The subcortical role in executive functions: Neural mechanisms of executive inhibition in the flanker task

While executive functions (EFs) have traditionally been linked to the cerebral cortex, our understanding of EFs has evolved with increasing evidence pointing to the involvement of cortico-subcortical networks. Despite the importance of investigating EFs within this broader context, the functional contributions of subcortical regions to these processes remain largely unexplored. This study addresses this gap by specifically examining the involvement of subcortical regions in executive inhibition, as measured by the classic Eriksen flanker task. In this study, we used a stereoscope to differentiate between subcortical (monocular) and cortical (mostly binocular) visual pathways in EF processes. Our findings indicate that monocular visual pathways play a crucial role in representing executive conflict, which necessitates cortical involvement. The persistence of a monoptic advantage in conflict representation highlights the substantial contribution of subcortical regions to these executive processes. This exploration of subcortical involvement in executive inhibition provides valuable insights into the intricate relationships between cortical and subcortical regions in EFs.

Enhancing Working Memory and Reducing Anxiety in University Students: A Neurofeedback Approach

(1) Background: Neurofeedback training (NFT) has emerged as a promising approach for enhancing cognitive functions and reducing anxiety, yet its specific impact on university student populations requires further investigation. This study aims to examine the effects of NFT on working memory improvement and anxiety reduction within this demographic. (2) Methods: A total of forty healthy university student volunteers were randomized into two groups: an experimental group that received NFT and a control group. The NFT protocol was administered using a 14-channel Emotiv Epoc X headset (EMOTIV, Inc., San Francisco, CA 94102, USA) and BrainViz software version Brain Visualizer 1.1 (EMOTIV, Inc., San Francisco, CA 94102, USA), focusing on the alpha frequency band to target improvements in working memory and reductions in anxiety. Assessment tools, including the Corsi Block and Memory Span tests for working memory and the State-Trait Anxiety Inventory-2 (STAI-2) for anxiety, were applied pre- and post-intervention. (3) Results: The findings indicated an increase in alpha wave amplitude in the experimental group from the second day of NFT, with statistically significant differences observed on days 2 (p < 0.05) and 8 (p < 0.01). Contrary to expectations based on the previous literature, the study did not observe a concurrent positive impact on working memory. Nonetheless, a significant reduction in state anxiety levels was recorded in the experimental group (p < 0.001), corroborating NFT's potential for anxiety management. (4) Conclusions: While these results suggest some potential of the technique in enhancing neural efficiency, the variability across different days highlights the need for further investigation to fully ascertain its effectiveness. The study confirms the beneficial impact of NFT on reducing state anxiety among university students, underscoring its value in psychological and cognitive performance enhancement. Despite the lack of observed improvements in working memory, these results highlight the need for continued exploration of NFT applications across different populations and settings, emphasizing its potential utility in educational and therapeutic contexts.

Effects of School-Based Neurofeedback Training on Attention in Students with Autism and Intellectual Disabilities

In this study we aimed to assess the influence of school-based neurofeedback training on the attention of students with autism and intellectual disabilities. We assessed 24 students of a special education center who attended neurofeedback training sessions during the schoolyear; we also assessed 25 controls from the same center. We used two computer tasks to assess sustained attention in simple and cognitively demanding test situations, and we used a pen-and-paper task to assess selective attention. Each student who took part in the study was tested at the beginning and at the end of the schoolyear. Students from the experimental group significantly improved their performance in the task related to sustained attention to simple stimuli. No performance improvement related to neurofeedback treatment was observed in either sustained attention in cognitively demanding situations or selective attention. School-based neurofeedback training may improve sustained attention to simple stimuli in students with developmental disabilities.

Impact of Mobile Neurofeedback on Internet Addiction and Neurocognitive Function in Neurotypical Children: Double-Blind, Sham-Controlled Randomized Clinical Trial

Objective

The purpose of this study was to evaluate the positive impact of mobile neurofeedback (MNF) in neurotypical children compared to sham mobile neurofeedback.

Methods

Neurotypical children aged 10-15 participated in the study. All subjects were assessed using the Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version Korean Version (K-SADS-PL-K) and confirmed to have no psychiatric symptoms. The participants were randomly assigned to the MNF active (N=31) or sham control (N=30) groups. The MNF program was administered using a mobile app for 30 min/day, 3 days/week, for 3 months. All participants and their parents completed self-report scales and participants complete neurocognitive function assessments including the continuous performance test, Stroop, children's color trails test-1 and 2, and intelligence test at baseline and after the 3-month MNF program.

Results

This study involved 61 participants (mean [SD] age, 11.24 [1.84] years; 30 male participants [49.2%]). To verify the difference between the MNF group and the sham group, 2(MNF-Sham) X 2(Pre-Post) repeated measures ANOVA was performed. The main effect of the K-scale (Korea Internet addiction scale) between-group factor (MNF vs Sham) was not significant, but the main effect of the within-group factor (Pre vs Post) was significant (F=7.595, p=0.008). The interaction effect of between-group factors and within-group factors was also significant (F=5.979, p=0.017). In other self-reported scales of children and parents and neurocognitive function assessments, there was no significant difference between the two groups.

Conclusion

Active mobile neurofeedback significantly improved children's K-scale score compared to the sham group. Therefore, mobile neurofeedback could be an easy-to-access therapeutic option for children at risk of Internet addiction. On the other hand, there was no significant difference in other scales and neurocognitive function. A 3-month intervention may not have been long enough to cause change, so longer interventions are needed for confirmation.

Mapping the evolution of neurofeedback research: a bibliometric analysis of trends and future directions

Introduction

This study conducts a bibliometric analysis on neurofeedback research to assess its current state and potential future developments.

Methods

It examined 3,626 journal articles from the Web of Science (WoS) using co-citation and co-word methods.

Results

The co-citation analysis identified three major clusters: "Real-Time fMRI Neurofeedback and Self-Regulation of Brain Activity," "EEG Neurofeedback and Cognitive Performance Enhancement," and "Treatment of ADHD Using Neurofeedback." The co-word analysis highlighted four key clusters: "Neurofeedback in Mental Health Research," "Brain-Computer Interfaces for Stroke Rehabilitation," "Neurofeedback for ADHD in Youth," and "Neural Mechanisms of Emotion and Self-Regulation with Advanced Neuroimaging.

Discussion

This in-depth bibliometric study significantly enhances our understanding of the dynamic field of neurofeedback, indicating its potential in treating ADHD and improving performance. It offers non-invasive, ethical alternatives to conventional psychopharmacology and aligns with the trend toward personalized medicine, suggesting specialized solutions for mental health and rehabilitation as a growing focus in medical practice.

A scoping review on the use of consumer-grade EEG devices for research

BACKGROUND

Commercial electroencephalography (EEG) devices have become increasingly available over the last decade. These devices have been used in a wide variety of fields ranging from engineering to cognitive neuroscience.

