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Böttcher A, Wilken S, Adelhöfer N, Raab M, Hoffmann S, Beste C. A dissociable functional relevance of theta- and beta-band activities during complex sensorimotor integration. Cereb Cortex 2023:7180375. [PMID: 37246154 DOI: 10.1093/cercor/bhad191] [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: 03/28/2023] [Revised: 05/12/2023] [Accepted: 05/14/2023] [Indexed: 05/30/2023] Open
Abstract
Sensorimotor integration processes play a central role in daily life and require that different sources of sensory information become integrated: i.e. the information related to the object being under control of the agent (i.e. indicator) and the information about the goal of acting. Yet, how this is accomplished on a neurophysiological level is contentious. We focus on the role of theta- and beta-band activities and examine which neuroanatomical structures are involved. Healthy participants (n = 41) performed 3 consecutive pursuit-tracking EEG experiments in which the source of visual information available for tracking was varied (i.e. that of the indicator and the goal of acting). The initial specification of indicator dynamics is determined through beta-band activity in parietal cortices. When information about the goal was not accessible, but operating the indicator was required nevertheless, this incurred increased theta-band activity in the superior frontal cortex, signaling a higher need for control. Later, theta- and beta-band activities encode distinct information within the ventral processing stream: Theta-band activity is affected by the indicator information, while beta-band activity is affected by the information about the action goal. Complex sensorimotor integration is realized through a cascade of theta- and beta-band activities in a ventral-stream-parieto-frontal network.
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Affiliation(s)
- Adriana Böttcher
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
- Faculty of Medicine, University Neuropsychology Center, TU Dresden, Dresden, Germany
| | - Saskia Wilken
- General Psychology: Judgment, Decision Making, & Action, Institute of Psychology, University of Hagen, Hagen, Germany
| | - Nico Adelhöfer
- Donders Institute of Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Markus Raab
- Performance Psychology, Institute of Psychology, German Sport University Cologne, Cologne, Germany
- School of Applied Sciences, London South Bank University, London, United Kingdom
| | - Sven Hoffmann
- General Psychology: Judgment, Decision Making, & Action, Institute of Psychology, University of Hagen, Hagen, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
- Faculty of Medicine, University Neuropsychology Center, TU Dresden, Dresden, Germany
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2
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Wu MK, Satogami K, Liang CS, Stubbs B, Carvalho AF, Brunoni AR, Su KP, Tu YK, Wu YC, Chen TY, Li DJ, Lin PY, Hsu CW, Chen YW, Suen MW, Zeng BY, Takahashi S, Tseng PT, Li CT. Multiple comparison of different noninvasive brain stimulation and pharmacologic interventions in patients with methamphetamine use disorders: A network meta-analysis of randomized controlled trials. Psychiatry Clin Neurosci 2022; 76:633-643. [PMID: 35876620 DOI: 10.1111/pcn.13452] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 07/04/2022] [Accepted: 07/18/2022] [Indexed: 11/30/2022]
Abstract
AIM In recent decades, the prevalence of amphetamine and methamphetamine use disorders has at least doubled in some regions/countries, with accompanying high risks of drug overdose-associated mortality. Noninvasive brain stimulation (NIBS) methods may be effective treatments. However, the comparative efficacy of the NIBS protocol for amphetamine/methamphetamine use disorder (AUD/MUD) remains unknown to date. The aim of this network meta-analysis (NMA) was to compare the efficacy and acceptability of various NIBS methods/protocols for AUD/MUD management. METHODS A frequentist model-based NMA was conducted. We included randomized controlled trials (RCTs) that investigated the efficacy of NIBS and guideline-recommended pharmacologic treatments to reduce craving severity in patients with either AUD or MUD. RESULTS Twenty-two RCTs including 1888 participants met the eligibility criteria. Compared with the sham/placebo group (study = 19, subjects = 891), a combination of intermittent theta burst stimulation over the left dorsolateral prefrontal cortex (DLPFC) and continuous TBS over the left ventromedial prefrontal cortex (study = 1, subjects = 19) was associated with the largest decreases in craving severity [standardized mean difference (SMD) = -1.50; 95% confidence intervals (95%CIs) = -2.70 to -0.31]. High-frequency repetitive transcranial magnetic stimulation over the left DLPFC was associated with the largest improvements in depression and quality of sleep (study = 3, subjects = 86) (SMD = -2.48; 95%CIs = -3.25 to -1.71 and SMD = -2.43; 95%CIs = -3.38 to -1.48, respectively). The drop-out rate of most investigated treatments did not significantly differ between groups. CONCLUSION The combined TBS protocol over the prefrontal cortex was associated with the greatest improvement in craving severity. Since few studies were available for inclusion, additional large-scale randomized controlled trials are warranted.
