Immediate effects of Alpha/theta and Sensory-Motor Rhythm feedback on music performance.

This is one of a series of investigations comparing two EEG-neurofeedback protocols - Alpha/theta (A/T) and Sensory-Motor Rhythm (SMR) - for performance enhancement in the Arts, here with the focus on music. The original report (Egner and Gruzelier, 2003) established a beneficial outcome for elite conservatoire musicians following A/T training in two investigations. Subsequently this A/T advantage was replicated for both advanced instrumental and novice singing abilities, including improvisation, while SMR training benefited novice performance only (Gruzelier, Holmes et al., 2014). Here we report a replication of the latter study in university instrumentalists who as before were novice singers with one design change - post-training performances were conducted within the tenth final session instead of on a subsequent occasion. As before expert judges rated the domains of Creativity/Musicality, Communication/Presentation and Technique. The proximity to training of the music performances within the last session likely compromised gains from A/T learning, but perhaps reinforced the impact of SMR training efficacy. In support of validation there was evidence of strong within- and across-session A/T learning and positive linear trends for across-session SMR/theta and SMR/beta-2 ratio learning. In support of mediation learning correlated with music performance. The A/T outcome was markedly discrepant from previous studies and should dispel any impression that the hypnogogic state itself is transferred to the performance context. The effects of SMR ratio training are consistent with an impact on lower-order abilities required in novice performance such as sustained attention and memory, and benefiting all three domains of music assessment.

Neurofeedback facilitation of implicit motor learning.

BACKGROUND: Mu rhythm desynchronisation via EEG-neurofeedback (NFB) has been previously been shown to induce durable motor-cortical disinhibition for at least 20 min. It was hypothesised that the presentation of a novel procedural learning task immediately after this NFB protocol would boost motor performance. METHOD: The protocol consisted of firstly activating the right primary motor cortex with a single session of Mu (8-12 Hz) suppression via NFB for a total of 30 min. Shortly after, and with their non-dominant (left) hand, subjects (n=10) performed the serial reaction time task (SRTT), which is used to assess reaction time improvement over multiple trials. During another occasion (1 week before/after), the same subjects were tested on a different sequence without prior NFB, as part of a counterbalanced control condition. RESULTS: Compared to a "cross-over" condition without NFB, subjects who received NFB immediately prior to SRTT performance exhibited a significantly faster rate of learning, reflected in a greater reduction of reaction times across blocks (p=0.02). This occurred in the absence of explicit awareness of a repeating sequence. Moreover, no significant differences were observed between conditions in error rate or reaction time variability. CONCLUSION: Our results suggest that a single NFB session may be directly used to facilitate the early acquisition of a procedural motor task, and are the first to demonstrate that neurofeedback effects could be exploited immediately after individual training sessions so as to boost behavioural performance and learning.

EEG-neurofeedback and psychodynamic psychotherapy in a case of adolescent anhedonia with substance misuse: mood/theta relations.

There is substantial evidence confirming the efficacy of neurofeedback with applications in clinical, educational and optimal performance domains. However, a psychodynamically informed NF-approach needs exploration. A male (19 y), college student whose first year was being seriously compromised after severe, 18-month, polydrug misuse, was treated with 11 sessions including a 2-month follow-up of neurofeedback combined with short-term psychodynamic psychotherapy. Pre/post-treatment and follow-up assessment with the Brief Psychiatric Rating Scale (BPRS) and the Montgomery-Asberg Depression Rating Scale confirmed that levels of psychopathology dropped almost to zero. Correlational evidence disclosed that SMR/theta training was positively associated with reduction in psychopathological ratings, largely due to theta amplitude reduction; the strongest relation being with reduced BPRS activation. Alpha/theta training was not correlated with clinical improvement. The combined treatment was found to be highly effective with the student who learned to deal with feelings of anhedonia and alienation. There was no relapse during the follow-up phase. Further research is recommended.

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.

Application of alpha/theta neurofeedback and heart rate variability training to young contemporary dancers: state anxiety and creativity.

As one in a series on the impact of EEG-neurofeedback in the performing arts, we set out to replicate a previous dance study in which alpha/theta (A/T) neurofeedback and heart rate variability (HRV) biofeedback enhanced performance in competitive ballroom dancers compared with controls. First year contemporary dance conservatoire students were randomised to the same two psychophysiological interventions or a choreology instruction comparison group or a no-training control group. While there was demonstrable neurofeedback learning, there was no impact of the three interventions on dance performance as assessed by four experts. However, HRV training reduced anxiety and the reduction correlated with improved technique and artistry in performance; the anxiety scale items focussed on autonomic functions, especially cardiovascular activity. In line with the putative impact of hypnogogic training on creativity A/T training increased cognitive creativity with the test of unusual uses, but not insight problems. Methodological and theoretical implications are considered.