PURPOSE

The aim of this study was to chart peer-review articles that used consumer-grade EEG devices to collect neural data. We provide an overview of the research conducted with these relatively more affordable and user-friendly devices. We also inform future research by exploring the current and potential scope of consumer-grade EEG.

METHODS

We followed a five-stage methodological framework for a scoping review that included a systematic search using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. We searched the following online databases: PsycINFO, MEDLINE, Embase, Web of Science, and IEEE Xplore. We charted study data according to application (BCI, experimental research, validation, signal processing, and clinical) and location of use as indexed by the first author's country.

RESULTS

We identified 916 studies that used data recorded with consumer-grade EEG: 531 were reported in journal articles and 385 in conference papers. Emotiv devices were used most, followed by the NeuroSky MindWave, OpenBCI, interaXon Muse, and MyndPlay Mindband. The most common usage was for brain-computer interfaces, followed by experimental research, signal processing, validation, and clinical purposes.

CONCLUSIONS

Consumer-grade EEG is a useful tool for neuroscientific research and will likely continue to be used well into the future. Our study provides a comprehensive review of their application, as well as future directions for researchers who plan to use these devices.

Review of the Evidence for Neurofeedback Training for Children and Adolescents Who Have Experienced Traumatic Events

Neurofeedback training is an established treatment for children with attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder and is an increasingly accepted modality of treatment in the context of child trauma. This treatment is typically delivered as a complement to more traditional talk therapy such as trauma-focused-cognitive behavioral therapy (TF-CBT). This review examined the evidence for the effectiveness of this intervention for children with trauma through a systematic search of the literature. A targeted search across databases identified 10 eligible studies that focused on children/young people who had experienced traumatic events and/or demonstrated symptoms of trauma, and which conducted a repeated measures study at a minimum. While the included studies suggest some benefits from neurofeedback training, the available studies, including randomized trials, have to date been relatively small, involve dramatically different treatment length and intensity, and show inconsistent benefits relative to usual treatment conditions. To advance knowledge of this intervention further research is needed with a clear best practice protocol and with a clearer target group.

The impact of comorbid anxiety on quantitative EEG heterogeneity in children with attention-deficit/hyperactivity disorder

Objective

The objective of this study was to compare quantitative electroencephalography (Q-EEG) characteristics of children with Attention-deficit/hyperactivity disorder (ADHD), taking into account the presence of a comorbidity for anxiety disorder. It also sought to investigate the impact of comorbid anxiety on the Q-EEG heterogeneity of children with ADHD.

Method

A total of 141 children with ADHD but without comorbid anxiety (ADHD-Only), 25 children with a comorbidity for anxiety disorder (ADHD-ANX) and 43 children in the control group were assessed. To compare Q-EEG characteristics between groups, we performed ANCOVA (Analysis of Covariance) on relative power and theta/beta ratio (TBR) controlling for covariates such as age, sex, and FSIQ. Relative power values from 19 electrodes were averaged for three regions (frontal, central and posterior). Furthermore, cluster analysis (Ward's method) using the squared Euclidian distance was conducted on participants with ADHD to explore the impact of anxiety on the heterogeneity of Q-EEG characteristics in ADHD.

Results

There were no significant group differences in cognitive and behavioral measures. However, significant differences between groups were observed in the theta values in the central region, and the beta values in the frontal, central and posterior regions. In post hoc analyses, It was found that the ADHD-ANX group has significantly higher beta power values than the ADHD-Only group in all regions. For the theta/beta ratio, the ADHD-Only group had significantly higher values than the ADHD-ANX group in frontal, central and posterior regions. However, the control group did not show significant differences compared to both the ADHD-Only and ADHD-ANX group. Through clustering analysis, the participants in the ADHD-Only and ADHD-ANX groups were classified into four clusters. The ratios of children with comorbidities for anxiety disorder within each cluster were significantly different (χ² = 10.018, p = 0.019).

Conclusion

Attention-deficit/hyperactivity disorder children with comorbid anxiety disorder showed lower theta power in the central region, higher beta power in all regions and lower TBR in all regions compared to those without comorbid anxiety disorder. The ratios of children with comorbidities for anxiety disorder within each cluster were significantly different.

A systematic comparison of deep learning methods for EEG time series analysis

Analyzing time series data like EEG or MEG is challenging due to noisy, high-dimensional, and patient-specific signals. Deep learning methods have been demonstrated to be superior in analyzing time series data compared to shallow learning methods which utilize handcrafted and often subjective features. Especially, recurrent deep neural networks (RNN) are considered suitable to analyze such continuous data. However, previous studies show that they are computationally expensive and difficult to train. In contrast, feed-forward networks (FFN) have previously mostly been considered in combination with hand-crafted and problem-specific feature extractions, such as short time Fourier and discrete wavelet transform. A sought-after are easily applicable methods that efficiently analyze raw data to remove the need for problem-specific adaptations. In this work, we systematically compare RNN and FFN topologies as well as advanced architectural concepts on multiple datasets with the same data preprocessing pipeline. We examine the behavior of those approaches to provide an update and guideline for researchers who deal with automated analysis of EEG time series data. To ensure that the results are meaningful, it is important to compare the presented approaches while keeping the same experimental setup, which to our knowledge was never done before. This paper is a first step toward a fairer comparison of different methodologies with EEG time series data. Our results indicate that a recurrent LSTM architecture with attention performs best on less complex tasks, while the temporal convolutional network (TCN) outperforms all the recurrent architectures on the most complex dataset yielding a 8.61% accuracy improvement. In general, we found the attention mechanism to substantially improve classification results of RNNs. Toward a light-weight and online learning-ready approach, we found extreme learning machines (ELM) to yield comparable results for the less complex tasks.

MiniQEEG and Neurofeedback in Diagnosis and Treatment of COVID-19-Related Panic Attacks: A Case Report

BACKGROUND

Both the global COVID-19 pandemic situation, as well as the current political situation in Eastern Europe may exacerbate anxiety and contribute to stress-related disorders such as panic disorder. Electroencephalography (EEG)-based neurofeedback provides both assessment of the subject's brainwave activity as well as the possibility of its therapeutic correction. It is possible that it can be implemented as an auxiliary treatment in panic disorders of different origin. The aim of this feasibility study was to demonstrate (both short- and long-term) effectiveness of neurofeedback therapy in a patient with previously diagnosed panic attacks, related to fear of COVID-19 infection.

METHODS

We report the case study of a 47-year-old man affected by panic attacks, related to his profound, constant fear of COVID-19 infection and its sequelae. For the initial diagnostic workup, several clinical and research tools were used: 1. Baseline psychological exam; 2. Anxiety-targeted interview performed by miniQEEG therapist; 3. Analysis of previous clinical test results (EEG record/lab blood test); and 4. The miniQEEG exam (central strip recording Cz-C3-C4), The patient was subjected to regular EEG Neurofeedback sessions for two consecutive months. After completing the treatment, follow-up tests, as listed above were repeated immediately after completing the whole treatment program, as well as 1 and 2 years later. MiniQEEG results were compared with healthy control (age-matched male subject not affected with panic attacks) and evaluated over the time that the subject was involved in the study.

