Neurofeedback Sessions Research Articles

Electrophysiological correlates of improved executive function following EEG neurofeedback in adult attention deficit hyperactivity disorder

ObjectiveEvent-related potentials (ERPs) are reported to be altered in relation to cognitive processing deficits in attention deficit hyperactivity disorder (ADHD). However, this evidence is mostly limited to cross-sectional data. The current study utilized neurofeedback (NFB) as a neuromodulatory tool to examine the ERP correlates of attentional and inhibitory processes in adult ADHD using a single-session, within-subject design. MethodsWe recorded high-density EEG in 25 adult ADHD patients and 22 neurotypical controls during a Go/NoGo task, before and after a 30-minute NFB session designed to down-regulate the alpha (8–12 Hz) rhythm. ResultsAt baseline, ADHD patients demonstrated impaired Go/NoGo performance compared to controls, while Go-P3 amplitude inversely correlated with ADHD-associated symptomatology in childhood. Post NFB, task performance improved in both groups, significantly enhancing stimulus detectability (d-prime) and reducing reaction time variability, while increasing N1 and P3 ERP component amplitudes. Specifically for ADHD patients, the pre-to-post enhancement in Go-P3 amplitude correlated with measures of improved executive function, i.e., enhanced d-prime, reduced omission errors and reduced reaction time variability. ConclusionsA single-session of alpha down-regulation NFB was able to reverse the abnormal neurocognitive signatures of adult ADHD during a Go/NoGo task. SignificanceThe study demonstrates for the first time the beneficial neurobehavioral effect of a single NFB session in adult ADHD, and reinforces the notion that ERPs could serve as useful diagnostic/prognostic markers of executive dysfunction.

Distinguishing Voluntarily Upregulation of Localized Central Alpha from Widespread Posterior Alpha.

Neurofeedback (NF) training based on alpha upregulation has been widely used on patient and healthy populations. However, active voluntary modulation of central or widespread posterior alpha in response to central alpha feedback is still ambiguous. The objective of this study is to confirm whether patients learn to truly increase alpha power and to determine if patients modulate central or widespread alpha power when alpha feedback is provided from central brain region. This EEG-based NF study was conducted on seven paraplegic patients with same injury type, pain location, and sensitization to ensure homogeneity. In addition to routine NF training sessions, various experiments were performed to compare alpha NF modulation received from C4 with alpha shift during cognitive tasks, occipital or parieto-occipital cortex, and Laplacian montage which is expected to separate localized alpha from widespread alpha, to attain objectives. Moreover, imaginary coherence analysis in alpha band was also performed to check whether C4 training site is coupled with other brain regions and to confirm whether activity at training site leads/lags the activity of other brain regions. The results indicate widespread alpha modulation in patients during regular NF sessions (p < 0.05) with large effect size (> 0.8), sufficiently high statistical power (> 80%), and a narrower confidence interval (CI) in response to NF provided from the central brain region reflecting less uncertainty and higher precision. However, small effect size obtained with Laplacian montage require patients to be trained with Laplacian feedback to achieve a reliable conclusion regarding localized alpha modulation. The outcomes of this study are not only limited to validate true alpha modulation in response to central alpha feedback but also to explore the mechanism of central alpha NF training.

Enhancing the Effects of Neurofeedback Training: The Motivational Value of the Reinforcers.

The brain activity that is measured by electroencephalography (EEG) can be modified through operant conditioning, specifically using neurofeedback (NF). NF has been applied to several disorders claiming that a change in the erratic brain activity would be accompanied by a reduction of the symptoms. However, the expected results are not always achieved. Some authors have suggested that the lack of an adequate response may be due to an incorrect application of the operant conditioning principles. A key factor in operant conditioning is the use of reinforcers and their value in modifying behavior, something that is not always sufficiently taken into account. This work aims to clarify the relevance of the motivational value versus the purely informational value of the reinforcer. In this study, 113 subjects were randomly assigned two different reinforcer conditions: a selected reinforcer—the subjects subjectively selected the reinforcers—or an imposed reinforcer—the reinforcers were assigned by the experimenter—and both groups undertook NF sessions to enhance the sensorimotor rhythm (SMR). In addition, the selected reinforcer group was divided into two subgroups: one receiving real NF and the other one sham NF. There were no significant differences between the groups at baseline in terms of SMR amplitude. After the intervention, only those subjects belonging to the selected reinforcer group and receiving real NF increased their SMR. Our results provide evidence for the importance of the motivational value of the reinforcer in Neurofeedback success.

