Electroencephalographic Biofeedback Research Articles

Psychological interventions for the self-regulated enhancement of music performance: A systematic review

Psychological interventions to enhance musicians’ self-regulation are increasingly being recognized as essential for supporting them in their development and optimization of performance skills. The aim of this review was to provide a synthesis of such interventions and examine their effects on expert-rated music performance quality. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) protocol, we initially identified 3,182 articles, of which we selected 89 studies. Using the theoretical framework of self-regulated learning, we present a comprehensive overview of experimental, quasi-experimental, and single-case studies published until April 2022 that tested how musicians can improve their performance through self-regulation strategies such as goal setting, imagery, attention focusing, relaxation, and self-evaluation. The results show mixed evidence with mostly positive or non-significant effects, indicating that expressive writing, external focus, feedback, combined electromyographic (EMG) and electroencephalographic (EEG) biofeedback, and imagery combined with physical practice can increase expert-rated music performance quality. The reported methodological quality, the applied performance task and evaluation, and potential mechanisms underlying the interventions should be considered when interpreting the results. We critically discuss possible improvements for future studies, as well as practical implications.

Efficacy of behavior modification training combined with electroencephalographic biofeedback therapy for attention deficit hyperactivity disorder in children: a randomized controlled trial.

Attention deficit hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in children. Multiple treatments are currently available with varying effectiveness, and our aim was to investigate the efficacy of behavior modification training combined with Electroencephalography (EEG) biofeedback treatment on ADHD in children. Children with ADHD were randomly divided into a control group (n = 42), an EEG biofeedback group (n = 30) and a behavior modification training combined with EEG biofeedback group (i.e., a combined intervention group) (n = 30) according to the intervention. Swanson, Nolan, and Pelham, Version IV (SNAP-IV) and Conners Parent Symptom Questionnaire (PSQ) were assessed before and after three months of treatment. We found that in the EEG biofeedback group and the combined intervention group, the scores of all factors except "anxiety" and "psychosomatic disorder" were lower than before treatment, and the difference was statistically significant (P < 0.05). After treatment, the scores of the three groups were compared. The scores of "impulsivity-hyperactivity", "learning problems", "inattention factor" and "hyperactivity factor" were all lower than before, and the difference was statistically significant (P < 0.05). In the post-treatment comprehensive intervention group and the control group, the efficacy was apparent, and the differences in the scores of each factor were statistically significant (P < 0.05). In the comparison between the EEG biofeedback group and the control group, except for "anxiety", "psychosomatic disorder" and "conduct problem" the scores of each factor were statistically significant (P < 0.05). For the comparison between the integrated intervention group and the EEG biofeedback group, the scores of all factors before and after treatment were statistically significant (P < 0.05), except for "anxiety", "impulsivity-hyperactivity" and the scores of all the factors before and after treatment were statistically significant (P < 0.05), except for "anxiety", "impulsivity-hyperactivity" and "psychosomatic disorder". The comprehensive efficacy of behavior modification training combined with EEG biofeedback therapy on the improvement of symptoms in children with ADHD is positive, and good compliance is worthy of clinical promotion. https://www.chictr.org.cn/indexEN.html, identifier (ChiCTR2300071511).

Effects of Virtual Reality-Based Relaxation Techniques on Psychological, Physiological, and Biochemical Stress Indicators.

Various relaxation techniques could benefit from merging with virtual reality (VR) technologies, as these technologies are easily applicable, involving, and user-friendly. To date, it is unclear which relaxation technique using biofeedback combined with VR technology is the most effective. The study aimed to compare the effectiveness of brief VR-based biofeedback-assisted relaxation techniques including electroencephalographic biofeedback, mindfulness-based biofeedback, galvanic skin response biofeedback, and respiratory biofeedback. Forty-three healthy volunteers (age 34.7 ± 7.2 years), comprising 28 (65%) women and 15 (35%) men, were enrolled in the study. All the participants were exposed to four distinct relaxation sessions according to a computer-generated random sequence. The efficacy of relaxation methods was evaluated by examining psychological, physiological, and biochemical stress indicators. All VR-based relaxation techniques reduced salivary steroid hormone (i.e., cortisol, cortisone, and total glucocorticoid) levels and increased galvanic skin response values. Similarly, all interventions led to a significantly reduced subjectively perceived psychological strain level. Three out of the four interventions (i.e., electroencephalographic, respiratory, and galvanic skin response-based biofeedback relaxation sessions) resulted in a decreased self-reported fatigue level. We suggest that newly developed VR-based relaxations techniques are potential tools for stress reduction and might be particularly suitable for individuals who are not capable of adhering to a strict and time-consuming stress management intervention schedule.

