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Yang X, Zeng Y, Jiao G, Gan X, Linden D, Hernaus D, Zhu C, Li K, Yao D, Yao S, Jiang Y, Becker B. A brief real-time fNIRS-informed neurofeedback training of the prefrontal cortex changes brain activity and connectivity during subsequent working memory challenge. Prog Neuropsychopharmacol Biol Psychiatry 2024; 132:110968. [PMID: 38354898 DOI: 10.1016/j.pnpbp.2024.110968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 11/06/2023] [Accepted: 02/11/2024] [Indexed: 02/16/2024]
Abstract
Working memory (WM) represents a building-block of higher cognitive functions and a wide range of mental disorders are associated with WM impairments. Initial studies have shown that several sessions of functional near-infrared spectroscopy (fNIRS) informed real-time neurofeedback (NF) allow healthy individuals to volitionally increase activity in the dorsolateral prefrontal cortex (DLPFC), a region critically involved in WM. For the translation to therapeutic or neuroenhancement applications, however, it is critical to assess whether fNIRS-NF success transfers into neural and behavioral WM enhancement in the absence of feedback. We therefore combined single-session fNIRS-NF of the left DLPFC with a randomized sham-controlled design (N = 62 participants) and a subsequent WM challenge with concomitant functional MRI. Over four runs of fNIRS-NF, the left DLPFC NF training group demonstrated enhanced neural activity in this region, reflecting successful acquisition of neural self-regulation. During the subsequent WM challenge, we observed no evidence for performance differences between the training and the sham group. Importantly, however, examination of the fMRI data revealed that - compared to the sham group - the training group exhibited significantly increased regional activity in the bilateral DLPFC and decreased left DLPFC - left anterior insula functional connectivity during the WM challenge. Exploratory analyses revealed a negative association between DLPFC activity and WM reaction times in the NF group. Together, these findings indicate that healthy individuals can learn to volitionally increase left DLPFC activity in a single training session and that the training success translates into WM-related neural activation and connectivity changes in the absence of feedback. This renders fNIRS-NF as a promising and scalable WM intervention approach that could be applied to various mental disorders.
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Affiliation(s)
- Xi Yang
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital; University of Electronic Science and Technology of China, Chengdu, China; MOE Key Laboratory for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China; Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Yixu Zeng
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital; University of Electronic Science and Technology of China, Chengdu, China; MOE Key Laboratory for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Guojuan Jiao
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital; University of Electronic Science and Technology of China, Chengdu, China; MOE Key Laboratory for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Xianyang Gan
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital; University of Electronic Science and Technology of China, Chengdu, China; MOE Key Laboratory for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - David Linden
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Dennis Hernaus
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Chaozhe Zhu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China; IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China; Center for Collaboration and Innovation in Brain and Learning Sciences, Beijing Normal University, Beijing, China
| | - Keshuang Li
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Dezhong Yao
- MOE Key Laboratory for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Shuxia Yao
- MOE Key Laboratory for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Yihan Jiang
- Center for the Cognitive Science of Language, Beijing Language and Culture University, Beijing, China.
| | - Benjamin Becker
- The University of Hong Kong, State Key Laboratory of Brain and Cognitive Sciences, Hong Kong, China; The University of Hong Kong, Department of Psychology, Hong Kong, China.
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Klein F. Optimizing spatial specificity and signal quality in fNIRS: an overview of potential challenges and possible options for improving the reliability of real-time applications. FRONTIERS IN NEUROERGONOMICS 2024; 5:1286586. [PMID: 38903906 PMCID: PMC11188482 DOI: 10.3389/fnrgo.2024.1286586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 04/29/2024] [Indexed: 06/22/2024]
Abstract
The optical brain imaging method functional near-infrared spectroscopy (fNIRS) is a promising tool for real-time applications such as neurofeedback and brain-computer interfaces. Its combination of spatial specificity and mobility makes it particularly attractive for clinical use, both at the bedside and in patients' homes. Despite these advantages, optimizing fNIRS for real-time use requires careful attention to two key aspects: ensuring good spatial specificity and maintaining high signal quality. While fNIRS detects superficial cortical brain regions, consistently and reliably targeting specific regions of interest can be challenging, particularly in studies that require repeated measurements. Variations in cap placement coupled with limited anatomical information may further reduce this accuracy. Furthermore, it is important to maintain good signal quality in real-time contexts to ensure that they reflect the true underlying brain activity. However, fNIRS signals are susceptible to contamination by cerebral and extracerebral systemic noise as well as motion artifacts. Insufficient real-time preprocessing can therefore cause the system to run on noise instead of brain activity. The aim of this review article is to help advance the progress of fNIRS-based real-time applications. It highlights the potential challenges in improving spatial specificity and signal quality, discusses possible options to overcome these challenges, and addresses further considerations relevant to real-time applications. By addressing these topics, the article aims to help improve the planning and execution of future real-time studies, thereby increasing their reliability and repeatability.
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Affiliation(s)
- Franziska Klein
- Biomedical Devices and Systems Group, R&D Division Health, OFFIS - Institute for Information Technology, Oldenburg, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany
- Neurocognition and Functional Neurorehabilitation Group, Department of Psychology, University of Oldenburg, Oldenburg, Germany
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Virk T, Letendre T, Pathman T. The convergence of naturalistic paradigms and cognitive neuroscience methods to investigate memory and its development. Neuropsychologia 2024; 196:108779. [PMID: 38154592 DOI: 10.1016/j.neuropsychologia.2023.108779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 12/12/2023] [Accepted: 12/23/2023] [Indexed: 12/30/2023]
Abstract
Studies that involve lab-based stimuli (e.g., words, pictures) are fundamental in the memory literature. At the same time, there is growing acknowledgment that memory processes assessed in the lab may not be analogous to how memory operates in the real world. Naturalistic paradigms can bridge this gap and over the decades a growing proportion of memory research has involved more naturalistic events. However, there is significant variation in the types of naturalistic studies used to study memory and its development, each with various advantages and limitations. Further, there are notable gaps in how often different types of naturalistic approaches have been combined with cognitive neuroscience methods (e.g., fMRI, EEG) to elucidate the neural processes and substrates involved in memory encoding and retrieval in the real world. Here we summarize and discuss what we identify as progressively more naturalistic methodologies used in the memory literature (movie, virtual reality, staged-events inside and outside of the lab, photo-taking, and naturally occurring event studies). Our goal is to describe each approach's benefits (e.g., naturalistic quality, feasibility), limitations (e.g., viability of neuroimaging method for event encoding versus event retrieval), and discuss possible future directions with each approach. We focus on child studies, when available, but also highlight past adult studies. Although there is a growing body of child memory research, naturalistic approaches combined with cognitive neuroscience methodologies in this domain remain sparse. Overall, this viewpoint article reviews how we can study memory through the lens of developmental cognitive neuroscience, while utilizing naturalistic and real-world events.
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Peng K, Moussavi Z, Karunakaran KD, Borsook D, Lesage F, Nguyen DK. iVR-fNIRS: studying brain functions in a fully immersive virtual environment. NEUROPHOTONICS 2024; 11:020601. [PMID: 38577629 PMCID: PMC10993907 DOI: 10.1117/1.nph.11.2.020601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 03/05/2024] [Accepted: 03/06/2024] [Indexed: 04/06/2024]
Abstract
Immersive virtual reality (iVR) employs head-mounted displays or cave-like environments to create a sensory-rich virtual experience that simulates the physical presence of a user in a digital space. The technology holds immense promise in neuroscience research and therapy. In particular, virtual reality (VR) technologies facilitate the development of diverse tasks and scenarios closely mirroring real-life situations to stimulate the brain within a controlled and secure setting. It also offers a cost-effective solution in providing a similar sense of interaction to users when conventional stimulation methods are limited or unfeasible. Although combining iVR with traditional brain imaging techniques may be difficult due to signal interference or instrumental issues, recent work has proposed the use of functional near infrared spectroscopy (fNIRS) in conjunction with iVR for versatile brain stimulation paradigms and flexible examination of brain responses. We present a comprehensive review of current research studies employing an iVR-fNIRS setup, covering device types, stimulation approaches, data analysis methods, and major scientific findings. The literature demonstrates a high potential for iVR-fNIRS to explore various types of cognitive, behavioral, and motor functions in a fully immersive VR (iVR) environment. Such studies should set a foundation for adaptive iVR programs for both training (e.g., in novel environments) and clinical therapeutics (e.g., pain, motor and sensory disorders and other psychiatric conditions).
