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Yeh WH, Ju YJ, Shaw FZ, Liu YT. Comparative effectiveness of electroencephalogram-neurofeedback training of 3-45 frequency band on memory in healthy population: a network meta-analysis with systematic literature search. J Neuroeng Rehabil 2025; 22:94. [PMID: 40275307 PMCID: PMC12020070 DOI: 10.1186/s12984-025-01634-8] [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: 08/31/2024] [Accepted: 04/15/2025] [Indexed: 04/26/2025] Open
Abstract
OBJECTIVE To investigate which brain activity frequency of electroencephalogram (EEG)-neurofeedback training (NFT) was the most effective for enhancing working memory (WM) and episodic memory (EM) in healthy participants through network meta-analysis (NMA). METHODS Searched PubMed, Embase, and Cochrane Library for studies published from January 1990 to January 2025. We performed Bayesian NMA, pooling continuous outcome data using the standardized mean difference effect size (ES). Global and local evaluations of inconsistency were conducted using the chi-square test, side-splitting, and loop-specific approaches. A consistency model was applied and the global approach to inconsistency showed no significance. Efficacy ranks were determined using the surface under the cumulative ranking curve (SUCRA) for each intervention. Publication bias was assessed using the comparison-adjusted funnel plot and Egger's test. Finally, sensitivity analysis confirmed our findings' robustness. RESULTS Sixty studies were included, comprising 50 trials on WM and 24 trials on EM. While the global inconsistency analysis showed no significant inconsistency for WM (χ2(22) = 30.89, p = 0.10) and EM (χ2(10) = 13.48, p = 0.19), the consistency model exhibited the most significant difference between active control (AC) and alpha combined with working memory training (WMT) (ES of 6.64, p < 0.001) for WM, and between AC and alpha (ES of 0.84, p = 0.01) for EM. Alpha combined with WMT for WM (100%) and alpha NFT for EM (87.0%) also showed the highest efficacy according to the SUCRA. No publication bias was found for either type of memory. The sensitivity analysis for WM and EM aligns with the original results. CONCLUSION Through NMA, alpha activity (7-13 Hz) may be a crucial frequency impacting memory. Brain activity combined with other training methods requires more robust studies for future investigation. This study registered with www.crd.york.ac.uk/prospero/ (CRD42024539656).
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Affiliation(s)
- Wen-Hsiu Yeh
- Department of Gerontological Health Care, Central Taiwan University of Science and Technology, Taichung City, 406, Taiwan.
| | - Ya-Ju Ju
- Teaching and Research Center, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 812, Taiwan
- Department of Physical Therapy, College of Health Care, China Medical University, Taichung, 406, Taiwan
| | - Fu-Zen Shaw
- Department of Psychology, National Cheng Kung University, Tainan, 701, Taiwan
- Mind Research and Imaging Center, National Cheng Kung University, Tainan, 701, Taiwan
| | - Yu-Ting Liu
- Department of Medical Science Industries, Chang Jung Christian University, Tainan, 711, Taiwan
- Bachelor Degree Program in Medical Sociology and Health Care, Chang Jung Christian University, Tainan, 711, Taiwan
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Chikhi S, Matton N, Sanna M, Blanchet S. Effects of one session of theta or high alpha neurofeedback on EEG activity and working memory. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2024; 24:1065-1083. [PMID: 39322825 DOI: 10.3758/s13415-024-01218-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/15/2024] [Indexed: 09/27/2024]
Abstract
Neurofeedback techniques provide participants immediate feedback on neuronal signals, enabling them to modulate their brain activity. This technique holds promise to unveil brain-behavior relationship and offers opportunities for neuroenhancement. Establishing causal relationships between modulated brain activity and behavioral improvements requires rigorous experimental designs, including appropriate control groups and large samples. Our primary objective was to examine whether a single neurofeedback session, designed to enhance working memory through the modulation of theta or high-alpha frequencies, elicits specific changes in electrophysiological and cognitive outcomes. Additionally, we explored predictors of successful neuromodulation. A total of 101 healthy adults were assigned to groups trained to increase frontal theta, parietal high alpha, or random frequencies (active control group). We measured resting-state EEG, working memory performance, and self-reported psychological states before and after one neurofeedback session. Although our analyses revealed improvements in electrophysiological and behavioral outcomes, these gains were not specific to the experimental groups. An increase in the frequency targeted by the training has been observed for the theta and high alpha groups, but training designed to increase randomly selected frequencies appears to induce more generalized neuromodulation compared with targeting a specific frequency. Among all the predictors of neuromodulation examined, resting theta and high alpha amplitudes predicted specifically the increase of those frequencies during the training. These results highlight the challenge of integrating a control group based on enhancing randomly selected frequency bands and suggest potential avenues for optimizing interventions (e.g., by including a control group trained in both up- and down-regulation).
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Affiliation(s)
- Samy Chikhi
- Laboratoire Mémoire, Cerveau et Cognition, Université Paris Cité, F-92100, Boulogne-Billancourt, France.