Multimodal intervention improves core symptoms in preschool children with attention-deficit/hyperactivity disorder

I tested the effect of a psychobehavioral intervention combined with electroencephalographic (EEG) biofeedback on the core symptoms of preschool children with attention-deficit/hyperactivity disorder (ADHD). Participants were 42 preschool children with attention-deficit, hyperactive-impulsive, or compound-type ADHD. They were randomly divided into the control group, a psychobehavioral intervention group, an EEG biofeedback intervention group, or a psychobehavioral + EEG biofeedback intervention group (i. e., comprehensive). After 4 months of intervention, I assessed (a) attention concentration time and (b) impulsivity and hyperactivity scores using Conners Parent Symptom Questionnaire. Results show that the multimodal intervention significantly improved participants' concentration time and behavioral hyperactive-impulsive symptoms. The multimodal (vs. single-modal) intervention was more effective in improving core symptoms. My results provide a reference for related research and practical application.

Dynamics of clinical and neurological changes in patients with acute ischemic stroke in an open clinical study.

Background: Studies of treatment methods for patients with acute ischaemic stroke should include aetiological causes, concomitant pathology, and localisation of the lesion, and the extent of the lesion in the brain. The purpose of the study was to determine changes in clinical and neurological parameters in patients with ischaemic stroke in the acute period. Methods: This is an open clinical study for which 240 patients were selected with an acute condition after an ischaemic stroke. All patients were divided into 4 groups (depending on the treatment). Clinical neurological examination and testing was performed upon admission to the hospital and upon discharge– after treatment. Electroencephalographic biofeedback (EEG-BFB) therapy was performed using a EEG-BSE device (Bio-Link). Data was processed according to the statistical method of experimental data assessment. Results: To study the effectiveness of treatment upon acute ischaemic stroke, a comprehensive treatment system was developed, involving acupuncture, Qigong breathing exercises, and electroencephalographic biological feedback (EEG-BIOFEEDBACK), based mainly on the mechanisms of action. The study investigated the features of the acupuncture treatment in patients with ischaemic stroke during recovery. The authors noted the degree of effectiveness of EEG-BFB therapy, Qigong therapy, acupuncture, and standard treatment. Studies revealed that the development of ischaemic stroke begins gradually and at an early age. Conclusion: It was concluded that the most effective method for treating the clinical and neurological manifestations of acute ischaemic stroke is EEG-BFB therapy, followed by acupuncture, Qigong therapy, and standard treatment.

Double-Blind Placebo-Controlled Randomized Clinical Trial of Neurofeedback for Attention-Deficit/Hyperactivity Disorder With 13-Month Follow-up