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Affiliation(s)
- Ke Peng
- University of Manitoba, Department of Electrical and Computer Engineering, Price Faculty of Engineering, Winnipeg, Manitoba, Canada
| | - Zahra Moussavi
- University of Manitoba, Department of Electrical and Computer Engineering, Price Faculty of Engineering, Winnipeg, Manitoba, Canada
| | - Keerthana Deepti Karunakaran
- Massachusetts General Hospital, Harvard Medical School, Department of Psychiatry, Boston, Massachusetts, United States
| | - David Borsook
- Massachusetts General Hospital, Harvard Medical School, Department of Psychiatry, Boston, Massachusetts, United States
- Massachusetts General Hospital, Harvard Medical School, Department of Radiology, Boston, Massachusetts, United States
| | - Frédéric Lesage
- University of Montreal, Institute of Biomedical Engineering, Department of Electrical Engineering, Ecole Polytechnique, Montreal, Quebec, Canada
- Montreal Heart Institute, Montreal, Quebec, Canada
| | - Dang Khoa Nguyen
- University of Montreal, Department of Neurosciences, Montreal, Quebec, Canada
- Research Center of the Hospital Center of the University of Montreal, Department of Neurology, Montreal, Quebec, Canada
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Hilbert A, Rösch SA, Petroff D, Prettin C, Lührs M, Ehlis AC, Schmidt R. Near-infrared spectroscopy and electroencephalography neurofeedback for binge-eating disorder: an exploratory randomized trial. Psychol Med 2024; 54:675-686. [PMID: 37964437 DOI: 10.1017/s0033291723002350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
BACKGROUND Binge-eating disorder (BED) co-occurs with neurobehavioral alterations in the processing of disorder-relevant content such as visual food stimuli. Whether neurofeedback (NF) directly targeting them is suited for treatment remains unclear. This study sought to determine feasibility and estimate effects of individualized, functional near-infrared spectroscopy-based real-time NF (rtfNIRS-NF) and high-beta electroencephalography-based NF (EEG-NF), assuming superiority over waitlist (WL). METHODS Single-center, assessor-blinded feasibility study with randomization to rtfNIRS-NF, EEG-NF, or WL and assessments at baseline (t0), postassessment (t1), and 6-month follow-up (t2). NF comprised 12 60-min food-specific rtfNIRS-NF or EEG-NF sessions over 8 weeks. Primary outcome was the binge-eating frequency at t1 assessed interview-based. Secondary outcomes included feasibility, eating disorder symptoms, mental and physical health, weight management-related behavior, executive functions, and brain activity at t1 and t2. RESULTS In 72 patients (intent-to-treat), the results showed feasibility of NF regarding recruitment, attrition, adherence, compliance, acceptance, and assessment completion. Binge eating improved at t1 by -8.0 episodes, without superiority of NF v. WL (-0.8 episodes, 95% CI -2.4 to 4.0), but with improved estimates in NF at t2 relative to t1. NF was better than WL for food craving, anxiety symptoms, and body mass index, but overall effects were mostly small. Brain activity changes were near zero. CONCLUSIONS The results show feasibility of food-specific rtfNIRS-NF and EEG-NF in BED, and no posttreatment differences v. WL, but possible continued improvement of binge eating. Confirmatory and mechanistic evidence is warranted in a double-blind randomized design with long-term follow-up, considering dose-response relationships and modes of delivery.
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Affiliation(s)
- Anja Hilbert
- Integrated Research and Treatment Center AdiposityDiseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, Leipzig University Medical Center, Leipzig, Germany
| | - Sarah Alica Rösch
- Integrated Research and Treatment Center AdiposityDiseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, Leipzig University Medical Center, Leipzig, Germany
| | - David Petroff
- Clinical Trial Centre Leipzig, University of Leipzig, Leipzig, Germany
| | | | - Michael Lührs
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Brain Innovation B.V., Maastricht, The Netherlands
| | - Ann-Christin Ehlis
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen, Germany
| | - Ricarda Schmidt
- Integrated Research and Treatment Center AdiposityDiseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, Leipzig University Medical Center, Leipzig, Germany
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Godet A, Serrand Y, Fortier A, Léger B, Bannier E, Val-Laillet D, Coquery N. Subjective feeling of control during fNIRS-based neurofeedback targeting the DL-PFC is related to neural activation determined with short-channel correction. PLoS One 2023; 18:e0290005. [PMID: 37585456 PMCID: PMC10431651 DOI: 10.1371/journal.pone.0290005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 07/31/2023] [Indexed: 08/18/2023] Open
Abstract
Neurofeedback (NF) training is a promising preventive and therapeutic approach for brain and behavioral impairments, the dorsolateral prefrontal cortex (DL-PFC) being a relevant region of interest. Functional near-infrared spectroscopy (NIRS) has recently been applied in NF training. However, this approach is highly sensitive to extra-cerebral vascularization, which could bias measurements of cortical activity. Here, we examined the feasibility of a NF training targeting the DL-PFC and its specificity by assessing the impact of physiological confounds on NF success via short-channel offline correction under different signal filtering conditions. We also explored whether the individual mental strategies affect the NF success. Thirty volunteers participated in a single 15-trial NF session in which they had to increase the oxy-hemoglobin (HbO2) level of their bilateral DL-PFC. We found that 0.01-0.09 Hz band-pass filtering was more suited than the 0.01-0.2 Hz band-pass filter to highlight brain activation restricted to the NF channels in the DL-PFC. Retaining the 10 out of 15 best trials, we found that 18 participants (60%) managed to control their DL-PFC. This number dropped to 13 (43%) with short-channel correction. Half of the participants reported a positive subjective feeling of control, and the "cheering" strategy appeared to be more effective in men (p<0.05). Our results showed successful DL-PFC fNIRS-NF in a single session and highlighted the value of accounting for extra cortical signals, which can profoundly affect the success and specificity of NF training.
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Affiliation(s)
- Ambre Godet
- INRAE, INSERM, Univ Rennes, CHU Rennes, Nutrition Metabolisms and Cancer, NuMeCan, Rennes, France
| | - Yann Serrand
- INRAE, INSERM, Univ Rennes, CHU Rennes, Nutrition Metabolisms and Cancer, NuMeCan, Rennes, France
| | - Alexandra Fortier
- INRAE, INSERM, Univ Rennes, CHU Rennes, Nutrition Metabolisms and Cancer, NuMeCan, Rennes, France
| | - Brieuc Léger
- INRAE, INSERM, Univ Rennes, CHU Rennes, Nutrition Metabolisms and Cancer, NuMeCan, Rennes, France
| | - Elise Bannier
- Inria, CRNS, Inserm, IRISA UMR 6074, Empenn U1228, Univ Rennes, Rennes, France
- CHU Rennes, Radiology Department, Rennes, France
| | - David Val-Laillet
- INRAE, INSERM, Univ Rennes, CHU Rennes, Nutrition Metabolisms and Cancer, NuMeCan, Rennes, France
| | - Nicolas Coquery
- INRAE, INSERM, Univ Rennes, CHU Rennes, Nutrition Metabolisms and Cancer, NuMeCan, Rennes, France
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Lee I, Kim D, Kim S, Kim HJ, Chung US, Lee JJ. Cognitive training based on functional near-infrared spectroscopy neurofeedback for the elderly with mild cognitive impairment: a preliminary study. Front Aging Neurosci 2023; 15:1168815. [PMID: 37564400 PMCID: PMC10410268 DOI: 10.3389/fnagi.2023.1168815] [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: 02/18/2023] [Accepted: 07/05/2023] [Indexed: 08/12/2023] Open
Abstract
Introduction Mild cognitive impairment (MCI) is often described as an intermediate stage of the normal cognitive decline associated with aging and dementia. There is a growing interest in various non-pharmacological interventions for MCI to delay the onset and inhibit the progressive deterioration of daily life functions. Previous studies suggest that cognitive training (CT) contributes to the restoration of working memory and that the brain-computer-interface technique can be applied to elicit a more effective treatment response. However, these techniques have certain limitations. Thus, in this preliminary study, we applied the neurofeedback paradigm during CT to increase the working memory function of patients with MCI. Methods Near-infrared spectroscopy (NIRS) was used to provide neurofeedback by measuring the changes in oxygenated hemoglobin in the prefrontal cortex. Thirteen elderly MCI patients who received CT-neurofeedback sessions four times on the left dorsolateral prefrontal cortex (dlPFC) once a week were recruited as participants. Results Compared with pre-intervention, the activity of the targeted brain region increased when the participants first engaged in the training; after 4 weeks of training, oxygen saturation was significantly decreased in the left dlPFC. The participants demonstrated significantly improved working memory compared with pre-intervention and decreased activity significantly correlated with improved cognitive performance. Conclusion Our results suggest that the applications for evaluating brain-computer interfaces can aid in elucidation of the subjective mental workload that may create additional or decreased task workloads due to CT.
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Affiliation(s)
- Ilju Lee
- Department of Psychology, College of Health Science, Dankook University, Cheonan, Republic of Korea
| | - Dohyun Kim
- Department of Psychiatry, Dankook University Hospital, Cheonan, Republic of Korea
- Department of Psychiatry, College of Medicine, Dankook University, Cheonan, Republic of Korea
| | - Sehwan Kim
- Department of Biomedical Engineering, College of Medicine, Dankook University, Cheonan, Republic of Korea
| | - Hee Jung Kim
- Department of Physiology, College of Medicine, Dankook University, Cheonan, Republic of Korea
| | - Un Sun Chung
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Jung Jae Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, Republic of Korea
- Department of Psychiatry, College of Medicine, Dankook University, Cheonan, Republic of Korea
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Phillips V Z, Canoy RJ, Paik SH, Lee SH, Kim BM. Functional Near-Infrared Spectroscopy as a Personalized Digital Healthcare Tool for Brain Monitoring. J Clin Neurol 2023; 19:115-124. [PMID: 36854332 PMCID: PMC9982178 DOI: 10.3988/jcn.2022.0406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 03/02/2023] Open
Abstract
The sustained growth of digital healthcare in the field of neurology relies on portable and cost-effective brain monitoring tools that can accurately monitor brain function in real time. Functional near-infrared spectroscopy (fNIRS) is one such tool that has become popular among researchers and clinicians as a practical alternative to functional magnetic resonance imaging, and as a complementary tool to modalities such as electroencephalography. This review covers the contribution of fNIRS to the personalized goals of digital healthcare in neurology by identifying two major trends that drive current fNIRS research. The first major trend is multimodal monitoring using fNIRS, which allows clinicians to access more data that will help them to understand the interconnection between the cerebral hemodynamics and other physiological phenomena in patients. This allows clinicians to make an overall assessment of physical health to obtain a more-detailed and individualized diagnosis. The second major trend is that fNIRS research is being conducted with naturalistic experimental paradigms that involve multisensory stimulation in familiar settings. Cerebral monitoring of multisensory stimulation during dynamic activities or within virtual reality helps to understand the complex brain activities that occur in everyday life. Finally, the scope of future fNIRS studies is discussed to facilitate more-accurate assessments of brain activation and the wider clinical acceptance of fNIRS as a medical device for digital healthcare.