RESULTS

Initially, the patient was suffering from severe panic attacks accompanied by vegetative symptoms and from destructive and negative thoughts. After 8 consecutive weeks of treatment encompassing sixteen QEEG neurofeedback training sessions (each lasting 30 min), a subjective improvement of his complaints was reported. More importantly, QEEG records of the patient also improved, approximating the pattern of QEEG recorded in the healthy control.

CONCLUSION

In this single case-based feasibility analysis, we demonstrate that systematic application of QEEG-Neurofeedback may result in manifest and durable therapeutic effect. Of note, use of this treatment may be a valuable option for patients with panic attack/panic disorder, especially if related to the psychological burden of the COVID-19/war era. Future studies on a larger patient population, especially with a longitudinal/prospective design, are warranted.

Treating Severe Traumatic Brain Injury: Combining Neurofeedback and Hyperbaric Oxygen Therapy in a Single Case Study

In 2014, a 26-year-old male was involved in a motor vehicle accident resulting in a severe traumatic brain injury (TBI). The patient sustained a closed-head left temporal injury with coup contrecoup impact to the frontal region. The patient underwent a left side craniotomy and was comatose for 26 days. After gaining consciousness, he was discharged to a brain injury treatment center that worked with physical, speech, and occupational issues. He was discharged after eight months with significant speech, ambulation, spasticity, and cognitive issues as well as the onset of posttraumatic epilepsy. His parents sought hyperbaric oxygen treatment (HBOT) from a doctor in Louisiana. After 165 dives, the HBOT doctor recommended an addition of neurofeedback (NFB) therapy. In March 2019 the patient started NFB therapy intermixed with HBOT. The combination of NFB and HBOT improved plasticity and functionality in the areas of injury and the correlated symptoms including short-term memory, personality, language, and executive function, as well as significantly reducing the incidence of seizures. Severe brain injuries often leave lasting deficits with little hope for major recovery and there is a need for further research into long-term, effective neurological treatments for severe brain injuries. These results suggest that HBOT combined with NFB may be a viable option in treating severe brain injuries and should be investigated.

Neurological Mechanisms of Diagnosis and Therapy in School Children with ADHD in Poland

The paper aims to present a holistic view of attention deficit hyperactivity disorder (ADHD) in pedagogical, psychological, legal, and social dimensions in Polish schools. The authors present the benefits of neurofeedback therapy for elementary school pupils. In order to verify the validity, the paper compares the concordance of a medical diagnosis confirming ADHD syndrome with the occurrence of abnormal electrical brain function recording and abnormalities therein as well as the effectiveness of the neurofeedback therapy. The study confirms that the reported problems faced by pupils and affecting their emotional functioning are reflected in their EEG records. Conclusions from the study lead to the proposal that the neurofeedback assessment should be performed at schools, which should result in the implementation of effective therapy. Moreover, the neurofeedback method should be promoted in Polish schools as an alternative to pharmacological therapy, which, as the research proves, is not always effective. Neurofeedback therapy, similarly to behavioral therapy, is very much needed and useful because it provides optimal conditions for the child’s development and shapes their relations with the environment effectively and harmlessly.

Emotional Activity Is Negatively Associated With Cognitive Load in Multimedia Learning: A Case Study With EEG Signals

We aimed to investigate the relationship between emotional activity and cognitive load during multimedia learning from an emotion dynamics perspective using electroencephalography (EEG) signals. Using a between-subjects design, 42 university students were randomly assigned to two video lecture conditions (color-coded vs. grayscale). While the participants watched the assigned video, their EEG signals were recorded. After processing the EEG signals, we employed the correlation-based feature selector (CFS) method to identify emotion-related subject-independent features. We then put these features into the Isomap model to obtain a one-dimensional trajectory of emotional changes. Next, we used the zero-crossing rate (ZCR) as the quantitative characterization of emotional changes ZCR EC . Meanwhile, we extracted cognitive load-related features to analyze the degree of cognitive load (CLI). We employed a linear regression fitting method to study the relationship between ZCR EC and CLI. We conducted this study from two perspectives. One is the frequency domain method (wavelet feature), and the other is the non-linear dynamic method (entropy features). The results indicate that emotional activity is negatively associated with cognitive load. These findings have practical implications for designing video lectures for multimedia learning. Learning material should reduce learners' cognitive load to keep their emotional experience at optimal levels to enhance learning.

Visualization, Self-Efficacy, and Locus of Control in a Virtual Reality Biofeedback Video Game for Anxiety Regulation

The current study aimed to identify specific feedback mechanics and psychological processes that may contribute to positive outcomes in biofeedback applications for anxiety regulation. Specifically, using a dismantling study design, the unique impact of visualizations that directly mirror users' breathing was examined in relation to anxiety regulation as well as locus of control and self-efficacy. Following an anxiety induction, participants (N = 67) were randomly assigned to play one of two variations of a biofeedback video game. In both versions, players' in-game movement was contingent on their breathing; however, the experimental condition additionally included visualizations that directly mirrored players' breathing. Changes in self-reported state anxiety and physiological arousal were measured as well as the level of internal control and self-efficacy participants experienced while playing the game. Results showed that all participants were able to effectively reduce their anxiety and arousal, but no condition differences were found. Implementing mirroring visualizations did not contribute to individuals' ability to self-regulate nor their self-efficacy or locus of control above and beyond receiving feedback based on their in-game movement. Overall, individuals who experienced higher self-efficacy and a stronger internal locus of control were better able to regulate their anxiety, but no clear links were found with changes in self-reported physiological arousal. In light of these results, we recommend the continued exploration of the role of specific design choices and intervention components as well as underlying mechanisms of change in biofeedback interventions, especially pertaining to how individuals perceive themselves and their ability to change.

A Two-Person Neuroscience Approach for Social Anxiety: A Paradigm With Interbrain Synchrony and Neurofeedback

Social anxiety disorder has been widely recognised as one of the most commonly diagnosed mental disorders. Individuals with social anxiety disorder experience difficulties during social interactions that are essential in the regular functioning of daily routines; perpetually motivating research into the aetiology, maintenance and treatment methods. Traditionally, social and clinical neuroscience studies incorporated protocols testing one participant at a time. However, it has been recently suggested that such protocols are unable to directly assess social interaction performance, which can be revealed by testing multiple individuals simultaneously. The principle of two-person neuroscience highlights the interpersonal aspect of social interactions that observes behaviour and brain activity from both (or all) constituents of the interaction, rather than analysing on an individual level or an individual observation of a social situation. Therefore, two-person neuroscience could be a promising direction for assessment and intervention of the social anxiety disorder. In this paper, we propose a novel paradigm which integrates two-person neuroscience in a neurofeedback protocol. Neurofeedback and interbrain synchrony, a branch of two-person neuroscience, are discussed in their own capacities for their relationship with social anxiety disorder and relevance to the paradigm. The newly proposed paradigm sets out to assess the social interaction performance using interbrain synchrony between interacting individuals, and to employ a multi-user neurofeedback protocol for intervention of the social anxiety.

