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Cheng MY, Yu CL, An X, Wang L, Tsai CL, Qi F, Wang KP. Evaluating EEG neurofeedback in sport psychology: a systematic review of RCT studies for insights into mechanisms and performance improvement. Front Psychol 2024; 15:1331997. [PMID: 39156814 PMCID: PMC11328324 DOI: 10.3389/fpsyg.2024.1331997] [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: 11/02/2023] [Accepted: 07/01/2024] [Indexed: 08/20/2024] Open
Abstract
Electroencephalographic Neurofeedback Training (EEG NFT) aims to improve sport performance by teaching athletes to control their mental states, leading to better cognitive, emotional, and physical outcomes. The psychomotor efficiency hypothesis suggests that optimizing brain function could enhance athletic ability, indicating the potential of EEG NFT. However, evidence for EEG-NFT's ability to alter critical brain activity patterns, such as sensorimotor rhythm and frontal midline theta-key for concentration and relaxation-is not fully established. Current research lacks standardized methods and comprehensive studies. This shortfall is due to inconsistent EEG target selection and insufficient focus on coherence in training. This review aims to provide empirical support for EEG target selection, conduct detailed control analyses, and examine the specificity of electrodes and frequencies to relation to the psychomotor efficiency hypothesis. Following the PRISMA method, 2,869 empirical studies were identified from PubMed, Science Direct, Web of Science, Embase, CNKI, and PsycINFO. Thirteen studies met the inclusion criteria: (i) proficient skill levels; (ii) use of EEG; (iii) neurofeedback training (NFT); (iv) motor performance metrics (reaction time, precision, dexterity, balance); (v) control group for NFT comparison; (vi) peer-reviewed English-language publication; and (vii) randomized controlled trial (RCT) design. Studies indicate that NFT can enhance sports performance, including improvements in shooting accuracy, golf putting, and overall motor skills, as supported by the psychomotor efficiency hypothesis. EEG NFT demonstrates potential in enhancing sports performance by optimizing performers' mental states and psychomotor efficiency. However, the current body of research is hampered by inconsistent methodologies and a lack of standardized EEG target selection. To strengthen the empirical evidence supporting EEG NFT, future studies need to focus on standardizing target selection, employing rigorous control analyses, and investigating underexplored EEG markers. These steps are vital to bolster the evidence for EEG NFT and enhance its effectiveness in boosting sport performance.
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Affiliation(s)
- Ming-Yang Cheng
- School of Psychology, Beijing Sport University, Beijing, China
| | - Chien-Lin Yu
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei City, Taiwan
| | - Xin An
- School of Psychology, Beijing Sport University, Beijing, China
| | - Letong Wang
- School of Psychology, Beijing Sport University, Beijing, China
| | - Chi-Lun Tsai
- Department of Sport Psychology, Faculty of Sport Science, Universität Leipzig, Leipzig, Germany
| | - Fengxue Qi
- Sports, Exercise and Brain Sciences Laboratory, Beijing Sport University, Beijing, China
| | - Kuo-Pin Wang
- Center for Cognitive Interaction Technology, Bielefeld University, Bielefeld, Germany
- Neurocognition and Action - Biomechanics Research Group, Faculty of Psychology and Sports Science, Bielefeld University, Bielefeld, Germany
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Iverson AM, Black KJ. Why Tic Severity Changes from Then to Now and from Here to There. J Clin Med 2022; 11:5930. [PMID: 36233797 PMCID: PMC9570874 DOI: 10.3390/jcm11195930] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/23/2022] [Accepted: 10/05/2022] [Indexed: 11/29/2022] Open
Abstract
Much of the research regarding Tourette's syndrome (TS) has focused on why certain individuals develop tics while others do not. However, a separate line of research focuses on the momentary influences that cause tics to increase or decrease in patients who are already known to have TS or another chronic tic disorder (CTD). Environmental and internal variables such as fatigue, anxiety, and certain types of thoughts all have been shown to worsen tic severity and may even overcome the positive effects of treatment. Other influences such as stress, distraction, and being observed have had mixed effects in the various studies that have examined them. Still, other variables such as social media exposure and dietary habits have received only minimal research attention and would benefit from additional study. Understanding the impact of these environmental and internal influences provides an opportunity to improve behavioral treatments for TS/CTD and to improve the lives of those living with these conditions. This review will examine the current literature on how these moment-to-moment influences impact tic expression in those with TS/CTD.