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Affiliation(s)
- Zephaniah Phillips V
- Global Health Technology Research Center, College of Health Science, Korea University, Seoul, Korea.
| | - Raymart Jay Canoy
- Program in Biomicro System Technology, College of Engineering, Korea University, Seoul, Korea
| | - Seung-ho Paik
- Global Health Technology Research Center, College of Health Science, Korea University, Seoul, Korea.,KLIEN Inc., Seoul Biohub, Seoul, Korea
| | - Seung Hyun Lee
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Korea
| | - Beop-Min Kim
- Department of Bio-Convergence Engineering, Korea University, Seoul, Korea
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Guo Z, Gong Y, Lu H, Qiu R, Wang X, Zhu X, You X. Multitarget high-definition transcranial direct current stimulation improves response inhibition more than single-target high-definition transcranial direct current stimulation in healthy participants. Front Neurosci 2022; 16:905247. [PMID: 35968393 PMCID: PMC9372262 DOI: 10.3389/fnins.2022.905247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 07/11/2022] [Indexed: 11/21/2022] Open
Abstract
Prior studies have focused on single-target anodal transcranial direct current stimulation (tDCS) over the right inferior frontal gyrus (rIFG) or pre-supplementary motor area (pre-SMA) to improve response inhibition in healthy individuals. However, the results are contradictory and the effect of multitarget anodal stimulation over both brain regions has never been investigated. The present study aimed to investigate the behavioral and neurophysiological effects of different forms of anodal high-definition tDCS (HD-tDCS) on improving response inhibition, including HD-tDCS over the rIFG or pre-SMA and multitarget HD-tDCS over both areas. Ninety-two healthy participants were randomly assigned to receive single-session (20 min) anodal HD-tDCS over rIFG + pre-SMA, rIFG, pre-SMA, or sham stimulation. Before and immediately after tDCS intervention, participants completed a stop-signal task (SST) and a go/nogo task (GNG). Their cortical activity was recorded using functional near-infrared spectroscopy (fNIRS) during the go/nogo task. The results showed multitarget stimulation produced a significant reduction in stop-signal reaction time (SSRT) relative to baseline. The pre-to-post SSRT change was not significant for rIFG, pre-SMA, or sham stimulation. Further analyses revealed multitarget HD-tDCS significantly decreased SSRT in both the high-performance and low-performance subgroups compared with the rIFG condition which decreased SSRT only in the low-performance subgroup. Only the multitarget condition significantly improved neural efficiency as indexed by lower △oxy-Hb after stimulation. In conclusion, the present study provides important preliminary evidence that multitarget HD-tDCS is a promising avenue to improve stimulation efficacy, establishing a more effective montage to enhance response inhibition relative to the commonly used single-target stimulation.
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Affiliation(s)
- Zhihua Guo
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Yue Gong
- School of Psychology, Shaanxi Normal University, Xi’an, China
| | - Hongliang Lu
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Rui Qiu
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Xinlu Wang
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
| | - Xia Zhu
- Department of Military Medical Psychology, Air Force Medical University, Xi’an, China
- *Correspondence: Xia Zhu,
| | - Xuqun You
- School of Psychology, Shaanxi Normal University, Xi’an, China
- Xuqun You,
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Zapała D, Augustynowicz P, Tokovarov M. Recognition of Attentional States in VR Environment: An fNIRS Study. SENSORS 2022; 22:s22093133. [PMID: 35590823 PMCID: PMC9104032 DOI: 10.3390/s22093133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/09/2022] [Accepted: 04/18/2022] [Indexed: 02/01/2023]
Abstract
An improvement in ecological validity is one of the significant challenges for 21st-century neuroscience. At the same time, the study of neurocognitive processes in real-life situations requires good control of all variables relevant to the results. One possible solution that combines the capability of creating realistic experimental scenarios with adequate control of the test environment is virtual reality. Our goal was to develop an integrative research workspace involving a CW-fNIRS and head-mounted-display (HMD) technology dedicated to offline and online cognitive experiments. We designed an experimental study in a repeated-measures model on a group of BCI-naïve participants to verify our assumptions. The procedure included a 3D environment-adapted variant of the classic n-back task (2-back version). Tasks were divided into offline (calibration) and online (feedback) sessions. In both sessions, the signal was recorded during the cognitive task for within-group comparisons of changes in oxy-Hb concentration in the regions of interest (the dorsolateral prefrontal cortex-DLPFC and middle frontal gyrus-MFG). In the online session, the recorded signal changes were translated into real-time feedback. We hypothesized that it would be possible to obtain significantly higher than the level-of-chance threshold classification accuracy for the enhanced attention engagement (2-back task) vs. relaxed state in both conditions. Additionally, we measured participants' subjective experiences of the BCI control in terms of satisfaction. Our results confirmed hypotheses regarding the offline condition. In accordance with the hypotheses, combining fNIRS and HMD technologies enables the effective transfer of experimental cognitive procedures to a controlled VR environment. This opens the new possibility of creating more ecologically valid studies and training procedures.
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Affiliation(s)
- Dariusz Zapała
- Department of Experimental Psychology, The John Paul II Catholic University of Lublin, 20-950 Lublin, Poland;
- Cortivision sp. z o.o., 20-803 Lublin, Poland
- Correspondence: ; Tel.: +48-668-548-184
| | - Paweł Augustynowicz
- Department of Experimental Psychology, The John Paul II Catholic University of Lublin, 20-950 Lublin, Poland;
- Cortivision sp. z o.o., 20-803 Lublin, Poland
| | - Mikhail Tokovarov
- Institute of Computer Science, Faculty of Electrical Engineering and Computer Science, Lublin University of Technology, 20-618 Lublin, Poland;
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A parallel-group study of near-infrared spectroscopy-neurofeedback in children with attention deficit hyperactivity disorder. Psychiatry Res 2022; 309:114364. [PMID: 35026672 DOI: 10.1016/j.psychres.2021.114364] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/21/2021] [Accepted: 12/23/2021] [Indexed: 11/20/2022]
Abstract
The present study aimed to assess the efficacy of Near-infrared spectroscopy (NIRS) real-time neurofeedback (NF) vs. atomoxetine (AT) in children with attention deficit hyperactivity disorder (ADHD). A parallel-group study was conducted to enroll children with ADHD between 8 and 12 years of age. Participants were assigned into the NIRS group and AT group as their wish. Subjects in the NIRS group received 12 sessions of NF training within 6 weeks, and subjects in the AT group were given oral medication. Changes in Swanson, Nolan, and Pelham-V rating scales (SNAP-IV), and performance of Go/No-Go and N-back working memory tasks at week 3, 6 and 8 were evaluated. Forty-nine patients completed the study, including 18 ADHD in the NIRS group and 31 in the AT group. Total scores of SNAP-IV significantly decreased from baseline to week 3, week 6, and week 8 in both groups. Patients in the NIRS group showed significant lower scores on the inattention subscale of SNAP-IV at week 3 and week 6, compared to the AT group. NIRS group had a shorter reaction time during the Go/No-Go task at week 6 and fewer errors during 2-back than the AT group at week 3. The findings revealed that NIRS real-time NF is more efficacious relative to AT in improving behavioral performance, highlighting its potential role and advantages in treating patients with ADHD.
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de With LA, Thammasan N, Poel M. Detecting Fear of Heights Response to a Virtual Reality Environment Using Functional Near-Infrared Spectroscopy. FRONTIERS IN COMPUTER SCIENCE 2022. [DOI: 10.3389/fcomp.2021.652550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
To enable virtual reality exposure therapy (VRET) that treats anxiety disorders by gradually exposing the patient to fear using virtual reality (VR), it is important to monitor the patient's fear levels during the exposure. Despite the evidence of a fear circuit in the brain as reflected by functional near-infrared spectroscopy (fNIRS), the measurement of fear response in highly immersive VR using fNIRS is limited, especially in combination with a head-mounted display (HMD). In particular, it is unclear to what extent fNIRS can differentiate users with and without anxiety disorders and detect fear response in a highly ecological setting using an HMD. In this study, we investigated fNIRS signals captured from participants with and without a fear of height response. To examine the extent to which fNIRS signals of both groups differ, we conducted an experiment during which participants with moderate fear of heights and participants without it were exposed to VR scenarios involving heights and no heights. The between-group statistical analysis shows that the fNIRS data of the control group and the experimental group are significantly different only in the channel located close to right frontotemporal lobe, where the grand average oxygenated hemoglobin Δ[HbO] contrast signal of the experimental group exceeds that of the control group. The within-group statistical analysis shows significant differences between the grand average Δ[HbO] contrast values during fear responses and those during no-fear responses, where the Δ[HbO] contrast values of the fear responses were significantly higher than those of the no-fear responses in the channels located towards the frontal part of the prefrontal cortex. Also, the channel located close to frontocentral lobe was found to show significant difference for the grand average deoxygenated hemoglobin contrast signals. Support vector machine-based classifier could detect fear responses at an accuracy up to 70% and 74% in subject-dependent and subject-independent classifications, respectively. The results demonstrate that cortical hemodynamic responses of a control group and an experimental group are different to a considerable extent, exhibiting the feasibility and ecological validity of the combination of VR-HMD and fNIRS to elicit and detect fear responses. This research thus paves a way toward the a brain-computer interface to effectively manipulate and control VRET.