An Approach for Stabilizing Abnormal Neural Activity in ADHD Using Chaotic Resonance

Reduced integrity of neural pathways from frontal to sensory cortices has been suggested as a potential neurobiological basis of attention-deficit hyperactivity disorder. Neurofeedback has been widely applied to enhance reduced neural pathways in attention-deficit hyperactivity disorder by repeated training on a daily temporal scale. Clinical and model-based studies have demonstrated that fluctuations in neural activity underpin sustained attention deficits in attention-deficit hyperactivity disorder. These aberrant neural fluctuations may be caused by the chaos–chaos intermittency state in frontal-sensory neural systems. Therefore, shifting the neural state from an aberrant chaos–chaos intermittency state to a normal stable state with an optimal external sensory stimulus, termed chaotic resonance, may be applied in neurofeedback for attention-deficit hyperactivity disorder. In this study, we applied a neurofeedback method based on chaotic resonance induced by “reduced region of orbit” feedback signals in the Baghdadi model for attention-deficit hyperactivity disorder. We evaluated the stabilizing effect of reduced region of orbit feedback and its robustness against noise from errors in estimation of neural activity. The effect of chaotic resonance successfully shifted the abnormal chaos-chaos intermittency of neural activity to the intended stable activity. Additionally, evaluation of the influence of noise due to measurement errors revealed that the efficiency of chaotic resonance induced by reduced region of orbit feedback signals was maintained over a range of certain noise strengths. In conclusion, applying chaotic resonance induced by reduced region of orbit feedback signals to neurofeedback methods may provide a promising treatment option for attention-deficit hyperactivity disorder.

Behavioral effect of mismatch negativity neurofeedback on foreign language learning

Listening is critical for foreign language learning. Listening difficulties can occur because of an inability to perceive or recognize sounds while listening to speech, whereas successful listening can boost understanding and improve speaking when learning a foreign language. Previous studies in our laboratory revealed that EEG-neurofeedback (NF) using mismatch negativity event-related brain potential successfully induced unconscious learning in terms of auditory discrimination of speech sounds. Here, we conducted a feasibility study with a small participant group (NF group and control group; six participants each) to examine the practical effects of mismatch negativity NF for improving the perception of speech sounds in a foreign language. Native Japanese speakers completed a task in which they learned to perceive and recognize spoken English words containing the consonants "l" or "r". Participants received neurofeedback training while not explicitly attending to auditory stimuli. The results revealed that NF training significantly improved the proportion of correct in discrimination and recognition trials, even though the training time for each word pair was reduced to 20% of the training time reported in our previous study. The learning effect was not affected by training with three pairs of words with different vowels. The current results indicate that NF resulted in long-term learning that persisted for at least 2 months.

Differentiation among bio- and augmented- feedback in technologically assisted rehabilitation

Introduction: In rehabilitation practice, the term 'feedback' is often improperly used, with augmented feedback and biofeedback frequently confused, especially when referring to the human-machine interaction during technologically assisted training. The absence of a clear differentiation between these categories represents an unmet need for rehabilitation, emphasized by the advent of new technologies making extensive use of video feedback, exergame, and virtual reality.Area covered: In this review we tried to present scientific knowledge about feedback, biofeedback, augmented feedback and neurofeedback, and related differences in rehabilitation settings, for a more proper use of this terminology. Despite the continuous expansion of the field, few researches clarify the differences among these terms. This scoping review was conducted through the searching of current literature up to May 2020, using following databases: PUBMED, EMBASE and Web of Science. After literature search a classification system, distinguishing feedback, augmented feedback, and biofeedback, was applied.Expert opinion: There is a need for clear definitions of feedback, biofeedback, augmented feedback, and neurofeedback in rehabilitation, especially in the technologically assisted one based on human-machine interaction. In fact, the fast development of new technologies requires to be based on solid concepts and on a common terminology shared among bioengineers and clinicians.

A Neurofeedback Protocol for Executive Function to Reduce Depression and Rumination: A Controlled Study

Objective

Rumination is a maladaptive emotional-regulation strategy that is strongly associated with depression. Impaired executive function can lead to difficulties in disengaging from rumination, thus exacerbating depression. In this study, we inspect an electroencephalograph neurofeedback protocol that enhance the target peak alpha frequency (PAF) activation in the prefrontal region. We examine the protocol’s effects on depression and rumination.

Methods

We randomly assigned 30 dysphoric participants into either the neurofeedback training group or the control group. We then evaluated their depression, rumination, and executive function at pre- and posttraining so as to examine the effects of the neurofeedback.

Results

The results show that this neurofeedback protocol can specifically enhance participants’ target PAF. The participants’ executive function performances significantly improved after undergoing 20 neurofeedback sessions. Compared with those in the control group, those in the neurofeedback group had significantly fewer depressive symptoms and significantly reduced rumination. Moreover, as target PAF and executive function improved, depression and rumination both declined.

Conclusion

Our data are in line with those of previous studies that indicated a relationship between upper-band alpha activity and executive function. This PAF neurofeedback can effectively enhance participants’ executive function, which can reduce rumination and ameliorate depression. This neurofeedback training is based on basic cognitive neuroscience, so it sheds light on depression’s pathological factors and etiology.

An Integrative Model for the Effectiveness of Biofeedback Interventions for Anxiety Regulation: Viewpoint

Biofeedback has shown to be a promising tool for the treatment of anxiety; however, several theoretical as well as practical limitations have prevented widespread adaptation until now. With current technological advances and the increasing interest in the use of self-monitoring technology to improve mental health, we argue that this is an ideal time to launch a new wave of biofeedback training. In this viewpoint paper, we reflect on the current state of biofeedback training, including the more traditional techniques and mechanisms that have been thought to explain the effectiveness of biofeedback such as the integration of operant learning and meditation techniques, and the changes in interoceptive awareness and physiology. Subsequently, we propose an integrative model that includes a set of cognitive appraisals as potential determinants of adaptive trajectories within biofeedback training such as growth mindset, self-efficacy, locus of control, and threat-challenge appraisals. Finally, we present a set of detailed guidelines based on the integration of our model with the mechanics and mechanisms offered by emerging interactive technology to encourage a new phase of research and implementation using biofeedback. There is a great deal of promise for future biofeedback interventions that harness the power of wearables and video games, and that adopt a user-centered approach to help people regulate their anxiety in a way that feels engaging, personal, and meaningful.