- Integrative Neuroscience and Cognition Center, Université Paris Cité, F-75006, Paris, France.
| | - Nadine Matton
- CLLE - Cognition, Langues, Langage, Ergonomie, Université de Toulouse, Toulouse, France
- Fédération ENAC ISAE-SUPAERO ONERA, Université de Toulouse, Toulouse, France
| | - Marie Sanna
- Laboratoire Mémoire, Cerveau et Cognition, Université Paris Cité, F-92100, Boulogne-Billancourt, France
| | - Sophie Blanchet
- Laboratoire Mémoire, Cerveau et Cognition, Université Paris Cité, F-92100, Boulogne-Billancourt, France
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Diotaiuti P, Valente G, Corrado S, Tosti B, Carissimo C, Di Libero T, Cerro G, Rodio A, Mancone S. Enhancing Working Memory and Reducing Anxiety in University Students: A Neurofeedback Approach. Brain Sci 2024; 14:578. [PMID: 38928578 PMCID: PMC11202122 DOI: 10.3390/brainsci14060578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 05/29/2024] [Accepted: 05/31/2024] [Indexed: 06/28/2024] Open
Abstract
(1) Background: Neurofeedback training (NFT) has emerged as a promising approach for enhancing cognitive functions and reducing anxiety, yet its specific impact on university student populations requires further investigation. This study aims to examine the effects of NFT on working memory improvement and anxiety reduction within this demographic. (2) Methods: A total of forty healthy university student volunteers were randomized into two groups: an experimental group that received NFT and a control group. The NFT protocol was administered using a 14-channel Emotiv Epoc X headset (EMOTIV, Inc., San Francisco, CA 94102, USA) and BrainViz software version Brain Visualizer 1.1 (EMOTIV, Inc., San Francisco, CA 94102, USA), focusing on the alpha frequency band to target improvements in working memory and reductions in anxiety. Assessment tools, including the Corsi Block and Memory Span tests for working memory and the State-Trait Anxiety Inventory-2 (STAI-2) for anxiety, were applied pre- and post-intervention. (3) Results: The findings indicated an increase in alpha wave amplitude in the experimental group from the second day of NFT, with statistically significant differences observed on days 2 (p < 0.05) and 8 (p < 0.01). Contrary to expectations based on the previous literature, the study did not observe a concurrent positive impact on working memory. Nonetheless, a significant reduction in state anxiety levels was recorded in the experimental group (p < 0.001), corroborating NFT's potential for anxiety management. (4) Conclusions: While these results suggest some potential of the technique in enhancing neural efficiency, the variability across different days highlights the need for further investigation to fully ascertain its effectiveness. The study confirms the beneficial impact of NFT on reducing state anxiety among university students, underscoring its value in psychological and cognitive performance enhancement. Despite the lack of observed improvements in working memory, these results highlight the need for continued exploration of NFT applications across different populations and settings, emphasizing its potential utility in educational and therapeutic contexts.
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Affiliation(s)
- Pierluigi Diotaiuti
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, 03043 Cassino, Italy; (G.V.); (S.C.); (B.T.); (T.D.L.); (A.R.); (S.M.)
| | - Giuseppe Valente
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, 03043 Cassino, Italy; (G.V.); (S.C.); (B.T.); (T.D.L.); (A.R.); (S.M.)
| | - Stefano Corrado
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, 03043 Cassino, Italy; (G.V.); (S.C.); (B.T.); (T.D.L.); (A.R.); (S.M.)
| | - Beatrice Tosti
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, 03043 Cassino, Italy; (G.V.); (S.C.); (B.T.); (T.D.L.); (A.R.); (S.M.)
| | - Chiara Carissimo
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy; (C.C.); (G.C.)
| | - Tommaso Di Libero
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, 03043 Cassino, Italy; (G.V.); (S.C.); (B.T.); (T.D.L.); (A.R.); (S.M.)
| | - Gianni Cerro
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy; (C.C.); (G.C.)
| | - Angelo Rodio
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, 03043 Cassino, Italy; (G.V.); (S.C.); (B.T.); (T.D.L.); (A.R.); (S.M.)
| | - Stefania Mancone
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, 03043 Cassino, Italy; (G.V.); (S.C.); (B.T.); (T.D.L.); (A.R.); (S.M.)