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Lenormand D, Piolino P. In search of a naturalistic neuroimaging approach: Exploration of general feasibility through the case of VR-fMRI and application in the domain of episodic memory. Neurosci Biobehav Rev 2021; 133:104499. [PMID: 34914938 DOI: 10.1016/j.neubiorev.2021.12.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 12/10/2021] [Accepted: 12/10/2021] [Indexed: 12/22/2022]
Abstract
Virtual Reality (VR) is an increasingly widespread tool for research as it allows the creation of experiments taking place in multimodal and daily-life-like environments, while keeping a strong experimental control. Adding neuroimaging to VR leads to a better understanding of the underlying brain networks activated during a naturalistic task, whether for research purposes or rehabilitation. The present paper focuses on the specific use of concurrent VR and fMRI and its technical challenges and feasibility, with a brief examination of the general existing solutions. Following the PRISMA guidelines, the review investigates the particular case of how VR-fMRI has explored episodic memory so far, with a comparison of object- and place-based episodic memory. This review confirms the involvement of cerebral regions well-known to be implicated in episodic memory and unravels other regions devoted to bodily and narrative aspects of the self, promoting new avenues of research in the domain of naturalistic episodic memory. Future studies should develop more immersive and interactive virtual neuroimaging features to increase ecological and embodied neurocognition aspects.
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Affiliation(s)
- Diane Lenormand
- Université de Paris, MC(2)Lab, 71 avenue Edouard Vaillant, 92100, Boulogne-Billancourt, France.
| | - Pascale Piolino
- Université de Paris, MC(2)Lab, 71 avenue Edouard Vaillant, 92100, Boulogne-Billancourt, France; Institut Universitaire de France (IUF), Paris, France
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Hou X, Xiao X, Gong Y, Li Z, Chen A, Zhu C. Functional Near-Infrared Spectroscopy Neurofeedback Enhances Human Spatial Memory. Front Hum Neurosci 2021; 15:681193. [PMID: 34658812 PMCID: PMC8511425 DOI: 10.3389/fnhum.2021.681193] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 09/09/2021] [Indexed: 11/13/2022] Open
Abstract
Spatial memory is an important cognitive function for human daily life and may present dysfunction or decline due to aging or clinical diseases. Functional near-infrared spectroscopy neurofeedback (fNIRS-NFB) is a promising neuromodulation technique with several special advantages that can be used to improve human cognitive functions by manipulating the neural activity of targeted brain regions or networks. In this pilot study, we intended to test the feasibility of fNIRS-NFB to enhance human spatial memory ability. The lateral parietal cortex, an accessible cortical region in the posterior medial hippocampal-cortical network that plays a crucial role in human spatial memory processing, was selected as the potential feedback target. A placebo-controlled fNIRS-NFB experiment was conducted to instruct individuals to regulate the neural activity in this region or an irrelevant control region. Experimental results showed that individuals learned to up-regulate the neural activity in the region of interest successfully. A significant increase in spatial memory performance was found after 8-session neurofeedback training in the experimental group but not in the control group. Furthermore, neurofeedback-induced neural activation increase correlated with spatial memory improvement. In summary, this study preliminarily demonstrated the feasibility of fNIRS-NFB to improve human spatial memory and has important implications for further applications.
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Affiliation(s)
- Xin Hou
- State Key Laboratory of Cognitive Neuroscience and Learning, IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China.,School of Education, Chongqing Normal University, Chongqing, China
| | - Xiang Xiao
- State Key Laboratory of Cognitive Neuroscience and Learning, IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Yilong Gong
- State Key Laboratory of Cognitive Neuroscience and Learning, IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Zheng Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Center for Cognition and Neuroergonomics, Beijing Normal University at Zhuhai, Zhuhai, China.,Center for Collaboration and Innovation in Brain and Learning Sciences, Beijing Normal University, Beijing, China
| | - Antao Chen
- Key Laboratory of Cognition and Personality of the Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Chaozhe Zhu
- State Key Laboratory of Cognitive Neuroscience and Learning, IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China.,Center for Collaboration and Innovation in Brain and Learning Sciences, Beijing Normal University, Beijing, China
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15
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Effects of hemoencephalographic biofeedback with virtual reality on selected aspects of attention in children with ADHD. Int J Psychophysiol 2021; 170:59-66. [PMID: 34653532 DOI: 10.1016/j.ijpsycho.2021.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 09/13/2021] [Accepted: 10/04/2021] [Indexed: 11/23/2022]
Abstract
For children with attention deficit/hyperactivity disorder (ADHD), a reduction of inattention by biofeedback has been shown in several studies. As evidenced by previous reports, biofeedback (BFB) with virtual reality (VR) allows for controlling distractors, providing an environment that captures participants' attention. The purpose of this study was to evaluate the effects of hemoencephalographic (HEG) BFB with VR in treating deficits in vigilance (assessed using the short form of the Mackworth Clock Task), visual search (the Visual Search Task), and divided attention (Multitasking Test) among children with ADHD. Data subjected to analysis were collected from 87 participants aged 9-15 years. Children were assigned to one of three groups (standard 2D BFB in the lab, VR BFB with a limited visual scene, VR BFB with a complex visual scene) and were subjected to ten HEG BFB sessions. Children in the VR BFB groups exhibited a bigger regional cerebral blood oxygenation slope during BFB and better performance in cognitive tests following the experiment compared to children in the 2D BFB group. The data obtained suggest that HEG BFB with VR may have a more beneficial effect in treating attention deficits compared to standard 2D HEG BFB. We believe that the strong effects of HEG BFB with VR stem from the increased commitment and motivation in individuals, rather than from manipulation with regard to visual scene complexity.
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Sawamura Y, Hirokawa-Ueda H, Kawakami T, Sakane H, Teramoto K, Yamamoto A, Taketani R, Ono H. Increased prefrontal cortex activity on near-infrared spectroscopy after interpersonal counseling in individuals with attention deficit hyperactivity disorder. J Phys Ther Sci 2021; 33:668-671. [PMID: 34539071 PMCID: PMC8436038 DOI: 10.1589/jpts.33.668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 06/06/2021] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The number of patients with attention deficit hyperactivity disorder has been
increasing. These patients show low activity in the prefrontal cortex, which can be
improved by pharmacotherapy and neurofeedback training. This exploratory study aimed to
examine whether the hemodynamic response in the prefrontal cortex during an inhibition
response in patients with attention deficit hyperactivity disorder tendencies increased
after interpersonal counseling. [Participants and Methods] Participants (n=5) received
three interpersonal counseling sessions. Interpersonal counseling focuses on the patient’s
current problems and devises specific coping strategies, and it can be performed by
healthcare personnel such as physiotherapists. Prefrontal cortex activity during a
suppression reaction task was measured by using near-infrared spectroscopy at baseline and
post-interpersonal counseling. The outcome was a difference in the oxyhemoglobin level
from baseline to post-interpersonal counseling. [Results] The oxyhemoglobin level in the
prefrontal cortex significantly increased post-interpersonal counseling. [Conclusion]
These results suggested that interpersonal counseling could improve the hemodynamic
response in the prefrontal cortex under inhibition in individuals with attention deficit
hyperactivity disorder tendencies, suggesting that interpersonal counseling may be
effective for treating attention deficit hyperactivity disorder symptoms.
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Affiliation(s)
- Yuki Sawamura
- Department of Psychological Science, Graduate School of Humanities, Kwansei Gakuin University: 1-155 Uegahara Ichibancho, Nishinomiya, Hyogo 662-8501, Japan
| | - Hitomi Hirokawa-Ueda
- Department of Psychological Science, Graduate School of Humanities, Kwansei Gakuin University: 1-155 Uegahara Ichibancho, Nishinomiya, Hyogo 662-8501, Japan
| | - Takuro Kawakami
- Department of Psychological Science, Graduate School of Humanities, Kwansei Gakuin University: 1-155 Uegahara Ichibancho, Nishinomiya, Hyogo 662-8501, Japan
| | - Haruka Sakane
- Department of Psychological Science, Graduate School of Humanities, Kwansei Gakuin University: 1-155 Uegahara Ichibancho, Nishinomiya, Hyogo 662-8501, Japan
| | - Koki Teramoto
- Department of Psychological Science, Graduate School of Humanities, Kwansei Gakuin University: 1-155 Uegahara Ichibancho, Nishinomiya, Hyogo 662-8501, Japan
| | - Ami Yamamoto
- Department of Psychological Science, Graduate School of Humanities, Kwansei Gakuin University: 1-155 Uegahara Ichibancho, Nishinomiya, Hyogo 662-8501, Japan
| | - Reiko Taketani
- Department of Psychological Science, Graduate School of Humanities, Kwansei Gakuin University: 1-155 Uegahara Ichibancho, Nishinomiya, Hyogo 662-8501, Japan
| | - Hisae Ono
- Department of Psychological Science, Graduate School of Humanities, Kwansei Gakuin University: 1-155 Uegahara Ichibancho, Nishinomiya, Hyogo 662-8501, Japan
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Ozawa S. Application of Near-Infrared Spectroscopy for Evidence-Based Psychotherapy. Front Psychol 2021; 12:527335. [PMID: 34366946 PMCID: PMC8342759 DOI: 10.3389/fpsyg.2021.527335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 06/23/2021] [Indexed: 11/13/2022] Open
Abstract
This perspective article discusses the importance of evidence-based psychotherapy and highlights the usefulness of near-infrared spectroscopy (NIRS) in assessing the effects of psychotherapeutic interventions as a future direction of clinical psychology. NIRS is a safe and non-invasive neuroimaging technique that can be implemented in a clinical setting to measure brain activity via a simple procedure. This article discusses the possible benefits and challenges of applying NIRS for this purpose, and the available methodology based on previous studies that used NIRS to evaluate psychotherapeutic effects. Furthermore, this perspective article suggests alternative methodologies that may be useful, namely, the single- and multi-session evaluations using immediate pre- and post-intervention measurements. These methods can be used to evaluate state changes in brain activity, which can be derived from a single session of psychotherapeutic interventions. This article provides a conceptual schema important in actualizing NIRS application for evidence-base psychotherapy.