Non-pharmacological Interventions for Intractable Epilepsy

In 30% of epileptic individuals, intractable epilepsy represents a problem for the management of seizures and severely affects the patient's quality of life due to pharmacoresistance with commonly used antiseizure drugs (ASDs). Surgery is not the best option for all resistant patients due to its post-surgical consequences. Therefore, several alternative or complementary therapies have scientifically proven significant therapeutic potential for the management of seizures in intractable epilepsy patients with seizure-free occurrences. Various non-pharmacological interventions include metabolic therapy, brain stimulation therapy, and complementary therapy. Metabolic therapy works out by altering the energy metabolites and include the ketogenic diets (KD) (that is restricted in carbohydrates and mimics the metabolic state of the body as produced during fasting and exerts its antiepileptic effect) and anaplerotic diet (which revives the level of TCA cycle intermediates and this is responsible for its effect). Neuromodulation therapy includes vagus nerve stimulation (VNS), responsive neurostimulation therapy (RNS) and transcranial magnetic stimulation therapy (TMS). Complementary therapies such as biofeedback and music therapy have demonstrated promising results in pharmacoresistant epilepsies. The current emphasis of the review article is to explore the different integrated mechanisms of various treatments for adequate seizure control, and their limitations, and supportive pieces of evidence that show the efficacy and tolerability of these non-pharmacological options.

Efficacy of Neurofeedback Interventions for Cognitive Rehabilitation Following Brain Injury: Systematic Review and Recommendations for Future Research

OBJECTIVES

Interest in neurofeedback therapies (NFTs) has grown exponentially in recent years, encouraged both by escalating public interest and the financial support of health care funding agencies. Given NFTs' growing prevalence and anecdotally reported success in treating common effects of acquired brain injury (ABI), a systematic review of the efficacy of NFTs for the rehabilitation of ABI-related cognitive impairment is warranted.

METHODS

Eligible studies included adult samples (18+ years) with ABI, the use of neurofeedback technology for therapeutic purposes (as opposed to assessment), the inclusion of a meaningful control group/condition, and clear cognitive-neuropsychological outcomes. Initial automated search identified n = 86 candidate articles, however, only n = 4 studies met the stated eligibility criteria.

RESULTS

Results were inconsistent across studies and cognitive domains. Methodological and theoretical limitations precluded robust and coherent conclusions with respect to the cognitive rehabilitative properties of NFTs. We take the results of these systematic analyses as a reflection of the state of the literature at this time. These results offer a constructive platform to further discuss a number of methodological, theoretical, and ethical considerations relating to current and future NFT-ABI research and clinical intervention.

CONCLUSIONS

Given the limited quantity and quality of the available research, there appears to be insufficient evidence to comment on the efficacy of NFTs within an ABI rehabilitation context at this time. It is imperative that future work increase the level of theoretical and methodological rigour if meaningful advancements are to be made understanding and evaluating NFT-ABI applications.

A novel training-free externally-regulated neurofeedback (ER-NF) system using phase-guided visual stimulation for alpha modulation

The efficacy of neurofeedback is a point of great controversy, because a certain proportion of users cannot properly regulate their brain activities and thereby fail to benefit from neurofeedback. To address the neurofeedback inefficacy problem, the present study is aimed to design and implement a new neurofeedback system that can more effectively and consistently regulate users' brain activities than the conventional way of training users to voluntarily regulate brain activities. The new neurofeedback system delivers external visual stimuli continuously at a specific alpha phase, which is real-time decoded from ongoing alpha wave, to regulate the alpha wave. Experimental results show that the proposed training-free externally-regulated neurofeedback (ER-NF) system can achieve consistent (effective in almost all sessions for almost all users), flexible (either increasing or decreasing peak alpha frequency and alpha power), and immediate (taking or losing effect immediately after stimulation is on or off) modulation effects on alpha wave. Therefore, the ER-NF system holds great potential to be able to more reliably and flexibly modulate cognition and behavior.

Long-Term Efficacy of Psychosocial Treatments for Adults With Attention-Deficit/Hyperactivity Disorder: A Meta-Analytic Review

Background: Recent evidence suggests that psychosocial treatments, particularly cognitive-behavioral therapy (CBT), are effective interventions for adult attention deficit hyperactivity disorder (ADHD). The objective of this review was to determine the long-term efficacy of psychosocial interventions in improving clinically relevant variables, including ADHD core symptoms, clinical global impression (CGI), and global functioning. Methods: In total, nine randomized controlled trials and three uncontrolled single-group pretest-posttest studies were included. The data from these studies were combined using the inverse variance method. Heterogeneity and risk of bias were assessed. Subgroup analyses and meta-regressions were performed, to determine the influence of different potential moderator variables (risk of bias, medication status, follow-up length, therapy type and setting, and control group type) on effect size (ES) estimates. Results: Up to 680 of a total of 1,073 participants assessed pre-treatment were retained at follow-up. Treatment groups showed greater improvement than control groups in self-reported total ADHD symptoms, inattention, and hyperactivity/impulsivity, in addition to CGI and global functioning. Blind assessors also reported a large ES in within-subject outcomes. Studies using dialectical behavioral therapy (DBT) in a group setting, with active control matching, and that were rated as having an unclear risk of bias, achieved significantly lower ES estimates for most outcomes. Treatment effectiveness, according to the CGI measure, and global functioning were significantly increased when the percentage of medicated participants was greater. Conclusions: Our results indicate that the post-treatment gains reported in previous reviews are sustained for at least 12 months. Nevertheless, these results must be interpreted with caution, because of a high level of heterogeneity among studies and the risk of bias observed in the majority of outcomes. Thus, these findings indicate that psychological interventions are a highly valuable and stable clinical tool for the treatment of core symptoms and global functioning in adults with ADHD.

An Overview of the Use of Neurofeedback Biofeedback for the Treatment of Symptoms of Traumatic Brain Injury in Military and Civilian Populations

Background: Neurofeedback, a type of biofeedback, is an operant conditioning treatment that has been studied for use in the treatment of traumatic brain injury (TBI) in both civilian and military populations. In this approach, users are able to see or hear representations of data related to their own physiologic responses to triggers, such as stress or distraction, in real time and, with practice, learn to alter these responses in order to reduce symptoms and/or improve performance. Objective: This article provides a brief overview of the use of biofeedback, focusing on neurofeedback, for symptoms related to TBI, with applications for both civilian and military populations, and describes a pilot study that is currently underway looking at the effects of a commercial neurofeedback device on patients with mild-to-moderate TBIs. Conclusions: Although more research, including blinded randomized controlled studies, is needed on the use of neurofeedback for TBI, the literature suggests that this approach shows promise for treating some symptoms of TBI with this modality. With further advances in technology, including at-home use of neurofeedback devices, preliminary data suggests that TBI survivors may benefit from improved motivation for treatment and some reduction of symptoms related to attention, mood, and mindfulness, with the addition of neurofeedback to treatment.

Effectiveness of neurofeedback therapy for anxiety and stress in adults living with a chronic illness: a systematic review protocol

REVIEW QUESTION/OBJECTIVE

The objective of this review is to systematically examine the effectiveness of neurofeedback therapy for managing anxiety and stress in adults living with a chronic illness.The specific objectives are to identify which neurofeedback systems and/or protocols demonstrate effectiveness and determine the level of supporting evidence.The review question is as follows: What is the effectiveness of neurofeedback therapy for managing anxiety and stress in an adult population aged 18 years of age or older living with a chronic illness?

