Stefania Mancone
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Lazio, Italy
| | - Tommaso Di Libero
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Lazio, Italy
| | - Angelo Rodio
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Lazio, Italy
| | - Alexandro Andrade
- Department of Physical Education, CEFID, Santa Catarina State University, Florianopolis, Santa Catarina, Brazil
| | - Pierluigi Diotaiuti
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Lazio, Italy
| |
Collapse
|
2
|
Pandria N, Athanasiou A, Styliadis C, Terzopoulos N, Mitsopoulos K, Paraskevopoulos E, Karagianni M, Pataka A, Kourtidou-Papadeli C, Makedou K, Iliadis S, Lymperaki E, Nimatoudis I, Argyropoulou-Pataka P, Bamidis PD. Does combined training of biofeedback and neurofeedback affect smoking status, behavior, and longitudinal brain plasticity? Front Behav Neurosci 2023; 17:1096122. [PMID: 36778131 PMCID: PMC9911884 DOI: 10.3389/fnbeh.2023.1096122] [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: 11/11/2022] [Accepted: 01/02/2023] [Indexed: 01/28/2023] Open
Abstract
Introduction: Investigations of biofeedback (BF) and neurofeedback (NF) training for nicotine addiction have been long documented to lead to positive gains in smoking status, behavior and to changes in brain activity. We aimed to: (a) evaluate a multi-visit combined BF/NF intervention as an alternative smoking cessation approach, (b) validate training-induced feedback learning, and (c) document effects on resting-state functional connectivity networks (rsFCN); considering gender and degree of nicotine dependence in a longitudinal design. Methods: We analyzed clinical, behavioral, and electrophysiological data from 17 smokers who completed five BF and 20 NF sessions and three evaluation stages. Possible neuroplastic effects were explored comparing whole-brain rsFCN by phase-lag index (PLI) for different brain rhythms. PLI connections with significant change across time were investigated according to different resting-state networks (RSNs). Results: Improvements in smoking status were observed as exhaled carbon monoxide levels, Total Oxidative Stress, and Fageström scores decreased while Vitamin E levels increased across time. BF/NF promoted gains in anxiety, self-esteem, and several aspects of cognitive performance. BF learning in temperature enhancement was observed within sessions. NF learning in theta/alpha ratio increase was achieved across baselines and within sessions. PLI network connections significantly changed across time mainly between or within visual, default mode and frontoparietal networks in theta and alpha rhythms, while beta band RSNs mostly changed significantly after BF sessions. Discussion: Combined BF/NF training positively affects the clinical and behavioral status of smokers, displays benefit in smoking harm reduction, plays a neuroprotective role, leads to learning effects and to positive reorganization of RSNs across time. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT02991781.
Collapse
Affiliation(s)
- Niki Pandria
- Laboratory of Medical Physics and Digital Innovation, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece
| | - Alkinoos Athanasiou
- Laboratory of Medical Physics and Digital Innovation, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece
| | - Charis Styliadis
- Laboratory of Medical Physics and Digital Innovation, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece
| | - Nikos Terzopoulos
- Laboratory of Medical Physics and Digital Innovation, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece
| | - Konstantinos Mitsopoulos
- Laboratory of Medical Physics and Digital Innovation, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece
| | - Evangelos Paraskevopoulos
- Laboratory of Medical Physics and Digital Innovation, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece,Department of Psychology, University of Cyprus, Nicosia, Cyprus
| | - Maria Karagianni
- Laboratory of Medical Physics and Digital Innovation, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece
| | - Athanasia Pataka
- Pulmonary Department-Oncology Unit, “G. Papanikolaou” General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Kali Makedou
- Laboratory of Biochemistry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stavros Iliadis
- Laboratory of Biochemistry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evgenia Lymperaki
- Department of Biomedical Sciences, International Hellenic University, Thessaloniki, Greece
| | - Ioannis Nimatoudis
