TEEG Based Brain Training Benefits
- Improves Focus & Attention
- Increases Resilience & Reduces Stress
- Leads to Better Quality Sleep
- Aids in Anxiety & Depression
- Enhances Cognitive Functioning
- Improves Peak Performance
- Increased Self-Regulation
- Improves Overall Well-Being
ZenFocus places its faith in science to reveal the incredible capabilities of neuroscience which our programs are based.
We allow the scientific research to take center stage as we outline the merits of EEG Brain Training.
Improves Focus & Attention
Neurofeedback training improves attention and working memory performance
Objectives: The present study aimed to investigate the effectiveness of the frontal-midline theta (fmh) activity uptraining protocol on attention and working memory performance of older and younger participants.
Methods: Thirty-two participants were recruited. Participants within each age group were randomly assigned to either the neurofeedback training (fmh uptraining) group or the sham-neurofeedback training group.
Results: There was a significant improvement in orienting scores in the older neurofeedback training group. In addition, there was a significant improvement in conflict scores in both the older and young neurofeedback training groups. However, alerting scores failed to increase. In addition, the fmh training was found to improve working memory function in the older participants. The results further showed that fmh training can modulate resting EEG for both neurofeedback groups.
Conclusions: Our study demonstrated that fmh uptraining improved attention and working memory performance and theta activity in the resting state for normal aging adults. In addition, younger participants also benefited from the present protocol in terms of improving their executive function.
Significance: The current findings contribute to a better understanding of the mechanisms underlying neurofeedback training in cognitive function, and suggest that the fmh uptraining protocol is an effective intervention program for cognitive aging.
Effect of neurofeedback training on the neural substrates of selective attention in children with attention-deficit/hyperactivity disorder: A functional magnetic resonance imaging study
Attention Deficit Hyperactivity Disorder (AD/HD) is a neurodevelopmental disorder mainly characterized by impairments in cognitive functions. Functional neuroimaging studies carried out in individuals with AD/HD have shown abnormal functioning of the anterior cingulate cortex (ACC) during tasks involving selective attention. In other respects, there is mounting evidence that neurofeedback training (NFT) can significantly improve cognitive functioning in AD/HD children. In this context, the present functional magnetic resonance imaging (fMRI) study was conducted to measure the effect of NFT on the neural substrates of selective attention in children with AD/HD. Twenty AD/HD children-not taking any psychostimulant and without co-morbidity-participated to the study. Fifteen children were randomly assigned to the Experimental (EXP) group (NFT), whereas the other five children were assigned to the Control (CON) group (no NFT). Subjects from both groups were scanned I week before the beginning of the NFT (Time 1) and I week after the end of this training (Time 2), while they performed a Counting Stroop task. At Time 1, for both groups, the Counting Stroop task was associated with significant loci of activation in the left superior parietal lobule. No activation was noted in the ACC. At Time 2, for both groups, the Counting Stroop task was still associated with significant activation of the left superior parietal lobule. This time, however, for the EXP group only there was a significant activation of the right ACC. These results suggest that in AD/HD children, Neurofeedback training has the capacity to normalize the functioning of the ACC, the key neural substrate of selective attention.
Neurofeedback treatment for attention-deficit/hyperactivity disorder in children: A comparison with methylphenidate
Clinical trials have suggested that neurofeedback may be efficient in treating attention-deficit/hyperactivity disorder (ADHD). We compared the effects of a 3-month electroencephalographic feedback program providing reinforcement contingent on the production of cortical sensorimotor rhythm (12-15 Hz) and beta1 activity (15-18 Hz) with stimulant medication. Participants were N = 34 children aged 8-12 years, 22 of which were assigned to the neurofeedback group and 12 to the methylphenidate group according to their parents’ preference. Both neurofeedback and methylphenidate were associated with improvements on all subscales of the Test of Variables of Attention, and on the speed and accuracy measures of the d2 Attention Endurance Test. Furthermore, behaviors related to the disorder were rated as significantly reduced in both groups by both teachers and parents on the IOWA-Conners Behavior Rating Scale. These findings suggest that neurofeedback was efficient in improving some of the behavioral concomitants of ADHD in children whose parents favored a nonpharmacological treatment.
Neurofeedback: An alternative and efficacious treatment for attention deficit hyperactivity disorder
Current research has shown that neurofeedback, or EEG biofeedback as it is sometimes called, is a viable alternative treatment for Attention Deficit Hyperactivity Disorder (ADHD). The aim of this article is to illustrate current treatment modalities(s), compare them to neurofeedback, and present the benefits of utilizing this method of treatment to control and potentially alleviate the symptoms of ADHD. In addition, this article examines the prevalence rates and possible etiology of ADHD, the factors associated with ADHD and brain dysfunction, the current pharmacological treatments of ADHD, Ritalin, and the potential risks and side effects. Behavior modification and cognitive behavioral treatment for ADHD is discussed as well. Lastly, a brief history of the study of neurofeedback, treatment successes and clinical benefits, comparisons to medication, and limitations are presented.