Neurofeedback as a form of cognitive rehabilitation therapy following stroke: A systematic review

Neurofeedback therapy (NFT) has been used within a number of populations however it has not been applied or thoroughly examined as a form of cognitive rehabilitation within a stroke population. Objectives for this systematic review included: i) identifying how NFT is utilized to treat cognitive deficits following stroke, ii) examining the strength and quality of evidence to support the use of NFT as a form of cognitive rehabilitation therapy (CRT) and iii) providing recommendations for future investigations. Searches were conducted using OVID (Medline, Health Star, Embase + Embase Classic) and PubMed databases. Additional searches were completed using the Cochrane Reviews library database, Google Scholar, the University of Toronto online library catalogue, ClinicalTrials.gov website and select journals. Searches were completed Feb/March 2015 and updated in June/July/Aug 2015. Eight studies were eligible for inclusion in this review. Studies were eligible for inclusion if they: i) were specific to a stroke population, ii) delivered CRT via a NFT protocol, iii) included participants who were affected by a cognitive deficit(s) following stroke (i.e. memory loss, loss of executive function, speech impairment etc.). NFT protocols were highly specific and varied within each study. The majority of studies identified improvements in participant cognitive deficits following the initiation of therapy. Reviewers assessed study quality using the Downs and Black Checklist for Measuring Study Quality tool; limited study quality and strength of evidence restricted generalizability of conclusions regarding the use of this therapy to the greater stroke population. Progression in this field requires further inquiry to strengthen methodology quality and study design. Future investigations should aim to standardize NFT protocols in an effort to understand the dose-response relationship between NFT and improvements in functional outcome. Future investigations should also place a large emphasis on long-term participant follow-up.

Psychological Neuromodulatory Treatments for Young People with Chronic Pain

The treatment of young people with chronic pain is a complex endeavor. Many of these youth do not obtain adequate relief from available interventions. Psychological neuromodulatory treatments have been shown to have potential benefit for adults with chronic pain. Here, we review and summarize the available information about the efficacy of three promising psychological neuromodulatory treatments-neurofeedback, meditation and hypnosis-when provided to young people with chronic pain. A total of 16 articles were identified and reviewed. The findings from these studies show that hypnotic treatments are effective in reducing pain intensity for a variety of pediatric chronic pain problems, although research suggests variability in outcomes as a function of the specific pain problem treated. There are too few studies evaluating the efficacy of neurofeedback or meditation training in young people with chronic pain to draw firm conclusions regarding their efficacy. However, preliminary data indicate that these treatments could potentially have positive effects on a variety of outcomes (e.g., pain intensity, frequency of pain episodes, physical and psychological function), at least in the short term. Clinical trials are needed to evaluate the effects of neurofeedback and meditation training, and research is needed to identify the moderators of treatment benefits as well as better understand the mechanisms underlying the efficacy of all three of these treatments. The findings from such research could enhance overall treatment efficacy by: (1) providing an empirical basis for better patient-treatment matching; and (2) identifying specific mechanisms that could be targeted with treatment.

Attentional and affective consequences of technology supported mindfulness training: a randomised, active control, efficacy trial

BACKGROUND

Mindfulness training (MT) programs represent an approach to attention training with well-validated mental health benefits. However, research supporting MT efficacy is based predominantly on weekly-meeting, facilitator-led, group-intervention formats. It is unknown whether participants might benefit from neurofeedback-assisted, technology-supported MT (N-tsMT), in which meditation is delivered individually, without the need for a facilitator, travel to a training site, or the presence of a supportive group environment. Mirroring the validation of group MT interventions, the first step in addressing this question requires identifying whether N-tsMT promotes measurable benefits. Here, we report on an initial investigation of a commercial N-tsMT system.

METHODS

In a randomized, active control trial, community-dwelling healthy adult participants carried out 6 weeks of daily practice, receiving either N-tsMT (n = 13), or a control condition of daily online math training (n = 13). Training effects were assessed on target measures of attention and well-being. Participants also completed daily post-training surveys assessing effects on mood, body awareness, calm, effort, and stress.

RESULTS

Analysis revealed training effects specific to N-tsMT, with attentional improvements in overall reaction time on a Stroop task, and well-being improvements via reduced somatic symptoms on the Brief Symptom Inventory. Attention and well-being improvements were correlated, and effects were greatest for the most neurotic participants. However, secondary, exploratory measures of attention and well-being did not show training-specific effects. N-tsMT was associated with greater body awareness and calm, and initially greater effort that later converged with effort in the control condition.

CONCLUSIONS

Preliminary findings indicate that N-tsMT promotes modest benefits for attention and subjective well-being in a healthy community sample relative to an active control condition. However, the findings would benefit from replication in a larger sample, and more intensive practice or more comprehensive MT instruction might be required to promote the broader benefits typically reported in group format, facilitated MT.

TRIAL REGISTRATION

Current Controlled Trials ISRCTN43629398 . Retrospectively registered on June 16, 2016.

Data-Driven User Feedback: An Improved Neurofeedback Strategy considering the Interindividual Variability of EEG Features

It has frequently been reported that some users of conventional neurofeedback systems can experience only a small portion of the total feedback range due to the large interindividual variability of EEG features. In this study, we proposed a data-driven neurofeedback strategy considering the individual variability of electroencephalography (EEG) features to permit users of the neurofeedback system to experience a wider range of auditory or visual feedback without a customization process. The main idea of the proposed strategy is to adjust the ranges of each feedback level using the density in the offline EEG database acquired from a group of individuals. Twenty-two healthy subjects participated in offline experiments to construct an EEG database, and five subjects participated in online experiments to validate the performance of the proposed data-driven user feedback strategy. Using the optimized bin sizes, the number of feedback levels that each individual experienced was significantly increased to 139% and 144% of the original results with uniform bin sizes in the offline and online experiments, respectively. Our results demonstrated that the use of our data-driven neurofeedback strategy could effectively increase the overall range of feedback levels that each individual experienced during neurofeedback training.

