Optimizing microsurgical skills with EEG neurofeedback

Background By enabling individuals to self-regulate their brainwave activity in the field of optimal performance in healthy individuals, neurofeedback has been found to improve cognitive and artistic performance. Here we assessed whether two distinct EEG neurofeedback protocols could develop surgical skill, given the important role this skill plays in medicine. Results National Health Service trainee ophthalmic microsurgeons (N = 20) were randomly assigned to either Sensory Motor Rhythm-Theta (SMR) or Alpha-Theta (AT) groups, a randomized subset of which were also part of a wait-list 'no-treatment' control group (N = 8). Neurofeedback groups received eight 30-minute sessions of EEG training. Pre-post assessment included a skills lab surgical procedure with timed measures and expert ratings from video-recordings by consultant surgeons, together with state/trait anxiety self-reports. SMR training demonstrated advantages absent in the control group, with improvements in surgical skill according to 1) the expert ratings: overall technique (d = 0.6, p < 0.03) and suture task (d = 0.9, p < 0.02) (judges' intraclass correlation coefficient = 0.85); and 2) with overall time on task (d = 0.5, p = 0.02), while everyday anxiety (trait) decreased (d = 0.5, p < 0.02). Importantly the decrease in surgical task time was strongly associated with SMR EEG training changes (p < 0.01), especially with continued reduction of theta (4–7 Hz) power. AT training produced marginal improvements in technique and overall performance time, which were accompanied by a standard error indicative of large individual differences. Notwithstanding, successful within session elevation of the theta-alpha ratio correlated positively with improvements in overall technique (r = 0.64, p = 0.047). Conclusion SMR-Theta neurofeedback training provided significant improvement in surgical technique whilst considerably reducing time on task by 26%. There was also evidence that AT training marginally reduced total surgery time, despite suboptimal training efficacies. Overall, the data set provides encouraging evidence of optimised learning of a complex medical specialty via neurofeedback training

Anodal tDCS to right dorsolateral prefrontal cortex facilitates performance for novice jazz improvisers but hinders experts

Research on creative cognition reveals a fundamental disagreement about the nature of creative thought, specifically, whether it is primarily based on automatic, associative (Type-1) or executive, controlled (Type-2) processes. We hypothesized that Type-1 and Type-2 processes make differential contributions to creative production that depend on domain expertise. We tested this hypothesis with jazz pianists whose expertise was indexed by the number of public performances given. Previous fMRI studies of musical improvisation have reported that domain expertise is characterized by deactivation of the right-dorsolateral prefrontal cortex (r-DLPFC), a brain area associated with Type-2 executive processing. We used anodal, cathodal, and sham transcranial direct-current stimulation (tDCS) applied over r-DLPFC with the reference electrode on the contralateral mastoid (1.5mA for 15 min., except for sham) to modulate the quality of the pianists’ performances while they improvised over chords with drum and bass accompaniment. Jazz experts rated each improvisation for creativity, aesthetic appeal, and technical proficiency. There was no main effect of anodal or cathodal stimulation on ratings compared to sham; however, a significant interaction between anodal tDCS and expertise emerged such that stimulation benefitted musicians with less experience but hindered those with more experience. We interpret these results as evidence for a dual-process model of creativity in which novices and experts differentially engage Type-1 and Type-2 processes during creative production

Consensus on the reporting and experimental design of clinical and cognitive-behavioural neurofeedback studies (CRED-nf checklist)

Neurofeedback has begun to attract the attention and scrutiny of the scientific and medical mainstream. Here, neurofeedback researchers present a consensus-derived checklist that aims to improve the reporting and experimental design standards in the field.</p

Hypnotic Susceptibility is Positively Related to a Subset of Schizotypy Items

A multidimensional measure of schizotypal personality, the Personality Syndrome Questionnaire (PSQ) was completed by 83 undergraduate medical students. It was predicted that perceptual and cognitive reality distortions would be positively associated with hypnotic susceptibility. Fifteen of 84 items showed the predicted association. When combined into a preliminary scale, a correlation of 0.43 was found for the total scale score and susceptibility. Cronbach's alpha for this scale was acceptable at 0.77. These preliminary results are potentially vulnerable to type I error. Replication on a larger sample and factorial analysis of the proposed scales structure are required and underway. Copyright © 2001 British Society of Experimental and Clinical Hypnosis

