A Systematic Review of The Potential Use of Neurofeedback in Patients with Schizophrenia.

Schizophrenia (SCZ) is a neurodevelopmental disorder characterized by positive symptoms (hallucinations and delusions), negative symptoms (anhedonia, social withdrawal) and marked cognitive deficits (memory, executive function, and attention). Current mainstays of treatment, including medications and psychotherapy, do not adequately address cognitive symptoms, which are essential for everyday functioning. However, recent advances in computational neurobiology have rekindled interest in neurofeedback (NF), a form of self-regulation or neuromodulation, in potentially alleviating cognitive symptoms in patients with SCZ. Therefore, we conducted a systematic review of the literature for NF studies in SCZ to identify lessons learned and to identify steps to move the field forward. Our findings reveal that NF studies to date consist mostly of case studies and small sample, single-group studies. Despite few randomized clinical trials, the results suggest that NF is feasible and that it leads to measurable changes in brain function. These findings indicate early proof-of-concept data that needs to be followed up by larger, randomized clinical trials, testing the efficacy of NF compared to well thought out placebos. We hope that such an undertaking by the field will lead to innovative solutions that address refractory symptoms and improve everyday functioning in patients with SCZ

Differential psychophysiological interactions of insular subdivisions during varied oropharyngeal swallowing tasks

Abstract The insula is a highly integrated cortical region both anatomically and functionally. It has been shown to have cognitive, social–emotional, gustatory, and sensorimotor functions. Insular involvement in both normal and abnormal swallowing behavior is well established, yet its functional connectivity is unclear. Studies of context‐dependent connectivity, or the connectivity during different task conditions, have the potential to reveal information about synaptic function of the insula. The goal of this study was to examine the functional connectivity of specific insular regions (ventral anterior, dorsal anterior, and posterior) with distant cortical regions during four swallowing conditions (water, sour, e‐stim, and visual biofeedback) using generalized psychophysiological interactions (gPPI). In 19 healthy adults, we found that the visual biofeedback condition was associated with the most and strongest increases in functional connectivity. The posterior insula/rolandic operculum regions had the largest clusters of increases in functional connectivity, but the ventral anterior insula was functionally connected to a more diverse array of cortical regions. Also, laterality assessments showed left lateralized increases in swallowing functional connectivity. Our results are aligned with reports about the insula's interconnectivity and extensive involvement in multisensory and cognitive tasks

Smart Biofeedback

Smart biofeedback is receiving attention because of the widespread availability of advanced technologies and smart devices that are used in effective collection, analysis, and feedback of physiologic data. Researchers and practitioners have been working on various aspects of smart biofeedback methodologies and applications by using wireless communications, the Internet of Things (IoT), wearables, biomedical sensors, artificial intelligence, big data analytics, clinical virtual reality, smartphones, and apps, among others. The current paradigm shift in information and communication technologies (ICT) has been propelling the rapid pace of innovation in smart biofeedback. This book addresses five important topics of the perspectives and applications in smart biofeedback: brain networks, neuromeditation, psychophysiological psychotherapy, physiotherapy, and privacy, security, and integrity of data

SWALLOWING DISORDERS IN CLINICAL PRACTICE: FUNCTIONAL ANATOMY, ASSESSMENT AND REHABILITATION STRATEGIES

Swallowing is a complex process consisting in transporting food from mouth to the stomach; it involves voluntary and reflex activity of more than 30 nerves and muscles, requiring complex neuromuscular coordination and brainstem and cortical centers for controle. Dysphagia is defined as a alteration in the swallowing process, which cause difficulty in transporting saliva and aliments from the mouth trough the pharynx and esophagus into the stomach . It is a frequent symptom, affecting especially old people, people with neurological diseases, cancers of head and neck or severe reflux . Dysphagia can result from a wide variety of functional or structural deficits of the oral cavity, pharynx, larynx or esophagus, which could e caused by neurological conditions. Dysphagia carries serious health risks: malnutrition, dehydration, increase risk of infections. Effective dysphagia management requires an interdisciplinary approach; the goal of rehabilitation is to identify and treat abnormalities of swallowing while maintaining safe and efficient nutrition. KEY WORDS: swallowing, dysphagia, functional anatomy, rehabilitation, neuroplasticit

EMG-based visual-haptic biofeedback: a tool to improve motor control in children with primary dystonia.

New insights suggest that dystonic motor impairments could also involve a deficit of sensory processing. In this framework, biofeedback, making covert physiological processes more overt, could be useful. The present work proposes an innovative integrated setup which provides the user with an electromyogram (EMG)-based visual-haptic biofeedback during upper limb movements (spiral tracking tasks), to test if augmented sensory feedbacks can induce motor control improvement in patients with primary dystonia. The ad hoc developed real-time control algorithm synchronizes the haptic loop with the EMG reading; the brachioradialis EMG values were used to modify visual and haptic features of the interface: the higher was the EMG level, the higher was the virtual table friction and the background color proportionally moved from green to red. From recordings on dystonic and healthy subjects, statistical results showed that biofeedback has a significant impact, correlated with the local impairment, on the dystonic muscular control. These tests pointed out the effectiveness of biofeedback paradigms in gaining a better specific-muscle voluntary motor control. The flexible tool developed here shows promising prospects of clinical applications and sensorimotor rehabilitation

Towards dynamical network biomarkers in neuromodulation of episodic migraine

Computational methods have complemented experimental and clinical neursciences and led to improvements in our understanding of the nervous systems in health and disease. In parallel, neuromodulation in form of electric and magnetic stimulation is gaining increasing acceptance in chronic and intractable diseases. In this paper, we firstly explore the relevant state of the art in fusion of both developments towards translational computational neuroscience. Then, we propose a strategy to employ the new theoretical concept of dynamical network biomarkers (DNB) in episodic manifestations of chronic disorders. In particular, as a first example, we introduce the use of computational models in migraine and illustrate on the basis of this example the potential of DNB as early-warning signals for neuromodulation in episodic migraine.Comment: 13 pages, 5 figure

Bra.Di.P.O. and P.I.G.R.O.: Innovative Devices for Motor Learning Programs

Two mechatronics prototypes, useful for robotic neurotreatments and new clinical trainings, are here presented. P.I.G.R.O. (pneumatic interactive gait rehabilitation orthosis) is an active exoskeleton with an electropneumatic control. It imposes movements on lower limbs in order to produce in the patient’s brain proper motor cortex activation. Bra.Di.P.O. (brain discovery pneumatic orthosis) is an MR-compatible device, designed to improve fMRI (functional magnetic resonance imaging) analysis. The two devices are presented together because both are involved in the study of new robotic treatments of patients affected by ictus or brain stroke or in some motor learning experimental investigations carried out on healthy subjects