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Li Q, Shi M, Steward CJ, Che K, Zhou Y. A Comparison Between Pre-Sleep Heart Rate Variability Biofeedback and Electroencephalographic Biofeedback Training on Sleep in National Level Athletes with Sleep Disturbances. Appl Psychophysiol Biofeedback 2024; 49:115-124. [PMID: 37804409 DOI: 10.1007/s10484-023-09604-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2023] [Indexed: 10/09/2023]
Abstract
The current study compared the effects of heart rate variability biofeedback (HRV-BF) and electroencephalographic biofeedback (EEG-BF) on sleep, mood, and reaction time. Fourteen highly trained male athletes with sleep disturbances participated in this randomised crossover study. Participants took part in HRV-BF and EEG-BF training, with each condition consisting of eight sessions over 15 days. Polysomnography (PSG) and the Pittsburgh sleep quality index (PSQI) were used to assess sleep quality, the profile of mood states (POMS) questionnaire to monitor mood, and reaction time to measure performance pre and post intervention. HRV-BF training improved PSG sleep efficiency (SE) (P = 0.022, d = 0.35, 95% CI 0.01 to 0.16) and subjective sleep duration (P = 0.011, ES = 0.40) when compared to EEG-BF. Only HRV-BF reduced reaction time pre to post biofeedback training (P = 0.020, d = 0.75, 95% CI 0.006 to 0.059). The PSQI showed that both HRV-BF (P = 0.025, ES = 0.31) and EEG-BF (P = 0.003, ES = 0.32) resulted in improved global PSQI scores. Total mood disturbance was also reduced though HRV-BF (P = 0.001, ES = 0.40) and EEG-BF (P = 0.001, ES = 0.30). HRV-BF and EEG-BF enhanced some subjective parameters of sleep and mood. HRV-BF increased PSG SE and subjective sleep duration more than EEG-BF in highly trained athletes with sleep disturbances.
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Affiliation(s)
- Qinlong Li
- Department of Sports Science, Beijing Sport University, Beijing, China
| | - Mingqiang Shi
- Department of Sports Science, Beijing Sport University, Beijing, China
| | | | - Kaixuan Che
- Department of Sports Science, Beijing Sport University, Beijing, China
| | - Yue Zhou
- Department of Sports Science, Beijing Sport University, Beijing, China.
- Department of Exercise Physiology, Beijing Sport University, 48 Xinxi Road, Haidian District, Beijing, 100084, China.
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Chikhi S, Matton N, Sanna M, Blanchet S. Mental strategies and resting state EEG: Effect on high alpha amplitude modulation by neurofeedback in healthy young adults. Biol Psychol 2023; 178:108521. [PMID: 36801435 DOI: 10.1016/j.biopsycho.2023.108521] [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: 08/22/2022] [Revised: 11/30/2022] [Accepted: 02/15/2023] [Indexed: 02/19/2023]
Abstract
Neurofeedback (NFB) is a brain-computer interface which allows individuals to modulate their brain activity. Despite the self-regulatory nature of NFB, the effectiveness of strategies used during NFB training has been little investigated. In a single session of NFB training (6*3 min training blocks) with healthy young participants, we experimentally tested if providing a list of mental strategies (list group, N = 46), compared with a group receiving no strategies (no list group, N = 39), affected participants' neuromodulation ability of high alpha (10-12 Hz) amplitude. We additionally asked participants to verbally report the mental strategies used to enhance high alpha amplitude. The verbatim was then classified in pre-established categories in order to examine the effect of type of mental strategy on high alpha amplitude. First, we found that giving a list to the participants did not promote the ability to neuromodulate high alpha activity. However, our analysis of the specific strategies reported by learners during training blocks revealed that cognitive effort and recalling memories were associated with higher high alpha amplitude. Furthermore, the resting amplitude of trained high alpha frequency predicted an amplitude increase during training, a factor that may optimize inclusion in NFB protocols. The present results also corroborate the interrelation with other frequency bands during NFB training. Although these findings are based on a single NFB session, our study represents a further step towards developing effective protocols for high alpha neuromodulation by NFB.
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Affiliation(s)
- Samy Chikhi
- Université Paris Cité, Laboratoire Mémoire, Cerveau et Cognition, F-92100 Boulogne-Billancourt, France
| | - Nadine Matton
- CLLE, Université de Toulouse, CNRS (UMR 5263), Toulouse, France; ENAC, École Nationale d'Aviation Civile, Université de Toulouse, France
| | - Marie Sanna
- Université Paris Cité, Laboratoire Mémoire, Cerveau et Cognition, F-92100 Boulogne-Billancourt, France
| | - Sophie Blanchet
- Université Paris Cité, Laboratoire Mémoire, Cerveau et Cognition, F-92100 Boulogne-Billancourt, France.
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Nawaz R, Wood G, Nisar H, Yap VV. Exploring the Effects of EEG-Based Alpha Neurofeedback on Working Memory Capacity in Healthy Participants. Bioengineering (Basel) 2023; 10:bioengineering10020200. [PMID: 36829694 PMCID: PMC9952280 DOI: 10.3390/bioengineering10020200] [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: 12/26/2022] [Revised: 01/20/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
Neurofeedback, an operant conditioning neuromodulation technique, uses information from brain activities in real-time via brain-computer interface (BCI) technology. This technique has been utilized to enhance the cognitive abilities, including working memory performance, of human beings. The aims of this study are to investigate how alpha neurofeedback can improve working memory performance in healthy participants and to explore the underlying neural mechanisms in a working memory task before and after neurofeedback. Thirty-six participants divided into the NFT group and the control group participated in this study. This study was not blinded, and both the participants and the researcher were aware of their group assignments. Increasing power in the alpha EEG band was used as a neurofeedback in the eyes-open condition only in the NFT group. The data were collected before and after neurofeedback while they were performing the N-back memory task (N = 1 and N = 2). Both groups showed improvement in their working memory performance. There was an enhancement in the power of their frontal alpha and beta activities with increased working memory load (i.e., 2-back). The experimental group showed improvements in their functional connections between different brain regions at the theta level. This effect was absent in the control group. Furthermore, brain hemispheric lateralization was found during the N-back task, and there were more intra-hemisphere connections than inter-hemisphere connections of the brain. These results suggest that healthy participants can benefit from neurofeedback and from having their brain networks changed after the training.
