Infra-Low-Frequency Neurofeedback Treatment in Dysthymia: A Case Study

Depression is one of the most common mental disorders worldwide. Dysthymia, a long-lasting form of depressive disorder that is also known as persistent depressive disorder (PDD) with pure dysthymic syndrome according to the Diagnostical and Statical Manual of Mental Disorders (DSM-5), is characterised by being difficult to treat. The most prominent therapeutic approaches in treating dysthymia are pharmacotherapy and psychotherapy, but recent studies also demonstrate the success of neurofeedback in treating individuals with depressive disorders. However, infra-low-frequency (ILF) neurofeedback, the main new neurofeedback protocol, lacks empirical evidence, and there is no evidence that it can treat dysthymia. This case report investigates the ILF neurofeedback method in a male patient with dysthymia. After 45 sessions of ILF neurofeedback combined with ILF synchrony, a decrease in symptom severity was found on assessment after treatment, and these results remained consistent at a low level at a 6-month follow-up. Additionally, the patient reported benefits on interpersonal and cognitive levels and in daily life situations. This study should incentivise further investigations into using ILF neurofeedback to treat dysthymia and all variations of depressive disorders.

Alpha-phase synchrony EEG training for multi-resistant chronic low back pain patients: an open-label pilot study

PURPOSE

Chronic low back pain (cLBP) affects a quarter of a population during its lifetime. The most severe cases include patients not responding to interventions such as 5-week-long in-hospital multi-disciplinary protocols. This document reports on a pilot study offering an alpha-phase synchronization (APS) brain rehabilitation intervention to a population of n = 16 multi-resistant cLBP patients.

METHODS

The intervention consists of 20 sessions of highly controlled electroencephalography (EEG) APS operant conditioning (neurofeedback) paradigm delivered in the form of visual feedback. Visual analogue scale for pain, Dallas, Hamilton, and HAD were measured before, after, at 6-month and 12-month follow-up. Full-scalp EEG data were analyzed to study significant changes in the brain's electrical activity.

RESULTS

The intervention showed a great and lasting response of most measured clinical scales. The clinical improvement was lasting beyond the 6-month follow-up endpoints. The EEG data confirm that patients did control (intra-session trends) and learned to better control (intersession trends) their APS neuromarker resulting in (nonsignificant) baseline changes in their resting state activity. Last and most significantly, the alpha-phase concentration (APC) neuromarker, specific to phase rather than amplitude, was found to correlate significantly with the reduction in clinical symptoms in a typical dose-response effect.

CONCLUSION

This first experiment highlights the role of the APC neuromarker in relation to the nucleus accumbens activity and its role on nociception and the chronicity of pain. This study suggests APC rehabilitation could be used clinically for the most severe cases of cLBP. Its excellent safety profile and availability as a home-use intervention makes it a potentially disruptive tool in the context of nonsteroidal anti-inflammatory drugs and opioid abuses. These slides can be retrieved under Electronic Supplementary Material.

Assessing the Effectiveness of Neurofeedback Training in the Context of Clinical and Social Neuroscience

Social neuroscience benefits from the experimental manipulation of neuronal activity. One possible manipulation, neurofeedback, is an operant conditioning-based technique in which individuals sense, interact with, and manage their own physiological and mental states. Neurofeedback has been applied to a wide variety of psychiatric illnesses, as well as to treat sub-clinical symptoms, and even to enhance performance in healthy populations. Despite growing interest, there persists a level of distrust and/or bias in the medical and research communities in the USA toward neurofeedback and other functional interventions. As a result, neurofeedback has been largely ignored, or disregarded within social neuroscience. We propose a systematic, empirically-based approach for assessing the effectiveness, and utility of neurofeedback. To that end, we use the term perturbative physiologic plasticity to suggest that biological systems function as an integrated whole that can be perturbed and guided, either directly or indirectly, into different physiological states. When the intention is to normalize the system, e.g., via neurofeedback, we describe it as self-directed neuroplasticity, whose outcome is persistent functional, structural, and behavioral changes. We argue that changes in physiological, neuropsychological, behavioral, interpersonal, and societal functioning following neurofeedback can serve as objective indices and as the metrics necessary for assessing levels of efficacy. In this chapter, we examine the effects of neurofeedback on functional connectivity in a few clinical disorders as case studies for this approach. We believe this broader perspective will open new avenues of investigation, especially within social neuroscience, to further elucidate the mechanisms and effectiveness of these types of interventions, and their relevance to basic research.

Open focus attention training

This article describes the role of attention training and brainwave synchrony training in the resolution of stress- and pain-related symptoms. It describes the origin of Open Focus attention training as it was distilled from observations of space-generated brain wave activity. It provides a map of the various attentional styles and associated EEG activity.