Increases Resilience & Reduces Stress
Electrical fingerprint of the amygdala guides neurofeedback training for stress resilience
Real-time functional magnetic resonance imaging (rt-fMRI) has revived the translational perspective of neurofeedback (NF)(1). Particularly for stress management, targeting deeply located limbic areas involved in stress processing(2) has paved new paths for brain-guided interventions. However, the high cost and immobility of fMRI constitute a challenging drawback for the scalability (accessibility and cost-effectiveness) of the approach, particularly for clinical purposes(3). The current study aimed to overcome the limited applicability of rt-fMRI by using an electroencephalography (EEG) model endowed with improved spatial resolution, derived from simultaneous EEG-fMRI, to target amygdala activity (termed amygdala electrical fingerprint (Amyg-EFP))(4-6). Healthy individuals (n = 180) undergoing a stressful military training programme were randomly assigned to six Amyg-EFP-NF sessions or one of two controls (control-EEG-NF or NoNF), taking place at the military training base. The results demonstrated specificity of NF learning to the targeted Amyg-EFP signal, which led to reduced alex-ithymia and faster emotional Stroop, indicating better stress coping following Amyg-EFP-NF relative to controls. Neural target engagement was demonstrated in a follow-up fMRI-NF, showing greater amygdala blood-oxygen-level-dependent downregulation and amygdala-ventromedial prefrontal cortex functional connectivity following Amyg-EFP-NF relative to NoNF. Together, these results demonstrate limbic specificity and efficacy of Amyg-EFP-NF during a stressful period, pointing to a scalable non-pharmacological yet neuroscience-based training to prevent stress-induced psychopathology.
Alpha oscillation neurofeedback modulates amygdala complex connectivity and arousal in posttraumatic stress disorder
Objective: Electroencephalogram (EEG) neurofeedback aimed at reducing the amplitude of the alpha-rhythm has been shown to alter neural networks associated with posttraumatic stress disorder (PTSD), leading to symptom alleviation. Critically, the amygdala is thought to be one of the central brain regions mediating PTSD symptoms. In the current study, we compare directly patterns of amygdala complex connectivity using fMRI, before and after EEG neurofeedback, in order to observe subcortical mechanisms associated with behavioural and alpha oscillatory changes among patients.
Method: We examined basolateral (BLA), centromedial (CMA), and superficial (SFA) amygdala complex resting-state functional connectivity using a seed-based approach via SPM Anatomy Toolbox. Amygdala complex connectivity was measured in twenty-one individuals with PTSD, before and after a 30-minute session of EEG neurofeedback targeting alpha desynchronization.
Results: EEG neurofeedback was associated with a shift in amygdala complex connectivity from areas implicated in defensive, emotional, and fear processing/memory retrieval (left BLA and left SFA to the periaqueductal gray, and left SFA to the left hippocampus) to prefrontal areas implicated in emotion regulation/modulation (right CMA to the medial prefrontal cortex). This shift in amygdala complex connectivity was associated with reduced arousal, greater resting alpha synchronization, and was negatively correlated to PTSD symptom severity.
Conclusion: These findings have significant implications for developing targeted non-invasive treatment interventions for PTSD patients that utilize alpha oscillatory neurofeedback, showing evidence of neuronal reconfiguration between areas highly implicated in the disorder, in addition to acute symptom alleviation.
The Effects of Neurofeedback Training on Physical, Psychoemotional Stress Response and Self-Regulation for Late Adolescence: A Non-Randomized Trial
Purpose: The aim of this study was to analyze the effects of neurofeedback training for reducing stress and enhancing self-regulation in late adolescence to identify the possibility of use for nursing intervention. Methods: A nonequivalent control group pre-post quasi-experimental design was used. Participants were 78 late adolescents assigned to the experimental group (n=39) that received the neurofeedback training and the control group (n=39). Data were collected on heart rate variability (HRV) and skin conductance level (SCL) to assess stress-biomarker response. The questionnaire contained 164 items from: Positive and Negative Affect Schedule (PANAS), Symptom Checklist-90-Revised (SCL-90-R) and Self-regulatory Ability scale. The neurofeedback training was based on the general adaptation syndrome and body-mind medicine. The intervention was conducted in a total of 10 sessions for 30 minutes per session with high-beta, theta and sensory motor rhythm training on scalp at central zero. Results: There were significant difference in standard deviation of normal to normal interval (p=.036) in HRV and SCL (p=.029) of stress-biomarker response between the two groups. Negative affect (p=.036) in PANAS and obsessive compulsive (p=.023) and depression (o<.001) in SCL-90-R were statistically significant. Self-regulation mode (p=.004) in self-regulation ability scale showed a significant difference between the two groups. Conclusion: The results indicated that the neurofeedback training is effective in stress-biomarkers, psychoemotional stress response and self-regulation. Therefore, neurofeedback training using neuroscientific approach based on brain-mind-body model can be used as an effective nursing intervention for late adolescents in clinics and communities for effective stress responses.
Method: We examined basolateral (BLA), centromedial (CMA), and superficial (SFA) amygdala complex resting-state functional connectivity using a seed-based approach via SPM Anatomy Toolbox. Amygdala complex connectivity was measured in twenty-one individuals with PTSD, before and after a 30-minute session of EEG neurofeedback targeting alpha desynchronization.
Results: EEG neurofeedback was associated with a shift in amygdala complex connectivity from areas implicated in defensive, emotional, and fear processing/memory retrieval (left BLA and left SFA to the periaqueductal gray, and left SFA to the left hippocampus) to prefrontal areas implicated in emotion regulation/modulation (right CMA to the medial prefrontal cortex). This shift in amygdala complex connectivity was associated with reduced arousal, greater resting alpha synchronization, and was negatively correlated to PTSD symptom severity.
Conclusion: These findings have significant implications for developing targeted non-invasive treatment interventions for PTSD patients that utilize alpha oscillatory neurofeedback, showing evidence of neuronal reconfiguration between areas highly implicated in the disorder, in addition to acute symptom alleviation.
