Search Results (30)

Background/Objectives: Neurodegenerative cerebellar ataxia (CA) is a movement disorder caused by progressive cell death in the cerebellum. Motor imagery represents a potential therapeutic tool to improve motor function by “exercising” brain regions associated with movement, without the need for overt activity. This study assessed the feasibility of combining motor imagery with real-time functional magnetic resonance imaging neurofeedback (rt-fMRI-NF) to improve motor function in CA. Methods: During finger tapping conditions, 16 participants with CA pushed a button at the same frequency in time with cross flashing at 1 Hz or 4 Hz, and this information was used to train the model. During motor imagery, participants imagined finger tapping while undergoing rt-fMRI-NF with visual feedback, steering them toward activating their motor circuit. Afterwards, they completed finger tapping again. FMRI analysis compared successful motor imagery trials versus all other imagery events. Brain activity on successful trials was covaried with pre–post rt-fMRI-NF tapping improvement scores. Results: Tapping was more accurate at 1 Hz than 4 Hz, and larger tapping error rates correlated with greater movement impairments. While not significant at the group level, 9 of the 16 participants improved tapping accuracy following rt-fMRI-NF. The size of motor improvements correlated with successful motor imagery activity at 1 Hz in the frontal lobe, insula, parietal lobe, basal ganglia, and cerebellum. Motor improvements were not associated with neurological impairment severity, mood, cognition, or imagery vividness. Conclusions: Feasibility was demonstrated for motor imagery therapy with neurofeedback to potentially improve fine motor precision in people with CA. Brain regions relevant to this process may be considered for targets of non-invasive therapeutic interventions. Full article

Background: Neurofeedback shows promise as an adjunctive therapy for post-traumatic stress disorder (PTSD), but its cost effectiveness has not been studied. Objectives: To assess the cost and effectiveness of neurofeedback plus other therapies (NF + OT) vs. guideline therapies alone. Methods: TreeAge software was used to develop Markov models comparing NF + OT therapy to psychotherapy and pharmacotherapy over 1–3 years. Costs were derived from Medicare rates and literature. Effectiveness was measured using CAPS-5 score reductions converted to quality-adjusted life years (QALYs) using regression analysis. Dropout and relapse rates were derived from systematic reviews and meta-analysis. Results: NF + OT resulted in greater improvements in CAPS-5 scores and was less costly than OT. In the base case, NF + OT was less expensive (on average) for years 1–3 by USD 2568−USD 4140 (vs. psychotherapy) and USD 2282−USD 7217 (vs. pharmacotherapy). QALYs improved by 0.04 compared to psychotherapy and 0.24 compared to pharmacotherapy. NF + OT dominated (lower cost, better outcomes) psychotherapy 12% of the time and pharmacotherapy 26.5% of the time in Monte Carlo simulation. Further, Monte Carlo simulation did not demonstrate dominance at any point in time for either pharmacotherapy or psychotherapy over NF + OT. Conclusions: Based on lower costs and improved effectiveness, NF + OT should be considered for treating PTSD. Full article

This critical review synthesizes findings from quantitative electroencephalography (QEEG) to bridge the gap between systems-level neurophysiology and the underlying cellular pathology of Attention-Deficit/Hyperactivity Disorder (ADHD). As a prevalent neurodevelopmental disorder, ADHD diagnosis is challenged by symptomatic heterogeneity, creating an urgent need for objective biological indicators. Analysis of QEEG data reveals consistent neurophysiological patterns in ADHD, primarily an excess of Theta-band activity and a deficit in Beta-band activity. These findings have led to the proposal of specific biomarkers, such as the Theta/Beta Ratio (TBR), and serve as the basis for neurofeedback interventions aimed at modulating brainwave activity. While not a standalone diagnostic tool, this review posits that QEEG-based biomarkers and Neurofeedback responses are systems-level manifestations of putative cellular and synaptic dysfunctions. By outlining these robust macro-scale patterns, this work provides a conceptual framework intended to guide future molecular and cellular research into the fundamental biology of ADHD. Full article