Components of Motor Deficiencies in ADHD and Possible Interventions

There is a growing body of evidence pointing at several types of motor abnormalities found in attention-deficit/hyperactivity disorder (ADHD). In this article we review findings stemming from different paradigms, and suggest an interweaving approach to the different stages involved in the motor regulation process. We start by reviewing various aspects of motor abnormalities found in ADHD and related brain mechanisms. Then, we classify reported motor impairments associated with ADHD, into four classes of motor stages: Attention to the task, motion preparation, motion execution and motion monitoring. Motor abnormalities and corresponding neural activations are analyzed in the context of each of the four identified motor patterns, along with the interactions among them and with other systems. Given the specifications and models of the role of the four motor impairments in ADHD, we ask what treatments correspond to the identified motor impairments. We analyze therapeutic interventions targeting motor difficulties most commonly experienced among individuals with ADHD; first, Neurofeedback training and EMG-biofeedback. As some of the identified components of attention, planning and monitoring have been shown to be linked to abnormal oscillation patterns in the brain, we examine neurofeedback interventions aimed to address these types of oscillations: Theta/beta frequency training and SCP neurofeedback targeted at elevating the CNV component. Additionally we discuss EMG-Biofeedback interventions targeted at feedback on motor activity. Further we review physical activity and motor interventions aimed at improving motor difficulties, associated with ADHD. These kinds of interventions are shown to be helpful not only in aspects of physical ability, but also in enhancing cognition and executive functioning.

Improvement of neurofeedback therapy for improved attention through facilitation of brain activity using local sinusoidal extremely low frequency magnetic field exposure

Traditional neurofeedback (NF) is a training approach aimed at altering brain activity using electroencephalography (EEG) rhythms as feedback. In NF training, external factors such as the subjects' intelligence can have an effect. In contrast, a low-energy NF system (LENS) does not require conscious effort from the subject, which results in fewer attendance sessions. However, eliminating the subject role seems to eliminate an important part of the NF system. This study investigated the facilitating effect on the theta-to-beta ratio from NF training, using a local sinusoidal extremely low frequency magnetic field (LSELF-MF) versus traditional NF. Twenty-four healthy, intelligent subjects underwent 10 training sessions to enhance beta (15-18 Hz), and simultaneously inhibit theta (4-7 Hz) and high beta (22-30 Hz) activity, at the Cz point in a 3-boat-race video game. Each session consisted of 3 statuses, PRE, DURING, and POST. In the DURING status, the NF training procedure lasted 10 minutes. Subjects were led to believe that they would be exposed to a magnetic field during NF training; however, 16 of the subjects who were assigned to the experimental group were really exposed to 45 Hz-360 µT LSELF-MF at Cz. For the 8 other subjects, only the coil was located at the Cz point with no exposure. The duty cycle of exposure was 40% (2-second exposure and 3-second pause). The results show that the theta-to-beta ratio in the DURING status of each group differs significantly from the PRE and POST statuses. Between-group analysis shows that the theta-to-beta ratio in the DURING status of the experimental group is significantly (P < .001) lower than in the sham group. The result shows the effect of LSELF-MF on NF training.

Neurofeedback and its possible relevance for the treatment of Tourette syndrome

Neurofeedback is an increasingly recognized therapeutic option in various neuropsychiatric disorders to treat dysfunctions in cognitive control as well as disorder-specific symptoms. In this review we propose that neurofeedback may also reflect a valuable therapeutic option to treat executive control functions in Gilles-de-la-Tourette syndrome (GTS). Deficits in executive control functions when ADHD symptoms appear in GTS likely reflect pathophysiological processes in cortico-thalamic-striatal circuits and may also underlie the motor symptoms in GTS. Such executive control deficits evident in comorbid GTS/ADHD depend on neurophysiological processes well-known to be modifiable by neurofeedback. However, so far efforts to use neurofeedback to treat cognitive dysfunctions are scarce. We outline why neurofeedback should be considered a promising treatment option, what forms of neurofeedback may prove to be most effective and how neurofeedback may be implemented in existing intervention strategies to treat comorbid GTS/ADHD and associated dysfunctions in cognitive control. As cognitive control deficits in GTS mostly appear in comorbid GTS/ADHD, neurofeedback may be most useful in this frequent combination of disorders.

Comparison of neurofeedback and transcutaneous electrical nerve stimulation efficacy on treatment of primary headaches: a randomized controlled clinical trial

Background:

Headache is one of the most prevalent investigated complaints in the neurology clinics and is the most common pain-related complaint worldwide. Stress is a significant factor that causes and triggers headaches. Since healthcare practitioners experience a lot of stress in their careers, they are more prone to headaches.

Objectives:

This study was designed to evaluate and compares the efficacy of neurofeedback behavioural therapy (NFB) and transcutaneous electrical nerve stimulation (TENS) in the treatment of primary headaches in healthcare providers.

Patients and Methods:

The current study was a clinical trial, performed in Teheran, IR Iran, with two experimental groups and a control group. Convenient sampling method was used to recruit patients. Independent variables were NFB and TENS and dependent variables were frequency, severity, and duration of headache. Blanchard headache diary was used for assessment. Hence, 45 healthcare providers with primary headache were selected and randomly allocated to one of the NFB, TENS, and control groups by block random assignment method. All three groups completed the headache diary during one week before and after the treatment period as pretest and posttests, respectively. The NFB group was treated in the period between pretest and posttest with fifteen 30-minute treatment sessions three times a week and the TENS group was treated with fifteen 20-minute daily sessions. The control group received none of these treatments.

Results:

The results from the analysis of covariance showed that treatment with NFB and TENS had caused significant decrease in the frequency, severity, and duration of headache in experimental groups. The results of the LSD post-hoc test indicated that there were significant differences in the frequency, severity, and duration of pain among experimental groups and the control group. Moreover, there were significant differences between pain frequencies in experimental groups.

Conclusions:

According to the results and given the significant reductions in the frequency, severity, and duration of headaches, it seems that NFB and TENS might have an effective role in reducing primary headaches of healthcare providers. In addition, comparing the two methods, treatment with NFB was more effective in reducing headache frequency and severity.

A dynamic attention assessment and enhancement tool using computer graphics

Training Programs to enhance Math Solving Skills, Memory, Visualization, etc in children are gaining popularity worldwide. Any skill is better acquired, when attention, the basic cognitive ability of the trainee is improved. This study makes an attempt to devise a technique in the form of a Brain Computer Interface (BCI) Game, to assist the trainers in monitoring and evaluating the attention levels of the trainees, at regular intervals during the training period.

The gaming environment is designed using Open Source Graphics Library (OpenGL) package and the game control is through the player’s brain waves using the BCI technology. The players control the movement of an object from a source to a destination location on the screen by focussing their thought processes. The time taken to complete one game can be recorded. More the time taken, lesser would be the attention sustaining capacity of the player.

Thirteen subjects under different levels of the ABACUS Math Solving training program controlled the ball movement while solving math problems mentally, the time taken reduced for most of the subjects as they reached higher levels of their training course, indicating the benefit of such training programmes. The game was also played by eight non-abacus literates. The evaluation procedure was found to be very easy and fast.

Preparation for action: psychophysiological activity preceding a motor skill as a function of expertise, performance outcome, and psychological pressure

Knowledge of the psychophysiological responses that characterize optimal motor performance is required to inform biofeedback interventions. This experiment compared cortical, cardiac, muscular, and kinematic activity in 10 experts and 10 novices as they performed golf putts in low- and high-pressure conditions. Results revealed that in the final seconds preceding movement, experts displayed a greater reduction in heart rate and EEG theta, high-alpha, and beta power, when compared to novices. EEG high-alpha power also predicted success, with participants producing less high-alpha power in the seconds preceding putts that were holed compared to those that were missed. Increased pressure had little impact on psychophysiological activity. It was concluded that greater reductions in EEG high-alpha power during preparation for action reflect more resources being devoted to response programming, and could underlie successful accuracy-based performance.