Personality and psychophysiological self-regulation influence individual efficacy of neurofeedback in tension-type headache

IntroductionDue to limited efficacy and side effects of pharmacological therapy in tension-type headache (TTH), alternative approaches are feasible. Neurofeedback is a noninvasive neuromodulation technique increasingly used in practice, but, however, there is limited research on its efficacy.ObjectivesTo evaluate the efficacy of neurofeedback in TTH and to reveal the factors moderating treatment effects.MethodsWe analyzed the data from a pilot phase of an ongoing single case design cross-over sham-controlled study. Four females with TTH underwent 10 sessions of neurofeedback and 10 sessions of sham-neurofeedback in a randomized order. Participants filled a detailed headache diary 3 weeks before, during and 3 weeks after the treatment. At enrollment, we evaluated the personality factors with the MMPI, and performed a specially developed test on psychophysiological regulation of breath.ResultsSignificant reduction of headache frequency and intensity was observed in 2 of 4 participants (responders). The responders were characterized by normal MMPI profile and, the same time, by lower baseline abilities for psychophysiological self-regulation. The non-responders had high MMPI profile (accentuation) and also higher abilities for psychophysiological self-regulation.ConclusionsOn the base of preliminary data, we suggest that neurofeedback may be feasible in TTH patients with lowered abilities for in psychophysiological self-regulation. Accentuation of personality traits may interfere with the efficacy of neurofeedback.

Differential neural plasticity of individual fingers revealed by fMRI neurofeedback.

Previous work has shown that functional magnetic resonance imaging (fMRI) activity patterns associated with individual fingers can be shifted by temporary impairment of the hand. Here, we investigated whether these neural activity patterns could be modulated endogenously and whether any behavioral changes result from this modulation. We used decoded neurofeedback in healthy individuals to encourage participants to shift the neural activity pattern in sensorimotor cortex of the middle finger toward the index finger, and the ring finger toward the little finger. We first mapped the neural activity patterns for all fingers of the right hand in an fMRI pattern localizer session. Then, in three subsequent neurofeedback sessions, participants were rewarded after middle/ring finger presses according to their activity pattern overlap during each trial. A force-sensitive keyboard was used to ensure that participants were not altering their physical finger coordination patterns. We found evidence that participants could learn to shift the activity pattern of the ring finger but not of the middle finger. Increased variability of these activity patterns during the localizer session was associated with the ability of participants to modulate them using neurofeedback. Participants also showed an increased preference for the ring finger but not for the middle finger in a postneurofeedback motor task. Our results show that neural activity and behaviors associated with the ring finger are more readily modulated than those associated with the middle finger. These results have broader implications for rehabilitation of individual finger movements, which may be limited or enhanced by individual finger plasticity after neurological injury.NEW & NOTEWORTHY It may be possible to remobilize fingers after neurological injury by altering neural activity patterns. Toward this end, we examined whether finger-related neural activity patterns could be modified in healthy individuals without physical intervention, using fMRI neurofeedback. Our findings show that greater variability of neural patterns at baseline predicted a participant's ability to successfully shift these patterns. Because neural variability is common in individuals poststroke, this illustrates a potential clinical benefit of this procedure.

Real-Time Decoding of Attentional States Using Closed-Loop EEG Neurofeedback.

Sustained attention is a cognitive ability to maintain task focus over extended periods of time (Mackworth, 1948; Chun, Golomb, & Turk-Browne, 2011). In this study, scalp electroencephalography (EEG) signals were processed in real time using a 32 dry-electrode system during a sustained visual attention task. An attention training paradigm was implemented, as designed in DeBettencourt, Cohen, Lee, Norman, and Turk-Browne (2015) in which the composition of a sequence of blended images is updated based on the participant's decoded attentional level to a primed image category. It was hypothesized that a single neurofeedback training session would improve sustained attention abilities. Twenty-two participants were trained on a single neurofeedback session with behavioral pretraining and posttraining sessions within three consecutive days. Half of the participants functioned as controls in a double-blinded design and received sham neurofeedback. During the neurofeedback session, attentional states to primed categories were decoded in real time and used to provide a continuous feedback signal customized to each participant in a closed-loop approach. We report a mean classifier decoding error rate of 34.3% (chance = 50%). Within the neurofeedback group, there was a greater level of task-relevant attentional information decoded in the participant's brain before making a correct behavioral response than before an incorrect response. This effect was not visible in the control group (interaction p=7.23e-4), which strongly indicates that we were able to achieve a meaningful measure of subjective attentional state in real time and control participants' behavior during the neurofeedback session. We do not provide conclusive evidence whether the single neurofeedback session per se provided lasting effects in sustained attention abilities. We developed a portable EEG neurofeedback system capable of decoding attentional states and predicting behavioral choices in the attention task at hand. The neurofeedback code framework is Python based and open source, and it allows users to actively engage in the development of neurofeedback tools for scientific and translational use.