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Affiliation(s)
- Rab Nawaz
- Department of Electronic Engineering, Faculty of Engineering and Green Technology, Universiti Tunku Abdul Rahman, Kampar 31900, Malaysia
- Biomedical Engineering Research Division, University of Glasgow, Glasgow G12 8QQ, UK
| | - Guilherme Wood
- Department of Psychology, University of Graz, Universitaetsplatz 2/III, 8010 Graz, Austria
- BioTechMed-Graz, 8010 Graz, Austria
| | - Humaira Nisar
- Department of Electronic Engineering, Faculty of Engineering and Green Technology, Universiti Tunku Abdul Rahman, Kampar 31900, Malaysia
- Centre for Healthcare Science and Technology, Universiti Tunku Abdul Rahman, Sungai Long 31900, Malaysia
- Correspondence:
| | - Vooi Voon Yap
- Department of Electronic Engineering, Faculty of Engineering and Green Technology, Universiti Tunku Abdul Rahman, Kampar 31900, Malaysia
- Department of Computer Science, Aberystwyth University, Penglais SY23 3FL, UK
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7
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Uslu S, Vögele C. The more, the better? Learning rate and self-pacing in neurofeedback enhance cognitive performance in healthy adults. Front Hum Neurosci 2023; 17:1077039. [PMID: 36733608 PMCID: PMC9887027 DOI: 10.3389/fnhum.2023.1077039] [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: 10/22/2022] [Accepted: 01/03/2023] [Indexed: 01/18/2023] Open
Abstract
Real time electroencephalogram (EEG) based neurofeedback has been shown to be effective in regulating brain activity, thereby modifying cognitive performance and behavior. Nevertheless, individual variations in neurofeedback learning rates limit the overall efficacy of EEG based neurofeedback. In the present study we investigated the effects of learning rate and control over training realized by self-pacing on cognitive performance and electrocortical activity. Using a double-blind design, we randomly allocated 60 participants to either individual upper alpha (IUA) or sham neurofeedback and subsequently to self- or externally paced training. Participants receiving IUA neurofeedback improved their IUA activity more than participants receiving sham neurofeedback. Furthermore, the learning rate predicted enhancements in resting-state activity and mental rotation ability. The direction of this linear relationship depended on the neurofeedback condition being positive for IUA and negative for sham neurofeedback. Finally, self-paced training increased higher-level cognitive skills more than externally paced training. These results underpin the important role of learning rate in enhancing both resting-state activity and cognitive performance. Our design allowed us to differentiate the effect of learning rate between neurofeedback conditions, and to demonstrate the positive effect of self-paced training on cognitive performance in IUA neurofeedback.
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New treatment strategy for chronic low back pain with alpha wave neurofeedback. Sci Rep 2022; 12:14532. [PMID: 36008457 PMCID: PMC9411546 DOI: 10.1038/s41598-022-18931-0] [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: 06/11/2022] [Accepted: 08/22/2022] [Indexed: 11/16/2022] Open
Abstract
The lifetime prevalence of low back pain is 83%. Since there is a lack of evidence for therapeutic effect by cognitive behavioral therapy (CBT) or physical therapy (PT), it is necessary to develop objective physiological indexes and effective treatments. We conducted a prospective longitudinal study to evaluate the treatment effects of CBT, PT, and neurofeedback training (NFT) during alpha wave NFT. The early-chronic cases within 1 year and late-chronic cases over 1 year after the diagnosis of chronic low back pain were classified into six groups: Controls, CBTs, PTs, NFTs, CBT-NFTs, PT-NFTs. We evaluated the difference in EEG, psychosocial factors, scores of low back pain before/after the intervention. Therapeutic effect was clearly more effective in the early-chronic cases. We found that the intensity of alpha waves increased significantly after therapeutic intervention in the NFT groups, but did not have the main effect of reducing low back pain; the interaction between CBT and NFT reduced low back pain. Factors that enhance therapeutic effect are early intervention, increased alpha waves, and self-efficacy due to parallel implementation of CBT/PT and NFT. A treatment protocol in which alpha wave neurofeedback training is subsidiarily used with CBT or PT should be developed in the future.
