Effects of a Theta/Sensorimotor Rhythm Neurofeedback Training Protocol on Measures of Impulsivity, Drug Craving, and Substance Abuse in Forensic Psychiatric Patients With Substance Abuse: Randomized Controlled Trial

Brain regulation training improves emotional competences in patients with alcohol use disorder

Alcohol use disorder (AUD) is defined as the impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences and still represents one of the biggest challenges for society regarding health conditions, social consequences, and financial costs, including the high relapse rates after traditional alcohol rehabilitation treatment. Especially, the deficient emotional competence in AUD is said to play a key role in the development of AUD and hinders the interruption of substance compulsion, often leading to a viscous circle of relapse. Although the empirical evidence of a neurophysiological basis of AUD is solid and increases even further, clinical interventions based on neurophysiology are still rare for individuals with AUD. This randomized controlled trial investigates changes in emotional competences, alcohol-related cognitions, and drinking behavior before and after an established alcohol rehabilitation treatment (control group: nCG = 29) compared to before and after an optimized, add-on neurofeedback (NF) training (experimental group: nEG = 27). Improvements on the clinical-psychological level, i.e. increases in emotional competences as well as life satisfaction, were found after the experimental electroencephalography (EEG) NF training. Neurophysiological measurements via resting-state EEG indicate decreases in low beta frequency band, while alpha and theta bands remained unaffected.

EEG Parameter Selection Reflecting the Characteristics of Internet Gaming Disorder While Playing League of Legends

Game playing is an accessible leisure activity. Recently, the World Health Organization officially included gaming disorder in the ICD-11, and studies using several bio-signals were conducted to quantitatively determine this. However, most EEG studies regarding internet gaming disorder (IGD) were conducted in the resting state, and the outcomes appeared to be too inconsistent to identify a general trend. Therefore, this study aimed to use a series of statistical processes with all the existing EEG parameters until the most effective ones to identify the difference between IGD subjects IGD and healthy subjects was determined. Thirty subjects were grouped into IGD (n = 15) and healthy (n = 15) subjects by using the Young's internet addition test (IAT) and the compulsive internet use scale (CIUS). EEG data for 16 channels were collected while the subjects played League of Legends. For the exhaustive search of parameters, 240 parameters were tested in terms of t-test, factor analysis, Pearson correlation, and finally logistic regression analysis. After a series of statistical processes, the parameters from Alpha, sensory motor rhythm (SMR), and MidBeta ranging from the Fp1, C3, C4, and O1 channels were found to be best indicators of IGD symptoms. The accuracy of diagnosis was computed as 63.5-73.1% before cross-validation. The most interesting finding of the study was the dynamics of EEG relative power in the 10-20 Hz band. This EEG crossing phenomenon between IGD and healthy subjects may explain why previous research showed inconsistent outcomes. The outcome of this study could be the referential guide for further investigation to quantitatively assess IGD symptoms.

Neuronal Abnormalities Induced by an Intelligent Virtual Reality System for Methamphetamine Use Disorder

Methamphetamine use disorder (MUD) is a brain disease that leads to altered regional neuronal activity. Virtual reality (VR) is used to induce the drug cue reactivity. Previous studies reported significant frequency-specific abnormalities in patients with MUD during VR induction of drug craving. However, whether those patients exhibit neuronal abnormalities after VR induction that could serve as the treatment target remains unclear. Here, we developed an integrated VR system for inducing drug related changes and investigated the neuronal abnormalities after VR exposure in patients. Fifteen patients with MUD and ten healthy subjects were recruited and exposed to drug-related VR environments. Resting-state EEG were recorded for 5 minutes twice-before and after VR and transformed to obtain the frequency-specific data. Three self-reported scales for measurement of the anxiety levels and impulsivity of participants were obtained after VR task. Statistical tests and machine learning methods were employed to reveal the differences between patients and healthy subjects. The result showed that patients with MUD and healthy subjects significantly differed in, and power changes after VR. These neuronal abnormalities in patients were associated with the self-reported behavioral scales, indicating impaired impulse control. Our findings of resting-state EEG abnormalities in patients with MUD after VR exposure have the translation value and can be used to develop the treatment strategies for methamphetamine use disorder.

Theta/SMR Neurofeedback Training Works Well for Some Forensic Psychiatric Patients, But Not for Others: A Sham-Controlled Clinical Case Series

Electroencephalographic (EEG) neurofeedback could be a promising treatment for forensic psychiatric patients. Increasing evidence shows some patients are unable to regulate cortical activity. Before neurofeedback can be applied successfully, research is needed to investigate the interpersonal mechanisms responsible for patients' ability to respond to neurofeedback. A single-case experimental design allows for close monitoring of individual patients, providing valuable information about patients' response to the intervention and the time frame in which changes in clinical symptoms can be observed. Four patients with Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR) substance use disorder and various comorbidities participated in a sham-controlled clinical case study. Self-report level of impulsivity and craving were assessed. Results indicate that one patient showed more improvements on behavioral measures after the neurofeedback training than did the others. This patient reported less impulsivity and reduced levels of self-reported craving. However, these findings could not be attributed to the neurofeedback intervention. The findings suggest that there is insufficient evidence for the beneficial effects of a theta/sensorimotor rhythm (SMR) neurofeedback intervention on measures of impulsivity and craving, and that there may be great interindividual differences in patients' ability to regulate cortical activity.