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Affiliation(s)
- Ming-Kung Wu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Kazumi Satogami
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan
| | - Chih-Sung Liang
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK
| | - Andre F Carvalho
- Innovation in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Andre R Brunoni
- Service of Interdisciplinary Neuromodulation, National Institute of Biomarkers in Psychiatry, Laboratory of Neurosciences (LIM-27), Departamento e Instituto de Psiquiatria, Faculdade de Medicina da University of Sao Paulo, Sao Paulo, Brazil.,Departamento de Ciências Médicas, Faculdade de Medicina da University of Sao Paulo, Sao Paulo, Brazil
| | - Kuan-Pin Su
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Department of Psychiatry and Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan.,An-Nan Hospital, China Medical University, Tainan, Taiwan
| | - Yu-Kang Tu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.,Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Cheng Wu
- Department of Sports Medicine, Landseed International Hospital, Taoyuan, Taiwan
| | - Tien-Yu Chen
- Department of Psychiatry, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Dian-Jeng Li
- Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan
| | - Pao-Yen Lin
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chih-Wei Hsu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yen-Wen Chen
- Prospect Clinic for Otorhinolaryngology and Neurology, Kaohsiung, Taiwan
| | - Mein-Woei Suen
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan.,Gender Equality Education and Research Center, Asia University, Taichung, Taiwan.,Department of Medical Research, Asia University Hospital, Asia University, Taichung, Taiwan.,Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Bing-Yan Zeng
- Department of Internal Medicine, E-Da Dachang Hospital, Kaohsiung, Taiwan.,Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Shun Takahashi
- Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan.,Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan.,Graduate School of Rehabilitation Science, Osaka Metropolitan University, Habikino, Japan.,Clinical Research and Education Center, Asakayama General Hospital, Sakai, Japan
| | - Ping-Tao Tseng
- Prospect Clinic for Otorhinolaryngology and Neurology, Kaohsiung, Taiwan.,Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan.,Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Institute of Brain Science and Brain Research Center, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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3
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The Effects of Different Theta and Beta Neurofeedback Training Protocols on Cognitive Control in ADHD. JOURNAL OF COGNITIVE ENHANCEMENT 2022; 6:463-477. [PMID: 36373033 PMCID: PMC9638270 DOI: 10.1007/s41465-022-00255-6] [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: 05/31/2021] [Accepted: 10/20/2022] [Indexed: 11/06/2022]
Abstract
Neurofeedback (NF) is an important treatment for attention deficit/hyperactivity disorder (ADHD). In ADHD, cognitive control deficits pose considerable problems to patients. However, NF protocols are not yet optimized to enhance cognitive control alongside with clinical symptoms, partly because they are not driven by basic cognitive neuroscience. In this study, we evaluated different EEG theta and/or beta frequency band NF protocols designed to enhance cognitive control. Participants were n = 157 children and adolescents, n = 129 of them were patients with ADHD (n = 28 typically developing (TD) controls). Patients with ADHD were divided into five groups in the order of referral, with four of them taking part in different NF protocols systematically varying theta and beta power. The fifth ADHD group and the TD group did not undergo NF. All NF protocols resulted in reductions of ADHD symptoms. Importantly, only when beta frequencies were enhanced during NF (without any theta regulation or in combination with theta upregulation), consistent enhancing effects in both response inhibition and conflict control were achieved. The theta/beta NF protocol most widely used in clinical settings revealed comparatively limited effects. Enhancements in beta band activity are key when aiming to improve cognitive control functions in ADHD. This calls for a change in the use of theta/beta NF protocols and shows that protocols differing from the current clinical standard are effective in enhancing important facets of cognitive control in ADHD. Further studies need to examine regulation data within the neurofeedback sessions to provide more information about the mechanisms underlying the observed effects.
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Hasslinger J, Meregalli M, Bölte S. How standardized are “standard protocols”? Variations in protocol and performance evaluation for slow cortical potential neurofeedback: A systematic review. Front Hum Neurosci 2022; 16:887504. [PMID: 36118975 PMCID: PMC9478392 DOI: 10.3389/fnhum.2022.887504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 07/26/2022] [Indexed: 11/16/2022] Open
Abstract
Neurofeedback (NF) aims to alter neural activity by enhancing self-regulation skills. Over the past decade NF has received considerable attention as a potential intervention option for many somatic and mental conditions and ADHD in particular. However, placebo-controlled trials have demonstrated insufficient superiority of NF compared to treatment as usual and sham conditions. It has been argued that the reason for limited NF effects may be attributable to participants' challenges to self-regulate the targeted neural activity. Still, there is support of NF efficacy when only considering so-called “standard protocols,” such as Slow Cortical Potential NF training (SCP-NF). This PROSPERO registered systematic review following PRISMA criteria searched literature databases for studies applying SCP-NF protocols. Our review focus concerned the operationalization of self-regulatory success, and protocol-details that could influence the evaluation of self-regulation. Such details included; electrode placement, number of trials, length per trial, proportions of training modalities, handling of artifacts and skill-transfer into daily-life. We identified a total of 63 eligible reports published in the year 2000 or later. SCP-NF protocol-details varied considerably on most variables, except for electrode placement. However, due to the increased availability of commercial systems, there was a trend to more uniform protocol-details. Although, token-systems are popular in SCP-NF for ADHD, only half reported a performance-based component. Also, transfer exercises have become a staple part of SCP-NF. Furthermore, multiple operationalizations of regulatory success were identified, limiting comparability between studies, and perhaps usefulness of so-called transfer-exercises, which purpose is to facilitate the transfer of the self-regulatory skills into every-day life. While studies utilizing SCP as Brain-Computer-Interface mainly focused on the acquisition of successful self-regulation, clinically oriented studies often neglected this. Congruently, rates of successful regulators in clinical studies were mostly low (<50%). The relation between SCP self-regulation and behavior, and how symptoms in different disorders are affected, is complex and not fully understood. Future studies need to report self-regulation based on standardized measures, in order to facilitate both comparability and understanding of the effects on symptoms. When applied as treatment, future SCP-NF studies also need to put greater emphasis on the acquisition of self-regulation (before evaluating symptom outcomes).