Background/Objectives: Up to 75% of patients with major depressive disorder (MDD) exhibit persistent anhedonia symptoms related to abnormalities in the positive valence system. Cumulative evidence points to brain dysfunction in the reward system (RS), including in the ventral striatum, in patients with MDD with anhedonia. This study aims to evaluate the safety and efficacy of a novel neurofeedback (NF) device (termed Prism) which incorporates the EEG–FRI-Pattern biomarker of the reward system (RS-EFP) for use in self-neuromodulation training (RS-EFP-NF) for alleviating depression in patients with MDD with anhedonia. Methods: A total of 49 adults (age range: M = 39.9 ± 11.03) with a DSM-5 diagnosis of MDD with anhedonia (per a SHAPS-C score ≥ 25) were screened for the administration of ten sessions of RS-EFP-NF twice a week on nonconsecutive days. Depression and anhedonia severity was assessed, respectively, by HDRS-17 and SHAPS-C at baseline, midway, and treatment end. Results: A total of 34 patients (77%) completed the protocol and were included in the analyses. No device-related adverse events were serious or required treatment. Depression symptoms were reduced at end of treatment as indicated by the HDRS-17, with a reduction of eight points on average (95% CI: −10.5 to −5.41, p < 0.0001), a clinical improvement rate of 78.47%, and a remission rate of 32.25%. Anhedonia, as indicated by the SHAPS-C score, was diminished, showing an average reduction of 6.3 points (95% CI: −8.51 to −4.14, p < 0.0001). Conclusions: Self-neuromodulation using RS-EFP-NF is a promising and safe treatment for MDD with anhedonia. The intervention demonstrates substantial clinical effects on both depression and anhedonia symptoms, with high patient acceptability and retention. Prism may address a critical mechanism-driven treatment gap for anhedonia that often persists despite conventional therapies. Larger controlled implementation, efficacy, and dosing studies are warranted. Full article

Background: Post-traumatic stress disorder (PTSD) manifests through distinct symptom clusters that can respond differently to treatments. Neurofeedback guided by the Amygdala-derived-EEG-fMRI-Pattern (Amyg-EFP-NF) has been utilized to train PTSD patients to regulate amygdala-related activity and decrease symptoms. Methods: We conducted a combined analysis of 128 PTSD patients from three clinical trials of Amyg-EFP-NF to evaluate effects across symptom clusters (as assessed by CAPS-5 subscales) and on emotion regulation processing (evaluated by the ERQ). Results: Amyg-EFP-NF significantly reduced severity across all PTSD symptom clusters immediately post-treatment, with improvements maintained at three-month follow-up. The arousal and reactivity cluster showed continued significant improvement during follow-up. Combined effect sizes were large (η²_p = 0.23–0.35) across all symptom clusters. Regression analysis revealed that emotion regulation processes significantly explained 17% of the variance in symptom improvement during the follow-up period. Conclusions: Reduction of PTSD symptoms following Amyg-EFP-NF occurs across all symptom clusters, with emotional regulation processes potentially serving as an underlying mechanism of action. These results support Amyg-EFP-NF as a comprehensive treatment approach for PTSD that continues to show benefits after treatment completion. Full article

Background: Sleep disturbances are a core feature of post-traumatic stress disorder (PTSD), affecting up to 90% of patients and often persisting after standard PTSD treatment. As all the current interventions have limitations, amygdala-targeted neuromodulation may offer a novel treatment pathway. Methods: Secondary analysis of a prospective, single-arm trial (n = 58) was carried out evaluating Prism™ amygdala-derived-EEG-fMRI-Pattern neurofeedback (Amyg-EFP-NF). Sleep outcomes were assessed using the Clinician-Administered PTSD Scale (CAPS-5) sleep item, PTSD Checklist (PCL-5) sleep item, and Patient Health Questionnaire (PHQ-9) sleep items at baseline, post-treatment, and 3-month follow-up. Treatment consisted of 15 sessions over 8 weeks. Results: At 3-months’ follow-up, 63.79% of participants demonstrated clinically meaningful reduction in sleep disturbances (≥1 point reduction in CAPS-5 Item 20). Sleep improvement showed a moderate correlation with overall PTSD symptom reduction (r = 0.484, p < 0.001) and a balanced improvement pattern (−15.1% early, −9.1% late). Sleep responders sustained improvement across multiple measures and showed significant increases in cognitive reappraisal (mean change: +2.57 ± 1.0, p = 0.006), while non-responders showed initial but un-sustained improvement in trauma-related dreams. Conclusions: Amyg-EFP-NF shows preliminary promise for treating PTSD-related sleep disturbances. Our exploratory analyses suggest distinct temporal patterns of sleep improvement and potential associations with enhanced cognitive reappraisal capacity that warrant rigorous investigation in future randomized controlled trials. Full article