EEG Neurofeedback for Anxiety Disorders and Post-Traumatic Stress Disorders: A Blueprint for a Promising Brain-Based Therapy
Purpose of Review This review provides an overview of current knowledge and understanding of EEG neurofeedback for anxiety disorders and post-traumatic stress disorders. Recent Findings The manifestations of anxiety disorders and post-traumatic stress disorders (PTSD) are associated with dysfunctions of neurophysiological stress axes and brain arousal circuits, which are important dimensions of the research domain criteria (RDoC). Even if the pathophysiology of these disorders is complex, one of its defining signatures is behavioral and physiological over-arousal. Interestingly, arousal-related brain activity can be modulated by electroencephalogram-based neurofeedback (EEG NF), a non-pharmacological and non-invasive method that involves neurocognitive training through a brain-computer interface (BCI). EEG NF is characterized by a simultaneous learning process where both patient and computer are involved in modifying neuronal activity or connectivity, thereby improving associated symptoms of anxiety and/or over-arousal. Positive effects of EEG NF have been described for both anxiety disorders and PTSD, yet due to a number of methodological issues, it remains unclear whether symptom improvement is the direct result of neurophysiological changes targeted by EEG NF. Thus, in this work we sought to bridge current knowledge on brain mechanisms of arousal with past and present EEG NF therapies for anxiety and PTSD. In a nutshell, we discuss the neurophysiological mechanisms underlying the effects of EEG NF in anxiety disorder and PTSD, the methodological strengths/weaknesses of existing EEG NF randomized controlled trials for these disorders, and the neuropsychological factors that may impact NF training success.
Method: We examined basolateral (BLA), centromedial (CMA), and superficial (SFA) amygdala complex resting-state functional connectivity using a seed-based approach via SPM Anatomy Toolbox. Amygdala complex connectivity was measured in twenty-one individuals with PTSD, before and after a 30-minute session of EEG neurofeedback targeting alpha desynchronization.
Results: EEG neurofeedback was associated with a shift in amygdala complex connectivity from areas implicated in defensive, emotional, and fear processing/memory retrieval (left BLA and left SFA to the periaqueductal gray, and left SFA to the left hippocampus) to prefrontal areas implicated in emotion regulation/modulation (right CMA to the medial prefrontal cortex). This shift in amygdala complex connectivity was associated with reduced arousal, greater resting alpha synchronization, and was negatively correlated to PTSD symptom severity.
Conclusion: These findings have significant implications for developing targeted non-invasive treatment interventions for PTSD patients that utilize alpha oscillatory neurofeedback, showing evidence of neuronal reconfiguration between areas highly implicated in the disorder, in addition to acute symptom alleviation.
Neurofeedback: A Noninvasive Treatment for Symptoms of Posttraumatic Stress Disorder in Veterans
This paper discusses positive therapeutic gains made with veterans whose primary treatment for posttraumatic stress disorder (PTSD)was artifact correctedneurofeedback. Assessments completed after both 20 and 40 half-hour sessions of treatment identifiedsignificant improvements for both auditory and visual attention using the IVA-2 and significant improvements in well-being based on the General Well-Being Scale (GWBS). It was discovered that neurofeedback impacted individuals’ overall auditory attentionand IVA-2 global auditory test scores significantly improved after both 20 (p< .007, Cohen’s d= 0.5) and 40 training sessions (p< .0001, Cohen’s d= 0.8). Veterans were found to have significant enhancements in auditory vigilance (p< .03), processingspeed (p< .0009) and focus (p< .01). The IVA-2 global measure of visual attention was also found to show significant improvements after 20 sessions (p< .004, Cohen’s d= 0.5) and after 40 sessions (p< .06, Cohen’s d= 0.4). Specific improvements in visual processing speed (p< .04) and focus (p< .02) were identified after 40 sessions. Ratings of well-being significantly improved after treatment (p< .001, Cohen’s d= 0.8) with 84% of the veterans improving five points or more on the GWBS. Improvements in well-being were found to be significantly correlated with increases in veterans’ overall auditory attention (r= .44, p< .03) and auditory processing speed (r= .57, p< .005).
Leads to Better Quality Sleep
An Exploratory Study on the Effects of Tele-neurofeedback and Tele-biofeedback on Objective and Subjective Sleep in Patients with Primary Insomnia
Insomnia is a sleeping disorder, usually studied from a behavioural perspective, with a focus on somatic and cognitive arousal. Recent studies have suggested that an impairment of information processes due to the presence of cortical hyperarousal might interfere with normal sleep onset and/or consolidation. As such, a treatment modality focussing on CNS arousal, and thus influencing information processing, might be of interest. Seventien insomnia patients were randomly assigned to either a tele-neurofeedback (n = 9) or an electromyography tele-biofeedback (n = 8) protocol. Twelve healthy controls were used to compare baseline sleep measures. A polysomnography was performed pre and post treatment. Total Sleep Time (TST), was considered as our primary outcome variable. Sleep latency decreased pre to post treatment in both groups, but a significant improvement in TST was found only after the neurofeedback (NFB) protocol. Furthermore, sleep logs at home showed an overall improvement only in the neurofeedback group, whereas the sleep logs in the lab remained the same pre to post training. Only NFB training resulted in an increase in TST. The mixed results concerning perception of sleep might be related to methodological issues, such as the different locations of the training and sleep measurements.
Comparing the Effectiveness of Neurofeedback and Transcranial Direct Current Stimulation on Sleep Quality of Patients With Migraine
Introduction: Migraine is considered one of the most common primary headache disorders. Migraine attacks may occur due to a lack of sleep. Furthermore, sleep is regarded as one of the smoothing factors of migraine pain. Patients with sleep disorders often suffer from headaches when they wake up compared with healthy individuals.