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Affiliation(s)
- Ann M. Iverson
- School of Medicine, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Kevin J. Black
- Departments of Psychiatry, Neurology, Radiology and Neuroscience, Washington University in St. Louis, St. Louis, MO 63110-1010, USA
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3
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Berardelli I, Pasquini M, Conte A, Bologna M, Berardelli A, Fabbrini G. Treatment of psychiatric disturbances in common hyperkinetic movement disorders. Expert Rev Neurother 2018; 19:55-65. [DOI: 10.1080/14737175.2019.1555475] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Isabella Berardelli
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Antonella Conte
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed
| | - Matteo Bologna
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed
| | - Alfredo Berardelli
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed
| | - Giovanni Fabbrini
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed
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Hohenfeld C, Nellessen N, Dogan I, Kuhn H, Müller C, Papa F, Ketteler S, Goebel R, Heinecke A, Shah NJ, Schulz JB, Reske M, Reetz K. Cognitive Improvement and Brain Changes after Real-Time Functional MRI Neurofeedback Training in Healthy Elderly and Prodromal Alzheimer's Disease. Front Neurol 2017; 8:384. [PMID: 28848488 PMCID: PMC5552678 DOI: 10.3389/fneur.2017.00384] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 07/19/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cognitive decline is characteristic for Alzheimer's disease (AD) and also for healthy ageing. As a proof-of-concept study, we examined whether this decline can be counteracted using real-time fMRI neurofeedback training. Visuospatial memory and the parahippocampal gyrus (PHG) were targeted. METHODS Sixteen healthy elderly subjects (mean age 63.5 years, SD = 6.663) and 10 patients with prodromal AD (mean age 66.2 years, SD = 8.930) completed the experiment. Four additional healthy subjects formed a sham-feedback condition to validate the paradigm. The protocol spanned five examination days (T1-T5). T1 contained a neuropsychological pre-test, the encoding of a real-world footpath, and an anatomical MRI scan of the brain. T2-T4 included the fMRI neurofeedback training paradigm, in which subjects learned to enhance activation of the left PHG while recalling the path encoded on T1. At T5, the neuropsychological post-test and another anatomical MRI brain scan were performed. The neuropsychological battery included the Montreal Cognitive Assessment (MoCA); the Visual and Verbal Memory Test (VVM); subtests of the Wechsler Memory Scale (WMS); the Visual Patterns Test; and Trail Making Tests (TMT) A and B. RESULTS Healthy elderly and patients with prodromal AD showed improved visuospatial memory performance after neurofeedback training. Healthy subjects also performed better in a working-memory task (WMS backward digit-span) and in the MoCA. Both groups were able to elicit parahippocampal activation during training, but no significant changes in brain activation were found over the course of the training. However, Granger-causality-analysis revealed changes in cerebral connectivity over the course of the training, involving the parahippocampus and identifying the precuneus as main driver of activation in both groups. Voxel-based morphometry showed increases in grey matter volumes in the precuneus and frontal cortex. Neither cognitive enhancements, nor parahippocampal activation were found in the control group undergoing sham-feedback. CONCLUSION These findings suggest that cognitive decline, either related to prodromal AD or healthy ageing, could be counteracted using fMRI-based neurofeedback. Future research needs to determine the potential of this method as a treatment tool.