Hypnotic Analgesia Affects the Processing of Painful Stimuli

This experiment explored the effects of hypnotic analgesia on painful stimuli in high and low susceptible participants (N = 33). Behavioural (target detection; RTs), subjective (pain ratings) and electrophysiological (SERP) responses of high and low susceptible participants were assessed during control, standard-hypnosis and hypnotic-analgesia conditions. The behavioural and subjective data showed that suggestion of hypnotic analgesia modulated the processing of painful stimuli, particularly in high susceptible participants. In contrast there were no significant changes in electrophysiological responses to these stimuli. Results in high susceptible participants demonstrate that hypnotic analgesia provides an important strategy for modulating experimentally induced pain. They also suggest that different brain mechanisms are involved in the processing of painful stimuli under hypnotic analgesia and attentional distraction instructions and support previous research findings that the differentiation of behavioural, subjective and electrophysiological responses may be a result of a dissociation between the processing of sensory information and the cognitive evaluation of that information

EEG-neurofeedback and psychodynamic psychotherapy in a case of adolescent anhedonia with substance misuse: Mood/theta relations

There is substantial evidence confirming the efficacy of neurofeedback with applications in clinical, educational and optimal performance domains. However, a psychodynamically informed NF-approach needs exploration. A male (19 y), college student whose first year was being seriously compromised after severe, 18-month, polydrug misuse, was treated with 11 sessions including a 2-month follow-up of neurofeedback combined with short-term psychodynamic psychotherapy. Pre/post-treatment and follow-up assessment with the Brief Psychiatric Rating Scale (BPRS) and the Montgomery–Asberg Depression Rating Scale confirmed that levels of psychopathology dropped almost to zero. Correlational evidence disclosed that SMR/theta training was positively associated with reduction in psychopathological ratings, largely due to theta amplitude reduction; the strongest relation being with reduced BPRS activation. Alpha/theta training was not correlated with clinical improvement. The combined treatment was found to be highly effective with the student who learned to deal with feelings of anhedonia and alienation. There was no relapse during the follow-up phase. Further research is recommended

Beneficial Effects of Electrostimulation Contingencies on Sustained Attention and Electrocortical Activity

Introduction: Chinese acupuncture therapy has been practiced for more than 3000 years. According to neuroimaging studies, electroacupuncture has been demonstrated to be effective via control of the frequency parameter of stimulation, based on the theory of frequency modulation of brain function. Aims: To investigate the following: (1) possible sustained effects of acustimulation in improving perceptual sensitivity in attention by comparing before, during, and 5 min following stimulation; (2) relations between commission errors and the motor inhibition event‐related potential (ERP) component measured with independent component analysis (ICA); (3) whether habituation would be demonstrated in the sham control group and would be militated by acustimulation in the experimental groups. Results: Twenty‐seven subjects were divided into three groups (n = 9). d‐Prime (d′) derived from signal detection theory was used as an index of perceptual sensitivity in the visual continuous performance attention test. Increased d′ was found during both alternating frequency (AE) and low frequency (LE) stimulation, but with no change in the sham control group (SE). However, only following AE was there a sustained poststimulation effect. Spatial filtration‐based independent components (ICs) in the AE group revealed significantly decreased amplitudes of the motor inhibition ICs both during and poststimulation. There was a significant habituation effect from task repetition in the sham group with decreased amplitudes of ICs as follows: the visual comparison component difference between go (correct response) and nogo cues (correct withheld response), the P400 action monitoring and the working memory component in the nogo condition, and the passive auditory component on control trials. Conclusion: The results showed associations between acustimulation and improved perceptual sensitivity with sustained improvements following AE, but not LE stimulation. Improvements in commission errors in the AE group were related to the motor inhibition IC. The activational effects of acustimulation apparently attenuated the across‐task habituation that characterized the control group

Short-term Beneficial Effects of 12 Sessions of Neurofeedback on Avoidant Personality Accentuation in the Treatment of Alcohol Use Disorder

This study evaluated the effects of alpha/theta neurofeedback on Clinical Personality Accentuations in individuals with alcohol use disorder. Twenty-five males were investigated using a pre-test/post-test design with a waiting-list control group. Participants were randomly assigned either to an experimental group (n = 13) receiving 12 sessions of neurofeedback twice a week as a treatment adjunct over a period of 6 weeks, or to a control group (n = 12) receiving treatment as usual. The Inventory of Clinical Personality Accentuations and the NEO-Five-Factor Inventory were applied at pre- and post-test. The neurofeedback protocol focused on enhancement of the EEG alpha (8–12 Hz) and theta (4–7 Hz) and used a visual feedback paradigm. Analyses of covariance showed improvements in Avoidant Personality Accentuation within the experimental group. Our data suggest that 12 sessions of this neurofeedback intervention might be effective in reducing avoidant and stress-related personality traits in patients with alcohol use disorder