- Third Department of Psychiatry, AHEPA University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Panagiotis D. Bamidis
- Laboratory of Medical Physics and Digital Innovation, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece,*Correspondence: Panagiotis D. Bamidis
| |
Collapse
|
3
|
Paolini M, Keeser D, Rauchmann BS, Gschwendtner S, Jeanty H, Reckenfelderbäumer A, Yaseen O, Reidler P, Rabenstein A, Engelbregt HJ, Maywald M, Blautzik J, Ertl-Wagner B, Pogarell O, Rüther T, Karch S. Correlations Between the DMN and the Smoking Cessation Outcome of a Real-Time fMRI Neurofeedback Supported Exploratory Therapy Approach: Descriptive Statistics on Tobacco-Dependent Patients. Clin EEG Neurosci 2022; 53:287-296. [PMID: 34878329 PMCID: PMC9174614 DOI: 10.1177/15500594211062703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 08/28/2021] [Accepted: 10/28/2021] [Indexed: 11/30/2022]
Abstract
The aim of this study was to explore the potential of default mode network (DMN) functional connectivity for predicting the success of smoking cessation in patients with tobacco dependence in the context of a real-time function al MRI (RT-fMRI) neurofeedback (NF) supported therapy.Fifty-four tobacco-dependent patients underwent three RT-fMRI-NF sessions including resting-state functional connectivity (RSFC) runs over a period of 4 weeks during professionally assisted smoking cessation. Patients were randomized into two groups that performed either active NF of an addiction-related brain region or sham NF. After preprocessing, the RSFC baseline data were statistically evaluated using seed-based ROI (SBA) approaches taking into account the smoking status of patients after 3 months (abstinence/relapse).The results of the real study group showed a widespread functional connectivity in the relapse subgroup (n = 10) exceeding the DMN template and mainly low correlations and anticorrelations in the within-seed analysis. In contrast, the connectivity pattern of the abstinence subgroup (n = 8) primarily contained the core DMN in the seed-to-whole-brain analysis and a left lateralized correlation pattern in the within-seed analysis. Calculated Multi-Subject Dictionary Learning (MSDL) matrices showed anticorrelations between DMN regions and salience regions in the abstinence group. Concerning the sham group, results of the relapse subgroup (n = 4) and the abstinence subgroup (n = 6) showed similar trends only in the within-seed analysis.In the setting of a RT-fMRI-NF-assisted therapy, a widespread intrinsic DMN connectivity and a low negative coupling between the DMN and the salience network (SN) in patients with tobacco dependency during early withdrawal may be useful as an early indicator of later therapy nonresponse.
Collapse
Affiliation(s)
- Marco Paolini
- Department of Radiology, University
Hospital, LMU Munich, Munich, Germany
| | - Daniel Keeser
- Department of Radiology, University
Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Boris-Stephan Rauchmann
- Department of Radiology, University
Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Sarah Gschwendtner
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Hannah Jeanty
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Arne Reckenfelderbäumer
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Omar Yaseen
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Paul Reidler
- Department of Radiology, University
Hospital, LMU Munich, Munich, Germany
| | - Andrea Rabenstein
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Hessel Jan Engelbregt
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Hersencentrum Mental Health Institute, Amsterdam, the
Netherlands
| | - Maximilian Maywald
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Janusch Blautzik
- Department of Radiology, University
Hospital, LMU Munich, Munich, Germany
- Institute for Radiology and Nuclear
Medicine St. Anna, Luzern, Switzerland
| | - Birgit Ertl-Wagner
- Department of Radiology, University
Hospital, LMU Munich, Munich, Germany
- Division of Neuro-Radiology, The Hospital for Sick Children,
University of Toronto, Toronto, Canada
| | - Oliver Pogarell
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Tobias Rüther
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Susanne Karch
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| |
Collapse
|
4
|
Keilani M, Steiner M, Crevenna R. The effect of biofeedback on smoking cessation-a systematic short review. Wien Klin Wochenschr 2021; 134:69-76. [PMID: 34870741 PMCID: PMC8825623 DOI: 10.1007/s00508-021-01977-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 10/20/2021] [Indexed: 11/29/2022]