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Behzadifard B, Sabaghypour S, Farkhondeh Tale Navi F, Nazari MA. Training the brain to time: the effect of neurofeedback of SMR-Beta1 rhythm on time perception in healthy adults. Exp Brain Res 2022; 240:2027-2038. [PMID: 35576072 DOI: 10.1007/s00221-022-06380-0] [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: 10/19/2021] [Accepted: 04/25/2022] [Indexed: 11/04/2022]
Abstract
The timing ability plays an important role in everyday activities and is influenced by several factors such as the attention and arousal levels of the individuals. The effects of these factors on time perception have been interpreted through psychological models of time, including Attentional Gate Model (AGM). On the other hand, research has indicated that neurofeedback (NFB) training improves attention and increases arousal levels in the clinical and healthy population. Regarding the link between attentional processing and arousal levels and NFB and their relation to time perception, this study is a pilot demonstration of the influence of SMR-Beta1 (12-18 Hz) NFB training on time production and reproduction performance in healthy adults. To this end, 12 (9 female and 3 males; M = 26.3, SD = 3.8) and 12 participants (7 female and 5 males; M = 26.9, SD = 3.1) were randomly assigned into the experimental (with SMR-Beta1 NFB) and control groups (without any NFB training), respectively. The experimental group underwent intensive 10 sessions (3 days a week) of the 12-18 Hz up-training. Time production and reproduction performance were assessed pre and post NFB training for all participants. Three-way mixed ANOVA was carried out on T-corrected scores of reproduction and production tasks. Correlation analysis was also performed between SMR-Beta1 and time perception. While NFB training significantly influenced time production (P < 0.01), no such effect was observed for the time reproduction task. The results of the study are finally discussed within the frameworks of AGM, dual-process and cognitive aspects of time perception. Overall, our results contribute to disentangling the underlying mechanisms of temporal performance in healthy individuals.
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Affiliation(s)
- Behnoush Behzadifard
- Department of Psychology, Kish International Branch, Islamic Azad University, Kish Island, Iran
| | - Saied Sabaghypour
- Department of Cognitive Neuroscience, University of Tabriz, Tabriz, Iran
| | | | - Mohammad Ali Nazari
- Department of Neuroscience, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Hemmat Exp.way, Tehran, Iran.
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The Effect of Alpha Neurofeedback Training on Cognitive Performance in Healthy Adults. MATHEMATICS 2022. [DOI: 10.3390/math10071095] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
This study investigates the effect of long-term alpha neurofeedback training (NFT) in healthy adults using music stimuli. The optimal protocol for future research is presented in this study. The data from 40 healthy participants, divided into two groups (NFT group and Control group), were analyzed in the current study. We found a significantly enhanced alpha rhythm after training in the NFT group which was not observed in the control group. The immediate subsequent effects were greater in more than 80% of the sessions from the initial recordings. Stroop task and behavioral questionnaires, mini-mental state exam (MMSE), and perceived stress scale (PSS) did not reveal any training-specific changes. Within-training session effects were significant from the baseline and were more pronounced at the beginning of the session as compared to the end of the session. It is also observed that a shorter session length with multiple sessions may be more effective than a long and continuous run of a single session.
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Grosselin F, Breton A, Yahia-Cherif L, Wang X, Spinelli G, Hugueville L, Fossati P, Attal Y, Navarro-Sune X, Chavez M, George N. Alpha activity neuromodulation induced by individual alpha-based neurofeedback learning in ecological context: a double-blind randomized study. Sci Rep 2021; 11:18489. [PMID: 34531416 PMCID: PMC8445968 DOI: 10.1038/s41598-021-96893-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 08/06/2021] [Indexed: 02/08/2023] Open
Abstract
The neuromodulation induced by neurofeedback training (NFT) remains a matter of debate. Investigating the modulation of brain activity specifically associated with NF requires controlling for multiple factors, such as reward, performance, congruency between task and targeted brain activity. This can be achieved using sham feedback (FB) control condition, equating all aspects of the experiment but the link between brain activity and FB. We aimed at investigating the modulation of individual alpha EEG activity induced by NFT in a double-blind, randomized, sham-controlled study. Forty-eight healthy participants were assigned to either NF (n = 25) or control (n = 23) group and performed alpha upregulation training (over 12 weeks) with a wearable EEG device. Participants of the NF group received FB based on their individual alpha activity. The control group received the auditory FB of participants of the NF group. An increase of alpha activity across training sessions was observed in the NF group only (p < 0.001). This neuromodulation was selective in that there was no evidence for similar effects in the theta (4-8 Hz) and low beta (13-18 Hz) bands. While alpha upregulation was found in the NF group only, psychological outcome variables showed overall increased feeling of control, decreased anxiety level and increased relaxation feeling, without any significant difference between the NF and the control groups. This is interpreted in terms of learning context and placebo effects. Our results pave the way to self-learnt, NF-based neuromodulation with light-weighted, wearable EEG systems.
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Affiliation(s)
- Fanny Grosselin
- Sorbonne Université, Institut du Cerveau-Paris Brain Institute (ICM), INSERM U 1127, CNRS UMR 7225, Equipe Aramis, 75013, Paris, France.
- myBrain Technologies, 75010, Paris, France.