Spezifische Effekte von EEG-basiertem Neurofeedbacktraining auf kognitive Leistungen nach einem Schlaganfall

Der Schlaganfall ist weltweit die häufigste neurologische Erkrankung und oft treten Störungen kognitiver Funktionen als Folgeerscheinungen auf. In dieser Studie wurde untersucht, inwiefern ein Elektroenzephalographie (EEG) basiertes Neurofeedbacktraining (NFT) genutzt werden kann, um neuronale Plastizität nach einem Schlaganfall anzuregen und spezifische kognitive Leistungen von Schlaganfallpatienten zu verbessern. Vorgängerstudien an neurologisch gesunden Probanden konnten zeigen, dass eine willentliche Erhöhung des sensomotorischen Rhythmus (SMR, 12 – 15 Hz) mit einer Verbesserung des deklarativen Gedächtnisses (Langzeitgedächtnis) und eine Verringerung des Theta/Beta Quotienten (4 – 8 Hz/13 – 21 Hz) mit einer Verbesserung der Aufmerksamkeit und Impulskontrolle einhergehen. Sieben neurologisch gesunde Personen (Kontrollgruppe) und sieben Schlaganfallpatienten mit Gedächtnisdefiziten erhielten ein SMR Neurofeedbacktraining. Sechs Schlaganfallpatienten mit Störungen der Aufmerksamkeit und Inhibitionskontrolle nahmen an einem Theta/Beta Neurofeedbacktraining teil. Um die Spezifität der beiden Neurofeedbacktrainings zu überprüfen, wurden vor und nach den Trainings generelle kognitive Fähigkeiten mittels einer umfangreichen neuropsychologischen Testbatterie erhoben. Alle Teilnehmer erhielten 10 Neurofeedback Sitzungen (SMR oder Theta/Beta), wobei sie die Aufgabe hatten ein audio-visuelles Feedbacksignal, das ihre eigene Gehirnaktivität widerspiegelte, zu kontrollieren. Bei Schlaganfallpatienten konnten positive Effekte des Neurofeedbacktrainings auf die kognitive Leistung festgestellt werden. Die Patientengruppen wiesen vor dem Training beträchtliche kognitive Leistungsdefizite im Vergleich zur Kontrollgruppe auf. Nach dem Training unterschieden sie sich jedoch in ihrer kognitiven Leistung nicht mehr auffällig von den Kontrollpersonen. Zusätzliche Analysen bestätigten die Spezifität der unterschiedlichen Trainingsprotokolle. So zeigten die Kontrollgruppe und die SMR Patientengruppe die stärksten Verbesserungen und ebenso die geringsten Verschlechterungen in ihrer deklarativen Gedächtnisleistung im Vergleich zur Theta/Beta Patientengruppe. Währenddessen verbesserte sich die Theta/Beta Patientengruppe im Vergleich zu den anderen Gruppen vor allem in den Tests zu Inhibition und Flexibilität und wies gleichzeitig die geringsten Verschlechterungen auf.

Is EEG-biofeedback an effective treatment in autism spectrum disorders? A randomized controlled trial

EEG-biofeedback has been reported to reduce symptoms of autism spectrum disorders (ASD) in several studies. However, these studies did not control for nonspecific effects of EEG-biofeedback and did not distinguish between participants who succeeded in influencing their own EEG activity and participants who did not. To overcome these methodological shortcomings, this study evaluated the effects of EEG-biofeedback in ASD in a randomized pretest-posttest control group design with blinded active comparator and six months follow-up. Thirty-eight participants were randomly allocated to the EEG-biofeedback, skin conductance (SC)-biofeedback or waiting list group. EEG- and SC-biofeedback sessions were similar and participants were blinded to the type of feedback they received. Assessments pre-treatment, post-treatment, and after 6 months included parent ratings of symptoms of ASD, executive function tasks, and 19-channel EEG recordings. Fifty-four percent of the participants significantly reduced delta and/or theta power during EEG-biofeedback sessions and were identified as EEG-regulators. In these EEG-regulators, no statistically significant reductions of symptoms of ASD were observed, but they showed significant improvement in cognitive flexibility as compared to participants who managed to regulate SC. EEG-biofeedback seems to be an applicable tool to regulate EEG activity and has specific effects on cognitive flexibility, but it did not result in significant reductions in symptoms of ASD. An important finding was that no nonspecific effects of EEG-biofeedback were demonstrated.

Local exposure of brain central areas to a pulsed ELF magnetic field for a purposeful change in EEG

This study examines the simultaneous exposure of 2 brain areas in the location of central electrodes (C3 and C4) to a weak and pulsed extremely low-frequency magnetic field (ELF-MF) on the electroencephalogram (EEG). The intent is to change the EEG for a therapeutic application, such as neurofeedback, by inducing the "resonance effect." A total of 10 healthy women received 9 minutes of ELF-MF (intensity 200 μT) and sham in a counterbalanced design. ELF-MF exposure frequencies were 10, 14, and 18 Hz. The paired t test revealed that local pulsed ELF-MF significantly decreases beta (15-25 Hz), sensorimotor rhythm (13-15 Hz), and theta (4-8 Hz) powers at a frequency of 10 Hz in C3 and C4 regions (12.0%-26.6%) after exposure, in comparison with that achieved during the exposure (P < .05). Variations during the exposure were transient and different from those after. The resonance effect was observed nowhere around the regions. The study suggests that this technique may be applied in the treatment of anxiety; however, further investigation is needed.

Training the brain: fact and fad in cognitive and behavioral remediation

Putatively safe and effective for improving cognitive performance in both health and disease, products purported to train the brain appeal to consumers and healthcare practitioners. In an increasingly health-centered society, these applications constitute a burgeoning commercial market. Sparse evidence coupled with lack of scientific rigor, however, leaves claims concerning the impact and duration of such brain training largely unsubstantiated. On the other hand, at least some scientific findings seem to support the effectiveness and sustainability of training for higher brain functions such as attention and working memory. In the present paper we provide a tectonic integration and synthesis of cognitive training approaches. Specifically, we sketch the relative merits and shortcomings of these programs, which often appeal to parents who must choose between side-effect-laden medication and other less conventional options. Here we examine how neuroplasticity allows the healthy as well the impaired to benefit from cognitive training programs. We evaluate the evidence and consider whether brain training can be a stand-alone treatment or an adjunct to pharmacotherapy, outline promising future prospects, and highlight what training outcomes are plausible in line with available data. Future research would determine whether the field of brain training realizes its potential to revolutionize education and rehabilitation or withers away engulfed in controversy.