Neurofeedback Training Sessions Research Articles

Assessing the Effectiveness of Audio-Visual vs. Visual Neurofeedback for Attention Enhancement: A Pilot Study with Neurological, Behavioural, and Neuropsychological Measures.

Electroencephalogram (EEG) based Neurofeedback training has gained traction as a practical method for enhancing executive functions, particularly attention, among healthy individuals. The neurofeedback protocols based on EEG channel locations, frequency bands, or EEG features has been tested. However, the improvement in attention was not measured by comparing different feedback stimulus types. We believe that multisensory nature feedback even with few training sessions may induce strong effect. Therefore, this study compares the effect of audio-visual and visual feedback stimuli for attention enhancement utilizing neurophysiological, behavioural and neuropsychological measures. Total 21 subjects were recruited, undergoing six alternate days of neurofeedback training sessions to upregulate EEG beta power of frontocentral (FC5). Dwell time, fractional occupancy and transition probability were also estimated from the EEG beta power. Audiovisual group (G1) as compared to visual group (G2) demonstrate a significant increase of global EEG beta activity alongside improved dwell time (t = 2.76, p = 0.003), fractional occupancy (t = 1.73, p = 0.042) and transition probability (t = 2.46, p = 0.008) over the course of six neurofeedback training sessions. Similarly, the group (G1) shows higher scores (t = 2.13, p = 0.032) and faster reaction times (t = 2.22, p = 0.028) in Stroop task, along with increased score in Mindfulness Attention Awareness Scale (MAAS-15) questionnaire (t = 2.306, p = 0.012). Audiovisual neurofeedback may enhance training effectiveness, potentially achieving the same outcomes in fewer sessions compared to visual-only feedback. However, sufficient training days are essential for effect consolidation. This highlights the feasibility of completing neurofeedback training, a significant challenge in practice.

The Impact of Neurofeedback Training on Cognitive Abilities Assessed by the Wechsler Intelligence Scale for Children-Revised in Children with Attention Deficit: A Randomized Single-Blind Sham-Controlled Study.

This study aims to investigate the effects of a neurofeedback system on cognitive skills, as measured by the Wechsler Intelligence Scale for Children-Revised (WISC-R), in a cohort of 100 children aged 8 to 12 who were diagnosed with attention deficit. A randomized single-blind sham control group design was employed, with 50 participants assigned to the experimental group receiving neurofeedback training and 50 participants assigned to the sham group receiving simulated training. Participants were selected through random sampling from individuals seeking assistance at a specialized education center over the course of one year (May 2021-2022). Pre- and post-test WISC-R assessments were administered to both groups to evaluate participants' mental performance. The experimental group underwent a total of 60 sessions of quantitative electroencephalography-based infralow frequency neurofeedback training, with half-hour sessions conducted three days a week over a five-month period. The post-test WISC-R was administered at the end of the sixth month. The results revealed significant differences between the pre- and post-training test scores, specifically in terms of verbal IQ, picture arrangement, performance IQ, and total IQ (p = 0.016, p = 0.001, p < 0.001, and p = 0.002, respectively), when comparing the differences between the two groups. These findings indicate a notable improvement in performance IQ, total IQ, and a reduction in attention deficits among the neurofeedback group based on the WISC-R assessments. Future studies should consider employing larger sample sizes, including appropriate control groups, and conducting long-term follow-ups to further elucidate the clinical significance of these results.

Effects of home-based EEG neurofeedback training as a non-pharmacological intervention for Parkinson's disease