Methods: This research was a quasi-experimental study with a pre-test-post-test design and a 2-month follow-up. The samples included 20 migraine patients within the age range of 15 to 55 years who were selected as volunteers for treatment by the neurologists and psychiatrists during 2017. The initial evaluation was then conducted based on the inclusion and exclusion criteria and using the Ahvaz migraine questionnaire, and Pittsburgh sleep quality index. The patients were randomly assigned to two neurofeedback (n=10) and transcranial Direct Current Stimulation (tDCS) (n=10) groups and evaluated three times. The obtained data were analyzed by the repeated measures ANCOVA and Chi-square test in SPSS.
Results: Based on the scores of both groups, no significant difference was observed between neurofeedback and tDCS groups. However, based on the results, neurofeedback decreased sleep latency, whereas tDCS increased sleep efficiency. Overall, these two treatments were effective in improving subjective sleep quality and sleep quality.
Conclusion: Both neurofeedback and tDCS treatments could significantly enhance sleep quality of the patients in the post-test and 2-month follow-up. Given the effectiveness of both treatments, neurofeedback and tDCS are recommended to be used for improving the sleep status of patients with migraine.
An intensive neurofeedback alpha-training to improve sleep quality and stress modulation in health-care workers during the COVID-19 pandemic: A pilot study
Introduction:
During the COVID-19 pandemic, health workers represented a group particularly vulnerable to work-related stress, but prevention and management of psychiatric symptoms are still under evaluation. Neurofeedback is a safe and non-invasive neuromodulation technique with the target of training participants in the self-regulation of neural substrates underlying specific psychiatric disorders. Protocols based on the increase of alpha frequencies, associated with the process of relaxation, are used for the treatment of stress, anxiety and sleep disturbances.
Objectives:
The aim of the present study was to assess the effectiveness of an alpha-increase NF protocol for the treatment of stress in healthcare workers exposed to the COVID-19 pandemic.
Methods:
Eighteen medical doctors belonging to the Sacco Hospital were recruited during the COVID-19 health emergency and underwent a 10 sessions NF alpha-increase protocol during two consecutive weeks. The level of stress was assessed at the beginning (T0) and at the end (T1) of the protocol through the following questionnaires: Severity of Acute Symptoms Stress (SASS), Copenhagen Burnout Inventory (CBI), Pittsburgh Sleep Quality Index (PSQI), Brief-COPE. Statistical analyses were performed with Paired Samples t-Test for continuous variables, setting significance at p < 0.05.
Results:
A significant increase in alpha waves mean values between T0 and T1 was observed. In addition, a significant reduction in the PSQI test score between T0 and T1 was observed.
Conclusions:
Alpha-increase protocol showed promising results in terms of stress modulation, sleep quality improvement and safety profile in a pilot sample of health-care workers. Larger controlled studies are warranted to confirm present results.
Aids in Depression & Anxiety
The Effects of Neurofeedback on Depression, Anxiety, and Academic Self-Efficacy
This preliminary study examined the effects of 16 sessions of neurofeedback (NF) training protocol on levels of depression, anxiety, and academic self-efficacy in college students with attention deficit hyperactivity disorder (ADHD). Results identified that NF was a viable option for mitigating depression and anxiety symptoms as well as increasing academic self-efficacy scores in college students with ADHD, based on their scores over time. Implications for college counselors are presented.
Efficacy Evaluation of Neurofeedback-Based Anxiety Relief
Anxiety disorder is a mental illness that involves extreme fear or worry, which can alter the balance of chemicals in the brain. This change and evaluation of anxiety state are accompanied by a comprehensive treatment procedure. It is well-known that the treatment of anxiety is chiefly based on psychotherapy and drug therapy, and there is no objective standard evaluation. In this paper, the proposed method focuses on examining neural changes to explore the effect of mindfulness regulation in accordance with neurofeedback in patients with anxiety. We designed a closed neurofeedback experiment that includes three stages to adjust the psychological state of the subjects. A total of 34 subjects, 17 with anxiety disorder and 17 healthy, participated in this experiment. Through the three stages of the experiment, electroencephalography (EEG) resting state signal and mindfulness-based EEG signal were recorded. Power spectral density was selected as the evaluation index through the regulation of neurofeedback mindfulness, and repeated analysis of variance (ANOVA) method was used for statistical analysis. The findings of this study reveal that the proposed method has a positive effect on both types of subjects. After mindfulness adjustment, the power map exhibited an upward trend. The increase in the average power of gamma wave indicates the relief of anxiety. The enhancement of the wave power represents an improvement in the subjects’ mindfulness ability. At the same time, the results of ANOVA showed that P < 0.05, i.e., the difference was significant. From the aspect of neurophysiological signals, we objectively evaluated the ability of our experiment to relieve anxiety. The neurofeedback mindfulness regulation can effect on the brain activity pattern of anxiety disorder patients.
Neurofeedback training improves anxiety trait and depressive symptom in GAD
Objective To investigate the effectiveness of alpha activity neurofeedback training over the parietal lobe in GAD patients.
Methods Twenty-six female patients who had been diagnosed as GAD according to the Diagnostic and Statistical Manual of Mental Disorders (5th edition, DSM-V) criteria were included in this study. Patients were randomized into two groups: the left parietal lobe training group (LPL group, n = 13) and the right parietal lobe training group (RPL group, n = 13), and then received ten 40-minute alpha training sessions in the relevant area. Evaluations included severity of anxiety (by State-Trait Anxiety Inventory, STAI) and depression (by Beck Depression Inventory, BDI-II) after the fifth training session and the last training session.