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Affiliation(s)
- Sachiyo Ozawa
- UTokyo Center for Integrative Science of Human Behavior (CiSHuB), Center for Evolutionary Cognitive Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
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Lin YP, Liang HY, Chen YS, Lu CH, Wu YR, Chang YY, Lin WC. Objective assessment of impulse control disorder in patients with Parkinson's disease using a low-cost LEGO-like EEG headset: a feasibility study. J Neuroeng Rehabil 2021; 18:109. [PMID: 34215283 PMCID: PMC8252252 DOI: 10.1186/s12984-021-00897-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 06/10/2021] [Indexed: 11/10/2022] Open
Abstract
Background Patients with Parkinson’s disease (PD) can develop impulse control disorders (ICDs) while undergoing a pharmacological treatment for motor control dysfunctions with a dopamine agonist (DA). Conventional clinical interviews or questionnaires can be biased and may not accurately diagnose at the early stage. A wearable electroencephalogram (EEG)-sensing headset paired with an examination procedure can be a potential user-friendly method to explore ICD-related signatures that can detect its early signs and progression by reflecting brain activity. Methods A stereotypical Go/NoGo test that targets impulse inhibition was performed on 59 individuals, including healthy controls, patients with PD, and patients with PD diagnosed by ICDs. We conducted two Go/NoGo sessions before and after the DA-pharmacological treatment for the PD and ICD groups. A low-cost LEGO-like EEG headset was used to record concurrent EEG signals. Then, we used the event-related potential (ERP) analytical framework to explore ICD-related EEG abnormalities after DA treatment. Results After the DA treatment, only the ICD-diagnosed PD patients made more behavioral errors and tended to exhibit the deterioration for the NoGo N2 and P3 peak amplitudes at fronto-central electrodes in contrast to the HC and PD groups. Particularly, the extent of the diminished NoGo-N2 amplitude was prone to be modulated by the ICD scores at Fz with marginal statistical significance (r = − 0.34, p = 0.07). Conclusions The low-cost LEGO-like EEG headset successfully captured ERP waveforms and objectively assessed ICD in patients with PD undergoing DA treatment. This objective neuro-evidence could provide complementary information to conventional clinical scales used to diagnose ICD adverse effects.
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Affiliation(s)
- Yuan-Pin Lin
- Institute of Medical Science and Technology, National Sun Yat-sen University, Kaohsiung, Taiwan.,Department of Electrical Engineering, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Hsing-Yi Liang
- Institute of Medical Science and Technology, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Yueh-Sheng Chen
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Cheng-Hsien Lu
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yih-Ru Wu
- Department of Neurology, Linkou Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Yung-Yee Chang
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wei-Che Lin
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung, Taiwan. .,Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, No. 123, Dapi Road, Niaosong District, Kaohsiung City, 833, Taiwan.
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Trambaiolli LR, Tiwari A, Falk TH. Affective Neurofeedback Under Naturalistic Conditions: A Mini-Review of Current Achievements and Open Challenges. FRONTIERS IN NEUROERGONOMICS 2021; 2:678981. [PMID: 38235228 PMCID: PMC10790905 DOI: 10.3389/fnrgo.2021.678981] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 04/28/2021] [Indexed: 01/19/2024]
Abstract
Affective neurofeedback training allows for the self-regulation of the putative circuits of emotion regulation. This approach has recently been studied as a possible additional treatment for psychiatric disorders, presenting positive effects in symptoms and behaviors. After neurofeedback training, a critical aspect is the transference of the learned self-regulation strategies to outside the laboratory and how to continue reinforcing these strategies in non-controlled environments. In this mini-review, we discuss the current achievements of affective neurofeedback under naturalistic setups. For this, we first provide a brief overview of the state-of-the-art for affective neurofeedback protocols. We then discuss virtual reality as a transitional step toward the final goal of "in-the-wild" protocols and current advances using mobile neurotechnology. Finally, we provide a discussion of open challenges for affective neurofeedback protocols in-the-wild, including topics such as convenience and reliability, environmental effects in attention and workload, among others.
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Affiliation(s)
- Lucas R. Trambaiolli
- Basic Neuroscience Division, McLean Hospital–Harvard Medical School, Belmont, MA, United States
| | - Abhishek Tiwari
- Institut National de la Recherche Scientifique, University of Quebec, Montreal, QC, Canada
| | - Tiago H. Falk
- Institut National de la Recherche Scientifique, University of Quebec, Montreal, QC, Canada
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20
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Veit R, Schag K, Schopf E, Borutta M, Kreutzer J, Ehlis AC, Zipfel S, Giel KE, Preissl H, Kullmann S. Diminished prefrontal cortex activation in patients with binge eating disorder associates with trait impulsivity and improves after impulsivity-focused treatment based on a randomized controlled IMPULS trial. NEUROIMAGE-CLINICAL 2021; 30:102679. [PMID: 34215149 PMCID: PMC8102655 DOI: 10.1016/j.nicl.2021.102679] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 04/14/2021] [Accepted: 04/15/2021] [Indexed: 01/18/2023]
Abstract
Persons with binge eating disorder show increased impulsivity. We investigated cognitive control to food cues using fNIRS. Compared to healthy controls, binge eaters show weaker activation of the prefrontal cortex. After behavioral therapy, binge eaters increase prefrontal cortex activation.
Background Behavioral and cognitive control are vital for healthy eating behavior. Patients with binge eating disorder (BED) suffer under recurrent binge eating episodes accompanied by subjective loss of control that results, among other factors, from increased impulsivity. Methods In the current study, we investigated the frontal network using functional near-infrared spectroscopy (fNIRS) during a food specific go/nogo task to assess response inhibition in 24 patients with BED (BMI range 22.6–59.7 kg/m2) compared to 12 healthy controls (HC) (BMI range 20.9–27 kg/m2). Patients with BED were invited to undergo fNIRS measurements before an impulsivity-focused cognitive behavioral group treatment, directly after this treatment and 3 months afterwards. As this was a planned subgroup analysis of the randomized controlled IMPULS trial, patients with BED were randomized either to the treatment group (n = 14) or to a control group (n = 10). The treatment group received 8 weekly sessions of the IMPULS treatment. Results We found a significant response inhibition effect (nogo minus go), in terms of an increased oxygenated hemoglobin response in the bilateral prefrontal cortex in both groups. The greatest response was observed when participants were instructed to go for healthy and withhold their response to unhealthy high caloric food cues. The healthy nogo condition failed to show a significant prefrontal inhibitory response, which was probably related to the task design, as the condition was considered more demanding. BED patients, especially those with higher trait impulsivity, showed a weaker activation of the prefrontal cortex during response inhibition, predominantly in the right hemisphere. Interestingly, three months after the treatment, patients of the treatment group increased their right prefrontal cortex activity during response inhibition. Likewise, increased prefrontal cortex activation correlated with decreased trait impulsivity after treatment. Conclusions Our results suggest that patients with BED have limited resources to activate the prefrontal cortex when asked to inhibit a reaction onto food-specific stimuli. However, this effect could be partly driven by differences in BMI between the HC and BED group. Cognitive-behavioral therapy targeting impulsive eating behavior may improve prefrontal cortex recruitment during response inhibition.
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Affiliation(s)
- Ralf Veit
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD), Tübingen, Germany
| | - Kathrin Schag
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Germany; Center of Excellence for Eating Disorders Tübingen (COMET), Tübingen, Germany
| | - Eric Schopf
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
| | - Maike Borutta
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD), Tübingen, Germany
| | - Jann Kreutzer
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
| | - Ann-Christine Ehlis
- Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Germany; Center of Excellence for Eating Disorders Tübingen (COMET), Tübingen, Germany
| | - Katrin E Giel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Germany; Center of Excellence for Eating Disorders Tübingen (COMET), Tübingen, Germany
| | - Hubert Preissl
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD), Tübingen, Germany; Department of Internal Medicine IV, Division of Diabetology, Endocrinology and Nephrology, University Hospital Tübingen, Germany; Institute for Diabetes and Obesity, Helmholtz Diabetes Center at Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany; Institute of Pharmaceutical Sciences, Department of Pharmacy and Biochemistry, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Stephanie Kullmann
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD), Tübingen, Germany; Department of Internal Medicine IV, Division of Diabetology, Endocrinology and Nephrology, University Hospital Tübingen, Germany.
