Neurofeedback Research Articles

Immersive virtual reality and neurofeedback for the management of cancer symptoms during treatment.

Millions of people are diagnosed with cancer each year in the USA and are living on systemic therapies designed to prolong their life. While these therapies are intended to treat the disease, most exacerbate cancer symptoms such as pain and anxiety. Oncologists and other healthcare providers are now challenged to deliver adjunctive therapies designed to improve quality of life of patients while they undergo cancer treatment, including minimizing already disruptive symptoms such as cancer pain and anxiety. Complementary and alternative medicines such as immersive virtual reality (VR) and neurofeedback (NF) are novel approaches to the management of cancer symptoms. While the evidence for combining VR and NF, specifically for management of cancer pain, while patients undergo systemic therapies, is still emerging; our preliminary findings suggest this treatment modality might offer relief of cancer symptoms. This paper briefly highlights the clinical need for supportive therapies such as VR and NF in the oncological setting and summarizes innovative research in this area.

Protocol description for a randomized controlled trial of fMRI neurofeedback for tics in adolescents with Tourette Syndrome

This article describes the protocol for a randomized, controlled clinical trial of a neurofeedback (NF) intervention for Tourette Syndrome (TS) and chronic tic disorder. The intervention involves using functional magnetic resonance imaging (fMRI) to provide feedback regarding activity in the supplementary motor area: participants practice controlling this brain area while using the feedback as a training signal. The previous version of this NF protocol was tested in a small study (n = 21) training adolescents with TS that yielded clinically promising results. Therefore, we plan a larger trial. Here we describe the background literature that motivated this work, the design of our original neurofeedback study protocol, and adaptations of the research study protocol for the new trial. We focus on those ideas incorporated into our protocol that may be of interest to others designing and running NF studies. For example, we highlight our approach for defining an unrelated brain region to be trained in the control group that is based on identifying a region with low functional connectivity to the target area. Consistent with a desire for transparency and open science, the new protocol is described in detail here prior to conducting the trial.

Effects of neurofeedback on standing postural control task with combined imagined and executed movements.

Motor imagery (MI) is a method of imagining movement without actual movement, and its use in combination with motor execution (ME) enhances the effects of motor learning. Neurofeedback (NFB) is another method that promotes the effects of MI. This study aimed to investigate the effects of NFB on combined MI and ME (MIME) training in a standing postural control task. Sixteen participants were randomly divided into MIME and MIME + NFB groups and performed 10 trials of a postural control task on an unstable board, with nine trials of MI in between. Electroencephalogram was assessed during MI, and the MIME + NFB group received neurofeedback on the degree of MI via auditory stimulation. A postural control task using an unstable board was performed before and after the MIME task, during which postural instability was evaluated. Postural instability was reduced after the MIME task in both groups. In addition, the root mean square, which indicates the sway of the unstable board, was significantly reduced in the MIME + NFB group compared to that in the MIME group. Our results indicate that MIME training is effective for motor learning of standing postural control. Furthermore, when MI and ME are combined, the feedback on the degree of MI enhances the learning effect.

Intracranial Neurofeedback Modulating Neural Activity in the Mesial Temporal Lobe During Memory Encoding: A Pilot Study

Removal of the mesial temporal lobe (MTL) is an established surgical procedure that leads to seizure freedom in patients with intractable MTL epilepsy; however, it carries the potential risk of memory damage. Neurofeedback (NF), which regulates brain function by converting brain activity into perceptible information and providing feedback, has attracted considerable attention in recent years for its potential as a novel complementary treatment for many neurological disorders. However, no research has attempted to artificially reorganize memory functions by applying NF before resective surgery to preserve memory functions. Thus, this study aimed (1) to construct a memory NF system that used intracranial electrodes to feedback neural activity on the language-dominant side of the MTL during memory encoding and (2) to verify whether neural activity and memory function in the MTL change with NF training. Two intractable epilepsy patients with implanted intracranial electrodes underwent at least five sessions of memory NF training to increase the theta power in the MTL. There was an increase in theta power and a decrease in fast beta and gamma powers in one of the patients in the late stage of memory NF sessions. NF signals were not correlated with memory function. Despite its limitations as a pilot study, to our best knowledge, this study is the first to report that intracranial NF may modulate neural activity in the MTL, which is involved in memory encoding. The findings provide important insights into the future development of NF systems for the artificial reorganization of memory functions.