Maintaining optimal levels of engagement during rehabilitation training is crucial for inducing neuroplasticity in the motor cortex, which directly influences positive rehabilitation outcomes. In this research article, we propose a virtual reality (VR) rehabilitation system that incorporates a steady-state visual evoked potential (SSVEP) paradigm to provide engagement feedback. The system utilizes a flickering target and cursor to detect the user’s engagement levels during a target-tracking task. Eighteen healthy participants were recruited to experience three experimental conditions: no feedback (NoF), performance feedback (PF), and neurofeedback (NF). Our results reveal significantly greater Mu suppression in the NF condition compared to the other conditions. However, no significant differences were observed in performance metrics, such as tracking error, among the three conditions. The amount of feedback between the PF and NF conditions also showed no substantial difference. These findings suggest the efficacy of our SSVEP-based engagement feedback paradigm in stimulating motor cortex activity during rehabilitation. Consequently, we conclude that neurofeedback, based on the user’s attentional state, proves to be more effective in promoting motor cortex activation and facilitating neuroplastic changes. This research highlights the potential of integrating VR rehabilitation with an engagement feedback system for successful rehabilitation training. Full article

Neurofeedback (NF) is a promising intervention for improvements in motor performance in Parkinson’s disease. This NF pilot study in healthy participants aimed to achieve the following: (1) determine participants’ ability to bi-directionally modulate sensorimotor beta power and (2) determine the effect of NF on movement performance. A real-time EEG-NF protocol was used to train participants to increase and decrease their individual motor cortex beta power amplitude, using a within-subject double-blind sham-controlled approach. Movement was assessed using a Go/No-go task. Participants completed the NASA Task Load Index and provided verbal feedback of the NF task difficulty. All 17 participants (median age = 38 (19–65); 10 females) reliably reduced sensorimotor beta power. No participant could reliably increase their beta activity. Participants reported that the NF task was challenging, particularly increasing beta. A modest but significant increase in reaction time correlated with a reduction in beta power only in the real condition. Findings suggest that beta power control difficulty varies by modulation direction, affecting participant perceptions. A correlation between beta power reduction and reaction times only in the real condition suggests that intentional beta power reduction may shorten reaction times. Future research should examine the minimum beta threshold for meaningful motor improvements, and the relationship between EEG mechanisms and NF learning to optimise NF outcomes. Full article

Schizophrenia is a neuropsychiatric disorder affecting approximately 1 in 300 people worldwide. It is characterized by a range of symptoms, including positive symptoms (delusions, hallucinations, and formal thought disorganization), negative symptoms (anhedonia, alogia, avolition, asociality, and blunted affect), and cognitive impairments (impaired memory, attention, executive function, and processing speed). Current treatments, such as psychopharmacology and psychotherapy, often do not fully address these symptoms, leading to impaired everyday functionality. In recent years, there has been a growing interest in neuromodulation due to computer and engineering science making extraordinary computational advances. Those put together have reinitiated the spark in the field of neurofeedback (NF) as a means for self-regulation and neuromodulation with the potential to alleviate the daily burden of schizophrenia. We review, in a systematic way, the primary reports of electroencephalogram (EEG)-based NF as a therapeutical tool for schizophrenia. The main body of research consists mostly of case studies and case reports. The results of a few randomized controlled studies, combined with case studies/series, underscore the potential use of NF as an add-on treatment option for improving the lives of suffering individuals, being sustained by the changes in brain function and symptomatology improvement. We aim to provide important evidence of neuromodulation using NF in patients with schizophrenia, summarizing the effects and conclusions found in several clinical trials. Full article

Introduction: Reelin is a neuropeptide responsible for the migration and positioning of pyramidal neurons, interneurons, and Purkinje cells. In adulthood, it still supports neuroplasticity, especially dendritic spines formation and glutamatergic neurotransmission. Genetic studies have confirmed the involvement of reelin system failure in the etiopathogenesis of mental diseases, including schizophrenia. Given the role of reelin in brain cytoarchitectonics and the regularly observed reduction in its activity in prefrontal areas in cases of schizophrenia, dysfunction of the reelin pathway fits the neurodevelopmental hypothesis of schizophrenia, both as a biochemical predisposition and/or the ultimate trigger of psychosis and as a biosocial factor determining the clinical course, and finally, as a potential target for disease monitoring and treatment. Aim: The purpose of this study was to examine associations of the reelin blood level with clinical and neurocognitive parameters during an intensive, structured neurofeedback therapy of patients with schizophrenia. Methods: Thirty-seven male patients with paranoid schizophrenia were randomly divided into two groups: a group with 3-month neurofeedback as an add-on to ongoing antipsychotic treatment (NF, N18), and a control group with standard social support and antipsychotic treatment (CON, N19). The reelin serum concentration, clinical and neurocognitive tests were compared between the groups. Results: After 3-month trial (T2), the reelin serum level increased in the NF group vs. the CON group. The negative and general symptoms of PANSS (Positive and Negative Syndrome Scale) were reduced significantly more in the NF group at T2, and the d2 (d2 Sustained Attention Test) and BCIS (Beck Cognitive Insight Scale) scores improved only in the NF group. The AIS scores improved more dynamically in the NF group, but not enough to differentiate them from the CON group at T2. Conclusions: The clinical and neurocognitive improvement within the 3-month NF add-on therapy trial was associated with a significant increase of reelin serum level in schizophrenia patients. Full article