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21
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Guerrero Moreno J, Biazoli CE, Baptista AF, Trambaiolli LR. Closed-loop neurostimulation for affective symptoms and disorders: An overview. Biol Psychol 2021; 161:108081. [PMID: 33757806 DOI: 10.1016/j.biopsycho.2021.108081] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 03/12/2021] [Accepted: 03/15/2021] [Indexed: 12/28/2022]
Abstract
Affective and anxiety disorders are the most prevalent and incident psychiatric disorders worldwide. Therapeutic approaches to these disorders using non-invasive brain stimulation (NIBS) and analogous techniques have been extensively investigated. In this paper, we discuss the combination of NIBS and neurofeedback in closed-loop setups and its application for affective symptoms and disorders. For this, we first provide a rationale for this combination by presenting some of the main original findings of NIBS, with a primary focus on transcranial magnetic stimulation (TMS), and neurofeedback, including protocols based on electroencephalography (EEG) and functional magnetic resonance imaging (fMRI). Then, we provide a scope review of studies combining real-time neurofeedback with NIBS protocols in the so-called closed-loop brain state-dependent neuromodulation (BSDS). Finally, we discuss the concomitant use of TMS and real-time functional near-infrared spectroscopy (fNIRS) as a possible solution to the current limitations of BSDS-based protocols for affective and anxiety disorders.
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Affiliation(s)
- Javier Guerrero Moreno
- Center of Mathematics, Computation and Cognition, Universidade Federal do ABC, Santo André, Brazil
| | - Claudinei Eduardo Biazoli
- Center of Mathematics, Computation and Cognition, Universidade Federal do ABC, Santo André, Brazil; Department of Psychology, School of Biological and Chemical Sciences, Queen Mary University of London, UK
| | - Abrahão Fontes Baptista
- Center of Mathematics, Computation and Cognition, Universidade Federal do ABC, Santo André, Brazil; Laboratory of Medical Investigations 54 (LIM-54), Universidade de São Paulo, São Paulo, Brazil; NAPeN Network (Rede de Núcleos de Assistência e Pesquisa em Neuromodulação), Brazil; Brazilian Institute of Neuroscience and Neurotechnology (BRAINN/CEPID-FAPESP), University of Campinas, Campinas, São Paulo, Brazil
| | - Lucas Remoaldo Trambaiolli
- McLean Hospital, Harvard Medical School, Boston, USA; School of Medicine and Dentistry, University of Rochester, Rochester, USA.
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22
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Soekadar SR, Kohl SH, Mihara M, von Lühmann A. Optical brain imaging and its application to neurofeedback. Neuroimage Clin 2021; 30:102577. [PMID: 33545580 PMCID: PMC7868728 DOI: 10.1016/j.nicl.2021.102577] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 12/30/2020] [Accepted: 01/15/2021] [Indexed: 12/30/2022]
Abstract
Besides passive recording of brain electric or magnetic activity, also non-ionizing electromagnetic or optical radiation can be used for real-time brain imaging. Here, changes in the radiation's absorption or scattering allow for continuous in vivo assessment of regional neurometabolic and neurovascular activity. Besides magnetic resonance imaging (MRI), over the last years, also functional near-infrared spectroscopy (fNIRS) was successfully established in real-time metabolic brain imaging. In contrast to MRI, fNIRS is portable and can be applied at bedside or in everyday life environments, e.g., to restore communication and movement. Here we provide a comprehensive overview of the history and state-of-the-art of real-time optical brain imaging with a special emphasis on its clinical use towards neurofeedback and brain-computer interface (BCI) applications. Besides pointing to the most critical challenges in clinical use, also novel approaches that combine real-time optical neuroimaging with other recording modalities (e.g. electro- or magnetoencephalography) are described, and their use in the context of neuroergonomics, neuroenhancement or neuroadaptive systems discussed.
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Affiliation(s)
- Surjo R Soekadar
- Clinical Neurotechnology Laboratory, Dept. of Psychiatry and Psychotherapy, Neuroscience Research Center, Campus Charité Mitte (CCM), Charité - University Medicine of Berlin, Berlin, Germany.
| | - Simon H Kohl
- JARA-Institute Molecular Neuroscience and Neuroimaging (INM-11), Jülich Research Centre, Jülich, Germany; Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, RWTH Aachen University, Germany
| | - Masahito Mihara
- Department of Neurology, Kawasaki Medical School, Kurashiki-City, Okayama, Japan
| | - Alexander von Lühmann
- Machine Learning Department, Computer Science, Technische Universität Berlin, Berlin, Germany; Neurophotonics Center, Biomedical Engineering, Boston University, Boston, USA
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Trambaiolli LR, Tossato J, Cravo AM, Biazoli CE, Sato JR. Subject-independent decoding of affective states using functional near-infrared spectroscopy. PLoS One 2021; 16:e0244840. [PMID: 33411817 PMCID: PMC7790273 DOI: 10.1371/journal.pone.0244840] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 12/01/2020] [Indexed: 11/25/2022] Open
Abstract
Affective decoding is the inference of human emotional states using brain signal measurements. This approach is crucial to develop new therapeutic approaches for psychiatric rehabilitation, such as affective neurofeedback protocols. To reduce the training duration and optimize the clinical outputs, an ideal clinical neurofeedback could be trained using data from an independent group of volunteers before being used by new patients. Here, we investigated if this subject-independent design of affective decoding can be achieved using functional near-infrared spectroscopy (fNIRS) signals from frontal and occipital areas. For this purpose, a linear discriminant analysis classifier was first trained in a dataset (49 participants, 24.65±3.23 years) and then tested in a completely independent one (20 participants, 24.00±3.92 years). Significant balanced accuracies between classes were found for positive vs. negative (64.50 ± 12.03%, p<0.01) and negative vs. neutral (68.25 ± 12.97%, p<0.01) affective states discrimination during a reactive block consisting in viewing affective-loaded images. For an active block, in which volunteers were instructed to recollect personal affective experiences, significant accuracy was found for positive vs. neutral affect classification (71.25 ± 18.02%, p<0.01). In this last case, only three fNIRS channels were enough to discriminate between neutral and positive affective states. Although more research is needed, for example focusing on better combinations of features and classifiers, our results highlight fNIRS as a possible technique for subject-independent affective decoding, reaching significant classification accuracies of emotional states using only a few but biologically relevant features.
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Affiliation(s)
- Lucas R. Trambaiolli
- Division of Basic Neuroscience, McLean Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- * E-mail:
| | - Juliana Tossato
- Center for Mathematics, Computing and Cognition, Federal University of ABC, São Bernardo do Campo, São Paulo, Brazil
| | - André M. Cravo
- Center for Mathematics, Computing and Cognition, Federal University of ABC, São Bernardo do Campo, São Paulo, Brazil
| | - Claudinei E. Biazoli
- Center for Mathematics, Computing and Cognition, Federal University of ABC, São Bernardo do Campo, São Paulo, Brazil
| | - João R. Sato
- Center for Mathematics, Computing and Cognition, Federal University of ABC, São Bernardo do Campo, São Paulo, Brazil
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24
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Head-Mounted Display-Based Application for Cognitive Training. SENSORS 2020; 20:s20226552. [PMID: 33212748 PMCID: PMC7696435 DOI: 10.3390/s20226552] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 11/08/2020] [Accepted: 11/12/2020] [Indexed: 12/20/2022]
Abstract
Virtual Reality (VR) has had significant advances in rehabilitation, due to the gamification of cognitive activities that facilitate treatment. On the other hand, Immersive Virtual Reality (IVR) produces outstanding results due to the interactive features with the user. This work introduces a VR application for memory rehabilitation by walking through a maze and using the Oculus Go head-mounted display (HMD) technology. The mechanics of the game require memorizing geometric shapes while the player progresses in two modes, autonomous or manual, with two levels of difficulty depending on the number of elements to remember. The application is developed in the Unity 3D video game engine considering the optimization of computational resources to improve the performance in the processing and maintaining adequate benefits for the user, while the generated data is stored and sent to a remote server. The maze task was assessed with 29 subjects in a controlled environment. The obtained results show a significant correlation between participants’ response accuracy in both the maze task and a face–pair test. Thus, the proposed task is able to perform memory assessments.
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Kohl SH, Mehler DMA, Lührs M, Thibault RT, Konrad K, Sorger B. The Potential of Functional Near-Infrared Spectroscopy-Based Neurofeedback-A Systematic Review and Recommendations for Best Practice. Front Neurosci 2020; 14:594. [PMID: 32848528 PMCID: PMC7396619 DOI: 10.3389/fnins.2020.00594] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 05/14/2020] [Indexed: 01/04/2023] Open
Abstract
Background: The effects of electroencephalography (EEG) and functional magnetic resonance imaging (fMRI)-neurofeedback on brain activation and behaviors have been studied extensively in the past. More recently, researchers have begun to investigate the effects of functional near-infrared spectroscopy-based neurofeedback (fNIRS-neurofeedback). FNIRS is a functional neuroimaging technique based on brain hemodynamics, which is easy to use, portable, inexpensive, and has reduced sensitivity to movement artifacts. Method: We provide the first systematic review and database of fNIRS-neurofeedback studies, synthesizing findings from 22 peer-reviewed studies (including a total of N = 441 participants; 337 healthy, 104 patients). We (1) give a comprehensive overview of how fNIRS-neurofeedback training protocols were implemented, (2) review the online signal-processing methods used, (3) evaluate the quality of studies using pre-set methodological and reporting quality criteria and also present statistical sensitivity/power analyses, (4) investigate the effectiveness of fNIRS-neurofeedback in modulating brain activation, and (5) review its effectiveness in changing behavior in healthy and pathological populations. Results and discussion: (1–2) Published studies are heterogeneous (e.g., neurofeedback targets, investigated populations, applied training protocols, and methods). (3) Large randomized controlled trials are still lacking. In view of the novelty of the field, the quality of the published studies is moderate. We identified room for improvement in reporting important information and statistical power to detect realistic effects. (4) Several studies show that people can regulate hemodynamic signals from cortical brain regions with fNIRS-neurofeedback and (5) these studies indicate the feasibility of modulating motor control and prefrontal brain functioning in healthy participants and ameliorating symptoms in clinical populations (stroke, ADHD, autism, and social anxiety). However, valid conclusions about specificity or potential clinical utility are premature. Conclusion: Due to the advantages of practicability and relatively low cost, fNIRS-neurofeedback might provide a suitable and powerful alternative to EEG and fMRI neurofeedback and has great potential for clinical translation of neurofeedback. Together with more rigorous research and reporting practices, further methodological improvements may lead to a more solid understanding of fNIRS-neurofeedback. Future research will benefit from exploiting the advantages of fNIRS, which offers unique opportunities for neurofeedback research.