Results The scores of STAI-S decreased significantly two weeks after the fifth training session in both groups (LPL group: from 47.15 +/- 10.65 to 38.69 +/- 8.78, p<.05; RPL group: from 44.92 +/- 12.37 to 37.31 +/- 6.41, p < .05) and decreased further at the four weeks’ time point after the last training session (LPL group: 35.15 +/- 9.24; RPL group: 29.85 +/- 6.18). Compared with baseline, the scores of STAI-T, BDI-II and ISI decrease at two weeks, no significant difference found between LPL group and RPL group. The scores of STAI-T, BDI-II and ISI decreased at four weeks when compared with two weeks, and no significant difference found between LPL group and RPL group.
Conclusion Neurofeedback training of alpha activity over the parietal lobe is effective in GAD patients, especially the anxiety trait and depressive symptoms
Neurofeedback with anxiety and affective disorders
A robust body of neurophysiologic research is reviewed on functional brain abnormalities associated with depression, anxiety, and obsessive-compulsive disorder. A review of more recent research finds that pharmacologic treatment may not be as effective as previously believed. A more recent neuroscience technology, electroencephalographic (EEG) biofeedback (neurofeedback), seems to hold promise as a methodology for retraining abnormal brain wave patterns. It has been associated with minimal side effects and is less invasive than other methods for addressing biologic brain disorders. Literature is reviewed on the use of neurofeedback with anxiety disorders, including posttraumatic stress disorder and obsessive-compulsive disorder, and with depression. Case examples are provided.
Enhances Cognitive Function
EEG-neurofeedback and executive function enhancement in healthy adults: A systematic review
Electroencephalographic (EEG)-neurofeedback training (NFT) is a promising technique that supports individuals in learning to modulate their brain activity to obtain cognitive and behavioral improvements. EEG-NFT is gaining increasing attention for its potential “peak performance” applications on healthy individuals. However, evidence for clear cognitive performance enhancements with healthy adults is still lacking. In particular, whether EEG-NFT represents an effective technique for enhancing healthy adults’ executive functions is still controversial. Therefore, the main objective of this systematic review is to assess whether the existing EEG-NFT studies targeting executive functions have provided reliable evidence for NFT effectiveness. To this end, we conducted a qualitative analysis of the literature since the limited number of retrieved studies did not allow us meta-analytical comparisons. Moreover, a second aim was to identify optimal frequencies as NFT targets for specifically improving executive functions. Overall, our systematic review provides promising evidence for NFT effectiveness in boosting healthy adults’ executive functions. However, more rigorous NFT studies are required in order to overcome the methodological weaknesses that we encountered in our qualitative analysis.
Methods: This study investigated cognitive improvement and hemodynamic changes in the prefrontal cortex (PFC) following NF training in patients with MCI. Five patients with MCI received NF training for enhanced beta band activity in the dorsolateral PFC-16 sessions for 8 weeks-with each session divided into 9 5-minute trials. The primary outcome measure was a cognitive assessment tool: the Korean version of the Montreal Cognitive Assessment. The secondary outcome measures were the Central Nervous System Vital Signs for neurocognitive testing, hemodynamic changes using functional near-infrared spectroscopy in the PFC during a working-memory task, and Beck Depression Inventory scores.
Results: After completing the training, patients’ cognitive function significantly improved in domains such as composite memory, cognitive flexibility, complex attention, reaction time, and executive function. Increased electroencephalogram beta power was observed over NF training sessions (Spearman rank correlation test: r=0.746, P=.001). The threshold value for gaining positive feedback from pre-NF baseline on beta power significantly increased (Spearman rank correlation test: r=0.805, P=.001). Hemodynamic response in PFC changed after NF training, and individual differences were identified. Specifically, hypoactivation of the hemodynamic response by emotional distraction recovered following NF training.
Conclusion: We suggest that patients’ cognitive processing efficiency was improved by the NF training. These beneficial results suggest that NF training may have potential therapeutic applications to prevent the progression from MCI to dementia.
Beta wave enhancement neurofeedback improves cognitive functions in patients with mild cognitive impairment A preliminary pilot study
Background: Mild cognitive impairment (MCI) is a symptom characterizing cognitive decline and a transitional state between normal aging and dementia; however, there is no definitive diagnosis and treatment for MCI. Neurofeedback (NF), which is a training mechanism that employs operant conditioning to regulate brain activity, has been increasingly investigated concerning its beneficial effects for dementia and MCI.
Methods: This study investigated cognitive improvement and hemodynamic changes in the prefrontal cortex (PFC) following NF training in patients with MCI. Five patients with MCI received NF training for enhanced beta band activity in the dorsolateral PFC-16 sessions for 8 weeks-with each session divided into 9 5-minute trials. The primary outcome measure was a cognitive assessment tool: the Korean version of the Montreal Cognitive Assessment. The secondary outcome measures were the Central Nervous System Vital Signs for neurocognitive testing, hemodynamic changes using functional near-infrared spectroscopy in the PFC during a working-memory task, and Beck Depression Inventory scores.
Results: After completing the training, patients’ cognitive function significantly improved in domains such as composite memory, cognitive flexibility, complex attention, reaction time, and executive function. Increased electroencephalogram beta power was observed over NF training sessions (Spearman rank correlation test: r=0.746, P=.001). The threshold value for gaining positive feedback from pre-NF baseline on beta power significantly increased (Spearman rank correlation test: r=0.805, P=.001). Hemodynamic response in PFC changed after NF training, and individual differences were identified. Specifically, hypoactivation of the hemodynamic response by emotional distraction recovered following NF training.
