Comparative Analysis of LORETA Z Score Neurofeedback and Cognitive Rehabilitation on Quality of Life and Response Inhibition in Individuals with Opioid Addiction.

Background. Previous studies has shown that conventional neurofeedback and cognitive rehabilitation can improve psychological outcomes in people with opioid use disorders. However, the effectiveness of LORETA Z-score neurofeedback (LZNFB) and attention bias modification training on quality of life and inhibitory control of these people has not been investigated yet. LZNFB targets deeper brain structures with higher precision, compared to conventional neurofeedback that typically focuses on surface EEG activity. The present study aims to compare the effect of these two methods on quality of life and response inhibition in men with opioid use disorders under methadone maintenance therapy (MMT). Methods. In this randomized controlled clinical trial with a pre-test, post-test, follow-up design, 30 men with opioid use disorders under MMT were randomly assigned into three groups of LZNFB, attention bias modification training, and control (MMT alone). The LZNFB and Cognitive Rehabilitation groups received 20 and 15 sessions of treatment, respectively. The Persian versions WHO Quality of Life-BREEF questionnaire and the Go/No-Go test were completed by the participants before, immediately after, and one month after interventions. The collected data were analyzed in SPSS v.22 software. Results. Both intervention groups showed a significant improvement in quality-of-life score and a significant reduction in response time at the post-test phase (P < .05), where LZNFB group showed more improvement in quality of life and more reduction in response inhibition. After one month, the increase in quality of life continued in both groups, while the decrease in response time continued only in the LZNFB group. Conclusion. Both LZNFB and attention bias modification training are effective in improving quality of life and response inhibition of men with OUD under MMT, however, LZNFB is more effective.

Effectiveness of Low-Resolution Brain Electromagnetic Tomography Z Score Neurofeedback Comparison with Cognitive Rehabilitation in Depression and Anxiety in Opioid Use Disorder.

Background: Previous studies have shown that conventional neurofeedback (NFB) and cognitive rehabilitation can improve psychological outcomes in people with opioid use disorders (OUDs). However, the effectiveness of Low-Resolution Brain Electromagnetic Tomography (LORETA) Z-score neurofeedback (LZNFB) and attention bias modification training (ABMT) on depression and anxiety of these people has not been investigated yet. The present study aims to compare the effect of these two methods on depression and anxiety of men with OUD under methadone maintenance therapy (MMT). Methods: In this randomized controlled clinical trial with a pre-test, post-test, and follow-up design, 30 men with OUD under MMT were randomly assigned into three groups of LZNFB, ABMT, and control (MMT alone). The LZNFB group underwent LZNFB at 20 sessions. The ABMT using the dot-probe task was provided individually to the second group for 2 weeks at 15 sessions. The Beck Anxiety Inventory and the Beck Depression Inventory were completed by the participants before, immediately after, and 1-month after interventions. The collected data were analyzed in SPSS v.22 software. Results: Both intervention groups showed a significant reduction in anxiety and depression at the post-test phase (p < 0.05), where LZNFB group showed more decrease in anxiety and depression than the ABMT group. This decrease continued in the follow-up period. Conclusion: Both LZNFB and ABMT with the dot-robe task are effective in reducing depression and anxiety of men with OUD under MMT. However, LZNFB is more effective. These findings add to the growing body of literature supporting the effectiveness of NFB and cognitive rehabilitation therapy in treating addiction-related comorbidities.

Comparing LORETA Z Score Neurofeedback and Cognitive Rehabilitation Regarding Their Effectiveness in Reducing Craving in Opioid Addicts.