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Affiliation(s)
- John Hasslinger
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet & Stockholm Healthcare Services, Region Stockholm, Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Healthcare Services, Region Stockholm, Stockholm, Sweden
- *Correspondence: John Hasslinger
| | - Micaela Meregalli
- Child and Adolescent Psychiatry, Stockholm Healthcare Services, Region Stockholm, Stockholm, Sweden
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet & Stockholm Healthcare Services, Region Stockholm, Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Healthcare Services, Region Stockholm, Stockholm, Sweden
- Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, Perth, WA, Australia
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5
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Wendiggensen P, Adelhöfer N, Jamous R, Mückschel M, Takacs A, Frings C, Münchau A, Beste C. Processing of embedded response plans is modulated by an interplay of fronto-parietal theta and beta activity. J Neurophysiol 2022; 128:543-555. [PMID: 35894437 DOI: 10.1152/jn.00537.2021] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Even simple actions like opening a door require integration/binding and flexible re-activation of different motor elements. Yet, the neural mechanisms underlying the processing of such 'embedded response plans' are largely elusive, despite theoretical frameworks, such as the Theory of Event Coding, describing the involved cognitive processes. In a sample of N = 40 healthy participants we combine time-frequency decomposition and various beamforming methods to examine neurophysiological dynamics of such action plans - with special emphasis on the interplay of theta and beta frequency activity during the processing of these plans. We show that the integration and rule-guided reactivation of embedded response plans is modulated by a complex interplay of theta and beta activity. Pre-trial BBA is related to different functional neuroanatomical structures which are activated in a consecutive fashion. Enhanced preparatory activity is positively associated with higher binding-related BBA in the precuneus/parietal areas, indicating that activity in the precuneus/parietal cortex facilitates the execution of an embedded action sequence. Increased preparation subsequently leads to reduced working memory retrieval demands. A cascading pattern of interactions between pre-trial and within-trial activity indicates the importance of preparatory brain activity. The study shows that there are multiple roles of beta and theta oscillations associated with different functional neuroanatomical structures during the integration and reactivation of motor elements during actions.
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Affiliation(s)
- Paul Wendiggensen
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany.,University Neuropsychology Center, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Nico Adelhöfer
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany.,University Neuropsychology Center, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Roula Jamous
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany.,University Neuropsychology Center, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Moritz Mückschel
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany.,University Neuropsychology Center, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Adam Takacs
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany.,University Neuropsychology Center, Faculty of Medicine, TU Dresden, Dresden, Germany
| | | | - Alexander Münchau
- Institute of Systems Motor Science, University of Lübeck, Lübeck, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany.,University Neuropsychology Center, Faculty of Medicine, TU Dresden, Dresden, Germany
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6
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Effects of Resistance Training on Skin Temperature and Its Relationship with Central Nervous System (CNS) Activation. Healthcare (Basel) 2022; 10:healthcare10020207. [PMID: 35206822 PMCID: PMC8871941 DOI: 10.3390/healthcare10020207] [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: 11/30/2021] [Revised: 01/07/2022] [Accepted: 01/19/2022] [Indexed: 11/30/2022] Open
Abstract
The aim of this work was to relate the activation of the sympathetic and parasympathetic nervous systems with the skin temperature (Tsk) of the lower limbs after a resistance training exercise. Under controlled conditions, the average Tsk in the areas of the anterior and posterior thighs, knees and legs was obtained with a thermal imager and the parasympathetic and sympathetic activation was registered with an Omegawave® device on 20 healthy and trained male volunteers (25.39 ± 8.21 years) before exercise, immediately after standard resistance training (3 exercises (2 quadriceps + 1 hamstrings) × 4 sets × 10 repetitions (70% 1RM), 90-sec recovery) and after 20 min of recovery. The results showed a significant effect of exercise and recovery on Tsk in all regions of interest (ROIs) considered (p < 0.05) and strong inverse relationships between sympathetic and parasympathetic activation values. Significant results were found for the total variation of Tsk (p < 0.05) with highly positive values for subjects with lower sympathetic activation and almost null or even negative values for those with higher sympathetic activation. Sympathetic activity was a significant predictor of total Tsk variation in the anterior thigh, posterior thigh and anterior knee but not in the posterior knee, anterior leg, and posterior leg. Baseline Tsk was a significant predictor of total Tsk variation the all ROIs except in the posterior knee. Tsk measured by thermography could be used to estimate the level of participation of muscle areas in exercise and registering the level of sympathetic activation before exercise could be interesting in predicting the athlete’s physiological response to strength training.
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A randomized-controlled neurofeedback trial in adult attention-deficit/hyperactivity disorder. Sci Rep 2021; 11:16873. [PMID: 34413344 PMCID: PMC8376871 DOI: 10.1038/s41598-021-95928-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 07/29/2021] [Indexed: 02/07/2023] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a childhood onset disorder persisting into adulthood for a large proportion of cases. Neurofeedback (NF) has shown promising results in children with ADHD, but randomized controlled trials in adults with ADHD are scarce. We aimed to compare slow cortical potential (SCP)- and functional near-infrared spectroscopy (fNIRS) NF to a semi-active electromyography biofeedback (EMG-BF) control condition regarding changes in symptoms and the impact of learning success, as well as changes in neurophysiological parameters in an adult ADHD population. Patients were randomly assigned to SCP-NF (n = 26), fNIRS-NF (n = 21) or EMG-BF (n = 20). Outcome parameters were assessed over 30 training sessions (pre, intermediate, post) and at 6-months follow-up (FU) including 3 booster sessions. EEG was recorded during two auditory Go/NoGo paradigms assessing the P300 and contingent negative variation (CNV). fNIRS measurements were conducted during an n-back- as well as a Go/NoGo task. All three groups showed equally significant symptom improvements suggesting placebo- or non-specific effects on the primary outcome measure. Only when differentiating between learners and non-learners, fNIRS learners displayed stronger reduction of ADHD global scores compared to SCP non-learners at FU, and fNIRS learners showed specifically low impulsivity ratings. 30.8% in the SCP-NF and 61.9% of participants in the fNIRS-NF learned to regulate the respective NF target parameter. We conclude that some adults with ADHD learn to regulate SCP amplitudes and especially prefrontal hemodynamic activity during NF. We did not find any significant differences in outcome between groups when looking at the whole sample. When evaluating learners only, they demonstrate superior effects as compared to non-learners, which suggests specific effects in addition to non-specific effects of NF when learning occurs.