Conclusion: We suggest that patients’ cognitive processing efficiency was improved by the NF training. These beneficial results suggest that NF training may have potential therapeutic applications to prevent the progression from MCI to dementia.
EEG alpha and theta oscillations reflect cognitive and memory performance: a review and analysis
Evidence is presented that EEG oscillations in the alpha and theta band reflect cognitive and memory performance in particular. Good performance is related to two types of EEG phenomena (i) a tonic increase in alpha but a decrease in theta power, and (ii) a large phasic (event-related) decrease in alpha but increase in theta, depending on the type of memory demands. Because alpha frequency shows large interindividual differences which are related to age and memory performance, this double dissociation between alpha vs. theta and tonic vs. phasic changes can be observed only if fixed frequency bands are abandoned. It is suggested to adjust the frequency windows of alpha and theta for each subject by using individual alpha frequency as an anchor point. Based on this procedure, a consistent interpretation of a variety of findings is made possible. As an example, in a similar way as brain volume does, upper alpha power increases (but theta power decreases) from early childhood to adulthood, whereas the opposite holds true for the late part of the lifespan. Alpha power is lowered and theta power enhanced in subjects with a variety of different neurological disorders. Furthermore, after sustained wakefulness and during the transition from waking to sleeping when the ability to respond to external stimuli ceases, upper alpha power decreases, whereas theta increases. Event-related changes indicate that the extent of upper alpha desynchronization is positively correlated with (semantic) long-term memory performance, whereas theta synchronization is positively correlated with the ability to encode new information. The reviewed findings are interpreted on the basis of brain oscillations. It is suggested that the encoding of new information is reflected by theta oscillations in hippocampo-cortical feedback loops, whereas search and retrieval processes in (semantic) long-term memory are reflected by upper alpha oscillations in thalamo-cortical feedback loops.
Methods: This study investigated cognitive improvement and hemodynamic changes in the prefrontal cortex (PFC) following NF training in patients with MCI. Five patients with MCI received NF training for enhanced beta band activity in the dorsolateral PFC-16 sessions for 8 weeks-with each session divided into 9 5-minute trials. The primary outcome measure was a cognitive assessment tool: the Korean version of the Montreal Cognitive Assessment. The secondary outcome measures were the Central Nervous System Vital Signs for neurocognitive testing, hemodynamic changes using functional near-infrared spectroscopy in the PFC during a working-memory task, and Beck Depression Inventory scores.
Results: After completing the training, patients’ cognitive function significantly improved in domains such as composite memory, cognitive flexibility, complex attention, reaction time, and executive function. Increased electroencephalogram beta power was observed over NF training sessions (Spearman rank correlation test: r=0.746, P=.001). The threshold value for gaining positive feedback from pre-NF baseline on beta power significantly increased (Spearman rank correlation test: r=0.805, P=.001). Hemodynamic response in PFC changed after NF training, and individual differences were identified. Specifically, hypoactivation of the hemodynamic response by emotional distraction recovered following NF training.
Conclusion: We suggest that patients’ cognitive processing efficiency was improved by the NF training. These beneficial results suggest that NF training may have potential therapeutic applications to prevent the progression from MCI to dementia.
Boosting brain functions: Improving executive functions with behavioral training, neurostimulation, and neurofeedback
Cognitive enhancement is a popular topic, attracting attention both from the general public and the scientific research community. Higher cognitive functions are involved in various aspects of everyday life and have been associated with manifest behavioral and psychiatric mental impairments when deteriorated. The improvement of these so-called executive functions (EFs) is of high individual, social, and economic relevances. This review provides a synopsis of two lines of research, investigating the enhancement of capabilities in executive functioning: a) computerized behavioral trainings, and b) approaches for direct neuromodulation (neurofeedback and transcranial electrostimulation). Task switching, memory updating, response inhibition, and dual task performance are addressed in terms of cognitive functions. It has been shown that behavioral cognitive training leads to enhanced performance in task switching, memory updating, and dual tasks. Similarly, direct neurocognitive modulation of brain regions that are crucially involved in specific EFs also leads to behavioral benefits in response inhibition, task switching, and memory updating. Response inhibition performance has been shown to be improved by neurostimulation of the right inferior frontal cortex, whereas neurostimulation of the dorsolateral prefrontal cortex exerts effects on task switching and memory updating. Due to a lack of consistency in experimental methods and findings, a comparison of different training approaches concerning their effectiveness is not yet possible. So far, current data suggest that training gains may indeed generalize to untrained tasks aiming at the same cognitive process, as well as across cognitive domains within executive control.
Improves Peak Performance
Neurofeedback training for peak performance
Aim. One of the applications of the Neurofeedback methodology is peak performance in sport. The protocols of the neurofeedback are usually based on an assessment of the spectral parameters of spontaneous EEG in resting state conditions. The aim of the paper was to study whether the intensive neurofeedback training of a well-functioning Olympic athlete who has lost his performance confidence after injury in sport, could change the brain functioning reflected in changes in spontaneous EEG and event related potentials (ERPs).
Case study. The case is presented of an Olympic athlete who has lost his performance confidence after injury in sport. He wanted to resume his activities by means of neurofeedback training. His QEEG/ERP parameters were assessed before and after 4 intensive sessions of neurotherapy. Dramatic and statistically significant changes that could not be explained by error measurement were observed in the patient.