Distinct effects of different neurofeedback protocols on the neural mechanisms of response inhibition in ADHD

ObjectiveIn attention deficit/hyperactivity disorder (ADHD), impaired response inhibition is frequently observed. A promising non-pharmacological treatment is electroencephalography (EEG)-neurofeedback (NF) training. However, the widely used theta-down/beta-up regulation (↓θ↑β) NF protocol may not be optimal for targeting these deficits. We examined how neurofeedback protocols training the upregulation of theta and/or beta power affect inhibitory control in children and adolescents with ADHD. Methods64 patients with ADHD took part in the three NF trainings. Aside from parent-reported ADHD symptoms and behavioural performance data, neurophysiological parameters collected via a Go/Nogo task and corrected to account for intraindividual variability were compared in a pre-post design and to an ADHD (n = 20) as well as a typically developing control group (n = 24). ResultsThe examined NF protocols resulted in similar improvements in response inhibition with the neurophysiological mechanisms differing substantially. The upregulation of theta led to a specific Nogo-P3 increase, while training beta upregulation as well as the combined protocol resulted in less specific effects. ConclusionsThis study shows distinct effects of different theta/beta-neurofeedback protocols on the neural mechanisms underlying improvements in response inhibition in patients with ADHD. SignificanceThese effects shed further light on the oscillatory dynamics underlying cognitive control in ADHD and how these may be targeted in neurofeedback treatments.

Neurofeedback Recuperates Cognitive Functions in Children with Autism Spectrum Disorders (ASD).

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impaired social interaction, verbal and nonverbal communication, and behaviors or interests. Besides behavioral, psychopharmacological and biomedical interventions there is increasing evidence of non-invasive treatments like neurofeedback (NFB) that can improve brain activity. In this study, we have investigated whether NFB can improve cognitive functions in children with ASD. Thirty-five children with ASD (7-17years) were selected by purposive sampling. The subjects underwent 30 sessions of NFB training for 20min over 10weeks' period. Psychometric tests i.e. Childhood Autism Rating Scale (CARS), IQ scoring and Reward sensitivity tests were administered at baseline. Pre and post NFB intervention assessment of executive functions, working memory and processing speed were done by NIH Toolbox Cognition Batteries. Friedman test revealed that children showed a statistically significant improvement in the NIH Tool Box cognitive assessments, including the Flankers Inhibitory Control and Attention Test (Pre-test = 3.63, Post-test = 5.22; p = 0.00), the Dimensional Change Card Sorting Test (Pre-test = 2.88, Post-test = 3.26; p = 0.00), the Pattern Comparison Processing Speed Test (Pre-test = 6.00, Post-test = 11:00; p = 0.00) and the List Sorting Working Memory Test (Pre-test = 4.00, Post-test = 6:00; p = 0.00), and displayed a trend of improvement at 2-month follow-up (Flankers Inhibitory Control and Attention Test (Post-test = 5.11 ± 2.79, Follow-Up = 5.31 ± 2.67; p = 0.21), the Dimensional Change Card Sorting Test (Post-test = 3.32 ± 2.37, Follow-Up = 3.67 ± 2.35; p = 0.054), the Pattern Comparison Processing Speed Test (Post-test = 13.69 ± 9.53, Follow-Up = 14.42 ± 10.23 p = 0.079) and the List Sorting Working Memory Test (Post-test = 6.17 ± 4.41, Follow-Up = 5.94 ± 4.03; p = 0.334). Our findings suggest NFB intervention for 10weeks produce improvement in executive functions (Inhibitory Control and Attention and Cognitive Flexibility), Processing Speed and Working Memory in ASD Children.