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8
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van Son D, van der Does W, Band GPH, Putman P. EEG Theta/Beta Ratio Neurofeedback Training in Healthy Females. Appl Psychophysiol Biofeedback 2021; 45:195-210. [PMID: 32458282 PMCID: PMC7391399 DOI: 10.1007/s10484-020-09472-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
A growing number of studies suggest that EEG theta/beta ratio (TBR) is inversely related to executive cognitive control. Neurofeedback training aimed at reducing TBR (TBR NFT) might provide a tool to study causality in this relation and might enhance human performance. To investigate whether TBR NFT reduces TBR in healthy participants. Twelve healthy female participants were assigned (single blind) to one of three groups. Groups differed on baseline durations and one group received only sham NFT. TBR NFT consisted of eight or fourteen 25-min sessions. No evidence was found that TBR NFT had any effect on TBR. The current TBR NFT protocol is possibly ineffective. This is in line with a previous study with a different protocol.
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Affiliation(s)
- Dana van Son
- Institute of Psychology, Leiden University, Leiden, The Netherlands. .,Leiden Institute for Brain and Cognition, Leiden, The Netherlands.
| | - Willem van der Does
- Institute of Psychology, Leiden University, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Guido P H Band
- Institute of Psychology, Leiden University, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Peter Putman
- Institute of Psychology, Leiden University, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden, The Netherlands
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9
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Jensen M, Hüttenrauch E, Schmidt J, Andersson G, Chavanon ML, Weise C. Neurofeedback for tinnitus: study protocol for a randomised controlled trial assessing the specificity of an alpha/delta neurofeedback training protocol in alleviating both sound perception and psychological distress in a cohort of chronic tinnitus sufferers. Trials 2020; 21:382. [PMID: 32370767 PMCID: PMC7201543 DOI: 10.1186/s13063-020-04309-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 04/02/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Tinnitus is a particularly common condition and can have debilitating psychological consequences for certain people. Although several interventions have been helpful in teaching individuals to better cope with tinnitus, no cure exists at present. Neurofeedback is an emerging treatment modality in tinnitus. Previous studies, utilising an alpha/delta training protocol, have shown promise. However, they were characterised by small sample sizes and a lack of neurofeedback control conditions. Therefore, the aim of this study is to investigate whether an alpha/delta neurofeedback training protocol, compared to beta/theta neurofeedback or a diary control group, is effective in reducing not only the tinnitus sound perception but also the psychological symptoms associated with the condition. METHODS The study is designed as a three-armed randomised controlled trial. Participants are randomly assigned to a) an established neurofeedback protocol for tinnitus (alpha/delta training), b) an active control group (beta/theta training) or c) a diary control group. In the 4-week intervention period, participants in both neurofeedback groups undergo 10 sessions, whereas participants in the diary control group complete a bi-weekly diary. The primary outcomes are between group differences in tinnitus sound perception change, as measured with the Tinnitus Magnitude Index (TMI), and changes in tinnitus distress, measured with the Tinnitus Handicap Inventory (THI), 4 weeks after the start of the intervention. Secondary outcome measures include changes in tinnitus distress, sleep quality, depressive symptoms and whether neurofeedback leads to specific power changes in the trained frequency bands. DISCUSSION This is the first randomised controlled trial examining the efficacy of an alpha/delta neurofeedback training protocol in reducing tinnitus sound perception and the distress associated with the condition. Compared to former studies, the present study is designed to assess both the specificity of an alpha/delta neurofeedback training protocol by including an active comparator and beta/theta neurofeedback training, in addition to controlling for placebo effects by the inclusion of a diary control group. This study aims to contribute to an understanding of the influences of both specific and non-specific effects in neurofeedback treatment for tinnitus. TRIAL REGISTRATION ClinicalTrials.gov: NCT03550430. Registered on 27 May 2018.
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Affiliation(s)
- Martin Jensen
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps University Marburg, Gutenbergstrasse 18, 35032, Marburg, Germany.