Conclusion. Neurofeedback training in the subject under study increased the amplitude of the monitoring component of ERPs generated in the anterior cingulate cortex, accompanied by an increase in beta activity over the medial prefrontal cortex. Taking these changes together, it can be concluded that that even a few sessions of neurofeedback in a high performance brain can significantly activate the prefrontal cortical areas associated with increasing confidence in sport performance.
Neurofeedback for peak performance
Neurofeedback has been found to be effective in the treatment of a number of clinical disorders, such as attention-deficit/hyperactivity disorder (ADHD/ADD) (Lubar, 2003), obsessive-compulsive disorder (Hammond, 2003), seizures (Sterman, 2000), and substance abuse (Burkett, Cummins, Dickson, & Skolnick, 2005; Saxby & Peniston, 1995). The benefits of neurofeedback have also been found useful in peak performance training. These benefits include improving attention/concentration, imagery, arousal level, and decreasing worry and rumination (Williams, 2006). The combination of cognitive, emotional, and psychophysiological benefits from neurofeedback results in improved performance. Due to individual differences in brain activity, as well as the large diversity of skills required in different sports, neurofeedback for performance training is not a “one size fits all” approach (Wilson, Thompson, Thompson, & Peper, 2011). In order to obtain optimal results, neurofeedback for peak performance training begins with appropriate assessment and evaluation of an individual’s brain wave (electroencephalographic) activity. Individualized training plans are based upon the assessment findings and the specific needs of the targeted sport or activity (Wilson et al., 2011). This article will discuss the benefits and applications of neurofeedback for peak performance training and the importance of assessment to create effective training programs.
Neurofeedback and Mindfulness in Peak Performance Training Among Athletes
Years of research have demonstrated that biofeedback, neurofeedback, and mindfulness, individually and in various combinations, have been employed to effectively improve sport performance. The present article discusses the literature supporting the combination of these techniques, the neurophysiologic measures that support the use of these techniques for performance enhancement, and practical methods for implementing a combination of biofeedback and mindfulness with athletes. Finally, a case study is presented to offer practical steps on implementing mindfulness and biofeedback for the purpose of performance enhancement.
Increases Self-Regulation
Enhancing cognitive control through neurofeedback: A role of gamma-band activity in managing episodic retrieval
Neural synchronization has been proposed to be the underlying mechanism for exchanging and integrating anatomically distributed information and has been associated with a myriad of cognitive domains, including visual feature binding, top–down control, and long-term memory. Moreover, it seems that separate frequency bands have different functions in these cognitive processes. Here we studied whether neurofeedback training designed either to increase local gamma band activity (GBA+; 36–44 Hz), or local beta band activity (BBA+; 12–20 Hz), would have an impact on performance of behavioral tasks measuring short-term and long-term episodic binding. Our results show that GBA-enhancing neurofeedback training increased occipital GBA within sessions, and occipital and frontal GBA across sessions. Both groups showed an increase of GBA coherence between frontal and occipital areas, but the BBA+ group increased BBA coherence between these areas as well. Neurofeedback training had profound effects on behavior. First, we replicated earlier findings that enhancing GBA led to greater flexibility in handling (selectively retrieving) episodic bindings, which points to a role of GBA in top–down control of memory retrieval. Moreover, the long-term memory task revealed a double dissociation: GBA-targeted training improved recollection, whereas BBA-targeted training improved familiarity memory. We conclude that GBA is important for controlling and organizing memory traces of relational information in both short-term binding and long-term memory, while frontal–occipital coherence in the beta band may facilitate familiarity processes.
Mindfulness-based Emotional Acceptance in Combination with Neurofeedback for Improving Emotion Self-Regulation: a Pilot Study
A feasibility of Mindfulness-based emotional acceptance in combination with neurofeedback for improving emotion selfregulation is presented. This represents, to our knowledge, an unexplored approach in the emotion regulation literature. The study was performed using a low-cost wearable system designed to perform electroencephalography (EEG) outside the clinical setting. The focused EEG feature is the beta-band Power Spectral Density along the midline (FCz-CPz electrodes). Four subjects new to the practice of mindfulness were involved in the experiments. A comparison between two neurofeedback conditions (in a within-subject design) is performed: a) cognitive reappraisal task; b) emotional acceptance task. In both cases the expected decrement of power spectral density in high-beta band linked to the neurofeedback training was found. Emotional acceptance in combination with neurofeedback emerged as a promising emotional regulation strategy.
Neurofeedback Training With an Electroencephalogram-Based Brain-Computer Interface Enhances Emotion Regulation
Emotion regulation plays a vital role in human beings daily lives by helping them deal with social problems and protects mental and physical health. However, objective evaluation of the efficacy of emotion regulation and assessment of the improvement in emotion regulation ability at the individual level remain challenging. In this study, we leveraged neurofeedback training to design a real-time EEG-based brain-computer interface (BCI) system for users to effectively regulate their emotions. Twenty healthy subjects performed 10 BCI-based neurofeedback training sessions to regulate their emotion towards a specific emotional state (positive, negative, or neutral), while their EEG signals were analyzed in real time via machine learning to predict their emotional states. The prediction results were presented as feedback on the screen to inform the subjects of their immediate emotional state, based on which the subjects could update their strategies for emotion regulation. The experimental results indicated that the subjects improved their ability to regulate these emotions through our BCI neurofeedback training. Further EEG-based spectrum analysis revealed how each emotional state was related to specific EEG patterns, which were progressively enhanced through long-term training. These results together suggested that long-term EEG-based neurofeedback training could be a promising tool for helping people with emotional or mental disorders.