To determine whether theta/beta-ratio (TBR) electroencephalographic biofeedback (neurofeedback [NF]) has a specific effect on attention-deficit/hyperactivity disorder (ADHD) beyond nonspecific benefit. In a 2-site double-blind randomized clinical trial, 144 children aged 7 to 10 years with rigorously diagnosed moderate/severe ADHD and theta/beta-ratio (TBR)≥4.5 were randomized 3:2 to deliberate TBR downtraining versus a control of equal duration, intensity, and appearance. Two early dropouts left 142 children for modified intent-to-treat analysis. The control used prerecorded electroencephalograms with the participant's artifacts superimposed. Treatment was programmed via Internet by an off-site statistician-guided co-investigator. Fidelity was 98.7% by trainers/therapists and 93.2% by NF expert monitor. The primary outcome was parent- and teacher-rated inattention; analysis was mixed-effects regression. Because the expense and effort of NF can be justified only by enduring benefit, follow-ups were integrated. Blinding was excellent. Although both groups showed significant improvement (p< .001, d= 1.5) in parent/teacher-rated inattention from baseline to treatment end and 13-month follow-up, NF was not significantly superior to the control condition at either time point on this primary outcome (d= 0.01, p= .965 at treatment end; d= 0.23, p= .412 at 13-month follow-up). Responders (Clinical Global Impression-Improvement [CGI-I]= 1-2) were 61% of NF and 54% of controls (p= .36). Adverse events were distributed proportionally between treatments. The 13-month follow-up found nonsignificant improvement from treatment end for NF (d= 0.1), with mild deterioration for controls (d=-0.07). NF required significantly less medication at follow-up (p= .012). This study does not support a specific effect of deliberate TBR NF at either treatment end or 13-month follow-up. Participants will be reassessed at 25-month follow-up. Double-Blind 2-Site Randomized Clinical Trial of Neurofeedback for ADHD; https://clinicaltrials.gov/; NCT02251743.

Application of electroencephalographic (EEG) biofeedback therapy in the rehabilitation of patients with chronic diseases

Schizophrenia is one of the chronic mental disorders characterized by disturbances in thought, emotion, language, perception, and behavior. There is no cure for this disease, and most of the current treatments are palliative. In this study, we aimed to analyze the application of electroencephalographic (EEG) biofeedback therapy, an adjunctive treatment used for many psychiatric disorders, in the rehabilitation of schizophrenic patients.Schizophrenic patients were selected as the experimental subjects, and the initial diagnosis criteria were set accordingly. A primary and a secondary efficacy index was then developed for the evaluation of EEG biofeedback therapy rather than traditional drug treatment. Lastly, the effects of the two methods were compared. The findings indicate that traditional drugs could be used in the treatment of mild schizophrenia, but showed poor results for severe and moderate schizophrenia. EEG biofeedback therapy was effective for the treatment of various degrees of schizophrenia and improved patients’ sleep quality and anxiety. These findings have significant practical implications for the rehabilitation of schizophrenic patients and patients with chronic diseases in general.

Clinical effect of electroencephalographic biofeedback therapy in treatment of memory disorders in patients with acute severe toxic encephalopathy

Objective: To investigate the clinical effect and safety of electroencephalographic biofeedback therapy in improving memory disorders in patientsin the recovery stage of acute severe toxic encephalopathy. Methods: A total of 52 patients in the recovery stage of acute severe toxic encephalopathy who were hospitalized in our hospital from March 2013 to December 2016 were enrolled and randomly divided into observation group with 27 patients and control group with 25 patients. Both groups were given the drugs to promote the metabolism of brain cells,and the patients in the observation group were given electroencephalographic biofeedback therapy in addition. The Chinese revised version of Wechsler Memory Scale Type A was used to measure memory ability before and after each course of treatment. The treatment outcome was evaluated for both groups. Results: There were no significant differences in the scores of long-term memory,short-term memory, immediate memory, and memory quotient between the two groups before treatment(P>0.05).After the first course of treatment ended, the observation group had significant increases in the scores of forward task,backward task,association,and memory quotient(P<0.05); compared with the control group, the observation group had a significant reduction in the score of backward task(P<0.05).After the second course of treatmentended, the observation group had significant increases in the scores offorward task,backward task,memorization of pictures,reproduction,association,comprehension,and memory quotient,and the control group had significant increases in the scores of reproduction,association,comprehension,and memory quotient(P<0.05); compared with the control group, the observation group had significant increases in the scores of forward task,backward task,memorization of pictures, reproduction, association, comprehension, and memory quotient(P<0.05).Two patients experiencedchest distress, palpitation, and dysphoria during treatment, which did not affect the treatment. Conclusion: Electroencephalographic biofeedback therapy has a certain effect in the treatment of memory disorders in patients with acute severe toxic encephalopathy.