Long-term improvements in executive functions after frontal-midline theta neurofeedback in a (sub)clinical group.

Impairments in executive functions (EFs) are common across disorders and can greatly affect daily functioning. Frontal-midline (FM) theta neurofeedback (NF) has been shown effective in enhancing EFs in healthy adults, prompting interest in exploring its potential as an alternative treatment for EFs in (sub)clinical samples. This study aims to determine the effects of FM theta NF on EFs in a sample of 58 adults (aged 20-60 years) with pronounced subjective EF complaints in daily life. Using a pre/post/follow-up design with a sham NF group, the present study assessed upregulation of FM theta in an eight-session individualized FM theta NF training and its immediate and long-term transfer effects on objective and subjective measures of EFs. These included behavioral performance on EF tasks assessing working memory updating (N-back task), set-shifting (Switching task), conflict monitoring (Stroop task), and response inhibition (Stop-signal task), as well as FM theta power during these tasks, and subjective EFs in daily life (BRIEF-A). The results indicate that there are only differences in FM theta self-upregulation between the NF group and sham group when non-responders are excluded from the analysis. Regarding behavioral transfer effects, NF-specific improvements are found in working memory updating reaction time (RT) and conflict monitoring RT variability at 6-month follow-up, but not immediately after the NF training. The effects on FM theta power during the EF tasks and subjective changes in EFs in daily life were not specific to the NF training. As a next step, research should identify the best predictors to stratify NF training, as well as explore ways to improve NF responsiveness, for instance by increasing neuroplasticity.

Real‐time Neurofeedback Rewards Memory‐related Potentials in Older Brains

AbstractBackgroundElectroencephalogram (EEG)‐based neurofeedback (NF) allows reward of desired brain activity in milliseconds. Compared to frequency power‐based approach during resting state EEG, event‐related potentials (ERPs) based NF during a task is technically challenging because of the cost of computation over a time window. We have previously established that left‐frontal memory‐related potentials discriminate normal cognitive aging from age‐ and education‐ matched older adults with risk of mild cognitive impairment (MCI). To modulate brainwaves during working memory retrieval towards healthier patterns, we develop an ERP‐based neurofeedback protocol to reward better memory‐related potentials.MethodThe training protocol is developed based on a modified delayed match‐to‐sample task also known as Bluegrass working memory paradigm. During each memory trial, a participant holds the sample target image in his/her working memory and responds whether each subsequent image is a Match or Nonmatch to the memory target by pressing the button. Real‐time classification of extracted ERP features is analyzed after stimulus onset, the dynamic machine‐learning program then modifies the stimulus by turning it into vivid color (reward) or leaving it with black‐and‐white (unrewarded). The processing pipeline has been developed using ERPs of older adults with and without MCI. The left frontal sites (F3 and F7) were preprocessed by re‐referencing and filtering with a 0.05 – 40 Hz band‐pass filter. For each participant, the EEG of 5 offline base trials in a 300‐600ms time window was used as a baseline. The ERP difference of the baseline versus the subsequent single trial is calculated to determine whether the image will be colored or left at black‐and‐white.ResultOur newly developed ERP‐neurofeedback protocol has succeeded in providing visual feedback based on fluctuation of single trial ERP in real time. The program was also designed to fit in each individual due to varied sensibility to NF. Currently we are to examine the feasibility and effectiveness of the proposed protocol by measuring memory indicators before and after NF training sessions.ConclusionWe have developed a new protocol using ERP‐based neurofeedback to improve personalized memory retrieval. The program is the first step to intervention trials for enhancing successful memory by rewarding desired memory‐related potentials in older brains.