Individual Alpha Peak Frequency, an Important Biomarker for Live Z-Score Training Neurofeedback in Adolescents with Learning Disabilities.

Learning disabilities (LDs) have an estimated prevalence between 5% and 9% in the pediatric population and are associated with difficulties in reading, arithmetic, and writing. Previous electroencephalography (EEG) research has reported a lag in alpha-band development in specific LD phenotypes, which seems to offer a possible explanation for differences in EEG maturation. In this study, 40 adolescents aged 10–15 years with LDs underwent 10 sessions of Live Z-Score Training Neurofeedback (LZT-NF) Training to improve their cognition and behavior. Based on the individual alpha peak frequency (i-APF) values from the spectrogram, a group with normal i-APF (ni-APF) and a group with low i-APF (li-APF) were compared in a pre-and-post-LZT-NF intervention. There were no statistical differences in age, gender, or the distribution of LDs between the groups. The li-APF group showed a higher theta absolute power in P4 (p = 0.016) at baseline and higher Hi-Beta absolute power in F3 (p = 0.007) post-treatment compared with the ni-APF group. In both groups, extreme waves (absolute Z-score of ≥1.5) were more likely to move toward the normative values, with better results in the ni-APF group. Conversely, the waves within the normal range at baseline were more likely to move out of the range after treatment in the li-APF group. Our results provide evidence of a viable biomarker for identifying optimal responders for the LZT-NF technique based on the i-APF metric reflecting the patient’s neurophysiological individuality.

Development of Enhanced Stimulus Content to Improve the Treatment Efficacy of EEG–Based Frontal Alpha Asymmetry Neurofeedback for Stress Mitigation

The neurofeedback stimulus content has direct implications for the efficacy of the psychophysiological applications for neurofeedback modality. In particular, enhancements of neurofeedback stimulus content can facilitate improvements in the efficacy of neurofeedback applications in clinical practice. To further elaborate on this aspect, this study introduced systematic enhancements in neurofeedback stimulus content by developing enhanced neurofeedback stimulus content for stress mitigation. The enhancements included the automatic selection of color of neurofeebdack stimulus content environment and instruction messages, as well as, the adaptive selection of threshold of quantitative electroencephalogram (QEEG) features, such as frontal alpha power and frontal alpha asymmetry. The enhancements were based on the outcomes from previous research on the selection of neurofeedback stimulus content for stress mitigation. The improvement in the efficacy of neurofeedback stimulus content was measured statistically by comparing the QEEG and topographic maps. In this study, electroencephalogram data from 20 participants were acquired during multiple sessions of neurofeedback. Analysis of variance and a post hoc test were used to verify the improvement in the efficacy of the neurofeedback application for stress mitigation after the enhancements of the neurofeedback stimulus content; a t–test was used to verify the statistical significance of the stress mitigation by the neurofeedback p < 0.05. The results indicate that the enhancement of the developed neurofeedback stimulus content facilitated stress mitigation during the early sessions of neurofeedback. In conclusion, the efficacy of neurofeedback can be improved using the developed stimulus content with enhancements.