| | - Eva Hüttenrauch
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps University Marburg, Gutenbergstrasse 18, 35032, Marburg, Germany
| | - Jennifer Schmidt
- HSD Hochschule Döpfer, University of Applied Sciences, Waidmarkt 3 und 9, DE-50676, Köln, Germany
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.,Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Mira-Lynn Chavanon
- Department of Psychology, Clinical Child and Adolescent Psychology, Philipps University Marburg, Marburg, Germany
| | - Cornelia Weise
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps University Marburg, Gutenbergstrasse 18, 35032, Marburg, Germany
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10
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Bluschke A, Schreiter ML, Friedrich J, Adelhöfer N, Roessner V, Beste C. Neurofeedback trains a superordinate system relevant for seemingly opposing behavioral control deficits depending on ADHD subtype. Dev Sci 2020; 23:e12956. [PMID: 32107844 DOI: 10.1111/desc.12956] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 09/30/2019] [Accepted: 02/19/2020] [Indexed: 11/29/2022]
Abstract
ADHD is one of the most prevalent neuropsychiatric disorders of childhood, but symptoms vary considerably between individuals. Therefore, different ADHD subtypes can be distinguished. Yet, it is widely elusive whether the specific subtype is critical to consider when examining treatment effects. Based on theoretical considerations, this could be the case for EEG theta/beta neurofeedback. We examine the effects of such an intervention on rapid response execution and inhibition processes using a Go/Nogo task in the inattentive (ADD) and the combined (ADHD-C) subtype. We show that a single neurofeedback protocol affects opposing deficits depending on the ADHD subtype - namely the execution (in ADD) and inhibition of action (in ADHD-C). No changes occurred in the healthy controls. These findings are discussed in relation to overarching principles of neural oscillations, particularly in the beta frequency band. The data suggest that theta/beta neurofeedback trains a superordinate system strongly related to the function of neural beta frequency oscillations to tune neural networks important for the sampling of sensory information used for behavioral control.
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Affiliation(s)
- Annet Bluschke
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden, Dresden, Germany
| | - Marie L Schreiter
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden, Dresden, Germany
| | - Julia Friedrich
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden, Dresden, Germany
| | - Nico Adelhöfer
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden, Dresden, Germany
| | - Veit Roessner
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden, Dresden, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden, Dresden, Germany
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Hepsomali P, Hadwin JA, Liversedge SP, Degno F, Garner M. The impact of cognitive load on processing efficiency and performance effectiveness in anxiety: evidence from event-related potentials and pupillary responses. Exp Brain Res 2019; 237:897-909. [DOI: 10.1007/s00221-018-05466-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Accepted: 12/23/2018] [Indexed: 10/27/2022]
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12
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Attention modulation during motor preparation in Parkinsonian freezers: A time–frequency EEG study. Clin Neurophysiol 2016; 127:3506-3515. [DOI: 10.1016/j.clinph.2016.09.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 09/02/2016] [Accepted: 09/06/2016] [Indexed: 11/19/2022]
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13
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Bhayee S, Tomaszewski P, Lee DH, Moffat G, Pino L, Moreno S, Farb NAS. Attentional and affective consequences of technology supported mindfulness training: a randomised, active control, efficacy trial. BMC Psychol 2016; 4:60. [PMID: 27894358 PMCID: PMC5127005 DOI: 10.1186/s40359-016-0168-6] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 11/22/2016] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Mindfulness training (MT) programs represent an approach to attention training with well-validated mental health benefits. However, research supporting MT efficacy is based predominantly on weekly-meeting, facilitator-led, group-intervention formats. It is unknown whether participants might benefit from neurofeedback-assisted, technology-supported MT (N-tsMT), in which meditation is delivered individually, without the need for a facilitator, travel to a training site, or the presence of a supportive group environment. Mirroring the validation of group MT interventions, the first step in addressing this question requires identifying whether N-tsMT promotes measurable benefits. Here, we report on an initial investigation of a commercial N-tsMT system. METHODS In a randomized, active control trial, community-dwelling healthy adult participants carried out 6 weeks of daily practice, receiving either N-tsMT (n = 13), or a control condition of daily online math training (n = 13). Training effects were assessed on target measures of attention and well-being. Participants also completed daily post-training surveys assessing effects on mood, body awareness, calm, effort, and stress. RESULTS Analysis revealed training effects specific to N-tsMT, with attentional improvements in overall reaction time on a Stroop task, and well-being improvements via reduced somatic symptoms on the Brief Symptom Inventory. Attention and well-being improvements were correlated, and effects were greatest for the most neurotic participants. However, secondary, exploratory measures of attention and well-being did not show training-specific effects. N-tsMT was associated with greater body awareness and calm, and initially greater effort that later converged with effort in the control condition. CONCLUSIONS Preliminary findings indicate that N-tsMT promotes modest benefits for attention and subjective well-being in a healthy community sample relative to an active control condition. However, the findings would benefit from replication in a larger sample, and more intensive practice or more comprehensive MT instruction might be required to promote the broader benefits typically reported in group format, facilitated MT. TRIAL REGISTRATION Current Controlled Trials ISRCTN43629398 . Retrospectively registered on June 16, 2016.
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Affiliation(s)
- Sheffy Bhayee
- Department of Psychology, University of Toronto Mississauga, 3359 Mississauga Rd., Mississauga, ON L5L 1C6 Canada
| | - Patricia Tomaszewski
- Department of Psychology, University of Toronto Mississauga, 3359 Mississauga Rd., Mississauga, ON L5L 1C6 Canada
| | | | | | | | | | - Norman A. S. Farb
- Department of Psychology, University of Toronto Mississauga, 3359 Mississauga Rd., Mississauga, ON L5L 1C6 Canada
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15
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Baumeister S, Wolf I, Holz N, Boecker-Schlier R, Adamo N, Holtmann M, Ruf M, Banaschewski T, Hohmann S, Brandeis D. Neurofeedback Training Effects on Inhibitory Brain Activation in ADHD: A Matter of Learning? Neuroscience 2016; 378:89-99. [PMID: 27659116 DOI: 10.1016/j.neuroscience.2016.09.025] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 08/31/2016] [Accepted: 09/12/2016] [Indexed: 12/01/2022]
Abstract
Neurofeedback training (NF) is a promising non-pharmacological treatment for ADHD that has been associated with improvement of attention-deficit/hyperactivity disorder (ADHD)-related symptoms as well as changes in electrophysiological measures. However, the functional localization of neural changes following NF compared to an active control condition, and of successful learning during training (considered to be the critical mechanism for improvement), remains largely unstudied. Children with ADHD (N=16, mean age: 11.81, SD: 1.47) were randomly assigned to either slow cortical potential (SCP, n=8) based NF or biofeedback control training (electromyogram feedback, n=8) and performed a combined Flanker/NoGo task pre- and post-training. Effects of NF, compared to the active control, and of learning in transfer trials (approximating successful transfer to everyday life) were examined with respect to clinical outcome and functional magnetic resonance imaging (fMRI) changes during inhibitory control. After 20 sessions of training, children in the NF group presented reduced ADHD symptoms and increased activation in areas associated with inhibitory control compared to baseline. Subjects who were successful learners (n=9) also showed increased activation in an extensive inhibitory network irrespective of the type of training. Activation increased in an extensive inhibitory network following NF training, and following successful learning through NF and control biofeedback. Although this study was only powered to detect large effects and clearly requires replication in larger samples, the results suggest a crucial role for learning effects in biofeedback trainings.