Multimodal biofeedback for Parkinson’s disease motor and nonmotor symptoms

Parkinson’s disease (PD) is a neurodegenerative disorder characterized by motor retardation, myotonia, quiescent tremor, and postural gait abnormality, as well as nonmotor symptoms such as anxiety and depression. Biofeedback improves motor and nonmotor functions of patients by regulating abnormal electroencephalogram (EEG), electrocardiogram (ECG), photoplethysmography (PPG), electromyography (EMG), respiration (RSP), or other physiological signals. Given that multimodal signals are closely related to PD states, the clinical effect of multimodal biofeedback on patients with PD is worth exploring. Twenty-one patients with PD in Beijing Rehabilitation Hospital were enrolled and divided into three groups: multimodal (EEG, ECG, PPG, and RSP feedback signal), EEG (EEG feedback signal), and sham (random feedback signal), and they received biofeedback training five times in two weeks. The combined clinical scale and multimodal signal analysis results revealed that the EEG group significantly improved motor symptoms and increased Berg balance scale scores by regulating β band activity; the multimodal group significantly improved nonmotor symptoms and reduced Hamilton rating scale for depression scores by improving θ band activity. Our preliminary results revealed that multimodal biofeedback can improve the clinical symptoms of PD, but the regulation effect on motor symptoms is weaker than that of EEG biofeedback.

Effects of neurofeedback on the self-concept of children with learning disorders.

Children with learning disorders (LDs) often have a lower self-concept than their typically developing peers. Neurofeedback (NFB) treatments seem to improve the cognitive and academic performance of these children, but the effects on self-concept have not been studied. In this exploratory study, 34 right-handed children (8-11 y.o.) with LD and delayed electroencephalographic maturation responded to the Piers-Harris Children's Self-Concept Scale. One group received NFB (n = 20), and another group (n = 14) served as control, which included 9 children treated with sham-NFB and 5 on a waiting-list. A nonparametric permutation approach was used to compare the academic performance and self-concept difference (postscores - prescores) between the NFB and control groups. Given the smaller size of the control subgroups, a comparison of the percent changes between sham-NFB and the waiting-list was performed with the non-overlap of all pairs (NAP) technique. In the NFB group, the scores of reading, math, and global self-concept increased significantly, highlighting the self-concept subdomains of physical appearance, nonanxiety, popularity, and happiness. Additionally, the sham-NFB subgroup showed better outcomes than the waiting-list subgroup, perhaps due to noncontrolled factors. We found improved academic performance and self-concept in children with LDs who received NFB treatment. This study is an important exploratory step in studying a relevant treatment that seems to ameliorate symptoms of LDs such as anxiety and low self-concept.

ITACA: An open-source framework for Neurofeedback based on Brain–Computer Interfaces

Background and objective:Neurofeedback (NF) is a paradigm that allows users to self-modulate patterns of brain activity. It is implemented with a closed-loop brain–computer interface (BCI) system that analyzes the user’s brain activity in real-time and provides continuous feedback. This paradigm is of great interest due to its potential as a non-pharmacological and non-invasive alternative to treat non-degenerative brain disorders. Nevertheless, currently available NF frameworks have several limitations, such as the lack of a wide variety of real-time analysis metrics or overly simple training scenarios that may negatively affect user performance. To overcome these limitations, this work proposes ITACA: a novel open-source framework for the design, implementation and evaluation of NF training paradigms. Methods:ITACA is designed to be easy-to-use, flexible and attractive. Specifically, ITACA includes three different gamified training scenarios with a choice of five brain activity metrics as real-time feedback. Among them, novel metrics based on functional connectivity and network theory stand out. It is complemented with five different computerized versions of widespread cognitive assessment tests. To validate the proposed framework, a computational efficiency analysis and an NF training protocol focused on frontal-medial theta modulation were conducted. Results:Efficiency analysis proved that all implemented metrics allow an optimal feedback update rate for conducting NF sessions. Furthermore, conducted NF protocol yielded results that support the use of ITACA in NF research studies. Conclusions:ITACA implements a wide variety of features for designing, conducting and evaluating NF studies with the goal of helping researchers expand the current state-of-the-art in NF training.