ObjectivesAberrant movement-related cortical activity has been linked to impaired motor function in Parkinson's disease (PD). Dopaminergic drug treatment can restore these, but dosages and long-term treatment are limited by adverse side-effects. Effective non-pharmacological treatments could help reduce reliance on drugs. This experiment reports the first study of home-based electroencephalographic (EEG) neurofeedback training as a non-pharmacological candidate treatment for PD. Our primary aim was to test the feasibility of our EEG neurofeedback intervention in a home setting. MethodsSixteen people with PD received six home visits comprising symptomology self-reports, a standardised motor assessment, and a precision handgrip force production task while EEG was recorded (visits 1, 2 and 6); and 3 × 1-hr EEG neurofeedback training sessions to supress the EEG mu rhythm before initiating handgrip movements (visits 3 to 5). ResultsParticipants successfully learned to self-regulate mu activity, and this appeared to expedite the initiation of precision movements (i.e., time to reach target handgrip force off-medication pre-intervention = 628 ms, off-medication post-intervention = 564 ms). There was no evidence of wider symptomology reduction (e.g., Movement Disorder Society Unified Parkinson's Disease Rating Scale Part III Motor Examination, off-medication pre-intervention = 29.00, off-medication post intervention = 30.07). Interviews indicated that the intervention was well-received. ConclusionBased on the significant effect of neurofeedback on movement-related cortical activity, positive qualitative reports from participants, and a suggestive benefit to movement initiation, we conclude that home-based neurofeedback for people with PD is a feasible and promising non-pharmacological treatment that warrants further research.

Enhancing poststroke hand movement recovery: Efficacy of RehabSwift, a personalized brain-computer interface system.

This study explores the efficacy of our novel and personalized brain-computer interface (BCI) therapy, in enhancing hand movement recovery among stroke survivors. Stroke often results in impaired motor function, posing significant challenges in daily activities and leading to considerable societal and economic burdens. Traditional physical and occupational therapies have shown limitations in facilitating satisfactory recovery for many patients. In response, our study investigates the potential of motor imagery-based BCIs (MI-BCIs) as an alternative intervention. In this study, MI-BCIs translate imagined hand movements into actions using a combination of scalp-recorded electrical brain activity and signal processing algorithms. Our prior research on MI-BCIs, which emphasizes the benefits of proprioceptive feedback over traditional visual feedback and the importance of customizing the delay between brain activation and passive hand movement, led to the development of RehabSwift therapy. In this study, we recruited 12 chronic-stage stroke survivors to assess the effectiveness of our solution. The primary outcome measure was the Fugl-Meyer upper extremity (FMA-UE) assessment, complemented by secondary measures including the action research arm test, reaction time, unilateral neglect, spasticity, grip and pinch strength, goal attainment scale, and FMA-UE sensation. Our findings indicate a remarkable improvement in hand movement and a clinically significant reduction in poststroke arm and hand impairment following 18 sessions of neurofeedback training. The effects persisted for at least 4 weeks posttreatment. These results underscore the potential of MI-BCIs, particularly our solution, as a prospective tool in stroke rehabilitation, offering a personalized and adaptable approach to neurofeedback training.

Exploring the efficacy of neurofeedback training in modulating alpha-frequency band and its effects on functional connectivity and band power

Electroencephalogram (EEG) based neurofeedback training (NFT) has shown to be effective in clinical applications, but healthy participants can also benefit from NFT. This research investigates the effect of 20 NFT sessions with frontal alpha Band Power (α-BP) as feedback on healthy participants by analyzing physiological and behavioral changes. The study participants were divided into two groups (n = 25), i.e., the Training Group (TG) and the control group (CG). Participants performed cognitive tasks, (attention network task (ANT), STROOP, and N-Back), and behavioral tests (MMSE, PSS, and SAM) at three stages: pre-NFT, mid-NFT, and post-NFT. Although the changes were not statistically significant, the behavioral tests showed improvement from pre-to-post stages. The TG showed a significant post-NFT decrease in response time (RT) in the ANT, indicating improved attention. However, the N-Back and STROOP task results show a non-significant change. BP analysis revealed a significant increase in alpha (α) and beta (β) BP from pre-NFT to post-NFT. Attention and memory enhancement, cognitive inhibition, and induced relaxation were inferred by an increase in α-BP in the frontal, temporal, and parietal lobes. Increased frontal and parietal β-BP show cognitive inhibition and auditory attention. Increased frontal lobe α Functional Connectivity (FC) represents enhanced attention, working memory, and decision-making. Increased temporal β-FC shows auditory perception and memory processing. The results signify the effectiveness of NFT in cognitive development.