- INRIA, Aramis Project-Team, 75013, Paris, France.
| | | | - Lydia Yahia-Cherif
- Institut du Cerveau-Paris Brain Institute-ICM, Centre MEG-EEG, Paris, France
- CNRS, UMR 7225, F-75013, Paris, France
- Inserm, U 1127, Paris, France
- Sorbonne Université, Paris, France
| | - Xi Wang
- myBrain Technologies, 75010, Paris, France
| | | | - Laurent Hugueville
- Institut du Cerveau-Paris Brain Institute-ICM, Centre MEG-EEG, Paris, France
- CNRS, UMR 7225, F-75013, Paris, France
- Inserm, U 1127, Paris, France
- Sorbonne Université, Paris, France
| | - Philippe Fossati
- CNRS, UMR 7225, F-75013, Paris, France
- Inserm, U 1127, Paris, France
- Sorbonne Université, Paris, France
- Institut du Cerveau-Paris Brain Institute-ICM, Equipe CIA-Cognitive Control, Interoception, Attention, 75013, Paris, France
- AP-HP, Hôpital Pitié-Salpêtrière, Service de Psychiatrie Adulte, 75013, Paris, France
| | | | | | | | - Nathalie George
- Institut du Cerveau-Paris Brain Institute-ICM, Centre MEG-EEG, Paris, France
- CNRS, UMR 7225, F-75013, Paris, France
- Inserm, U 1127, Paris, France
- Sorbonne Université, Paris, France
- Institut du Cerveau-Paris Brain Institute-ICM, Equipe Experimental Neurosurgery, 75013, Paris, France
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Viviani G, Vallesi A. EEG-neurofeedback and executive function enhancement in healthy adults: A systematic review. Psychophysiology 2021; 58:e13874. [PMID: 34117795 PMCID: PMC8459257 DOI: 10.1111/psyp.13874] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 04/03/2021] [Accepted: 05/17/2021] [Indexed: 01/19/2023]
Abstract
Electroencephalographic (EEG)-neurofeedback training (NFT) is a promising technique that supports individuals in learning to modulate their brain activity to obtain cognitive and behavioral improvements. EEG-NFT is gaining increasing attention for its potential "peak performance" applications on healthy individuals. However, evidence for clear cognitive performance enhancements with healthy adults is still lacking. In particular, whether EEG-NFT represents an effective technique for enhancing healthy adults' executive functions is still controversial. Therefore, the main objective of this systematic review is to assess whether the existing EEG-NFT studies targeting executive functions have provided reliable evidence for NFT effectiveness. To this end, we conducted a qualitative analysis of the literature since the limited number of retrieved studies did not allow us meta-analytical comparisons. Moreover, a second aim was to identify optimal frequencies as NFT targets for specifically improving executive functions. Overall, our systematic review provides promising evidence for NFT effectiveness in boosting healthy adults' executive functions. However, more rigorous NFT studies are required in order to overcome the methodological weaknesses that we encountered in our qualitative analysis.
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Affiliation(s)
- Giada Viviani
- Department of Neuroscience and Padova Neuroscience CenterUniversity of PadovaPadovaItaly
| | - Antonino Vallesi
- Department of Neuroscience and Padova Neuroscience CenterUniversity of PadovaPadovaItaly
- IRCCS San Camillo HospitalVeniceItaly
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Orendáčová M, Kvašňák E. Effects of Transcranial Alternating Current Stimulation and Neurofeedback on Alpha (EEG) Dynamics: A Review. Front Hum Neurosci 2021; 15:628229. [PMID: 34305549 PMCID: PMC8297546 DOI: 10.3389/fnhum.2021.628229] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 06/03/2021] [Indexed: 12/14/2022] Open
Abstract
Transcranial alternating current stimulation (tACS) and neurofeedback (NFB) are two different types of non-invasive neuromodulation techniques, which can modulate brain activity and improve brain functioning. In this review, we compared the current state of knowledge related to the mechanisms of tACS and NFB and their effects on electroencephalogram (EEG) activity (online period/stimulation period) and on aftereffects (offline period/post/stimulation period), including the duration of their persistence and potential behavioral benefits. Since alpha bandwidth has been broadly studied in NFB and in tACS research, the studies of NFB and tACS in modulating alpha bandwidth were selected for comparing the online and offline effects of these two neuromodulation techniques. The factors responsible for variability in the responsiveness of the modulated EEG activity by tACS and NFB were analyzed and compared too. Based on the current literature related to tACS and NFB, it can be concluded that tACS and NFB differ a lot in the mechanisms responsible for their effects on an online EEG activity but they possibly share the common universal mechanisms responsible for the induction of aftereffects in the targeted stimulated EEG band, namely Hebbian and homeostatic plasticity. Many studies of both neuromodulation techniques report the aftereffects connected to the behavioral benefits. The duration of persistence of aftereffects for NFB and tACS is comparable. In relation to the factors influencing responsiveness to tACS and NFB, significantly more types of factors were analyzed in the NFB studies compared to the tACS studies. Several common factors for both tACS and NFB have been already investigated. Based on these outcomes, we propose several new research directions regarding tACS and NFB.