The Changes of the Infra-Slow EEG Fluctuations of the Brain Potentials under Influence of Infra-Low Frequency Neurofeedback

This study presents a comparison of the effect on EEG electrical activity in the range of infraslow frequencies of two methods: infra-low frequency EEG biofeedback and heart rate variability training. The study involved 17 healthy subjects aged 21 to 50 years with minor symptoms of a physiological or psychological nature, who did not have a history of neurological or psychiatric diseases. To evaluate the results of the training, we analyzed the spectral power of slow EEG oscillations during the performance of the attention test (Visual Go/NoGo), recorded before and after twenty sessions of biofeedback. Both the subjective assessment of the physiological and psychological state and the results of the visual test showed more pronounced positive changes under the influence of EEG biofeedback compared to the cases of heart rate variability training. A significant increase in the amplitudes of oscillations in the infraslow EEG range was observed only after EEG biofeedback.

Effects of Neurofeedback on Cognitive Function, Productive Activity, and Quality of Life in Patients With Traumatic Brain Injury: A Randomized Controlled Trial

Background Cognitive impairment is common in patients with traumatic brain injury (TBI). Studies that have examined the effectiveness of neurofeedback (NFB) on cognitive function following TBI have had poor study designs and small sample sizes. Objectives This randomized controlled trial assessed the effects of low-resolution tomography Z-score NFB (LZNFB) and theta/beta NFB on cognitive impairment, return to productive activity, and quality of life in patients with TBI. Methods We randomly assigned 87 patients with TBI with cognitive impairment to LZNFB, theta/beta NFB, or usual care (UC) groups. Patients in both NFB groups received weekly 60-minute treatment for 10 weeks, and those in the control group received UC and telephone interviews for 10 weeks. The primary outcome was cognitive function as measured by performance on cognitive tasks; the secondary outcomes included productive activity and quality of life based on the Community Integration Questionnaire-revised (CIQ-R) and the Quality of Life after Brain Injury (QOLIBRI), respectively, at baseline and immediately after the last intervention. Results The LZNFB group exhibited significantly greater improvements in immediate recall, delayed recall, recognition memory, and selective attention compared with the UC group; the theta/beta NFB group exhibited improvements in only immediate memory and selective attention (P < .05). The total CIQ-R scores of the LZNFB group after treatment were significantly improved than those of the UC group were. Conclusion Consecutive LZNFB achieved therapeutic effects in memory, attention, and productive activity, whereas theta/beta NFB improved memory and attention in patients with TBI. This trial was prospectively registered at ClinicalTrial.gov (registration number: NCT03515317; https://clinicaltrials.gov/ct2/show/NCT03515317).

Effect of Biofeedback-Based Interventions on the Psychological Outcomes of Pediatric Populations: A Systematic Review and Meta-analysis.

We performed a systematic and meta-analytic review of biofeedback-based interventions on psychological outcomes among pediatric populations. The literature search for this study was conducted in eight databases, including PubMed, the Cochrane Library, Scopus, CINAHL, Embase (OVID), Web of Science, PsycINFO (all via Ovid SP), and Google Scholar. The methodological quality of the studies was assessed using the Critical Appraisal Checklists for experimental and quasi-experimental studies that was developed by the Joanna Briggs Institute. We analyzed the effects of biofeedback-based interventions on psychological outcomes in the pediatric population by following the Preferred Reporting System for Systematic Reviews and Meta-Analysis. This systematic review and meta-analysis included nine studies with a total sample size of 658 children. In this study, EEG, EMG, and heart rate variability biofeedback were utilized to treat psychological symptoms in children. All studies focused on anxiety, with only one studying depression. As a result, it was found that all types of biofeedback effectively reduced children's anxiety levels. It was recommended that biofeedback-based interventions should be used to reduce children's anxiety.