Functional near-infrared spectroscopy-based neurofeedback training regulates time-on-task effects and enhances sustained cognitive performance.

Time-on-task effect is a common consequence of long-term cognitive demand work, which reflects reduced behavioral performance and increases the risk of accidents. Neurofeedback is a neuromodulation method that can guide individuals to regulate their brain activity and manifest as changes in related symptoms and cognitive behaviors. This study aimed to examine the effects of functional near-infrared spectroscopy-based neurofeedback training on time-on-task effects and sustained cognitive performance. A randomized, single-blind, sham-controlled study was performed: 17 participants received feedback signals of their own dorsolateral prefrontal cortex activity (neurofeedback group), and 16 participants received feedback signals of dorsolateral prefrontal cortex activity from the neurofeedback group (sham-neurofeedback group). All participants received 5 neurofeedback training sessions and completed 2 sustained cognitive tasks, including a 2-back task and a psychomotor vigilance task, to evaluate behavioral performance changes following neurofeedback training. Results showed that neurofeedback relative to the sham-neurofeedback group exhibited increased dorsolateral prefrontal cortex activation, increased accuracy in the 2-back task, and decreased mean response time in the psychomotor vigilance task after neurofeedback training. In addition, the neurofeedback group showed slower decline performance during the sustained 2-back task after neurofeedback training compared with sham-neurofeedback group. These findings demonstrate that neurofeedback training could regulate time-on-task effects on difficult task and enhance performance on sustained cognitive tasks by increasing dorsolateral prefrontal cortex activity.

Effects of School-Based Neurofeedback Training on Attention in Students with Autism and Intellectual Disabilities.

In this study we aimed to assess the influence of school-based neurofeedback training on the attention of students with autism and intellectual disabilities. We assessed 24 students of a special education center who attended neurofeedback training sessions during the schoolyear; we also assessed 25 controls from the same center. We used two computer tasks to assess sustained attention in simple and cognitively demanding test situations, and we used a pen-and-paper task to assess selective attention. Each student who took part in the study was tested at the beginning and at the end of the schoolyear. Students from the experimental group significantly improved their performance in the task related to sustained attention to simple stimuli. No performance improvement related to neurofeedback treatment was observed in either sustained attention in cognitively demanding situations or selective attention. School-based neurofeedback training may improve sustained attention to simple stimuli in students with developmental disabilities.

Mu-Suppression Neurofeedback Training Targeting the Mirror Neuron System: A Pilot Study

Neurofeedback training (NFT) is a promising adjuvant intervention method. The desynchronization of mu rhythm (8–13 Hz) in the electroencephalogram (EEG) over centro-parietal areas is known as a valid indicator of mirror neuron system (MNS) activation, which has been associated with social skills. Still, the effect of neurofeedback training on the MNS requires to be well investigated. The present study examined the possible impact of NFT with a mu suppression training protocol encompassing 15 NFT sessions (45 min each) on 16 healthy neurotypical participants. In separate pre- and post-training sessions, 64-channel EEG was recorded while participants (1) observed videos with various types of movements (including complex goal-directed hand movements and social interaction scenes) and (2) performed the "Reading the Mind in the Eyes Test" (RMET). EEG source reconstruction analysis revealed statistically significant mu suppression during hand movement observation across MNS-attributed fronto-parietal areas after NFT. The frequency analysis showed no significant mu suppression after NFT, despite the fact that numerical mu suppression appeared to be visible in a majority of participants during goal-directed hand movement observation. At the behavioral level, RMET accuracy scores did not suggest an effect of NFT on the ability to interpret subtle emotional expressions, although RMET response times were reduced after NFT. In conclusion, the present study exhibited preliminary and partial evidence that mu suppression NFT can induce mu suppression in MNS-attributed areas. More powerful experimental designs and longer training may be necessary to induce substantial and consistent mu suppression, particularly while observing social scenarios.