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Affiliation(s)
- Mária Orendáčová
- Department of Medical Biophysics and Medical Informatics, Third Faculty of Medicine, Charles University in Prague, Prague, Czechia
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Israsena P, Jirayucharoensak S, Hemrungrojn S, Pan-Ngum S. Brain Exercising Games With Consumer-Grade Single-Channel Electroencephalogram Neurofeedback: Pre-Post Intervention Study. JMIR Serious Games 2021; 9:e26872. [PMID: 34128816 PMCID: PMC8277357 DOI: 10.2196/26872] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 03/27/2021] [Accepted: 04/17/2021] [Indexed: 01/19/2023] Open
Abstract
Background The aging population is one of the major challenges affecting societies worldwide. As the proportion of older people grows dramatically, so does the number of age-related illnesses such as dementia-related illnesses. Preventive care should be emphasized as an effective tool to combat and manage this situation. Objective The aim of this pilot project was to study the benefits of using neurofeedback-based brain training games for enhancing cognitive performance in the elderly population. In particular, aiming for practicality, the training games were designed to operate with a low-cost consumer-grade single-channel electroencephalogram (EEG) headset that should make the service scalable and more accessible for wider adoption such as for home use. Methods Our training system, which consisted of five brain exercise games using neurofeedback, was serviced at 5 hospitals in Thailand. Participants were screened for cognitive levels using the Thai Mental State Examination and Montreal Cognitive Assessment. Those who passed the criteria were further assessed with the Cambridge Neuropsychological Test Automated Battery (CANTAB) computerized cognitive assessment battery. The physiological state of the brain was also assessed using 16-channel EEG. After 20 sessions of training, cognitive performance and EEG were assessed again to compare pretraining and posttraining results. Results Thirty-five participants completed the training. CANTAB results showed positive and significant effects in the visual memory (delayed matching to sample [percent correct] P=.04), attention (median latency P=.009), and visual recognition (spatial working memory [between errors] P=.03) domains. EEG also showed improvement in upper alpha activity in a resting state (open-eyed) measured from the occipital area (P=.04), which similarly indicated improvement in the cognitive domain (attention). Conclusions Outcomes of this study show the potential use of practical neurofeedback-based training games for brain exercise to enhance cognitive performance in the elderly population.
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Affiliation(s)
- Pasin Israsena
- National Electronics and Computer Technology Center, National Science and Technology Development Agency, Pathumthani, Thailand
| | - Suwicha Jirayucharoensak
- National Electronics and Computer Technology Center, National Science and Technology Development Agency, Pathumthani, Thailand
| | - Solaphat Hemrungrojn
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Cognitive Fitness Research Center, Chulalongkorn University, Bangkok, Thailand
| | - Setha Pan-Ngum
- Department of Computer Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand
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Musical Auditory Alpha Wave Neurofeedback: Validation and Cognitive Perspectives. Appl Psychophysiol Biofeedback 2021; 46:323-334. [PMID: 33929674 PMCID: PMC8553721 DOI: 10.1007/s10484-021-09507-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2021] [Indexed: 12/01/2022]
Abstract
Neurofeedback through visual, auditory, or tactile sensations improves cognitive functions and alters the activities of daily living. However, some people, such as children and the elderly, have difficulty concentrating on neurofeedback for a long time. Constant stressless neurofeedback for a long time may be achieved with auditory neurofeedback using music. The primary purpose of this study was to clarify whether music-based auditory neurofeedback increases the power of the alpha wave in healthy subjects. During neurofeedback, white noise was superimposed on classical music, with the noise level inversely correlating with normalized alpha wave power. This was a single-blind, randomized control crossover trial in which 10 healthy subjects underwent, in an assigned order, normal and random feedback (NF and RF), either of which was at least 4 weeks long. Cognitive functions were evaluated before, between, and after each neurofeedback period. The secondary purpose was to assess neurofeedback-induced changes in cognitive functions. A crossover analysis showed that normalized alpha-power was significantly higher in NF than in RF; therefore, music-based auditory neurofeedback facilitated alpha wave induction. A composite category-based analysis of cognitive functions revealed greater improvements in short-term memory in subjects whose alpha-power increased in response to NF. The present study employed a long period of auditory alpha neurofeedback and achieved successful alpha wave induction and subsequent improvements in cognitive functions. Although this was a pilot study that validated a music-based alpha neurofeedback system for healthy subjects, the results obtained are encouraging for those with difficulty in concentrating on conventional alpha neurofeedback. Trial registration: 2018077NI, date of registration: 2018/11/27
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Yeh WH, Hsueh JJ, Shaw FZ. Neurofeedback of Alpha Activity on Memory in Healthy Participants: A Systematic Review and Meta-Analysis. Front Hum Neurosci 2021; 14:562360. [PMID: 33469422 PMCID: PMC7813983 DOI: 10.3389/fnhum.2020.562360] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 12/04/2020] [Indexed: 11/30/2022] Open
Abstract
Background: Neurofeedback training (NFT) has recently been proposed as a valuable technique for cognitive enhancement and psychiatric amelioration. However, effect of NFT of alpha activity on memory is controversial. The current study analyzed previous works in terms of randomized and blinded analyses, training paradigms, and participant characteristics to validate the efficacy of alpha NFT on memory in a healthy population. Objectives: A systematic meta-analysis of studies with randomized controlled trials was performed to explore the effect of alpha NFT on working memory (WM) and episodic memory (EM) in a healthy population. Methods: We searched PubMed, Embase, and Cochrane Library from January 1, 1999, to November 30, 2019. Previous studies were evaluated with the Cochrane risk of bias (RoB). A meta-analysis calculating absolute weighted standardized mean difference (SMD) using random-effects models was employed. Heterogeneity was estimated using I 2 statistics. Funnel plots and Egger's test were performed to evaluate the quality of evidence. Results: Sixteen studies with 217 healthy participants in the control group and 210 participants in the alpha group met the eligibility criteria. Alpha NFT studies with WM measures presented little publication bias (P = 0.116), and 5 of 7 domains in the Cochrane RoB exhibited a low risk of bias. The overall effect size from 14 WM studies was 0.56 (95% CI 0.31-0.81, P < 0.0001; I 2 = 28%). Six EM studies exhibited an effect size of 0.77 (95% CI 0.06-1.49, P = 0.03; I 2 = 77%). Conclusion: Meta-analysis results suggest that alpha NFT seems to have a positive effect on the WM and EM of healthy participants. Future efforts should focus on the neurophysiological mechanisms of alpha NFT in memory.