The Long-term Effect of Neurofeedback Therapy as Adjuvant Therapy on the Management of Tinnitus: A Prospective Clinical Trial

Background: Recently, various studies have been performed to examine the effect of neurofeedback on treating tinnitus. However, these studies reported different results. In this process, the nervous activity of the patient is evaluated. For example, the aspects associated with brain processes are extracted through temporal processing signs, and then auditory or visual feedback is given to the person. Objectives: The present study investigates the effect of neurofeedback sessions on treating tinnitus. Materials &amp; Methods: In this clinical trial study, 30 patients with tinnitus who met the inclusion criteria were included. They referred to the otorhinolaryngology clinic of Azahra and Kashani hospitals in Isfahan City, Iran. The patients underwent 20 sessions of neurofeedback and were examined at time intervals before the intervention and then 1, 3, and 5 months after the intervention. To evaluate the patients, we used tinnitus handicap inventory and visual analog scale. To examine the changes in VAS and THI data at different times, repeated measure ANOVA test was utilized. The significance level was considered less than 0.05. The analysis was performed in SPSS V. 24. Results: Five months after the intervention, tinnitus handicap inventory (P&lt;0.001) and visual analog scale (P&lt;0.001) scores of the patients significantly improved. Also, no complication resulting from the use of neurofeedback was observed in the patients. Conclusion: Usage of neurofeedback sessions as adjuvant therapy could be an effective treatment in patients who suffer from tinnitus.

Comparison of Biofeedback and Combined Interventions on Athlete's Performance.

The aim of this study was the comparison of neurofeedback and biofeedback as a combination, against biofeedback intervention alone on athletic performance. 45 novice basketball players were allocated into three groups and assigned accordingly, two experimental and one control group. The experimental group 1 received 24 biofeedback sessions only, experimental group 2 received 24 biofeedback and neurofeedback sessions combined, whereas the control group didn't receive any form of intervention. Athletic performance scales were used before and after each intervention and multivariate analysis of covariance was used to compare the two groups. Results showed that in comparison to the control group, the athletic performance scales scores in both experimental groups were significantly increased. Furthermore, in experimental group 2 (combined method), we noticed a significantly greater improvement in performance levels than experimental group 1. We concluded that neurofeedback and biofeedback interventions combined, can be used as an effective method to enhance athletic performance.

Biofeedback as an intervention for persistent post-concussive symptoms: A randomized feasibility trial

Background Case reports indicate that low-resolution electromagnetic tomography neurofeedback and heart rate variability biofeedback may improve physiological functioning in individuals with persistent post-concussive symptoms. However, it is unclear whether larger-scale studies are feasible. Purpose To evaluate the feasibility of a combined low-resolution electromagnetic tomography neurofeedback and heart rate variability biofeedback intervention for individuals with persistent post-concussive symptoms. Methods Individuals with persistent post-concussive symptoms were randomized into intervention and control groups, and their baseline and post-test assessments were compared to a healthy control group. Outcomes included self-report questionnaires, resting electroencephalograph and electrocardiograph recordings, and a driving simulation task. Participants in the intervention group completed three 20 min low-resolution electromagnetic tomography neurofeedback sessions per week and at-home heart rate variability biofeedback training every morning and night for 8 weeks. Feasibility was evaluated according to recruitment capability and sample characteristics, data collection procedures, suitability of the intervention and study procedures, management and implementation of the study intervention, and preliminary participant responses to the intervention. Results Thirty-three individuals were recruited and 24 completed this study (seven intervention participants, nine persistent post-concussive symptoms control participants, and eight healthy control participants). One-quarter of participants (four intervention participants and three persistent post-concussive symptoms control participants) experienced simulator sickness during the driving simulator task and had to withdraw from the study. Intervention participants had an 88% and 86% compliance rate for the low-resolution electromagnetic tomography neurofeedback and heart rate variability biofeedback sessions, respectively. Low-resolution electromagnetic tomography neurofeedback sessions took approximately 1 h to complete per participant. Preliminary analysis indicated that the intervention reduced electroencephalograph z-score deviation with a very large effect size ( d = 1.36) compared to the other study groups. Conclusions Pilot studies evaluating the efficacy of low-resolution electromagnetic tomography neurofeedback and heart rate variability biofeedback should be performed to confirm these preliminary findings. However, the protocol should be modified to reduce participant fatigue and withdrawal. This trial was registered with Clinicialtrials.gov (NCT03338036; https://clinicaltrials.gov/ct2/show/NCT03338036?term=03338036&amp;draw=2&amp;rank=1 ).