User Experience in Neurofeedback Applications Using AR as Feedback Modality

Neurofeedback (NF) is a brain–computer interface in which users can learn to modulate their own brain activation while receiving real-time feedback thereof. To increase motivation and adherence to training, virtual reality has recently been used as a feedback modality. In the presented study, we focused on the effects of augmented reality (AR) based visual feedback on subjective user experience, including positive/negative affect, cybersickness, flow experience, and experience with the use of this technology, and compared it with a traditional 2D feedback modality. Also, half of the participants got real feedback and the other half got sham feedback. All participants performed one NF training session, in which they tried to increase their sensorimotor rhythm (SMR, 12–15 Hz) over central brain areas. Forty-four participants received conventional 2D visual feedback (moving bars on a conventional computer screen) about real-time changes in SMR activity, while 45 participants received AR feedback (3D virtual flowers grew out of a real pot). The subjective user experience differed in several points between the groups. Participants from the AR group received a tendentially higher flow score, and the AR sham group perceived a tendentially higher feeling of flow than the 2D sham group. Further, participants from the AR group reported a higher technology usability, experienced a higher feeling of control, and perceived themselves as more successful than those from the 2D group. Psychological factors like this are crucial for NF training motivation and success. In the 2D group, participants reported more concern related to their performance, a tendentially higher technology anxiety, and also more physical discomfort. These results show the potential advantage of the use of AR-based feedback in NF applications over traditional feedback modalities.

Inconclusive results of slow cortical potential neurofeedback for the treatment of chronic post-stroke attention deficits.

Individuals who have suffered a stroke may experience long-lasting cognitive impairments that can worsen if left untreated. We investigated whether voluntary control of slow cortical potentials (SCP) through neurofeedback would help alleviate chronic post-stroke symptoms of impaired attention. The study initially enrolled twenty-eight participants, but due to a high drop-out rate, only sixteen participants completed eight SCP neurofeedback training sessions within three to four weeks. During these sessions, we gave feedback to the participants on their ability to regulate SCPs on a computer screen. Our findings showed a non-significant increase in SCP regulation towards cortical negativity. On the behavioral level, we found improved test values in the divided attention and attentional flexibility subtests of the test battery for attention performance. However, we cannot eliminate the possibility that nonspecific effects influenced or caused our results. We have not observed any improvement regarding the effects of attention deficits on participants' daily lives. We identified five individuals who could gain SCP control successfully and consistently towards negativity. In this group of responders, we observed an improvement in the test results related to divided attention but no other attention-related improvements. Based on our observations, results of SCP neurofeedback training for the treatment of attention deficits after a stroke are inconclusive. More research is necessary to determine the effectiveness of SCP neurofeedback in helping stroke survivors cope with attention-related challenges in their daily lives.

Do Miniature Eye Movements Affect Neurofeedback Training Performance? A Combined EEG-Eye Tracking Study

EEG-based neurofeedback is a prominent method to modulate one’s own brain activity in a desired direction. However, the EEG signal can be disturbed by artifacts, e.g., eye movements, which can consequently confound the neurofeedback performance. Involuntary miniature eye movements can be hardly detected by conventional EEG correction methods such as recording the electro-oculogram (EOG) and subtracting EOG activity from the EEG signal. However, such miniature eye movements can influence EEG activity, especially in the Gamma frequency range, enormously. In the present study, we investigated whether power in different EEG frequencies can be effectively modulated by self-control of brain signals during neurofeedback training and/or whether changes in EEG power are provoked by miniature eye movements during the training. To this end, 24 participants performed one session of SMR and one session of Gamma neurofeedback training. Additionally, in each training session sham feedback was performed. An eye tracker was used to detect miniature eye movements (< 1°) during neurofeedback training. About two thirds of the participants were able to increase their SMR power over the course of NF training, while one third was able to increase Gamma power. Generally, miniature eye movements induced a strong Gamma power increase. The number of eye movements also increased numerically over the course of the NF training. However, we did not find a significant relationship with the NF training performance. This is a first indication that miniature saccades do not affect NF training performance, but should not be neglected during NF training. Our results have to be confirmed in future studies.