Replication of elite music performance enhancement following alpha/theta neurofeedback and application to novice performance and improvisation with SMR benefits.

Alpha/theta (A/T) and sensory-motor rhythm (SMR) neurofeedback were compared in university instrumentalists who were novice singers with regard to prepared and improvised instrumental and vocal performance in three music domains: creativity/musicality, technique and communication/presentation. Only A/T training enhanced advanced playing seen in all three domains by expert assessors and validated by correlations with learning indices, strongest with Creativity/Musicality as shown by Egner and Gruzelier (2003). Here A/T gains extended to novice performance - prepared vocal, improvised vocal and instrumental - and were recognised by a lay audience who judged the prepared folk songs. SMR learning correlated positively with Technical Competence and Communication in novice performance, in keeping with SMR neurofeedback's known impact on lower-order processes such as attention, working memory and psychomotor skills. The importance of validation through learning indices was emphasised in the interpretation of neurofeedback outcome.

The effects of neurofeedback training on the spectral topography of the electroencephalogram.

OBJECTIVE: To investigate the impact of EEG frequency band biofeedback (neurofeedback) training on spectral EEG topography, which is presumed to mediate cognitive-behavioural training effects. In order to assess the effect of commonly applied neurofeedback protocols on spectral EEG composition, two studies involving healthy participants were carried out. METHODS: In Experiment 1, subjects were trained on low beta (12-15 Hz), beta1 (15-18 Hz), and alpha/theta (8-11 Hz/5-8 Hz) protocols, with spectral resting EEG assessed before and after training. The specific associations between learning indices of each individual training protocol and changes in absolute and relative spectral EEG topography was assessed by means of partial correlation analyses. Results of Experiment 1 served to generate hypotheses for Experiment 2, where subjects were randomly allocated to independent groups of low beta, beta1, and alpha/theta training. Spectral resting EEG measures were contrasted prior and subsequent to training within each group. RESULTS: Only few associations between particular protocols and spectral EEG changes were found to be consistent across the two studies, and these did not correspond to expectations based on the operant contingencies trained. Low-beta training was found to be somewhat associated with reduced post-training low-beta activity, while more reliably, alpha/theta training was associated with reduced relative frontal beta band activity. CONCLUSIONS: The results document that neurofeedback training of frequency components does affect spectral EEG topography in healthy subjects, but that these effects do not necessarily correspond to either the frequencies or the scalp locations addressed by the training contingencies. The association between alpha/theta training and replicable reductions in frontal beta activity constitutes novel empirical neurophysiological evidence supporting inter alia the training's purported role in reducing agitation and anxiety. SIGNIFICANCE: These results underline the complexity of the neural dynamics involved EEG self-regulation and emphasize the need for empirical validation of predictable neurophysiological outcomes of training EEG biofeedback protocols.

EEG biofeedback of low beta band components: frequency-specific effects on variables of attention and event-related brain potentials.

OBJECTIVE: To test a common assumption underlying the clinical use of electroencephalographic (EEG) biofeedback training (neurofeedback), that the modulation of discreet frequency bands is associated with frequency-specific effects. Specifically, the proposal was assessed that enhancement of the low beta components sensorimotor rhythm (SMR: 12-15 Hz) and beta1 (15-18 Hz) affect different aspects of attentional processing. METHODS: Subjects (n=25) were randomly allocated to training with either an SMR or beta1 protocol, or to a non-neurofeedback control group. Subjects were assessed prior and subsequent to the training process on two tests of sustained attention. The neurofeedback participants were also assessed on target P300 event-related potential (ERP) amplitudes in a traditional auditory oddball paradigm. RESULTS: Protocol-specific effects were obtained in that SMR training was associated with increased perceptual sensitivity 'd prime' (d'), and reduced omission errors and reaction time variability. Beta1 training was associated with faster reaction times and increased target P300 amplitudes, whereas no changes were evident in the control group. CONCLUSIONS: Neurofeedback training of SMR and beta1 band components led to significant and protocol-specific effects in healthy subjects. The data can be interpreted as indicating a general attention-enhancing effect of SMR training, and an arousal-enhancing effect of beta1 training.

Chronic schizophrenics with positive symptomatology have shortened EEG microstate durations.