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Affiliation(s)
- Christian Hohenfeld
- Department of Neurology, RWTH Aachen University, Aachen, Germany.,Institute of Neuroscience and Medicine (INM-4, 6), Research Centre Jülich GmbH, Jülich, Germany.,JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Aachen, Germany
| | - Nils Nellessen
- Department of Neurology, RWTH Aachen University, Aachen, Germany.,Institute of Neuroscience and Medicine (INM-4, 6), Research Centre Jülich GmbH, Jülich, Germany.,JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Aachen, Germany
| | - Imis Dogan
- Department of Neurology, RWTH Aachen University, Aachen, Germany.,Institute of Neuroscience and Medicine (INM-4, 6), Research Centre Jülich GmbH, Jülich, Germany.,JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Aachen, Germany
| | - Hanna Kuhn
- Department of Neurology, RWTH Aachen University, Aachen, Germany.,Institute of Neuroscience and Medicine (INM-4, 6), Research Centre Jülich GmbH, Jülich, Germany.,JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Aachen, Germany
| | - Christine Müller
- Department of Neurology, RWTH Aachen University, Aachen, Germany.,Institute of Neuroscience and Medicine (INM-4, 6), Research Centre Jülich GmbH, Jülich, Germany.,JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Aachen, Germany
| | - Federica Papa
- Department of Neurology, RWTH Aachen University, Aachen, Germany.,Institute of Neuroscience and Medicine (INM-4, 6), Research Centre Jülich GmbH, Jülich, Germany.,JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Aachen, Germany
| | - Simon Ketteler
- Department of Neurology, RWTH Aachen University, Aachen, Germany.,Institute of Neuroscience and Medicine (INM-4, 6), Research Centre Jülich GmbH, Jülich, Germany.,JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Aachen, Germany
| | - Rainer Goebel
- Department of Cognitive Neuroscience, Maastricht University, Maastricht, Netherlands.,Maastricht Brain Imaging Centre, Maastricht University, Maastricht, Netherlands.,Brain Innovation, Maastricht, Netherlands
| | | | - N Jon Shah
- Department of Neurology, RWTH Aachen University, Aachen, Germany.,Institute of Neuroscience and Medicine (INM-4, 6), Research Centre Jülich GmbH, Jülich, Germany.,JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Aachen, Germany
| | - Jörg B Schulz
- Department of Neurology, RWTH Aachen University, Aachen, Germany.,JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Aachen, Germany
| | - Martina Reske
- Institute of Neuroscience and Medicine (INM-4, 6), Research Centre Jülich GmbH, Jülich, Germany.,JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Aachen, Germany
| | - Kathrin Reetz
- Department of Neurology, RWTH Aachen University, Aachen, Germany.,Institute of Neuroscience and Medicine (INM-4, 6), Research Centre Jülich GmbH, Jülich, Germany.,JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Aachen, Germany
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Fründt O, Woods D, Ganos C. Behavioral therapy for Tourette syndrome and chronic tic disorders. Neurol Clin Pract 2017; 7:148-156. [PMID: 29185535 DOI: 10.1212/cpj.0000000000000348] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 02/12/2017] [Indexed: 11/15/2022]
Abstract
Purpose of review To summarize behavioral interventions for the treatment of primary tic disorders. Recent findings Although tics were attributed to a disordered weak volition, the shift towards neurobiological models of tic disorders also transformed nonpharmacologic treatment practices. Current international guidelines recommend habit reversal training, comprehensive behavioral intervention, and exposure and response prevention as first-line therapies for tics. Appropriate patient selection, including age and presence of comorbidities, are salient clinical features that merit consideration. Evidence for further behavioral interventions is also presented. Summary Currently recommended behavioral interventions view tics as habitual responses that may be further strengthened through negative reinforcement. Although availability and costs related to these interventions may limit their effect, Internet-based and telehealth approaches may facilitate wide accessibility. Novel nonpharmacologic treatments that take different approaches, such as autonomic modulation or attention-based interventions, may also hold therapeutic promise.