Accelerating P300-based neurofeedback training for attention enhancement using iterative learning control: a randomised controlled trial

Objective. Neurofeedback (NFB) training through brain–computer interfacing has demonstrated efficacy in treating neurological deficits and diseases, and enhancing cognitive abilities in healthy individuals. It was previously shown that event-related potential (ERP)-based NFB training using a P300 speller can improve attention in healthy adults by incrementally increasing the difficulty of the spelling task. This study aims to assess the impact of task difficulty adaptation on ERP-based attention training in healthy adults. To achieve this, we introduce a novel adaptation employing iterative learning control (ILC) and compare it against an existing method and a control group with random task difficulty variation. Approach. The study involved 45 healthy participants in a single-blind, three-arm randomised controlled trial. Each group underwent one NFB training session, using different methods to adapt task difficulty in a P300 spelling task: two groups with personalised difficulty adjustments (our proposed ILC and an existing approach) and one group with random difficulty. Cognitive performance was evaluated before and after the training session using a visual spatial attention task and we gathered participant feedback through questionnaires. Main results. All groups demonstrated a significant performance improvement in the spatial attention task post-training, with an average increase of 12.63%. Notably, the group using the proposed iterative learning controller achieved a 22% increase in P300 amplitude during training and a 17% reduction in post-training alpha power, all while significantly accelerating the training process compared to other groups. Significance. Our results suggest that ERP-based NFB training using a P300 speller effectively enhances attention in healthy adults, with significant improvements observed after a single session. Personalised task difficulty adaptation using ILC not only accelerates the training but also enhances ERPs during the training. Accelerating NFB training, while maintaining its effectiveness, is vital for its acceptability by both end-users and clinicians.

Enhancing Overt and Covert Attention Using a Real-Time Neurofeedback Game With Consumer-Grade EEG

Neurofeedback training is emerging as a promising tool for cognitive enhancement in healthy as well as cognitive-deficit patients. In this paper, we propose the design of a real-time neurofeedback game using a consumer-grade wireless Electroencephalography (EEG) system and examine its efficacy in enhancing overt and covert attention abilities for healthy individuals. The game uses a simulated car navigation task, in which a car is navigated using the attention level of the player. A total of twenty-three healthy subjects participated in four sessions of neurofeedback training. The effectiveness of the proposed neurofeedback game is evaluated using attention scores based on the Sample entropy of EEG signals, beta-to-(alpha + theta) ratio, and the time taken for completing the game. The variations in covert attention are assessed by introducing visual distractions when the player navigates the car and quantified using changes in the attention score and the time taken for restoring the initial attention level. The attention score significantly improved from the first session to the final session by 22.64% and 21.43% for overt attention and covert attention tasks, respectively. The experimental results demonstrate that the proposed neurofeedback game is an effective tool for enhancing overt and covert attention skills in healthy individuals.

Neurofeedback for alcohol addiction: Changes in resting state network activity✰

Alcohol dependence continues to be a major global burden despite significant research progress and treatment development. The aim of this study was to investigate whether neurofeedback training can alter resting state fMRI activity in brain regions that play a crucial role in addiction disorders in patients with alcohol dependence. For this purpose, a total of 52 patients were recruited for the present study, randomized, and divided into an active and a sham group. Patients in the active group received three sessions of neurofeedback training. We compared the resting state data in the active group as part of the NF training on six measurement days. When comparing the results of the active group from neurofeedback day 3 with baseline 1, a significant reduction in activated voxels in the ventral attention network area was seen. This suggests that reduced activity over the course of therapy in subjects may lead to greater independence from external stimuli. Overall, a global decrease in activated voxels within all three analysed networks compared to baseline was observed in the study. The use of resting-state data as potential biomarkers, as activity changes within these networks, may be to help restore cognitive processes and alcohol abuse-related craving and emotions.