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Affiliation(s)
- Sarah Baumeister
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Isabella Wolf
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany; Department Neuroimaging, Central Institute of Mental Health Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Nathalie Holz
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Regina Boecker-Schlier
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Nicoletta Adamo
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Martin Holtmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany; LWL-University Hospital for Child and Adolescent Psychiatry Hamm, Ruhr-University Bochum, Bochum, Germany
| | - Matthias Ruf
- Department Neuroimaging, Central Institute of Mental Health Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany; Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland; Neuroscience Centre Zurich, University and ETH Zurich, Zurich, Switzerland.
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16
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Zhigalov A, Kaplan A, Palva JM. Modulation of critical brain dynamics using closed-loop neurofeedback stimulation. Clin Neurophysiol 2016; 127:2882-2889. [DOI: 10.1016/j.clinph.2016.04.028] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 04/05/2016] [Accepted: 04/30/2016] [Indexed: 11/16/2022]
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Dimitriadis SI, Linden D. Modulation of brain criticality via suppression of EEG long-range temporal correlations (LRTCs) in a closed-loop neurofeedback stimulation. Clin Neurophysiol 2016; 127:2878-2881. [PMID: 27323657 DOI: 10.1016/j.clinph.2016.05.359] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 05/28/2016] [Indexed: 12/29/2022]
Affiliation(s)
- Stavros I Dimitriadis
- Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, CF24 4HQ, UK; Cardiff University Brain Research Imaging Center (CUBRIC), School of Psychology, Cardiff University, Cardiff, CF24 4HQ, UK; Artificial Intelligence and Information Analysis Laboratory, Department of Informatics, Aristotle University, 54124 Thessaloniki, Greece; NeuroInformatics Group, AUTH, Thessaloniki, Greece.
| | - David Linden
- Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, CF24 4HQ, UK; Cardiff University Brain Research Imaging Center (CUBRIC), School of Psychology, Cardiff University, Cardiff, CF24 4HQ, UK
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18
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Bluschke A, Roessner V, Beste C. Editorial Perspective: How to optimise frequency band neurofeedback for ADHD. J Child Psychol Psychiatry 2016; 57:457-61. [PMID: 26968314 DOI: 10.1111/jcpp.12521] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/01/2015] [Indexed: 11/28/2022]
Abstract
Attention deficit/hyperactivity disorder (ADHD) is one of the most prevalent paediatric neuropsychiatric disorders and is characterised by hyperactivity, inattention and increased impulsivity. Children with ADHD are often also characterised by deficits in a variety of cognitive domains, including problems in working memory, a generally slower and more variable style of information processing and deficits in temporal processing, inhibitory functions and delay processing. Overarching executive functions like information updating, response inhibition and mental set shifting are also impaired in many, but not all, children with ADHD, demonstrating the neuropsychological heterogeneity characterising this disorder. Deficits in executive functions can persist into adulthood and have a substantial negative impact on everyday life. A variety of approaches are commonly considered for the treatment of ADHD (including pharmacological interventions, patient-centred cognitive-behavioural therapy approaches and specific teacher/parent training programmes). More recently, adding to this multimodal treatment approach, neurofeedback has grown in popularity as an intervention option for patients with ADHD. This article considers this intervention approach and the opportunities for optimising treatment for executive control dysfunctions in ADHD using theta/beta neurofeedback.
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Affiliation(s)
- Annet Bluschke
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Veit Roessner
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
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19
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Neurofeedback of slow cortical potentials as a treatment for adults with Attention Deficit-/Hyperactivity Disorder. Clin Neurophysiol 2016; 127:1374-1386. [DOI: 10.1016/j.clinph.2015.11.013] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 11/16/2015] [Accepted: 11/17/2015] [Indexed: 11/21/2022]
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20
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Nan W, Wan F, Vai MI, Da Rosa AC. Resting and Initial Beta Amplitudes Predict Learning Ability in Beta/Theta Ratio Neurofeedback Training in Healthy Young Adults. Front Hum Neurosci 2015; 9:677. [PMID: 26732846 PMCID: PMC4685657 DOI: 10.3389/fnhum.2015.00677] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 11/30/2015] [Indexed: 12/31/2022] Open
Abstract
Neurofeedback (NF) training has been proved beneficial in cognitive and behavioral performance improvement in healthy individuals. Unfortunately, the NF learning ability shows large individual difference and in a number of NF studies there are even some non-learners who cannot successfully self-regulate their brain activity by NF. This study aimed to find out the neurophysiological predictor of the learning ability in up-regulating beta-1 (15-18 Hz)/theta (4-7 Hz) ratio (BTR) training in healthy young adults. Eighteen volunteers finished five training sessions in successive 5 days. We found that low beta (12-15 Hz) amplitude in a 1-min eyes-open resting baseline measured before training and the beta-1 amplitude in the first training block with 4.5-min duration could predict the BTR learning ability across sessions. The results provide a low cost, convenient and easy way to predict the learning ability in up-regulating BTR training, and would be helpful in avoiding potential frustration and adjusting training protocol for the participants with poor learning ability.