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Affiliation(s)
- Simon H Kohl
- JARA-Institute Molecular Neuroscience and Neuroimaging (INM-11), Jülich Research Centre, Jülich, Germany.,Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - David M A Mehler
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Michael Lührs
- Brain Innovation B.V., Research Department, Maastricht, Netherlands.,Faculty of Psychology and Neuroscience, Department of Cognitive Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Robert T Thibault
- School of Psychological Science, University of Bristol, Bristol, United Kingdom.,MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | - Kerstin Konrad
- JARA-Institute Molecular Neuroscience and Neuroimaging (INM-11), Jülich Research Centre, Jülich, Germany.,Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Bettina Sorger
- Faculty of Psychology and Neuroscience, Department of Cognitive Neuroscience, Maastricht University, Maastricht, Netherlands
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Putze F, Herff C, Tremmel C, Schultz T, Krusienski DJ. Decoding Mental Workload in Virtual Environments: A fNIRS Study using an Immersive n-back Task. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:3103-3106. [PMID: 31946544 DOI: 10.1109/embc.2019.8856386] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Virtual Reality (VR) has emerged as a novel paradigm for immersive applications in training, entertainment, rehabilitation, and other domains. In this paper, we investigate the automatic classification of mental workload from brain activity measured through functional near-infrared spectroscopy (fNIRS) in VR. We present results from a study which implements the established n-back task in an immersive visual scene, including physical interaction. Our results show that user workload can be detected from fNIRS signals in immersive VR tasks both person-dependently and -adaptively.
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27
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BAHADIR A. Applications of Functional Near-Infrared Spectroscopy (fNIRS)- Based Neurofeedback (NF) Training in Neurophsychiatric Disorders. KONURALP TIP DERGISI 2020. [DOI: 10.18521/ktd.670281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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28
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Torner J, Skouras S, Molinuevo JL, Gispert JD, Alpiste F. Multipurpose Virtual Reality Environment for Biomedical and Health Applications. IEEE Trans Neural Syst Rehabil Eng 2019; 27:1511-1520. [PMID: 31283482 DOI: 10.1109/tnsre.2019.2926786] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Virtual reality is a trending, widely accessible, and contemporary technology of increasing utility to biomedical and health applications. However, most implementations of virtual reality environments are tailored to specific applications. We describe the complete development of a novel, open-source virtual reality environment that is suitable for multipurpose biomedical and healthcare applications. This environment can be interfaced with different hardware and data sources, ranging from gyroscopes to fMRI scanners. The developed environment simulates an immersive (first-person perspective) run in the countryside, in a virtual landscape with various salient features. The utility of the developed VR environment has been validated via two test applications: an application in the context of motor rehabilitation following injury of the lower limbs and an application in the context of real-time functional magnetic resonance imaging neurofeedback, to regulate brain function in specific brain regions of interest. Both applications were tested by pilot subjects that unanimously provided very positive feedback, suggesting that appropriately designed VR environments can indeed be robustly and efficiently used for multiple biomedical purposes. We attribute the versatility of our approach on three principles implicit in the design: selectivity, immersiveness, and adaptability. The software, including both applications, is publicly available free of charge, via a GitHub repository, in support of the Open Science Initiative. Although using this software requires specialized hardware and engineering know-how, we anticipate our contribution to catalyze further progress, interdisciplinary collaborations and replicability, with regards to the usage of virtual reality in biomedical and health applications.
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Shereena EA, Gupta RK, Bennett CN, Sagar KJV, Rajeswaran J. EEG Neurofeedback Training in Children With Attention Deficit/Hyperactivity Disorder: A Cognitive and Behavioral Outcome Study. Clin EEG Neurosci 2019; 50:242-255. [PMID: 30453757 DOI: 10.1177/1550059418813034] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Attention deficit/hyperactivity disorder (ADHD) is a highly prevalent childhood disorder with symptoms of inattention, impulsivity, and hyperactivity. EEG neurofeedback training (NFT) is a new intervention modality based on operant conditioning of brain activity, which helps reduce symptoms of ADHD in children. METHODS AND PROCEDURES To examine the efficacy of NFT in children with ADHD, an experimental longitudinal design with pre-post comparison was adopted. A total of 30 children in the age range of 6 to 12 years diagnosed as ADHD with or without comorbid conditions were assigned to treatment group (TG; n = 15) and treatment as usual group (TAU; n = 15). TG received EEG-NFT along with routine clinical management and TAU received routine clinical management alone. Forty sessions of theta/beta NFT at the C3 scalp location, 3 to 4 sessions in a week for a period of 3.5 to 5 months were given to children in TG. Children were screened using sociodemographic data and Binet-Kamat test of intelligence. Pre-and postassessment tools were neuropsychological tests and behavioral scales. Follow-up was carried out on 8 children in TG using parent-rated behavioral measures. RESULTS Improvement was reported in TG on cognitive functions (sustained attention, verbal working memory, and response inhibition), parent- and teacher-rated behavior problems and on academic performance rated by teachers. Follow-up of children who received NFT showed sustained improvement in ADHD symptoms when assessed 6 months after receiving NFT. CONCLUSION The present study suggests that NFT is an effective method to enhance cognitive deficits and helps reduce ADHD symptoms and behavior problems. Consequently, academic performance was found to be improved in children with ADHD. Improvement in ADHD symptoms induced by NFT were maintained at 6-month follow-up in children with ADHD.
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Affiliation(s)
- E A Shereena
- 1 National Institute of Mental Health & Neuro Sciences, Bengaluru, Karnataka, India
| | - R K Gupta
- 1 National Institute of Mental Health & Neuro Sciences, Bengaluru, Karnataka, India
| | - C N Bennett
- 2 Department of Psychology, Christ (Deemed to be University), Bengaluru, Karnataka, India
| | - K J V Sagar
- 1 National Institute of Mental Health & Neuro Sciences, Bengaluru, Karnataka, India
| | - J Rajeswaran
- 1 National Institute of Mental Health & Neuro Sciences, Bengaluru, Karnataka, India
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30
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Prat Q, Andueza J, Echávarri B, Camerino O, Fernandes T, Castañer M. A Mixed Methods Design to Detect Adolescent and Young Adults' Impulsiveness on Decision-Making and Motor Performance. Front Psychol 2019; 10:1072. [PMID: 31178778 PMCID: PMC6543009 DOI: 10.3389/fpsyg.2019.01072] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 04/24/2019] [Indexed: 11/25/2022] Open
Abstract
Impulsiveness in adolescents and young adults is an important aspect of psychological research. However, there still is lack of research that relates impulsiveness and motor performance in those. Thus, we aim to detect the levels of impulsiveness related to motor skills, motor laterality, spatial orientation, and individual interaction on the decision-making of adolescents and young adults across three staggered workouts. The study had 71 participants (53 males and 18 females), ranging in age from 17 to 24 years old (Mage = 18.5 years; SD = 1.72) and classified as non-impulsiveness (n = 47), impulsiveness (n = 17), and attention deficit hyperactivity disorder (ADHD) (n = 7). A Mixed Methods research was conducted throughout four research tools (a) The Observational System of Motor Skills (OSMOS) was used to observe and detect the movement sequences patterns; (b) The Spanish version of Impulsive Behavior Scale (UPPS-P) was administered to obtain the impulsiveness profiles; (c) The Precision and Agility Tapping over Hoops (PATHoops) was carried out to observe the decision-making and temporal-spatial over movement effectiveness; (d) Motor Laterality Inventory (MOTORLAT) was applied to obtain the laterality profiles related to motor skills performance. This Mixed Methods approach has obtained useful results for impulsiveness in motor situations as the results from the different tools converge to established three clear profiles of impulsiveness. Participants with ADHD showed lack of interpersonal interaction, non-resolute decision-making, and lesser richness of motor skills patterns than non-impulsiveness and impulsiveness subjects. Additionally, impulsiveness participants also showed rich motor patterns, dyadic interactions, good decision making in spatial orientation tasks, and more versatile laterality in the lower limbs.