A cybernetic theory for EEG biofeedback

PurposeThe purpose of this paper is to present a theory that applies Miller et al.’s (1960) Test-Operate-Test-Exit (TOTE) concept to the psychophysiology involved in electroencephalographic (EEG) biofeedback (BFB).Design/methodology/approachSix components are presented, namely, the teleological brain, attractors as the “test” in TOTEs, EEG production, positive and negative feedback, synaptogenesis and designated actor, and then integrated into a theoretical structure. Comparisons with the previous conceptualizations are discussed, and finally, suggestions for practical application and needed research are offered.FindingsPrevious theories neglected significant variables and promoted unverified conceptualizations. These issues are redressed with a psychophysiological, cybernetic theory.Research limitations/implicationsThe pursuit of substantive research needed to verify the theory would improve the scientific foundations for EEG BFB.Practical implicationsThis theory shifts the designated actor in BFB to the participant’s brain, away from the BFB provider. EEG BFB is thus viewed as a means for neuronominalization driven by the brain’s attractor systems instead of as an intrusive intervention.Social implicationsThe theory proposes a much more participant-centric process than previous modes, which also promotes self-determination. The research validation needed for the theory could produce wider EEG BFB acceptance and application.Originality/valueThe theory is a complete departure from previous conceptualizations. It is the first instance of TOTE application to psychophysiological processes, and it is the first fully cybernetic conceptualization of EEG BFB.

Bio/neurofeedback

Biofeedback (BF) techniques were developed by psychology in the 1960s having then a long history in which they have proved their usefulness and therapeutic efficacy in a considerable variety of clinical disorders: neurologic, neuromuscular, cardiovascular, gastrointestinal, chronic pain, dermatological, sleep, respiratory, trauma and stress, among many other disorders. Practical applications of the BF include in particular Electroencephalographic Biofeedback (BF-EEG), known as Neurofeedback (NF), whose importance and clinical applications have grown and continue to grow rapidly thanks to the significant development in the fields of neuroscience and computer science on which NF rests. This paper describes and analyzes the technique and process of BF and NF, apart from their methodological foundations but, above all, from a critical point of view, the paper examines their main clinical applications together with the level of utility and therapeutic effectiveness currently achieved.

Neurotherapy As a Catalyst in the Treatment of Fatigue in Breast Cancer Survivorship

Pharmacologic and non-pharmacologic treatments for cancer-related fatigue (CRF) have produced mixed and often disappointing results. Treatment using the Flexyx Neurotherapy System (FNS), a novel variant of electroencephalograph biofeedback that involves minutely pulsed electromagnetic (EM) stimulation of brainwave functioning, was explored to determine utility for alleviating CRF in a 45-year-old woman who had debilitating fatigue with onset during chemotherapy for stage II infiltrating right breast cancer, who had been free of signs of disease for over five years, and who had been struggling to increase her activity level and engage in regular exercise without benefit. FNS was administered in 10 weekly sessions. Alleviation of fatigue and other potentially interrelated symptoms (cognitive clouding, sleep disturbance, pain, and negative mood/emotions) and overall greater activity level was sustained at six-month follow-up. Very low energy EM brainwave stimulation therapies such as FNS may contribute to an enlivening of drive to engage in greater energized activity.

Non-pharmacological interventions for people with epilepsy and intellectual disabilities.