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Affiliation(s)
- Wenya Nan
- Department of Electrical and Computer Engineering, Faculty of Science and Technology, University of Macau Macau, China
| | - Feng Wan
- Department of Electrical and Computer Engineering, Faculty of Science and Technology, University of Macau Macau, China
| | - Mang I Vai
- Department of Electrical and Computer Engineering, Faculty of Science and Technology, University of Macau Macau, China
| | - Agostinho C Da Rosa
- Department of Bio Engineering, Instituto Superior Tecnico and Systems and Robotics Institute, University of Lisbon Lisbon, Portugal
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21
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Arns M, Heinrich H, Ros T, Rothenberger A, Strehl U. Editorial: Neurofeedback in ADHD. Front Hum Neurosci 2015; 9:602. [PMID: 26578942 PMCID: PMC4626559 DOI: 10.3389/fnhum.2015.00602] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 10/18/2015] [Indexed: 11/13/2022] Open
Affiliation(s)
- Martijn Arns
- Research Institute Brainclinics Nijmegen, Netherlands ; Department of Experimental Psychology, Utrecht University Utrecht, Netherlands
| | - Hartmut Heinrich
- Department of Child and Adolescent Mental Health, University Hospital of Erlangen Erlangen, Germany ; kbo-Heckscher-Klinikum München, Germany
| | - Tomas Ros
- Laboratory for Neurology and Imaging of Cognition, Department of Neurosciences, University of Geneva Geneva, Switzerland
| | - Aribert Rothenberger
- Child and Adolescent Psychiatry, University Medical Center Göttingen Göttingen, Germany
| | - Ute Strehl
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tuebingen Tuebingen, Germany
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22
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Mayer K, Wyckoff SN, Fallgatter AJ, Ehlis AC, Strehl U. Neurofeedback as a nonpharmacological treatment for adults with attention-deficit/hyperactivity disorder (ADHD): study protocol for a randomized controlled trial. Trials 2015; 16:174. [PMID: 25928870 PMCID: PMC4433028 DOI: 10.1186/s13063-015-0683-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 03/26/2015] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Neurofeedback has been applied effectively in various areas, especially in the treatment of children with attention-deficit/hyperactivity disorder (ADHD). This study protocol is designed to investigate the effect of slow cortical potential (SCP) feedback and a new form of neurofeedback using near-infrared spectroscopy (NIRS) on symptomatology and neurophysiological parameters in an adult ADHD population. A comparison of SCP and NIRS feedback therapy methods has not been previously conducted and may yield valuable findings about alternative treatments for adult ADHD. METHODS/DESIGN The outcome of both neurofeedback techniques will be assessed over 30 treatment sessions and after a 6-month follow-up period, and then will be compared to a nonspecific biofeedback treatment. Furthermore, to investigate if treatment effects in this proof-of-principle study can be predicted by specific neurophysiological baseline parameters, regression models will be applied. Finally, a comparison with healthy controls will be conducted to evaluate deviant pretraining neurophysiological parameters, stability of assessment measures, and treatment outcome. DISCUSSION To date, an investigation and comparison of SCP and NIRS feedback training to an active control has not been conducted; therefore, we hope to gain valuable insights in effects and differences of these types of treatment for ADHD in adults. TRIAL REGISTRATION This study is registered with the German Registry of Clinical Trials: DRKS00006767 , date of registration: 8 October 2014.
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Affiliation(s)
- Kerstin Mayer
- Institute for Medical Psychology and Behavioral Neurobiology, University of Tübingen, Silcherstrasse 5, 72076, Tübingen, Germany.
| | - Sarah Nicole Wyckoff
- Institute for Medical Psychology and Behavioral Neurobiology, University of Tübingen, Silcherstrasse 5, 72076, Tübingen, Germany.
- Sense Labs, Mesa, AZ, 1918 N. Higley Rd, 85205, Mesa, AZ, USA.
| | - Andreas J Fallgatter
- Department for Psychiatry and Psychotherapy, University of Tübingen, Osianderstr. 24, 72076, Tübingen, Germany.
- LEAD Graduate School, University of Tübingen, 72074, Tübingen, Germany.
- CIN Excellence Cluster, University of Tübingen, 72076, Tübingen, Germany.
| | - Ann-Christine Ehlis
- Department for Psychiatry and Psychotherapy, University of Tübingen, Osianderstr. 24, 72076, Tübingen, Germany.
| | - Ute Strehl
- Institute for Medical Psychology and Behavioral Neurobiology, University of Tübingen, Silcherstrasse 5, 72076, Tübingen, Germany.