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Affiliation(s)
- Wen-Hsiu Yeh
- Institute of Basic Medical Science, National Cheng Kung University, Tainan, Taiwan
| | - Jen-Jui Hsueh
- Mind Research and Imaging Center, National Cheng Kung University, Tainan, Taiwan
| | - Fu-Zen Shaw
- Institute of Basic Medical Science, National Cheng Kung University, Tainan, Taiwan
- Mind Research and Imaging Center, National Cheng Kung University, Tainan, Taiwan
- Department of Psychology, National Cheng Kung University, Tainan, Taiwan
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Pino O. A randomized controlled trial (RCT) to explore the effect of audio-visual entrainment among psychological disorders. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021408. [PMID: 35075067 PMCID: PMC8823583 DOI: 10.23750/abm.v92i6.12089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 07/31/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIM Although many mental disorders have relevant proud in neurobiological dysfunctions, most intervention approaches neglect neurophysiological features or use pharmacological intervention alone. Non-invasive Brain-Computer Interfaces (BCIs), providing natural ways of modulating mood states, can be promoted as an alternative intervention to cope with neurobiological dysfunction. METHODS A BCI prototype was proposed to feedback a person's affective state such that a closed-loop interaction between the participant's brain responses and the musical stimuli is established. It feedbacks in real-time flickering lights matching with the individual's brain rhythms undergo to auditory stimuli. A RCT was carried out on 15 individuals of both genders (mean age = 49.27 years) with anxiety and depressive spectrum disorders randomly assigned to 2 groups (experimental vs. active control). RESULTS Outcome measures revealed either a significant decrease in Hamilton Rating Scale for Depression (HAM-D) scores and gains in cognitive functions only for participants who undergone to the experimental treatment. Variability in HAM-D scores seems explained by the changes in beta 1, beta 2 and delta bands. Conversely, the rise in cognitive function scores appear associated with theta variations. CONCLUSIONS Future work needs to validate the relationship proposed here between music and brain responses. Findings of the present study provided support to a range of research examining BCI brain modulation and contributes to the understanding of this technique as instruments to alternative therapies We believe that Neuro-Upper can be used as an effective new tool for investigating affective responses, and emotion regulation (www.actabiomedica.it).
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Affiliation(s)
- Olimpia Pino
- University of Parma, Department of Medicine & Surgery, Neuroscience Unit.
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Le TP, Lucas HD, Schwartz EK, Mitchell KR, Cohen AS. Frontal alpha asymmetry in schizotypy: electrophysiological evidence for motivational dysfunction. Cogn Neuropsychiatry 2020; 25:371-386. [PMID: 32873177 DOI: 10.1080/13546805.2020.1813096] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Introduction: Schizotypy is defined as personality traits reflecting an underlying risk for schizophrenia-spectrum disorders. As yet, there is a dearth of suitable objective markers for measuring schizotypy. Frontal alpha asymmetry, characterised by reduced left versus right frontal region activity, reflects trait-like diminished approach-related systems and has been found in schizophrenia. Methods: The present study used electroencephalography (EEG) recorded on a consumer-grade mobile headset to examine asymmetric resting-state frontal alpha, beta, and gamma power within the multidimensional schizotypy (e.g. positive, negative, disorganised) during a three-minute "eyes closed" resting period in college undergraduates (n=49). Results: Findings suggest that schizotypy was exclusively related to reduced left versus right-lateralised power in the alpha frequency (8.1-12.9 Hz., R2= .16). Follow-up analysis suggested that positive schizotypy was uniquely associated with increased right alpha activity, indicating increased withdrawal motivation. Conclusions: Frontal asymmetry is a possible ecologically valid objective marker for schizotypy that may be detectable using easily accessible, consumer-grade technology.
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Affiliation(s)
- Thanh P Le
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Heather D Lucas
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Elana K Schwartz
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Kyle R Mitchell
- Desert Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), La Jolla, CA, USA
| | - Alex S Cohen
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
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