Breathing is one of the most vital functions for being mentally and emotionally healthy. A growing number of studies confirm that breathing, although unconscious, can be under voluntary control. However, it requires systematic practice to acquire relevant experience and skillfulness to consciously utilize breathing as a tool for self-regulation. After the COVID-19 pandemic, a global discussion has begun about the potential role of emerging technologies in breath-control interventions. Emerging technologies refer to a wide range of advanced technologies that have already entered the race for mental health training. Artificial intelligence, immersive technologies, biofeedback, non-invasive neurofeedback, and other wearable devices provide new, but yet underexplored, opportunities in breathing training. Thus, the current systematic review examines the synergy between emerging technologies and breathing techniques for improving mental and emotional health through the lens of skills development. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology is utilized to respond to the objectives and research questions. The potential benefits, possible risks, ethical concerns, future directions, and implications are also discussed. The results indicated that digitally assisted breathing can improve various aspects of mental health (i.e., attentional control, emotional regulation, mental flexibility, stress management, and self-regulation). A significant finding of this review indicated that the blending of different technologies may maximize training outcomes. Thus, future research should focus on the proper design and evaluation of different digital designs in breathing training to improve health in different populations. This study aspires to provide positive feedback in the discussion about the role of digital technologies in assisting mental and emotional health-promoting interventions among populations with different needs (i.e., employees, students, and people with disabilities). Full article

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. Full article

Neurodevelopmental psychopathology seeks to understand higher-order emotion regulation circuitry to develop new therapies for adolescents with depression. Depressed (N = 34) and healthy youth (N = 19) completed neurofeedback (NF) training and exhibited increased bilateral amygdala and hippocampus activity in the region of interest (ROI) analyses by recalling positive autobiographical memories. We tested factors supportive of the engagement of emotion regulation’s neural areas during NF (i.e., parental support, medication, and gender effects upon anterior cingulate cortex (ACC) engagement). Whole-brain analyses yielded effects of NF vs. control condition and effects of diagnosis. Youth showed higher amygdala and hippocampus (AMYHIPPO) activity during the NF vs. control condition, particularly in the left hippocampus. ACC’s activity was also higher during NF vs. control. Higher average ACC activity was linked to better parental support, absent depression, female gender, and absent medication. Control youth showed higher average AMYHIPPO and ACC activity throughout the task and a faster decline in activity vs. depressed youths. Whole-brain level analyses showed higher activity in the frontotemporal network during the NF vs. control conditions, suggesting targeting their connectivity in future neurofeedback trials. Full article

The aim of this study was to investigate the inner link between the small-world brain network and inhibitory control. Functional near-infrared spectroscopy (fNIRS) was used to construct a neurofeedback (NF) training system and regulate the frontal small-world brain network. The small-world network downregulation group (DOWN, n = 17) and the small-world network upregulation group (UP, n = 17) received five days of fNIRS-NF training and performed the color–word Stroop task before and after training. The behavioral and functional brain network topology results of both groups were analyzed by a repeated-measures analysis of variance (ANOVA), which showed that the upregulation training helped to improve inhibitory control. The upregulated small-world brain network exhibits an increase in the brain network regularization, links widely dispersed brain resources, and reduces the lateralization of brain functional networks between hemispheres. This suggests an inherent correlation between small-world functional brain networks and inhibitory control; moreover, dynamic optimization under cost efficiency trade-offs provides a neural basis for inhibitory control. Inhibitory control is not a simple function of a single brain region or connectivity but rather an emergent property of a broader network. Full article

Neurofeedback (NF) shows promise in enhancing memory, but its application to the medial temporal lobe (MTL) still needs to be studied. Therefore, we aimed to develop an NF system for the memory function of the MTL and examine neural activity changes and memory task score changes through NF training. We created a memory NF system using intracranial electrodes to acquire and visualise the neural activity of the MTL during memory encoding. Twenty trials of a tug-of-war game per session were employed for NF and designed to control neural activity bidirectionally (Up/Down condition). NF training was conducted with three patients with drug-resistant epilepsy, and we observed an increasing difference in NF signal between conditions (Up–Down) as NF training progressed. Similarities and negative correlation tendencies between the transition of neural activity and the transition of memory function were also observed. Our findings demonstrate NF’s potential to modulate MTL activity and memory encoding. Future research needs further improvements to the NF system to validate its effects on memory functions. Nonetheless, this study represents a crucial step in understanding NF’s application to memory and provides valuable insights into developing more efficient memory enhancement strategies. Full article