Изменение полной мощности бета- и тета-диапазонов при использовании ЭЭГ-биоуправления у младших школьников с трудностями произвольной регуляции

This article presents the results of the study on spectral electroencephalogram (EEG) characteristics in 7–10-year-old children (8 girls and 22 boys) having difficulties with voluntary regulation of activity after 10 and 20 neurofeedback sessions using beta-activating training. Brain bioelectric activity was recorded in 16 standard leads using the Neuron-Spectrum-4/VPM complex. The dynamics was assessed by EEG beta and theta bands during neurofeedback. An increase in the total power of beta band oscillations was established both after 10 and after 20 sessions of EEG biofeedback in the frontal (p ≤ 0.001), left parietal (p ≤ 0.036), and temporal (p ≤ 0.003) areas of the brain. A decrease in the spectral characteristics of theta band oscillations was detected: after 10 neurofeedback sessions in the frontal (p ≤ 0.008) and temporal (p ≤ 0.006) areas of both hemispheres, as well as in the parietal area of the left hemisphere (p ≤ 0.005); after 20 sessions, in the central (p ≤ 0.004), frontal (p ≤ 0.001) and temporal (p ≤ 0.001) areas of both hemispheres, as well as in the occipital (p ≤ 0.047) and parietal (p ≤ 0.001) areas of the left hemisphere. The study into the dynamics of bioelectric activity during biofeedback using EEG parameters in 7–10-year-old children with impaired voluntary regulation of higher mental functions allowed us to prove the advisability of 20 sessions, as the increase in high-frequency activity and decrease in low-frequency activity do not stop with the 10th session. Changes in these parameters after 10 EEG biofeedback sessions are expressed mainly in the frontotemporal areas of both hemispheres, while after a course of 20 sessions, in both the frontotemporal and central parietal areas of the brain.

A portable neurofeedback device for treating chronic subjective tinnitus: Feasibility and results of a pilot study.

Several clinical studies have shown that neurofeedback (NFB) has the potential to significantly improve the quality of life of patients complaining of chronic subjective tinnitus. Yet the clinical applicability of such a therapeutic approach in the everyday practice has not been tested so far. This study aims at investigating the feasibility and efficacy of a semi-automated NFB intervention by means of a portable device that eventually could be used by the patients at home on an everyday basis. The duration of setup procedures is minimized through the use of a dry electrodes electroencephalography (EEG) headset and an automated user-interface. We conducted a pilot clinical study (non-controlled, single arm, NCT03773926). According to a predetermined power calculation, a homogeneous population of 33 subjects with strict inclusion criteria was enrolled. After inclusion, all patients underwent 10 NFB sessions lasting 50min each, over a period of 5 weeks and a 3-month follow-up period. According to previous studies, the NFB training aimed at increasing the alpha-band power (8-12Hz) in the EEG power spectrum on the averaged signal of leads FC1, FC2, F3 and F4. Tinnitus handicap inventory (THI) was used as a primary outcome measure. Secondary outcome measures were the visual analog scales (VAS) and the change of the alpha-band power within sessions and across training. Time points of assessment were before intervention (T1), after intervention (T2) and at the 3-month follow-up (T3). Patient exhibited a clinically significant decrease of the THI score, with a 23% decrease (N=28) on average between T1 and T2 and a 31% decrease (N=25) between T1 and T3. A significant increase of the alpha-band power within sessions was observed. No significant increase of the alpha-band power across sessions was observed. For the 19 subjects where sufficient data were exploitable, a significant correlation was found between the evolution of the alpha-band training across sessions and the evolution of the THI between T1 and T2. The sessions were well tolerated and no adverse effect was reported. This study suggests that neurofeedback has potential to suit everyday clinical practice with the goal to significantly reduce tinnitus intrusiveness. The merits and limitations of this NFB procedure are discussed, especially with respect to the choice of EEG electrodes to ensure a good signal quality.

Expectancy effects of placebo neurofeedback in ADHD treatment seekers: A neuropsychological investigation.

Though there is evidence to suggest that expectancies can impact outcomes of various medical and psychological treatments, little is known about the role of expectancy effects in neurocognitive interventions, such as neurofeedback for attention-deficit/hyperactivity disorder (ADHD). The present study investigated the effects of treatment expectancies on ADHD symptom report and neuropsychological performance by using an expectancy manipulation in the context of placebo neurofeedback. Eighty-five young adults seeking treatment for ADHD were administered 1 session of placebo neurofeedback and randomly assigned to positive or negative expectancy groups. Primary outcome measures include ADHD symptom self-report questionnaires and neuropsychological tests. Consistent with hypotheses, participants in the positive expectancy group who received positive false feedback reported fewer ADHD symptoms at postfeedback (p < .001, ηp² = .41), whereas participants in the negative expectancy group who received negative false feedback reported more symptoms at postfeedback (p = .01, ηp² = .15). As expected, individuals who received positive expectancies also significantly improved their performance on a working memory test (p = .002, ηp² = .22); no other neuropsychological test performance was impacted by expectancies. Beliefs about neurofeedback effectiveness did not moderate or mediate expectancy effects. Results indicate that treatment expectancies impact ADHD symptom report and some neuropsychological test performance. Therefore, expectancy effects should be considered in the evaluation of outcomes for neurocognitive interventions, such as neurofeedback for ADHD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A Neurofeedback Protocol for Executive Function to Reduce Depression and Rumination: A Controlled Study.