Особенности реактивности μ-ритма ЭЭГ у детей с расстройствами аутистического спектра в ситуациях помогающего поведения

One of the subjects being discussed by the professional community currently is the role possibly played by the mirror neuron system (MNS) in the violation of social behavior of children with autism spectrum disorders (ASD). The MNS is known to shape the perception of emotions of others and understanding and imitation of their actions. Mu rhythm desynchronization in EEG is considered to be the indicator of the MNS activation. The purpose of this study was to identify the features of reactivity of the EEG mu rhythm within an individually determined frequency range in preschoolers with ASD in situations requiring instrumental, emotional and altruistic helping behavior (HB). The study involved children 4–7 years old with ASD (n = 26) and their normally developing peers without the condition (n = 37). Although in most cases, HB was more pronounced in the group of normally developing children, the differences between the groups are significant only for altruistic HP (p &lt; 0.01), and for the situation requiring complex altruistic and emotional HP it approaches significance (p = 0.09). Evaluation of the mu rhythm reactivity indices showed that the tasks invoking complex altruistic and emotional HB bring this indicator down significantly in children with ASD compared to the group of normally developing participants, as shown by the central leads of the left and right hemispheres and the parietal lead of the right hemisphere (C3: p = 0.02 ; C4: p = 0.03; P4: p = 0.03). It is assumed that the detected features stem from the impaired functioning of the MNS and the downstream regulation to the MNS from prefrontal cortex and other areas of the neocortex. The data obtained can be used in development of EEG biofeedback training protocols for children with ASD.

Neurofeedback Effects on EEG Connectivity among Children with Reading Disorders: I. Coherence

Electroencephalograms (EEGs) of children with reading disorders (RDs) are characterized by a higher theta and a lower alpha than those of typically developing children. Neurofeedback (NFB) may be helpful for treating learning disorders by reinforcing a reduction in the theta/alpha ratio. Several studies have suggested that NFB may lead to EEG power normalization and cognitive improvements. To further explore brain changes in isolated areas, the aim of this study was to explore the effects of an NFB protocol on functional connectivity (coherence) among children with RDs. Twenty children with an RD and an abnormally high theta/alpha ratio underwent 30 NFB sessions, and five children with the same characteristics received a sham NFB treatment. On average, the children in the NFB group showed an increase in reading accuracy and comprehension scores; their coherence diminished in the delta, theta, and beta bands and increased in the alpha band, primarily the theta intrahemispheric coherences of the left hemisphere, which is closely associated with reading. In contrast, children who received the sham NFB treatment did not show reading changes and had few changes in their coherence patterns. These preliminary results suggest that NFB can positively impact reading-related functions in the brain networks of children with RDs.

A meta‐analysis of neurofeedback for treating substance use disorders

AbstractA meta‐analysis was conducted to assess the efficacy of neurofeedback (NFB) in the treatment of individuals with substance use disorder (SUD) in between‐group studies. This study reports findings from the first exhaustive search of the literature on the topic and included articles selected from a total of 58 databases/repositories. Studies were evaluated using Hedge's g as the effect size measure and were assessed for risk of bias using funnel plot, Fail‐Safe N, and Trim and Fill analysis. Ten studies, containing 30 effect sizes were evaluated to determine the overall efficacy of NFB for decreasing symptoms of SUD (N = 397), yielding a mean effect size of g = –1.49 (CI 95 = –1.95, –1.03; PI 95 = –4.37 to 1.39). This meta‐analysis provides strong evidence for the efficacy of NFB in treating SUD while also highlighting the value of wholistic client care in SUD treatment.