Approximately 30% of patients with epilepsy remain refractory to drug treatment and continue to experience seizures whilst taking one or more antiepileptic drugs (AEDs). Several non-pharmacological interventions that may be used in conjunction with or as an alternative to AEDs are available for refractory patients. In view of the fact that seizures in people with intellectual disabilities are often complex and refractory to pharmacological interventions, it is evident that good quality randomised controlled trials (RCTs) are needed to assess the efficacy of alternatives or adjuncts to pharmacological interventions.This is an updated version of the original Cochrane review (Beavis 2007) published in The Cochrane Library (2007, Issue 4). To assess data derived from randomised controlled trials of non-pharmacological interventions for people with epilepsy and intellectual disabilities.Non-pharmacological interventions include, but are not limited to, the following.• Surgical procedures.• Specialised diets, for example, the ketogenic diet, or vitamin and folic acid supplementation.• Psychological interventions for patients or for patients and carers/parents, for example, cognitive-behavioural therapy (CBT), electroencephalographic (EEG) biofeedback and educational intervention.• Yoga.• Acupuncture.• Relaxation therapy (e.g. music therapy). For the latest update of this review, we searched the Cochrane Epilepsy Group Specialised Register (19 August 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) via CRSO (19 August 2014), MEDLINE (Ovid, 1946 to 19 August 2014) and PsycINFO (EBSCOhost, 1887 to 19 August 2014). Randomised controlled trials of non-pharmacological interventions for people with epilepsy and intellectual disabilities. Two review authors independently applied the inclusion criteria and extracted study data. One study is included in this review. When two surgical procedures were compared, results indicated that corpus callosotomy with anterior temporal lobectomy was more effective than anterior temporal lobectomy alone in improving quality of life and performance on IQ tests among people with epilepsy and intellectual disabilities. No evidence was found to support superior benefit in seizure control for either intervention. This is the only study of its kind and was rated as having an overall unclear risk of bias. The previous update (December 2010) identified one RCT in progress. The study authors have confirmed that they are aiming to publish by the end of 2015; therefore this study (Bjurulf 2008) has not been included in the current review. This review highlights the need for well-designed randomised controlled trials conducted to assess the effects of non-pharmacological interventions on seizure and behavioural outcomes in people with intellectual disabilities and epilepsy.

Systematic review of interventions for fatigue after traumatic brain injury: a NIDRR traumatic brain injury model systems study.

To conduct a systematic review of the evidence on interventions for posttraumatic brain injury fatigue (PTBIF). Systematic searches of multiple databases for peer-reviewed studies published in English on interventions targeting PTBIF as a primary or secondary outcome through January 22, 2014. Reference sections were also reviewed to identify additional articles. Articles were rated using the 2011 American Academy of Neurology Classification of Evidence Scheme for therapeutic studies. The searches yielded 1526 articles. Nineteen articles met all inclusion criteria: 4 class I, 1 class II/III, 10 class III, and 4 class IV. Only 5 articles examined fatigue as a primary outcome. Interventions were pharmacological and psychological or involved physical activity, bright blue light, electroencephalographic biofeedback, or electrical stimulation. Only 2 interventions (modafinil and cognitive behavioral therapy with fatigue management) were evaluated in more than 1 study. Despite areas of promise, there is insufficient evidence to recommend or contraindicate any treatments of PTBIF. Modafinil is not likely to be effective for PTBIF. Piracetam may reduce it, as may bright blue light. Cognitive behavioral therapy deserves additional study. High-quality research incorporating appropriate definition and measurement of fatigue is required to explore the potential benefits of promising interventions, evaluate fatigue treatments shown to be effective in other populations, and develop new interventions for PTBIF.

Relaxation for perimenopausal and postmenopausal symptoms.