Abstract
Purpose The aim of this systematic review was to focus on the effect of biofeedback on smoking cessation. Material and methods This review was conducted following the PRISMA guidelines. Peer-reviewed original articles including biofeedback and/or neurofeedback training as an intervention for smoking cessation were included. The PubMed, MEDLINE, Web of Science, Scopus, and Cochrane Library databases were screened for trials published up to July 2021. The effects on smoking rates and smoking behavior, and biofeedback/neurofeedback training measures are summarized here. Results In total, three articles fulfilled the inclusion criteria. The total Downs and Black checklist scores ranged from 11 to 23 points, showing that the articles were of poor to good methodological quality. The included studies were heterogeneous, both in terms of treatment protocols and in terms of outcome parameters. Pooling of data for a meta-analysis was not possible. Therefore, we were limited to describing the included studies. The included biofeedback study demonstrated that skin temperature training might improve the patients’ ability to raise their skin temperature aiming at stress alleviation. All three studies reported positive effects of biofeedback/neurofeedback in supporting smokers to quit. Furthermore, individualized electroencephalography neurofeedback training showed promising results in one study in modulating craving-related responses. Conclusion The results of the present review suggest that biofeedback/neurofeedback training might facilitate smoking cessation by changing behavioral outcomes. Although the investigated studies contained heterogeneous methodologies, they showed interesting approaches that could be further investigated and elaborated. To improve the scientific evidence, prospective randomized controlled trials are needed to investigate biofeedback/neurofeedback in clinical settings for smoking cessation.
Collapse
Affiliation(s)
- Mohammad Keilani
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
| | - Margarete Steiner
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Richard Crevenna
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| |
Collapse
|
5
|
Pandria N, Athanasiou A, Konstantara L, Karagianni M, Bamidis PD. Advances in biofeedback and neurofeedback studies on smoking. Neuroimage Clin 2020; 28:102397. [PMID: 32947225 PMCID: PMC7502375 DOI: 10.1016/j.nicl.2020.102397] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 08/02/2020] [Accepted: 08/19/2020] [Indexed: 11/19/2022]
Abstract
Smoking is a leading cause of morbidity and premature death constituting a global health challenge. Although, pharmacological and behavioral approaches comprise the mainstay of smoking cessation interventions, the efficacy and safety of pharmacotherapy is not demonstrated for some populations. Non-pharmacological approaches, such as biofeedback (BF) and neurofeedback (NF) could facilitate self-regulation of predisposing factors of relapse such as craving and stress. The current review aims to aggregate the existing evidence regarding the effects of BF and NF training on smokers. Relevant studies were identified through searching in Scopus, PubMed and Cochrane Library, and through hand-searching the references of screened articles. Peer-reviewed controlled and uncontrolled studies, where BF and/or NF training was administered, were included and evaluated according to PICOS framework. Narrative qualitative synthesis of ten eligible studies was performed, aggregated into three categories according to training provided. BF outcomes seem to be affected by smoking behavior prior to training; individualized EEG NF training holds promise for modulating craving-related response while minimizing the required number of sessions. Real-time fMRI NF studies concluded that nicotine-dependent individuals could modulate craving-related brain responses, while mixed results were revealed regarding smokers' ability to modulate brain responses related to resistance towards the urge to smoke. BF and NF training seem to facilitate modulation of autonomous and/or central nervous system activity while also transferring this learned self-regulation to behavioral outcomes. BF and NF training should a) address remaining issues on specificity and scientific validity, b) target diverse demographics, and c) produce robust reproducible methodologies and clinical guidelines for relevant health care providers, in order to be considered as viable complementary tools to standard smoking cessation care.