ObjectiveRumination is a maladaptive emotional-regulation strategy that is strongly associated with depression. Impaired executive function can lead to difficulties in disengaging from rumination, thus exacerbating depression. In this study, we inspect an electroencephalograph neurofeedback protocol that enhance the target peak alpha frequency (PAF) activation in the prefrontal region. We examine the protocol’s effects on depression and rumination.MethodsWe randomly assigned 30 dysphoric participants into either the neurofeedback training group or the control group. We then evaluated their depression, rumination, and executive function at pre- and posttraining so as to examine the effects of the neurofeedback.ResultsThe results show that this neurofeedback protocol can specifically enhance participants’ target PAF. The participants’ executive function performances significantly improved after undergoing 20 neurofeedback sessions. Compared with those in the control group, those in the neurofeedback group had significantly fewer depressive symptoms and significantly reduced rumination. Moreover, as target PAF and executive function improved, depression and rumination both declined.ConclusionOur data are in line with those of previous studies that indicated a relationship between upper-band alpha activity and executive function. This PAF neurofeedback can effectively enhance participants’ executive function, which can reduce rumination and ameliorate depression. This neurofeedback training is based on basic cognitive neuroscience, so it sheds light on depression’s pathological factors and etiology.

Effect of Simulation-Based Training and Neurofeedback Interventions on Radiation Technologists’ Workload, Situation Awareness, and Performance

PurposeOur purpose was to assess the effect of a combined intervention – simulation-based training supported by neurofeedback sessions – on radiation technologists’ (RTs’) workload, situation awareness, and performance during routine quality assurance and treatment delivery tasks. Methods and MaterialsAs part of a prospective institutional review board approved study, 32 RTs previously randomized to receive versus not receive simulation-based training focused on patient safety were again randomized to receive versus not receive a 3-week neurofeedback intervention (8 sessions of alpha-theta protocol) focused on stress reduction as well as conscious precision, strong focus, and ability to solve arising problems. Perceived workload was quantified using the NASA Task Load Index. Situation awareness was quantified using the situation awareness rating technique. Performance score was calculated using procedural compliance with time-out components and error detection. ResultsRTs randomized to simulation-based training followed by neurofeedback sessions demonstrated no significant changes in perceived workload or situation awareness scores, but did have better performance compared with other study groups (P < .01). ConclusionsThis finding is encouraging and provides basis for using neurofeedback as means to possibly augment performance improvements gained during simulation-based training.

Improving Real-Time Brain State Classification of Motor Imagery Tasks During Neurofeedback Training.

In this study, we investigated the effect of the dynamic changes in brain activation during neurofeedback training in the classification of the different brain states associated with the target tasks. We hypothesized that ongoing activation patterns could change during neurofeedback session due to learning effects and, in the process, could affect the performance of brain state classifiers trained using data obtained prior to the session. Using a motor imagery paradigm, we then examined the application of an incremental training approach where classifiers were continuously updated in order to account for these activation changes. Our results confirmed our hypothesis that neurofeedback training could be associated with dynamic changes in brain activation characterized by an initially more widespread brain activation followed by a more focused and localized activation pattern. By continuously updating the trained classifiers after each feedback run, significant improvement in accurately classifying the different brain states associated with the target motor imagery tasks was achieved. These findings suggest the importance of taking into account brain activation changes during neurofeedback in order to provide more reliable and accurate feedback information to the participants, which is critical for an effective neurofeedback application.

Modulation of Intrinsic Brain Connectivity by Implicit Electroencephalographic Neurofeedback.