Effects of Electroencephalogram Biofeedback on Emotion Regulation and Brain Homeostasis of Late Adolescents in the COVID-19 Pandemic
Purpose: The purpose of this study was to examine the effects of electroencephalogram (EEG) biofeedback training for emotion regulation and brain homeostasis on anxiety about COVID-19 infection, impulsivity, anger rumination, meta-mood, and self-regulation ability of late adolescents in the prolonged COVID-19 pandemic situation.
Methods: A non-equivalent control group pretest-posttest design was used. The participants included 55 late adolescents in the experimental and control groups. The variables were evaluated using quantitative EEG at pre-post time points in the experimental group. The experimental groups received 10 sessions using the three-band protocol for five weeks. The collected data were analyzed using the Shapiro-Wilk test, Wilcoxon rank sum test, Wilcoxon signed-rank test, t-test and paired t-test using the SAS 9.3 program. The collected EEG data used a frequency series power spectrum analysis method through fast Fourier transform.
Results: Significant differences in emotion regulation between the two groups were observed in the anxiety about COVID-19 infection (W = 585.50, p = .002), mood repair of meta-mood (W = 889.50, p = .024), self-regulation ability (t = -5.02, p< .001), self-regulation mode (t = -4.74, p < .001), and volitional inhibition mode (t = -2.61, p = .012). Neurofeedback training for brain homeostasis was effected on enhanced sensory-motor rhythm (S = 177.00, p < .001) and inhibited theta (S = -166.00, p < .001).
Conclusion: The results demonstrate the potential of EEG biofeedback training as an independent nursing intervention that can markedly improve anxiety, mood-repair, and self-regulation ability for emotional distress during the COVID-19 pandemic.
Improves Overall Well-being
EEG-neurofeedback for optimising performance. I: A review of cognitive and affective outcome in healthy participants
A re-emergence of research on EEG-neurofeedback followed controlled evidence of clinical benefits and validation of cognitive/affective gains in healthy participants including correlations in support of feedback learning mediating outcome. Controlled studies with healthy and elderly participants, which have increased exponentially, are reviewed including protocols from the clinic: sensory-motor rhythm, beta1 and alpha/theta ratios, down-training theta maxima, and from neuroscience: upper-alpha, theta, gamma, alpha desynchronisation. Outcome gains include sustained attention, orienting and executive attention, the P300b, memory, spatial rotation, RT, complex psychomotor skills, implicit procedural memory, recognition memory, perceptual binding, intelligence, mood and well-being. Twenty-three of the controlled studies report neurofeedback learning indices along with beneficial outcomes, of which eight report correlations in support of a meditation link, results which will be supplemented by further creativity and the performing arts evidence in Part II. Validity evidence from optimal performance studies represents an advance for the neurofeedback field demonstrating that cross fertilisation between clinical and optimal performance domains will be fruitful. Theoretical and methodological issues are outlined further in Part III.
Beneficial outcome from EEG-neurofeedback on creative music performance, attention and well-being in school children
We earlier reported benefits for creativity in rehearsed music performance from alpha/theta (A/T) neurofeedback in conservatoire studies (Egner & Gruzelier, 2003) which were not found with SMR, Beta1, mental skills, aerobics or Alexander training, or in standby controls. Here the focus was the impact on novice music performance. A/T and SMR training were compared in 11-year old school children along with non-intervention controls with outcome measures not only of rehearsed music performance but also of creative improvisation, as well as sustained attention and phenomenology. Evidence of effective learning in the school setting was obtained for A/T and SMR/beta2 ratios. Preferential benefits from A/T for rehearsed music performance were replicated in children for technique and communication ratings. Benefits extended to creativity and communication ratings for creative improvisation which were shared with SMR training, disclosing an influence of SMR on unrehearsed music performance at a novice level with its greater cognitive demands. In a first application of A/T for improving sustained attention (TOVA), it was found to be more successful than SMR training, with a notable reduction in commission errors in the children, 15/33 of whom had attention indices in the ADHD range. Phenomenological reports were in favour of neurofeedback and well-being benefits. Implementing neurofeedback in the daily school setting proved feasible and holds pedagogic promise.
The Psychotherapeutic Effects of Consumer-Grade EEG Neurofeedback on Mental Health and Well-Being
The current study assessed whether pairing mindfulness meditation with consumer-grade neurofeedback (using Muse) would be a feasible and satisfying (i.e., fulfillment and pleasure) intervention for mental health and well-being. This was assessed via a four-day mindfulness program where participants (N=34) were assigned to mindfulness with neurofeedback (n=17) or guided meditation (control; n=17) group. On each day of the program, participants engaged in two mindful sessions (five minutes each) in the morning and afternoon. Participants were administered a series of affective measures before and after the program, as well as throughout. Upon completion, participants were asked to rate their satisfaction with their program. A series of factorial repeated measures ANOVAs were performed to assess for differences between groups. Results confirmed the feasibility of this format of intervention. There was no significant difference in satisfaction reports between groups. Further, no significant differences were found between groups in pre- and post-measures of depressive, anxious, and trauma symptoms, as well as mindful traits. There were significant differences in scores of positive and negative moods found between neurofeedback and control groups, suggesting an added benefit to pairing neurofeedback with mindfulness practice. Overall, this initial feasibility study demonstrated that mindfulness with neurofeedback may have some enhanced psychological benefits compared to meditation alone. However, this intervention needs to be carried out on a much larger and more diverse scale, with consideration for electrophysiological changes, to strengthen its efficacy as an intervention for mental health and wellbeing.