Collapse
Affiliation(s)
- N Pandria
- Lab of Medical Physics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece; Northern Greece Neurofeedback Center, Thessaloniki, Greece.
| | - A Athanasiou
- Lab of Medical Physics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece.
| | - L Konstantara
- Lab of Medical Physics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece.
| | - M Karagianni
- Lab of Medical Physics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece.
| | - P D Bamidis
- Lab of Medical Physics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece.
| |
Collapse
|
6
|
Vardavas CI, Kyriakos CN, Fernández E, Bamidis P, Siddiqi K, Chavannes NH, van der Kleij R, Parker G, Radu-Loghin C, Ward B, Berkouk K. H2020 funding for respiratory research: scaling up for the prevention and treatment of lung diseases. Eur Respir J 2019; 54:54/3/1901417. [DOI: 10.1183/13993003.01417-2019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 07/28/2019] [Indexed: 02/02/2023]
|
7
|
Douka S, Zilidou VI, Lilou O, Tsolaki M. Greek Traditional Dances: A Way to Support Intellectual, Psychological, and Motor Functions in Senior Citizens at Risk of Neurodegeneration. Front Aging Neurosci 2019; 11:6. [PMID: 30740051 PMCID: PMC6356054 DOI: 10.3389/fnagi.2019.00006] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 01/10/2019] [Indexed: 12/14/2022] Open
Abstract
One of the major problems that elderly people are facing is dementia. For scientist’s dementia is a medical, social and economic problem, as it has been characterized as the epidemic of the 21st century. Prevention and treatment in the initial stages of dementia are essential, and community awareness and specialization of health professionals are required, with the aim of early and valid diagnosis of the disease. Activities are recommended to the senior citizens to improve their physical and mental health. Dance has been suggested as an appropriate recreational activity for the elderly that brings functional adjustments to the various systems of the body, psychological benefits, and makes exercise to seem interesting and entertaining as it combines the performance of multiple animations with musical accompaniment. A Greek traditional dance program was performed where our sample consisted of 30 healthy elderly and 30 with Mild Cognitive Impairment – MCI. It lasted 24 weeks, two times a week for 60 min. Specific traditional dances from all over Greece were selected. The dances were of a moderate intensity at the beginning with a gradual increase in intensity, according to the age and physical abilities of the participants. The results showed a significant improvement in: attention (S4viac-Healthy: z = -3.085, p = 0.002; MCI: z = -3.695, p < 0.001, S4viti-Healthy: z = -2.800, p = 0.005; MCI: z = -3.538, p < 0.001), anxiety (Healthy: z = -2.042, p = 0.041; MCI: z = -2.168, p = 0.030), verbal fluency for MCI (Verflx: t = -2.396, df = 29, p = 0.023, Verfls: t = -3.619, df = 29, p = 0.001, Verfmo: t = -3.295, df = 29, p = 0.003) and in executive functions (FUCAS: z = –2.168, p = 0.030). Significant improvement also showed in physical condition (Arm curl– Healthy: z = –3.253, p = 0.001; MCI: z = -3.308, p = 0.001, Chair stand – Healthy: t = –3.232, df = 29, p = 0.003; MCI: t = -2.242, df = 29, p = 0.033, Back scratch– Healthy: z = -1.946, p = 0.052; MCI: z = -2.845, p = 0.004, 2 min step– Healthy: z = –2.325, p = 0.020; MCI: z = -2.625, p = 0.009, FootUpandGo– Healthy: z = -4.289, p < 0.001; MCI: z = -3.137, p = 0.002, Sit and Reach: z = -3.082, p = 0.002, Balance on One leg: z = -3.301, p = 0.001) and Quality of life (Healthy: z = -1.937, p = 0.053; MCI: z = -2.130, p = 0.033). This study proves that dancing not only improves the cognitive and physical condition of the elderly but also contributes to a better quality of life.
Collapse
Affiliation(s)
- Styliani Douka
- Laboratory of Sports, Tourism and Recreation Management, School of Physical Education and Sport Science, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasiliki I Zilidou
- Laboratory of Sports, Tourism and Recreation Management, School of Physical Education and Sport Science, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Laboratory of Medical Physics, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Olympia Lilou
- Laboratory of Sports, Tourism and Recreation Management, School of Physical Education and Sport Science, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Magda Tsolaki
- Department of Neurology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| |
Collapse
|