The effects of neurofeedback training for children with cerebral palsy and co-occurring attention deficits: A pilot study.

BACKGROUND: Limited research exists regarding the effectiveness of electroencephalogram (EEG) neurofeedback training for children with cerebral palsy (CP) and co-occurring attention deficits (ADs), despite the increasing prevalence of these dual conditions. This study aimed to fill this gap by examining the impact of neurofeedback training on the attention levels of children with CP and AD. METHODS: Nineteen children with both CP and co-occurring ADs were randomly assigned to either a neurofeedback or control group. The neurofeedback group received 20 sessions of training, lasting approximately 1 h per day, twice a week. Theta/beta ratios of the quantitative electroencephalography (QEEG) recordings were measured pre-training and post-training in the resting state. The Continuous Performance Test (CPT), the Test of Visual Perceptual Skills-3rd Version (TVPS-3) and the Conners' Parent Rating Scale (CPRS) were measured at pre- and post-training. RESULTS: The neurofeedback group showed both decreased theta/beta ratios compared with control group (p = 0.04) at post-training and a within-group improvement during training (p = 0.02). Additionally, the neurofeedback group had a trend of decreased omission rates of the CPT (p = 0.08) and the visual sequential memory and the visual closure subscores in the TVPS-3, compared with the control group (p = 0.02 and p = 0.01, respectively). CONCLUSIONS: The results suggested that children with CP and co-occurring AD may benefit from neurofeedback training in their attention level. Further research is needed to explore long-term effects and expand its application in this population.

Client buy-in: An essential consideration for graded motor imagery in hand therapy.

STUDY DESIGN: This is a cross-sectional survey research. INTRODUCTION: Current evidence provides efficacy of graded motor imagery (GMI) in chronic pain conditions but also reveals barriers to its implementation. PURPOSE OF THE STUDY: The purpose of this study was to describe current utilization of GMI in hand therapy practice. METHODS: Survey tool, informed by literature and Revised Neurophysiology of Pain Questionnaire (NPQ) was electronically distributed to members of the American Society of Hand Therapists. RESULTS: 132 therapists completed the survey. 65.2% reported they would always or very likely use GMI in clients with central sensitization, but no relationship between the likelihood of therapists using GMI to score achieved on the NPQ was found. Lack of patient buy-in, was the main barrier cited. "Sell it well" with pain neuroscience education the most cited strategy. DISCUSSION: GMI is frequently used in clients with central sensitization but requires client buy-in. CONCLUSIONS: Understanding and explaining pain mechanism is essential for implementing GMI.

Probing the relative contribution of the first and second responses to sensory gating indices: a meta-analysis.

Sensory gating deficit in schizophrenia patients has been well-documented. However, a central conceptual issue, regarding whether the gating deficit results from an abnormal initial response (S1) or difficulty in attenuating the response to the repeating stimulus (S2), raise doubts about the validity and utility of the S2/S1 ratio as a measure of sensory gating. This meta-analysis study, therefore, sought to determine the consistency and relative magnitude of the effect of the two essential components (S1 and S2) and the ratio. The results of weighted random effects meta-analysis revealed that the overall effect sizes for the S1 amplitude, S2 amplitude, and P50 S2/S1 ratio were -0.19 (small), 0.65 (medium to large), and 0.93 (large), respectively. These results confirm that the S2/S1 ratio and the repeating (S2) stimulus differ robustly between schizophrenia patients and healthy controls in contrast to the consistent but smaller effect size for the S1 amplitude. These findings are more likely to reflect defective inhibition of repeating redundant input rather than an abnormal response to novel stimuli.

Maturation of sensory gating performance in children with and without sensory processing disorders.

Recent interest in sensory gating in children with and without neuropsychological disorders has resulted in a number of studies and the results regarding the developmental trajectory of sensory gating are inconsistent. We investigated the maturational course of sensory gating in samples of typically developing children and children with sensory processing deficits (SPD) and compared their performance to adults. Besides gating ratios, we also examined the brain responses to conditioning and test click stimuli in the sensory gating paradigm separately to clarify if the changes in click amplitudes could explain the maturational change in the T/C ratio in children. Eighteen adults with no known disorders, 25 typical children, and 28 children with SPD participated in this study. The children ranged in ages between 5 and 12 years. The three groups differed in their P50 and N100 ERP components. Both child groups displayed significantly less gating than the adults. Children with SPD demonstrated significantly less gating and more within-group variability compared to typical children. There were significant relationships between age and T/C ratios and between age and peak-to-peak amplitude of the conditioning click in typical children but not in children with SPD. Typical children demonstrated significantly smaller brain response amplitudes to the clicks as compared to adults. These findings suggest that there is a maturational course of sensory gating in typical children and if there is a maturational trajectory in children with SPD it appears to be different than typical children. In addition, children with SPD were found to be lacking in their ability to filter out repeated auditory input and failed to selectively regulate their sensitivity to sensory stimuli.