Despite the increasing popularity of neurofeedback, its mechanisms of action are still poorly understood. This study aims to describe the processes underlying implicit electroencephalographic neurofeedback. Fifty-two healthy volunteers were randomly assigned to a single session of infra-low frequency neurofeedback or sham neurofeedback, with electrodes over the right middle temporal gyrus and the right inferior parietal lobule. They observed a moving rocket, the speed of which was modulated by the waveform derived from a band-limited infra-low frequency filter. Immediately before and after the session, the participants underwent a resting-state fMRI. Network-based statistical analysis was applied, comparing post- vs. pre-session and real vs. sham neurofeedback conditions. As a result, two phenomena were observed. First, we described a brain circuit related to the implicit neurofeedback process itself, consisting of the lateral occipital cortex, right dorsolateral prefrontal cortex, left orbitofrontal cortex, right ventral striatum, and bilateral dorsal striatum. Second, we found increased connectivity between key regions of the salience, language, and visual networks, which is indicative of integration in sensory processing. Thus, it appears that a single session of implicit infra-low frequency electroencephalographic neurofeedback leads to significant changes in intrinsic brain connectivity.

Using mind control to modify cue-reactivity in AUD: the impact of mindfulness-based relapse prevention on real-time fMRI neurofeedback to modify cue-reactivity in alcohol use disorder: a randomized controlled trial

BackgroundAlcohol Use Disorder is a severe mental disorder affecting the individuals concerned, their family and friends and society as a whole. Despite its high prevalence, novel treatment options remain rather limited. Two innovative interventions used for treating severe disorders are the use of real-time functional magnetic resonance imaging neurofeedback that targets brain regions related to the disorder, and mindfulness-based treatments. In the context of the TRR SFB 265 C04 “Mindfulness-based relapse prevention as an addition to rtfMRI NFB intervention for patients with Alcohol Use Disorder (MiND)” study, both interventions will be combined to a state-of-the art intervention that will use mindfulness-based relapse prevention to improve the efficacy of a real-time neurofeedback intervention targeting the ventral striatum, which is a brain region centrally involved in cue-reactivity to alcohol-related stimuli.Methods/designAfter inclusion, N = 88 patients will be randomly assigned to one of four groups. Two of those groups will receive mindfulness-based relapse prevention. All groups will receive two fMRI sessions and three real-time neurofeedback sessions in a double-blind manner and will regulate either the ventral striatum or the auditory cortex as a control region. Two groups will additionally receive five sessions of mindfulness-based relapse prevention prior to the neurofeedback intervention. After the last fMRI session, the participants will be followed-up monthly for a period of 3 months for an assessment of the relapse rate and clinical effects of the intervention.DiscussionThe results of this study will give further insights into the efficacy of real-time functional magnetic resonance imaging neurofeedback interventions for the treatment of Alcohol Use Disorder. Additionally, the study will provide further insight on neurobiological changes in the brain caused by the neurofeedback intervention as well as by the mindfulness-based relapse prevention. The outcome might be useful to develop new treatment approaches targeting mechanisms of Alcohol Use Disorder with the goal to reduce relapse rates after discharge from the hospital.Trial registrationThis trial is pre-registered at clinicaltrials.gov (trial identifier: NCT04366505; WHO Universal Trial Number (UTN): U1111–1250-2964). Registered 30 March 2020, published 29 April 2020.

Changes in EEG complexity with neurofeedback and multi-sensory learning in children with dyslexia: A multiscale entropy analysis

Multiscale entropy analysis (MSE) is a novel entropy-based approach for measuring dynamical complexity in physiological systems over a range of temporal scales. MSE has been successfully applied in the literature when measuring autism traits, Alzheimer’s, and schizophrenia. However, until now, there has been no research on MSE applied to children with dyslexia. In this study, we have applied MSE analysis to the EEG data of an experimental group consisting of children with dyslexia as well as a control group consisting of typically developing children and compared the results. The experimental group comprised 16 participants with dyslexia who visited Ankara University Medical Faculty Child Neurology Department, and the control group comprised 20 age-matched typically developing children with no reading or writing problems. MSE was calculated for one continuous 60-s epoch for each experimental and control group’s EEG session data. The experimental group showed significantly lower complexity at the lowest temporal scale and the medium temporal scales than the typically developing group. Moreover, the experimental group received 60 neurofeedback and multi-sensory learning sessions, each lasting 30 min, with Auto Train Brain. Post-treatment, the experimental group’s lower complexity increased to the typically developing group’s levels at lower and medium temporal scales in all channels.