Successful learning of alpha up-regulation through neurofeedback training modulates sustained attention

As a fundamental attention function, sustained attention plays a critical role in general cognitive abilities and is closely linked to EEG alpha oscillations. Neurofeedback training (NFT) of alpha activity on different aspects of attention has been studied previously. However, it remains unclear how NFT with up- or down-regulation directions modulates sustained attention. Here we employed a counterbalanced single-blind sham-controlled crossover design, in which healthy young adults underwent one NFT session of alpha up-regulation, one NFT session of alpha down-regulation, and one sham-control NFT session over the posterior area. The session order was counterbalanced with a 7-day interval between each session. After each NFT session, the participants completed a visual continuous temporal expectancy task (vCTET) to assess their sustained attention performance. The results showed that compared to sham-control NFT, successful learning of alpha up-regulation resulted in increased reaction time at the beginning of the attention task but a slower increase over vCTET blocks. On the other hand, successful learning of alpha down-regulation had no impact on attention performance compared to sham-control NFT. These findings suggest that successful learning of alpha up-regulation through NFT could impair initial attention performance but slow down visual attention deterioration over time, i.e., alpha enhancement by NFT stabilizing visual attention.

Real‐time Memory‐related Neurofeedback Training Improves Intrinsic Brain Oscillations in Older Adults

AbstractBackgroundMild cognitive impairment (MCI), manifesting as working memory deficits for example, is the most common and earliest symptom of Alzheimer’s disease and related dementias (AD/ADRD). To combat the brain aging processes, early intervention is needed. Electroencephalogram (EEG)‐based neurofeedback (NF) has been found to be beneficial in treating a variety of brain disorders. Increased intrinsic delta power and decreased alpha is associated with brain aging and AD pathologies. We have developed an ERP‐based NF protocol to reward memory‐related potentials. In this study, we aim to evaluate the effect of NF training protocol.MethodThree older males (ages, 63, 78, and 79) participated in a newly developed NF training protocol including baseline and memory‐related NF training (twice a week). Each participant was recorded using 90‐second of eyes closed (EC) before multiple NF sessions during each visit. Their brain signals were collected with a 14‐channel wireless electroencephalogram (EEG) headset and processed in real‐time. The NF training contained 2 sham sessions followed by 2 intervention sessions. Compared to the intervention, visual feedback in the sham was provided in random order rather than triggered by participants’ ERP fluctuations. The EEG signal collected with EC before the experiment (Baseline, T0), 3 days after the sham (Sham, T1), and 3 days after the intervention (post‐intervention, T2) were preprocessed as 4s epoch windows and computed as the delta, theta, alpha, beta, and gamma band power. The average EEG band powers from T0, T1, and T2 and memory performances from the three participants were calculated.ResultThe working memory performance (accuracy and reaction times during retrievals of memory target and rejection of nontarget) did not show significant change among the three participants. In contrast, the EC intrinsic delta and alpha power changed towards brainwaves seen in younger brains after several sessions of NF training. Additionally, sham also improves in the alpha band (associated with attention and vigilance).ConclusionThe pilot results demonstrated the effectiveness of a newly developed NF training using working memory related potentials in two out of three older adults. The results indicate the promise of cognitive enhancement using event‐related potentials‐based NF training in real time.

Effect of a single session of sensorimotor rhythm neurofeedback training on the putting performance of professional golfers.

Sensorimotor rhythm (SMR) activity has been associated with automaticity and flow in motor execution. Studies have revealed that neurofeedback training (NFT) of the SMR can improve sports performance; however, few studies have adequately explored the effects of a single session of such NFT or examined the possible mechanisms underlying these effects on sports performance. This study recruited 44 professional golfers to address these gaps in the literature. A crossover design was employed to determine the order of the participation in the NFT and no-training control conditions. The participants were asked to perform 60 10-foot putts while electroencephalograms (EEGs) were recorded before and after the tasks. In pre-and post-tests, visual analog scales were used to assess the psychological states associated with SMR activities including the levels of attention engagement, conscious motor control, and physical relaxation. The results revealed that a single NFT session effectively increased SMR power and improved putting performance compared with the control condition. The subjective assessments also revealed that the participants reported lower attention engagement, less conscious control of the motor details and were more relaxed in the putting task, suggesting that SMR NFT promoted effortless and quiescent mental states during motor preparation for a putting task. This study aligns with theoretical hypotheses and extends current knowledge by revealing that a single session of SMR NFT can effectively enhance SMR power and improve putting performance in professional golfers. It also provides preliminary evidence of the possible underlying mechanisms that drive the effect of SMR NFT on putting performances.