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Affiliation(s)
- Odette Fründt
- Department of Neurology (OF, CG), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; and Department of Psychology (DW), Marquette University, Milwaukee, WI
| | - Douglas Woods
- Department of Neurology (OF, CG), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; and Department of Psychology (DW), Marquette University, Milwaukee, WI
| | - Christos Ganos
- Department of Neurology (OF, CG), University Medical Center Hamburg-Eppendorf, Hamburg, Germany; and Department of Psychology (DW), Marquette University, Milwaukee, WI
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Albrecht JS, Bubenzer-Busch S, Gallien A, Knospe EL, Gaber TJ, Zepf FD. Effects of a structured 20-session slow-cortical-potential-based neurofeedback program on attentional performance in children and adolescents with attention-deficit hyperactivity disorder: retrospective analysis of an open-label pilot-approach and 6-month follow-up. Neuropsychiatr Dis Treat 2017; 13:667-683. [PMID: 28293109 PMCID: PMC5342612 DOI: 10.2147/ndt.s119694] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The aim of this approach was to conduct a structured electroencephalography-based neurofeedback training program for children and adolescents with attention-deficit hyperactivity disorder (ADHD) using slow cortical potentials with an intensive first (almost daily sessions) and second phase of training (two sessions per week) and to assess aspects of attentional performance. PATIENTS AND METHODS A total of 24 young patients with ADHD participated in the 20-session training program. During phase I of training (2 weeks, 10 sessions), participants were trained on weekdays. During phase II, neurofeedback training occurred twice per week (5 weeks). The patients' inattention problems were measured at three assessment time points before (pre, T0) and after (post, T1) the training and at a 6-month follow-up (T2); the assessments included neuropsychological tests (Alertness and Divided Attention subtests of the Test for Attentional Performance; Sustained Attention Dots and Shifting Attentional Set subtests of the Amsterdam Neuropsychological Test) and questionnaire data (inattention subscales of the so-called Fremdbeurteilungsbogen für Hyperkinetische Störungen and Child Behavior Checklist/4-18 [CBCL/4-18]). All data were analyzed retrospectively. RESULTS The mean auditive reaction time in a Divided Attention task decreased significantly from T0 to T1 (medium effect), which was persistent over time and also found for a T0-T2 comparison (larger effects). In the Sustained Attention Dots task, the mean reaction time was reduced from T0-T1 and T1-T2 (small effects), whereas in the Shifting Attentional Set task, patients were able to increase the number of trials from T1-T2 and significantly diminished the number of errors (T1-T2 & T0-T2, large effects). CONCLUSION First positive but very small effects and preliminary results regarding different parameters of attentional performance were detected in young individuals with ADHD. The limitations of the obtained preliminary data are the rather small sample size, the lack of a control group/a placebo condition and the open-label approach because of the clinical setting and retrospective analysis. The value of the current approach lies in providing pilot data for future studies involving larger samples.
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Affiliation(s)
- Johanna S Albrecht
- Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen; JARA Translational Brain Medicine, Aachen & Jülich; Center for Pediatrics and Adolescent Medicine Elisabeth Hospital Rheydt, Mönchengladbach
| | - Sarah Bubenzer-Busch
- Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen; JARA Translational Brain Medicine, Aachen & Jülich
| | - Anne Gallien
- Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen; Clinic for Neurology, Medical Center City Region Aachen, Würselen
| | - Eva Lotte Knospe
- Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen; JARA Translational Brain Medicine, Aachen & Jülich
| | - Tilman J Gaber
- Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen; JARA Translational Brain Medicine, Aachen & Jülich; NeuroCare Group, Munich, Germany
| | - Florian D Zepf
- Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen; JARA Translational Brain Medicine, Aachen & Jülich; Centre and Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, School of Paediatrics and Child Health & School of Psychiatry and Clinical Neurosciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia; Department of Health in Western Australia, Specialised Child and Adolescent Mental Health Services, Perth, WA, Australia
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