A randomized controlled trial to examine the posttreatment efficacy of neurofeedback, behavior therapy, and pharmacology on ADHD measures

Objective: To examine the efficacy of neurofeedback (NF), behavior therapy (BT), and pharmacology (PH) on the improvement of ADHD-related symptoms. Method: Fifty-nine children with ADHD (M = 8.80 years, SD = 1.92 years) were randomly assigned to one of the three treatments in a pre/post assessment design. Mother- and teacher-rated ADHD scales and children were assessed using The Integrated Visual and Auditory Continuous Performance Test (IVA/CPT). Results: The three treatments were effective on the IVA/CPT, but with different trends. BT and especially NF achieved improvement on response control and attention, and PH mainly in visual attention. On the rating scales, BT improved all measures, and NF and PH had a minor but interesting influence. Conclusion: From a global perspective, behavior therapy had the most extensive results, but PH had the greatest capacity to improve overall attention. NF was able to improve both control response and inattention. Clinical implications are discussed.Plan Nacional i+d+i PSI2008–06008-C02–0

Reversed cortical over-activity during movement imagination following neurofeedback treatment for central neuropathic pain

Objective: One of the brain signatures of the central neuropathic pain (CNP) is the theta band over-activity of wider cortical structures, during imagination of movement. The objective of the study was to investigate whether this over-activity is reversible following the neurofeedback treatment of CNP. Methods: Five paraplegic patients with pain in their legs underwent from twenty to forty neurofeedback sessions that significantly reduced their pain. In order to assess their dynamic cortical activity they were asked to imagine movements of all limbs a week before the first and a week after the last neurofeedback session. Using time–frequency analysis we compared EEG activity during imagination of movement before and after the therapy and further compared it with EEG signals of ten paraplegic patients with no pain and a control group of ten able-bodied people. Results: Neurofeedback treatment resulted in reduced CNP and a wide spread reduction of cortical activity during imagination of movement. The reduction was significant in the alpha and beta band but was largest in the theta band. As a result cortical activity became similar to the activity of other two groups with no pain. Conclusions: Reduction of CNP is accompanied by reduced cortical over-activity during movement imagination. Significance: Understanding causes and consequences mechanism through which CNP affects cortical activity

Neurofeedback-Based Moral Enhancement and the Notion of Morality

Some skeptics question the very possibility of moral bioenhancement by arguing that if we lack a widely acceptable notion of morality, we will not be able to accept the use of a biotechnological technique as a tool for moral bioenhancement. I will examine this skepticism and argue that the assessment of moral bioenhancement does not require such a notion of morality. In particular, I will demonstrate that this skepticism can be neutralized in the case of recent neurofeedback techniques. This goal will be accomplished in four steps. First, I will draw an outline of the skepticism against the possibility of moral bioenhancement and point out that a long-lasting dispute among moral philosophers nourishes this skepticism. Second, I will survey recent neurofeedback techniques and outline their three features: the variety of the target human faculties, such as emotion, cognition, and behavior; the flexibility or personalizability of the target brain state; and the nonclinical application of neurofeedback techniques. Third, I will argue that, by virtue of these three unique features, neurofeedback techniques can be a tool for moral bioenhancement without adopting any specific notion of morality. Fourth, I will examine the advantages and threats that neurofeedback-based moral enhancement may have. Finally, I will conclude that neurofeedback-based moral enhancement can become a new and promising tool for moral bioenhancement and requires further ethical investigations on its unique features

Self-Regulation of SMR Power Led to an Enhancement of Functional Connectivity of Somatomotor Cortices in Fibromyalgia Patients