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23
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Zuberer A, Brandeis D, Drechsler R. Are treatment effects of neurofeedback training in children with ADHD related to the successful regulation of brain activity? A review on the learning of regulation of brain activity and a contribution to the discussion on specificity. Front Hum Neurosci 2015; 9:135. [PMID: 25870550 PMCID: PMC4376076 DOI: 10.3389/fnhum.2015.00135] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 02/27/2015] [Indexed: 11/17/2022] Open
Abstract
While issues of efficacy and specificity are crucial for the future of neurofeedback training, there may be alternative designs and control analyses to circumvent the methodological and ethical problems associated with double-blind placebo studies. Surprisingly, most NF studies do not report the most immediate result of their NF training, i.e., whether or not children with ADHD gain control over their brain activity during the training sessions. For the investigation of specificity, however, it seems essential to analyze the learning and adaptation processes that take place in the course of the training and to relate improvements in self-regulated brain activity across training sessions to behavioral, neuropsychological and electrophysiological outcomes. To this aim, a review of studies on neurofeedback training with ADHD patients which include the analysis of learning across training sessions or relate training performance to outcome is presented. Methods on how to evaluate and quantify learning of EEG regulation over time are discussed. “Non-learning” has been reported in a small number of ADHD-studies, but has not been a focus of general methodological discussion so far. For this reason, selected results from the brain-computer interface (BCI) research on the so-called “brain-computer illiteracy”, the inability to gain control over one’s brain activity, are also included. It is concluded that in the discussion on specificity, more attention should be devoted to the analysis of EEG regulation performance in the course of the training and its impact on clinical outcome. It is necessary to improve the knowledge on characteristic cross-session and within-session learning trajectories in ADHD and to provide the best conditions for learning.
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Affiliation(s)
- Agnieszka Zuberer
- Department of Child and Adolescent Psychiatry, University of Zurich Zurich, Switzerland
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry, University of Zurich Zurich, Switzerland ; Neuroscience Center Zurich, University of Zurich and ETH Zurich Zurich, Switzerland ; Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/ Heidelberg University Mannheim, Germany ; Center for Integrative Human Physiology, University of Zurich Zurich, Switzerland
| | - Renate Drechsler
- Department of Child and Adolescent Psychiatry, University of Zurich Zurich, Switzerland
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24
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Enriquez-Geppert S, Huster RJ, Figge C, Herrmann CS. Self-regulation of frontal-midline theta facilitates memory updating and mental set shifting. Front Behav Neurosci 2014; 8:420. [PMID: 25538585 PMCID: PMC4257088 DOI: 10.3389/fnbeh.2014.00420] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 11/17/2014] [Indexed: 11/13/2022] Open
Abstract
Frontal-midline (fm) theta oscillations as measured via the electroencephalogram (EEG) have been suggested as neural "working language" of executive functioning. Their power has been shown to increase when cognitive processing or task performance is enhanced. Thus, the question arises whether learning to increase fm-theta amplitudes would functionally impact the behavioral performance in tasks probing executive functions (EFs). Here, the effects of neurofeedback (NF), a learning method to self-up-regulate fm-theta over fm electrodes, on the four most representative EFs, memory updating, set shifting, conflict monitoring, and motor inhibition are presented. Before beginning and after completing an individualized, eight-session gap-spaced NF intervention, the three-back, letter/number task-switching, Stroop, and stop-signal tasks were tested while measuring the EEG. Self-determined up-regulation of fm-theta and its putative role for executive functioning were compared to an active control group, the so-called pseudo-neurofeedback group. Task-related fm-theta activity after training differed significantly between groups. More importantly, though, after NF significantly enhanced behavioral performance was observed. The training group showed higher accuracy scores in the three-back task and reduced mixing and shifting costs in letter/number task-switching. However, this specific protocol type did not affect performance in tasks probing conflict monitoring and motor inhibition. Thus, our results suggest a modulation of proactive but not reactive mechanisms of cognitive control. Furthermore, task-related EEG changes show a distinct pattern for fm-theta after training between the NF and the pseudo-neurofeedback group, which indicates that NF training indeed tackles EFs-networks. In sum, the modulation of fm-theta via NF may serve as potent treatment approach for executive dysfunctions.
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Affiliation(s)
- Stefanie Enriquez-Geppert
- Experimental Psychology Laboratory, Department of Psychology, European Medical School, Carl von Ossietzky University of Oldenburg Oldenburg, Germany ; Karl-Jaspers Clinic, European Medical School Oldenburg-Groningen Oldenburg, Germany
| | - René J Huster
- Experimental Psychology Laboratory, Department of Psychology, European Medical School, Carl von Ossietzky University of Oldenburg Oldenburg, Germany ; Research Center Neurosensory Science, Carl von Ossietzky University Oldenburg, Germany
| | - Christian Figge
- Karl-Jaspers Clinic, European Medical School Oldenburg-Groningen Oldenburg, Germany
| | - Christoph S Herrmann
- Experimental Psychology Laboratory, Department of Psychology, European Medical School, Carl von Ossietzky University of Oldenburg Oldenburg, Germany ; Research Center Neurosensory Science, Carl von Ossietzky University Oldenburg, Germany ; Center for Excellence 'Hearing4all', Carl von Ossietzky University of Oldenburg Oldenburg, Germany
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25
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Bilder RM, Knudsen KS. Creative cognition and systems biology on the edge of chaos. Front Psychol 2014; 5:1104. [PMID: 25324809 PMCID: PMC4179729 DOI: 10.3389/fpsyg.2014.01104] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Accepted: 09/11/2014] [Indexed: 11/13/2022] Open
Affiliation(s)
- Robert M Bilder
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, University of California, Los Angeles Los Angeles, CA, USA ; Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles Los Angeles, CA, USA ; Department of Psychology, University of California Los Angeles Los Angeles, CA, USA
| | - Kendra S Knudsen
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles Los Angeles, CA, USA
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