Attention-related power and functional connectivity modulation associated with long-term alpha neurofeedback training

Electroencephalography (EEG) based Neurofeedback training (NFT) is a non-invasive, brain-modulation technique that can improve the subject’s attention. In this research, the effectiveness of long-term NFT on the subject’s attention is explored. Real-time frontal lobe alpha band (8–13 Hz) power was used as feedback. The subjects were divided into the NFT group (n = 25) which received training and the control group (n = 25) which did not. All the subjects participated in the attention network task (ANT) at three stages i.e., before, mid, and at the end of NFT sessions. The EEG and behavioral data (Response time (RT) of the ANT task) were recorded for all subjects. The EEG data were pre-processed using a manual artifact removal procedure to avoid event-related information loss. Alpha band modulation can affect other bands such as theta (4–8 Hz) and beta (13–30 Hz) hence event-related functional connectivity (FC) and band power (BP) were analyzed in these bands as well. In event-related analysis, a significant increase (ANOVA & T-Test: P < 0.05) in theta and alpha power and FC within the NFT group was observed after NFT sessions whereas the changes observed within the control group were not significant. The RT of the subjects in the NFT group decreased. The increase in event-related power and connectivity within the theta and alpha band and the decrease in RT in the NFT group indicate the effectiveness of NFT sessions in the enhancement of attention.

Neurofeedback therapy to improve cognitive function in patients with chronic post-stroke attention deficits: a within-subjects comparison.

We investigated a slow-cortical potential (SCP) neurofeedback therapy approach for rehabilitating chronic attention deficits after stroke. This study is the first attempt to train patients who survived stroke with SCP neurofeedback therapy. We included N = 5 participants in a within-subjects follow-up design. We assessed neuropsychological and psychological performance at baseline (4 weeks before study onset), before study onset, after neurofeedback training, and at 3 months follow-up. Participants underwent 20 sessions of SCP neurofeedback training. Participants learned to regulate SCPs toward negativity, and we found indications for improved attention after the SCP neurofeedback therapy in some participants. Quality of life improved throughout the study according to engagement in activities of daily living. The self-reported motivation was related to mean SCP activation in two participants. We would like to bring attention to the potential of SCP neurofeedback therapy as a new rehabilitation method for treating post-stroke cognitive deficits. Studies with larger samples are warranted to corroborate the results.

Amygdala downregulation training using fMRI neurofeedback in post-traumatic stress disorder: a randomized, double-blind trial

Hyperactivation of amygdala is a neural marker for post-traumatic stress disorder (PTSD) and improvement in control over amygdala activity has been associated with treatment success in PTSD. In this randomized, double-blind clinical trial we evaluated the efficacy of a real-time fMRI neurofeedback intervention designed to train control over amygdala activity following trauma recall. Twenty-five patients with PTSD completed three sessions of neurofeedback training in which they attempted to downregulate the feedback signal after exposure to personalized trauma scripts. For subjects in the active experimental group (N = 14), the feedback signal was from a functionally localized region of their amygdala associated with trauma recall. For subjects in the control group (N = 11), yoked-sham feedback was provided. Changes in control over the amygdala and PTSD symptoms served as the primary and secondary outcome measurements, respectively. We found significantly greater improvements in control over amygdala activity in the active group than in the control group 30-days following the intervention. Both groups showed improvements in symptom scores, however the symptom reduction in the active group was not significantly greater than in the control group. Our finding of greater improvement in amygdala control suggests potential clinical application of neurofeedback in PTSD treatment. Thus, further development of amygdala neurofeedback training in PTSD treatment, including evaluation in larger samples, is warranted.