Neuroimaging studies have demonstrated that altered activity in somatosensory and motor cortices play a key role in pain chronification. Neurofeedback training of sensorimotor rhythm (SMR) is a tool which allow individuals to self-modulate their brain activity and to produce significant changes over somatomotor brain areas. Several studies have further shown that neurofeedback training may reduce pain and other pain-related symptoms in chronic pain patients. The goal of the present study was to analyze changes in SMR power and brain functional connectivity of the somatosensory and motor cortices elicited by neurofeedback task designed to both synchronize and desynchronize the SMR power over motor and somatosensory areas in fibromyalgia patients. Seventeen patients were randomly assigned to the SMR training (n = 9) or to a sham protocol (n = 8). All participants were trained during 6 sessions, and fMRI and EEG power elicited by synchronization and desynchronization trials were analyzed. In the SMR training group, four patients achieved the objective of SMR modulation in more than 70% of the trials from the second training session (good responders), while five patients performed the task at the chance level (bad responders). Good responders to the neurofeedback training significantly reduced pain and increased both SMR power modulationandfunctionalconnectivityofmotorandsomatosensoryrelatedareasduring the last neurofeedback training session, whereas no changes in brain activity or pain were observed in bad responders or participants in the sham group. In addition, we observed that good responders were characterized by reduced impact of fibromyalgia and pain symptoms, as well as by increased levels of health-related quality of life during the pre-training sessions. In summary, the present study revealed that neurofeedback training of SMR elicited significant brain changes in somatomotor areas leading to a significant reduction of pain in fibromyalgia patients. In this sense, our research provide evidence that neurofeedback training is a promising tool for a better understanding of brain mechanisms involved in pain chronification

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

Bacteria Hunt: Evaluating multi-paradigm BCI interaction

The multimodal, multi-paradigm brain-computer interfacing (BCI) game Bacteria Hunt was used to evaluate two aspects of BCI interaction in a gaming context. One goal was to examine the effect of feedback on the ability of the user to manipulate his mental state of relaxation. This was done by having one condition in which the subject played the game with real feedback, and another with sham feedback. The feedback did not seem to affect the game experience (such as sense of control and tension) or the objective indicators of relaxation, alpha activity and heart rate. The results are discussed with regard to clinical neurofeedback studies. The second goal was to look into possible interactions between the two BCI paradigms used in the game: steady-state visually-evoked potentials (SSVEP) as an indicator of concentration, and alpha activity as a measure of relaxation. SSVEP stimulation activates the cortex and can thus block the alpha rhythm. Despite this effect, subjects were able to keep their alpha power up, in compliance with the instructed relaxation task. In addition to the main goals, a new SSVEP detection algorithm was developed and evaluated

Home Used, Patient Self-Managed, Brain-Computer Interface for Treatment of Central Neuropathic Pain in Spinal Cord Injury: Feasibility Study

Central Neuropathic Pain (CNP) is a frequent chronic condition in people with spinal cord injury (SCI). In a previous study, we showed that using laboratory brain-computer interface (BCI) technology for neurofeedback training, it is possible to reduce pain in SCI people who suffered from CNP for many years. In this study, we show initial results from 12 people with SCI and CNP who practiced neurofeedback on their own using our portable BCI, consisting of a wearable EEG headset (Emotiv, EPOC, USA) and a computer tablet. Eight participants showed a positive initial response to neurofeedback and seven learned how to use portable BCI on their own at home. In this paper, we present a portable BCI and discuss the main challenges of training lay people, patients and their caregivers, to use a custom designed BCI application at home

Brain–computer interface game applications for combined neurofeedback and biofeedback treatment for children on the autism spectrum

Individuals with Autism Spectrum Disorder (ASD) show deficits in social and communicative skills, including imitation, empathy, and shared attention, as well as restricted interests and repetitive patterns of behaviors. Evidence for and against the idea that dysfunctions in the mirror neuron system are involved in imitation and could be one underlying cause for ASD is discussed in this review. Neurofeedback interventions have reduced symptoms in children with ASD by self-regulation of brain rhythms. However, cortical deficiencies are not the only cause of these symptoms. Peripheral physiological activity, such as the heart rate, is closely linked to neurophysiological signals and associated with social engagement. Therefore, a combined approach targeting the interplay between brain, body and behavior could be more effective. Brain-computer interface applications for combined neurofeedback and biofeedback treatment for children with ASD are currently nonexistent. To facilitate their use, we have designed an innovative game that includes social interactions and provides neural- and body-based feedback that corresponds directly to the underlying significance of the trained signals as well as to the behavior that is reinforced