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Affiliation(s)
- Queralt Prat
- INEFC (National Institute of Physical Education of Catalonia), University of Lleida, Lleida, Spain
| | - Juan Andueza
- INEFC (National Institute of Physical Education of Catalonia), University of Lleida, Lleida, Spain
| | | | | | - Tiago Fernandes
- Faculty of Sport, Center for Research, Training, Innovation and Intervention in Sport, University of Porto, Porto, Portugal
| | - Marta Castañer
- INEFC (National Institute of Physical Education of Catalonia), University of Lleida, Lleida, Spain.,IRBLLEIDA (Lleida Institute for Biomedical Research Dr. Pifarré Foundation), University of Lleida, Lleida, Spain
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Hilbert A, Ehlis AC. Neurowissenschaftlich fundierte Psychotherapie. PSYCHOTHERAPEUT 2019. [DOI: 10.1007/s00278-019-0355-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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32
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Neurofeedback bei adulter Aufmerksamkeitsdefizit‑/Hyperaktivitätsstörung. PSYCHOTHERAPEUT 2019. [DOI: 10.1007/s00278-019-0350-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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33
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Storchak H, Hudak J, Fallgatter AJ, Ehlis AC. Entwicklung eines Neurofeedback-Protokolls zur Reduktion verbal akustischer Halluzinationen. PSYCHOTHERAPEUT 2019. [DOI: 10.1007/s00278-019-0353-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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34
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Kutscheidt K, Dresler T, Hudak J, Barth B, Blume F, Ethofer T, Fallgatter AJ, Ehlis AC. Interoceptive awareness in patients with attention-deficit/hyperactivity disorder (ADHD). ACTA ACUST UNITED AC 2019; 11:395-401. [DOI: 10.1007/s12402-019-00299-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 03/18/2019] [Indexed: 10/27/2022]
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35
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Kohl SH, Veit R, Spetter MS, Günther A, Rina A, Lührs M, Birbaumer N, Preissl H, Hallschmid M. Real-time fMRI neurofeedback training to improve eating behavior by self-regulation of the dorsolateral prefrontal cortex: A randomized controlled trial in overweight and obese subjects. Neuroimage 2019; 191:596-609. [PMID: 30798010 DOI: 10.1016/j.neuroimage.2019.02.033] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 01/30/2019] [Accepted: 02/13/2019] [Indexed: 01/17/2023] Open
Abstract
Obesity is associated with altered responses to food stimuli in prefrontal brain networks that mediate inhibitory control of ingestive behavior. In particular, activity of the dorsolateral prefrontal cortex (dlPFC) is reduced in obese compared to normal-weight subjects and has been linked to the success of weight-loss dietary interventions. In a randomized controlled trial in overweight/obese subjects, we investigated the effect on eating behavior of volitional up-regulation of dlPFC activity via real-time functional magnetic resonance imaging (fMRI) neurofeedback training. Thirty-eight overweight or obese subjects (BMI 25-40 kg/m2) took part in fMRI neurofeedback training with the aim of increasing activity of the left dlPFC (dlPFC group; n = 17) or of the visual cortex (VC/control group; n = 21). Participants were blinded to group assignment. The training session took place on a single day and included three training runs of six trials of up-regulation and passive viewing. Food appraisal and snack intake were assessed at screening, after training, and in a follow-up session four weeks later. Participants of both groups succeeded in up-regulating activity of the targeted brain area. However, participants of the control group also showed increased left dlPFC activity during up-regulation. Functional connectivity between dlPFC and ventromedial PFC, an area that processes food value, was generally increased during up-regulation compared to passive viewing. At follow-up compared to baseline, both groups rated pictures of high-, but not low-calorie foods as less palatable and chose them less frequently. Actual snack intake remained unchanged but palatability and choice ratings for chocolate cookies decreased after training. We demonstrate that one session of fMRI neurofeedback training enables individuals with increased body weight to up-regulate activity of the left dlPFC. Behavioral effects were observed in both groups, which might have been due to dlPFC co-activation in the control group and, in addition, unspecific training effects. Improved dlPFC-vmPFC functional connectivity furthermore suggested enhanced food intake-related control mechanisms. Neurofeedback training might support therapeutic strategies aiming at improved self-control in obesity, although the respective contributions of area-specific mechanisms and general regulation effects are in need of further investigation.
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Affiliation(s)
- Simon H Kohl
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany; Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Jülich Research Center, Jülich, Germany
| | - Ralf Veit
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany; Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen; German Center for Diabetes Research (DZD), Tübingen, Germany; High-Field Magnetic Resonance Center, Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| | - Maartje S Spetter
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany; School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - Astrid Günther
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany
| | - Andriani Rina
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany; High-Field Magnetic Resonance Center, Max Planck Institute for Biological Cybernetics, Tübingen, Germany; Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Michael Lührs
- Brain Innovation B.V, Research Department, Maastricht, Netherlands; Faculty of Psychology and Neuroscience, Department of Cognitive Neuroscience, Maastricht University, Netherlands
| | - Niels Birbaumer
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany; Wyss Center for Bio and Neuroengineering, Geneva, 1202, Switzerland
| | - Hubert Preissl
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen; German Center for Diabetes Research (DZD), Tübingen, Germany; Institute of Pharmaceutical Sciences, Interfaculty Centre for Pharmacogenomics and Pharma Research, Department of Pharmacy and Biochemistry, University of Tübingen, Tübingen, Germany.
| | - Manfred Hallschmid
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany; Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen; German Center for Diabetes Research (DZD), Tübingen, Germany
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Storchak H, Hudak J, Haeussinger FB, Rosenbaum D, Fallgatter AJ, Ehlis AC. Reducing auditory verbal hallucinations by means of fNIRS neurofeedback - A case study with a paranoid schizophrenic patient. Schizophr Res 2019; 204:401-403. [PMID: 30269928 DOI: 10.1016/j.schres.2018.09.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 09/10/2018] [Accepted: 09/16/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Helena Storchak
- Psychophysiology and Optical Imaging, Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Calwerstr. 14, 72076 Tübingen, Germany.
| | - Justin Hudak
- Psychophysiology and Optical Imaging, Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Calwerstr. 14, 72076 Tübingen, Germany; LEAD Graduate School & Research Network, University of Tübingen, Gartenstr. 29, 72074 Tübingen, Germany
| | - Florian B Haeussinger
- Psychophysiology and Optical Imaging, Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Calwerstr. 14, 72076 Tübingen, Germany
| | - David Rosenbaum
- Psychophysiology and Optical Imaging, Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Calwerstr. 14, 72076 Tübingen, Germany
| | - Andreas J Fallgatter
- Psychophysiology and Optical Imaging, Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Calwerstr. 14, 72076 Tübingen, Germany; LEAD Graduate School & Research Network, University of Tübingen, Gartenstr. 29, 72074 Tübingen, Germany; Werner Reichardt Centre for Integrative Neuroscience (CIN), University of Tübingen, Otfried-Mueller-Str. 25, 72076 Tübingen, Germany
| | - Ann-Christine Ehlis
- Psychophysiology and Optical Imaging, Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Calwerstr. 14, 72076 Tübingen, Germany; LEAD Graduate School & Research Network, University of Tübingen, Gartenstr. 29, 72074 Tübingen, Germany
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Feasibility of NIRS-based neurofeedback training in social anxiety disorder: behavioral and neural correlates. J Neural Transm (Vienna) 2018; 126:1175-1185. [DOI: 10.1007/s00702-018-1954-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 11/04/2018] [Indexed: 11/27/2022]
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38
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Ehlis AC, Barth B, Hudak J, Storchak H, Weber L, Kimmig ACS, Kreifelts B, Dresler T, Fallgatter AJ. Near-Infrared Spectroscopy as a New Tool for Neurofeedback Training: Applications in Psychiatry and Methodological Considerations. JAPANESE PSYCHOLOGICAL RESEARCH 2018. [DOI: 10.1111/jpr.12225] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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39
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Hudak J, Rosenbaum D, Barth B, Fallgatter AJ, Ehlis AC. Functionally disconnected: A look at how study design influences neurofeedback data and mechanisms in attention-deficit/hyperactivity disorder. PLoS One 2018; 13:e0200931. [PMID: 30096196 PMCID: PMC6086395 DOI: 10.1371/journal.pone.0200931] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 07/04/2018] [Indexed: 01/13/2023] Open
Abstract
Neurofeedback (NF) is a form of behavioral therapy used to treat e.g. attention-deficit/hyperactivity disorder (ADHD). Briefly, subjects are fed-back a putatively dysfunctional parameter of their brain activity in real time and must learn to control it in a suggested direction. NF protocols for ADHD have been used in practice for decades, though no clear standards on NF design have been implemented. Furthermore, studies often present only data from the general outcome of the NF treatment and do not look at how exactly the NF paradigm affects brain functionality, or what exactly the NF is training. The current study is two-fold: firstly, we look at how the functional connectivity (FC) patterns within key networks associated with ADHD differ between rests, feedback trials, success and failure in a complete functional near-infrared spectroscopy-based NF experiment on adults with ADHD. Secondly, due to methodological concerns discovered during the analysis of our data, we address important considerations in the design of NF that are often ignored in protocols being used widely in therapy and research today. In particular, we examine the common average reference and its impact on network activity as well as the importance of balancing the randomization in a design. Finally, we discuss how these methodological considerations may have influenced our FC results.
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Affiliation(s)
- Justin Hudak
- LEAD Graduate School & Research Network, University of Tübingen, Tübingen, Germany
- Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
- * E-mail:
| | - David Rosenbaum
- Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Beatrix Barth
- Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
- Centre for Integrative Neuroscience, University of Tübingen, Tübingen, Germany
| | - Andreas J. Fallgatter
- LEAD Graduate School & Research Network, University of Tübingen, Tübingen, Germany
- Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
- Graduate School of Neural and Behavioral Sciences, University of Tübingen, Tübingen, Germany
| | - Ann-Christine Ehlis
- LEAD Graduate School & Research Network, University of Tübingen, Tübingen, Germany
- Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
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