Since the time of publication of the Women's Health Initiative (WHI) study, menopausal symptom management has become more complex because of increased awareness of the risks associated with hormone replacement therapy (HRT). Currently, a wide range of management options is available. Some women take prescription drugs, and others use self care strategies, including lifestyle modifications, over-the-counter preparations and complementary and alternative therapies, such as herbal preparations, exercise programmes and relaxation techniques. Relaxation techniques consist of a group of behavioural interventions. They are considered relatively harmless, but their effectiveness in treating vasomotor symptoms and sleep disturbances remains debatable. To determine the effectiveness of relaxation techniques as treatment for vasomotor symptoms and associated sleep disturbances in perimenopausal and postmenopausal women. Searches of the following electronic bibliographic databases were performed in February 2014 to identify randomised controlled trials (RCTs): the Cochrane Menstrual Disorders and Subfertility Group Specialised Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, AMED, PsycINFO, Social Science Citation Index and CINAHL. Handsearches of trial registers, relevant journals and published conference abstracts were also performed. RCTs were included if they compared any type of relaxation intervention with no treatment or other treatments (except hormones) for vasomotor symptoms in symptomatic perimenopausal/postmenopausal women. Two review authors selected studies, assessed quality and extracted data. Included studies were combined, if appropriate, by using a random-effects model to calculate pooled mean differences and 95% confidence intervals. Four studies were eligible for inclusion (281 participants): Two studies compared relaxation with electroacupuncture or superficial needling, one study compared relaxation with paced respiration or placebo control (α-wave electroencephalographic biofeedback) and one study compared relaxation with no treatment.No evidence was found of a difference between relaxation and acupuncture or superficial needle insertion in the number of hot flushes per 24 hours (mean difference (MD) 0.05, 95% confidence interval (CI) -1.33 to 1.43, two studies, 72 participants, I(2) = 0%; very low-quality evidence). Nor did any evidence suggest a difference between the two interventions in hot flush severity, measured using the Kupperman Index (MD -1.32, 95% CI -5.06 to 2.43, two studies, 72 participants, I(2) = 0%; very low-quality evidence).The other two studies found no clear evidence of a difference in hot flush frequency between relaxation and paced respiration, placebo or no treatment. The data for these comparisons were unsuitable for analysis.None of these studies reported night sweats, sleep disturbances associated with night sweats or adverse effects as an outcome.The main limitations of identified evidence were lack of data, imprecision and failure to report study methods in adequate detail. Evidence is insufficient to show the effectiveness of relaxation techniques as treatment for menopausal vasomotor symptoms, or to determine whether this treatment is more effective than no treatment, placebo, acupuncture, superficial needle insertion or paced respiration.

EEG BIOFEEDBACK THERAPY FOR ADHD: A SYSTEMATIC REVIEW

ObjectiveTo examine systematically the evidence for the application of electroencephalographic (EEG) biofeedback, otherwise called neurofeedback, in the treatment of children and young people with Attention Deficit Hyperactivity Disorder (ADHD).MethodA literature...

The effect of electroencephalographic biofeedback on subclinical depression

Objective To explore the effect of electroencephalographic biofeedback (EEGBF) on subclinical depression by observing patients' outcome after 3 weeks of EEGBF intervention.Methods Sixty depressed patients were assigned to a treatment group and a control group using a random digits table,with 30 in each group.Patients in the treatment group received EEGBF twice weekly for 3 weeks and were evaluated once a week; patients in control group were not treated but were also evaluated weekly.The patients were observed for 3 weeks,then followed up 6 weeks after the treatment had ended.Scores on the Hamilton depression scale (HAMD),the self-rating depression scale (SDS) and the Center for Epidemiology survey (CES-D) were analyzed.Reduced HAMD score was regarded as the standard for evaluating the effectiveness of EEGBF.Results The effect in the treated group was significantly better than in the control group.After 3 weeks of treatment,the rate of cure was 23％,excellence was rated 70％ and effectiveness was 6.67％.The corresponding ratings for the control group were 0％,10％ and 17％ respectively.In treated group,SDS and CES-D scores were significantly lower than before treatment and significantly better than in the control group.Conclusion EEGBF can reduce patients' SDS,HAMD and CES-D scores and improve the signs of subclinical depression effectively. Key words: Depression; Electroencephalographic biofeedback; Hamilton depression scale; Self-rating depression scale

Treating urination disorders after stroke with electroencephalographic biofeedback, cognitive intervention and intermittent catheterization