Introduction: Previous studies have shown that conventional neurofeedback and cognitive modification treatments have numerous psychological benefits for patients with substance use disorders. However, the effectiveness of LORETA (Low-Resolution Brain Electromagnetic Tomography) Z Score Neurofeedback (LZNFB) and cognitive rehabilitation therapy in reducing opioid craving has not been investigated. Thus, the present study aimed to compare the effectiveness of LZNFB and cognitive rehabilitation therapy with Methadone Maintenance Treatment (MMT) in reducing craving in patients with opioid use disorder. Methods: Thirty patients with opioid use disorder undergoing MMT were randomly assigned into three groups: LZNFB with MMT, cognitive rehabilitation with MMT (as experimental groups), and MMT alone control group. The LZNFB and cognitive rehabilitation groups received 20 and 15 sessions of treatment, respectively. The three groups were assessed using several questionnaires and dot-probe task at pretest, posttest, and one-month follow-up. Results: The results showed that both experimental groups accomplished a significantly greater reduction in opioid craving than MMT alone group at posttest and follow-up (P<0.05). The LZNFB plus MMT group showed a greater decrease in opioid craving than the cognitive rehabilitation plus MMT group. In addition, the cognitive rehabilitation plus MMT group experienced greater improvement in attentional bias towards craving cues than the LZNFB with MMT group at posttest and follow-up. Finally, the LZNFB plus MMT group and cognitive rehabilitation plus MMT group got higher scores on the recovery assessment scale than MMT alone group at posttest and follow-up. According to study results, LZNFB training is more effective than cognitive rehabilitation in decreasing cravings and improving the quality of life in addiction to opioids. Conclusion: The current study's findings provided preliminary support for the effectiveness of LZNFB and cognitive rehabilitation in reducing opioid craving, improving attentional bias towards craving cues, and the quality of life among Iranian opioid use patients. Highlights: LZNFB training showed higher decrease in opioid craving than the Cognitive rehabilitation in opioid addicts.Cognitive rehabilitation group experienced greater improvement on attentional bias towards craving cues than LZNFB.LZNFB and Cognitive rehabilitation with MMT group got higher scores on the recovery assessment scale than MMT alone group.LZNFB training is more effective than Cognitive Rehabilitation in decreasing of craving in addiction. opioids. Plain Language Summary: Addiction is a chronic relapsing disease that makes many problems for human society. Routine medical treatments are not completely effective and they have relapse. New forms of non-medical treatments such as neurofeedback and cognitive rehabilitation are effective and safe without impressive side effects . This article shows the efficacy of above mentioned interventions for decrease craving and control of this problem.

Using Bilateral tDCS to Modulate EEG Amplitude and Coherence of Men With Opioid Use Disorder Under Methadone Therapy: A Sham-controlled Clinical Trial.

Objective. This study aimed to investigate the effect of bilateral transcranial direct current stimulation (tDCS) on the electroencephalography (EEG) amplitude and coherence in male patients with opioid use disorder (OUD), who were under methadone therapy. It compares the effects of active versus sham tDCS. Methods. This is a double-blind sham-controlled clinical trial. Participants were 30 male patients with OUD; they were divided into 3 groups of left anode/right cathode tDCS, right anode/left cathode tDCS, and sham tDCS. Their brainwave activity was measured by quantitative EEG before study and then active groups underwent tDCS (2 mA, 20 min) applied over their right/left dorsolateral prefrontal cortex (DLPFC) for 10 consecutive days. After stimulation, they were re-assessed. The collected data were analyzed in SPSS, MATLAB, and NeuroGuide v.2 applications. Results. After active tDCS, a significant decrease in amplitude of slow brain waves (delta, theta, and alpha) in prefrontal, frontal, occipital, and parietal areas, and an increase in the coherence of beta, delta, and theta frequency bands in the parietal, central, and temporal regions of addicts were reported. In the sham group, there was a significant decrease in the amplitude of the alpha wave and in the coherence of delta and theta waves. Conclusion. The active tDCS over the right/left DLPFC, as a noninvasive and complementary treatment, can modulate the amplitude and coherence of brainwaves in patients with OUD.

Epidemiology of hepatitis B, hepatitis C, and human immunodeficiency virus infecions in patients with beta-thalassemia in Iran: a multicenter study.

BACKGROUND: Though regular blood transfusion improves the overall survival of patients with beta-thalassemia, it carries a definite risk of infection with blood-borne viruses. We carried out this multicenter study to provide epidemiologic data on hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infection among Iranian beta-thalassemic patients. Moreover, HCV infection-associated risk factors were investigated in this population. METHODS: Seven hundred and thirty-two patients with beta-thalassemia major or beta-thalassemia intermedia, selected from five provinces of Iran including Tehran (n = 410), Kerman (n = 100), Qazvin (n = 95), Semnan (n = 81), and Zanjan (n = 46), were enrolled in this study. Using ELISA, their sera were tested for HBsAg, HBcAb, HBsAb, HCVAb, and HIVAb. The positive HCVAb results were confirmed by RIBA-2nd generation. RESULTS: The study sample consisted of 413 males and 319 females, with a mean +/- SD age of 17.9 +/- 9.0 years. One hundred forty-one (19.3%) patients were HCVAb positive; 11 (1.5%) were HBsAg positive. No one was HIVAb positive. Univariate analysis showed that beta-thalassemia major (P = 0.01), older age (P = 0.001), longer transfusion duration (P = 0.000), HBsAg seropositivity (P = 0.03), and higher serum ferritin level (P = 0.002) were significantly associated with a higher prevalence of HCV. Furthermore, the prevalence of HCV infection dropped significantly after the implementation of blood donors screening (22.8% vs. 2.6%; P = 0.000). Using multivariate analysis, beta-thalassemia major (P = 0.002), age (P < 0.001), serum ferritin level (P < 0.001), as well as consumption of unscreened blood (P = 0.003), were independent factors associated with HCV infection. CONCLUSION: The prevalence of HCV infection is much higher among Iranian beta-thalassemic patients as compared with HBV and HIV infections. Routine screening of donated blood for HCV is highly recommended.