Mental strategies and resting state EEG: Effect on high alpha amplitude modulation by neurofeedback in healthy young adults

Neurofeedback (NFB) is a brain-computer interface which allows individuals to modulate their brain activity. Despite the self-regulatory nature of NFB, the effectiveness of strategies used during NFB training has been little investigated. In a single session of NFB training (6*3 min training blocks) with healthy young participants, we experimentally tested if providing a list of mental strategies (list group, N = 46), compared with a group receiving no strategies (no list group, N = 39), affected participants’ neuromodulation ability of high alpha (10–12 Hz) amplitude. We additionally asked participants to verbally report the mental strategies used to enhance high alpha amplitude. The verbatim was then classified in pre-established categories in order to examine the effect of type of mental strategy on high alpha amplitude. First, we found that giving a list to the participants did not promote the ability to neuromodulate high alpha activity. However, our analysis of the specific strategies reported by learners during training blocks revealed that cognitive effort and recalling memories were associated with higher high alpha amplitude. Furthermore, the resting amplitude of trained high alpha frequency predicted an amplitude increase during training, a factor that may optimize inclusion in NFB protocols. The present results also corroborate the interrelation with other frequency bands during NFB training. Although these findings are based on a single NFB session, our study represents a further step towards developing effective protocols for high alpha neuromodulation by NFB.

Cognitive markers for efficacy of neurofeedback for attention-deficit hyperactivity disorder – personalized medicine using computational psychiatry in a randomized clinical trial

ABSTRACT Background Exploring whether cognitive components (identified by baseline cognitive testing and computational modeling) moderate clinical outcome of neurofeedback (NF) for attention-deficit hyperactivity disorder (ADHD). Method 142 children (aged 7–10) with ADHD were randomly assigned to either NF (n = 84) or control treatment (n = 58) in a double-blind clinical trial (NCT02251743). The NF group received live, self-controlled downtraining of electroencephalographic theta/beta ratio power. The control group received identical-appearing reinforcement from prerecorded electroencephalograms from other children. 133 (78 NF, 55 control) children had cognitive processing measured at baseline with the Integrated Visual and Auditory Continuous Performance Test (IVA2-CPT) and were included in this analysis. A diffusion decision model applied to the IVA2-CPT data quantified two latent cognitive components deficient in ADHD: drift rate and drift bias, indexing efficiency and context sensitivity of cognitive processes involving information integration. We explored whether these cognitive components moderated the improvement in parent- and teacher-rated inattention symptoms from baseline to treatment end (primary clinical outcome). Results Baseline cognitive components reflecting information integration (drift rate, drift bias) moderated the improvement in inattention due to NF vs. control treatment (p = 0.006). Specifically, those with either the most or least severe deficits in these components showed more improvement in parent- and teacher-rated inattention when assigned to NF (Cohen’s d = 0.59) than when assigned to control (Cohen’s d = −0.21). Conclusions Pre-treatment cognitive testing with computational modeling identified children who benefitted more from neurofeedback than control treatment for ADHD.

Intensive Neurofeedback Protocol: An Alpha Training to Improve Sleep Quality and Stress Modulation in Health Care Professionals During the Covid-19 Pandemic. A Pilot Study.

health care workers (HCWs) represent a vulnerable group in the COVID-19 pandemic, given the exposure to greater risk and higher levels of work-related stress. Neurofeedback (NF) has shown to be effective in the treatment of stress-related symptoms. We aimed to assess the effectiveness of an alpha-increase NF protocol for the treatment of acute stress symptoms in HCWs exposed to the COVID-19 pandemic. eighteen medical doctors on duty during the COVID-19 health emergency underwent an intensive NF alpha-increase protocol. The mean alpha wave values were recorded at the beginning (T0) and at the last day of stimulation (T1). Rapid Stress Assessment: Italian version; Copenhagen Burnout Inventory (CBI); Pittsburgh Sleep Quality Index (PSQI), and Brief-COPE were administered as psychometric assessment. a significant increase in alpha wave values and a significant reduction of the PSQI scores from T0 to T1 were found. NF alpha-increase protocol showed promising results in terms of stress modulation, sleep quality improvement, and safety in a pilot sample of HCWs.