Objective To analyze the abnormal urodynamics of urination disorders after stroke and evaluate the treatment effects of a combination of electroencephalagraphic biofeedback ( EEGBF),cognitive intervention and intermittent catheterization.Methods Ninety-eight patients with urination disorders after stroke were selected and randomly divided into a treatment group ( n =49 ) which was treated with EEGBF and a cognitive intervention and intermittent catheterization group ( n =49) which was only given routine stroke treatment.Urodynamic examination was carried out before and 2 weeks after treatment to analyze the functions of the bladder and urethral canal.Results The patients' urination disorders manifested abnormal urine flow dynamic changes mainly as detrusor urinae hyperreflexia and urethral external sphincter uninhibited relaxation.The urodynamic examination results of the treatment group improved significantly compared with before treatment.The maximum urine flow rate of the bladder,maximum capacity of the bladder,urethral closing pressure,functional urethral length,leak point pressure of the detrusor urinae and residual urine volume all decreased compared with before treatment and bladder compliance increased.The excellent efficacy in the treatment group was remarkably higher than that in the control group.Conclusion Common urodynamic abnormalities after stroke are mainly detrusor urinae hyperreflexia and uninhibited urethral external sphincter relaxation.Routine treatment combined with EEGBF,cognitive intervention and intermittent catheterization had excellent treatment effects. Key words: Stroke; Urination disorders; Urodynamics; Electroencephalagraphic biofeedback; Cognitive interventions ; Intermittent catheterization

Neurotherapy of Fibromyalgia?

To evaluate the efficacy of a novel variant of electroencephalograph biofeedback, the Low Energy Neurofeedback System (LENS), that utilizes minute pulses of electromagnetic stimulation to change brainwave activity for the amelioration of fibromyalgia (FM) symptoms. Randomized, double-blind, placebo-controlled clinical trial. Tertiary referral academic medical center, outpatient. Thirty-four patients diagnosed with FM according to 1990 American College of Rheumatology classification criteria. Active or sham LENS, depending on randomization, for 22 treatment sessions. Primary outcome measure was the Fibromyalgia Impact Questionnaire total score. Secondary outcome measures included number of tender points (TPs) and pressure required to elicit TPs on physical examination, quantitative sensory testing heat pain threshold, and self-reported cognitive dysfunction, fatigue, sleep problems, global psychological distress, and depression obtained at baseline, immediate post-treatment, and 3- and 6-month follow-up. Participants who received the active or sham interventions improved (Ps < 0.05) on the primary and a variety of secondary outcome measures, without statistically significant between group differences in evidence at post-treatment or 3- or 6-month follow-up. Individual session self-reported ratings of specific symptoms (cognitive dysfunction, fatigue, pain, and sleep, and overall activity level) over the course of the 22 intervention sessions indicated significant linear trends for improvement for the active intervention condition only (Ps < 0.05). LENS cannot be recommended as a single modality treatment for FM. However, further study is warranted to investigate the potential of LENS to interact synergistically with other pharmacologic and nonpharmacologic therapies for improving symptoms in FM.

Efficacy of Alfa EEG wave biofeedback in the management of anxiety

Background:Biofeedback is a technique in which people are trained to improve their health by learning to control certain internal bodily processes that normally occur involuntarily. Various studies in the past have shown usefulness of Alfa electroencephalographic (EEG) biofeedback in the alleviation of anxiety symptoms. Though most of the psychiatric centers in the armed forces have this facility, not much work has been done in our setup to assess its efficacy in the management of anxiety. Hence this study was undertaken.Materials and Methods:This study was carried out in a multispecialty Command Hospital by enrolling 100 patients with psychiatric diagnosis from both inpatient and outpatient services. The anxiety level was assessed clinically and by using Hamilton Anxiety Scale and Taylor's Manifest Anxiety Scale. One group of 50 patients was treated with Alfa EEG biofeedback sessions only, 5 times in a week for 8 weeks, along with specific pharmacotherapy. The other group was treated with appropriate dose of anxiolytics. The anxiety level was reassessed after 4 weeks and 8 weeks.Results:The response was better for mixed anxiety and depressive disorder with pharmacotherapy than with the biofeedback, but female patients showed better response with EEG biofeedback.Conclusion:In the short term, Alfa EEG biofeedback therapy is almost as efficacious as pharmacological intervention in the management of anxiety symptoms, and relatively more useful in females.

P338 The effect of psycho-educational therapy on electroencephalographic biofeedback scores in ADHD

P338 The effect of psycho-educational therapy on electroencephalographic biofeedback scores in ADHD