OBJECTIVE: In young, first-episode, never-treated schizophrenics compared with controls, (a) generally shorter durations of EEG microstates were reported (Koukkou et al., Brain Topogr 6 (1994) 251; Kinoshita et al., Psychiatry Res Neuroimaging 83 (1998) 58), and (b) specifically, shorter duration of a particular class of microstates (Koenig et al., Eur Arch Psychiatry Clin Neurosci 249 (1999) 205). We now examined whether older, chronic schizophrenic patients with positive symptomatology also show these characteristics. METHODS: Multichannel resting EEG (62.2 s/subject) from two subject groups, 14 patients (36.1+/-10.2 years old) and 13 controls (35.1+/-8.2 years old), all males, was analyzed into microstates using a global approach for microstate analysis that clustered the microstates into 4 classes (Koenig et al., 1999). RESULTS: (a) Hypothesis testing of general microstate shortening supported a trend (P=0.064). (b) Two-way repeated measure ANOVA (two subject groupsx4 microstate classes) showed a significant group effect for microstate duration. Posthoc tests revealed that a microstate class with brain electric field orientation from left central to right central-posterior had significantly shorter microstates in patients than controls (68.5 vs. 76.1 ms, P=0.034). CONCLUSIONS: The results were in line with the results from young, never-treated, productive patients, thus suggesting that in schizophrenic information processing, one class of mental operations might intermittently cause deviant mental constructs because of premature termination of processing.

A review of the impact of hypnosis, relaxation, guided imagery and individual differences on aspects of immunity and health.

This review considers psychological interventions involving relaxation and guided imagery targeting immune functions. The review provides evidence of immune control accompanied by reports of enhanced mood and well-being. Three recent investigations of the author and his colleagues with self-hypnosis training incorporating imagery of the immune system are outlined. In two studies, hypnosis buffered the effects of stress on immune functions in medical students at exam time, and the comparison of self-hypnosis with and without immune imagery confirmed advantages to targeted imagery for both immune function and mood, and importantly, fewer winter viral infections. The implications for health were investigated in a third study in patients with virulent and chronic herpes simplex virus-2 HSV-2). Six weeks of training almost halved recurrence, improved mood and reduced levels of clinical depression and anxiety. Immune functions were up-regulated, notably functional natural killer cell activity to HSV-1. Individual differences in hypnotic susceptibility and absorption have typically been found to predict efficacy. New replicable evidence is reviewed of the importance of cognitive activation, a personality difference whose neurophysiological underpinning is consistent with left hemispheric preferential influences over the immune system. Now that the validation of psychological interventions includes advantages for health, this field of enquiry, which has been characterised by modest, small scale, largely preliminary studies, warrants a greater investment in research.

Learned self-regulation of EEG frequency components affects attention and event-related brain potentials in humans.

Learned enhancement of EEG frequency components in the lower beta range by means of biofeedback has been reported to alleviate attention deficit hyperactivity disorder (ADHD) symptoms. In order to elucidate frequency-specific behavioural effects and neurophysiological mediators, this study applied neurofeedback protocols to healthy volunteers, and assessed impact on behavioural and electrocortical attention measures. Operant enhancement of a 12-15 Hz component was associated with reduction in commission errors and improved perceptual sensitivity on a continuous performance task (CPT), while the opposite relation was found for 15-18 Hz enhancement. Both 12-15 Hz and 15-18 Hz enhancement were associated with significant increases in P300 event-related brain potential amplitudes in an auditory oddball task. These relations are interpreted as stemming from band-specific effects on perceptual and motor aspects of attention measures.

Electrophysiological evidence of serotonergic impairment in long-term MDMA ("ecstasy") users.

OBJECTIVE: "Ecstasy," or 3,4-methylenedioxymethamphetamine (MDMA), causes long-term impairment to the serotonin (5-HT) system in rats, dogs, and nonhuman primates. 5-HT dysfunction has also been observed in human recreational users of the drug, but whether 5-HT dysfunction in humans is caused by MDMA has not been established, since dysfunction may have preceded MDMA exposure. This ambiguity about causation is particularly important in MDMA research, because 5-HT deficiency is a predictor of risky behavior. METHOD: The 5-HT function of 22 long-term MDMA users was compared to that of 20 drug-naive comparison subjects and 19 cannabis users. 5-HT function was assessed with the intensity dependence paradigm, a tool that measures 5-HT-related attenuation of neural response to auditory stimuli (measured with EEG). RESULTS: Long-term MDMA users exhibited 5-HT dysfunction, relative to both cannabis users and drug-naive comparison subjects. This dysfunction was related to total MDMA consumption (after removing the effect of frequency of use) but not to frequency of use (after removing the effect of total consumption). CONCLUSIONS: These data show that 5-HT dysfunction occurs in MDMA users, is related to users' MDMA consumption, and is independent of cannabis use. The results do not suggest that self-medication explains this relationship, because the deficit was related to total MDMA consumption but not frequency of consumption. The results are thus consistent with the thesis that MDMA consumption causes 5-HT impairment in humans.

Associations of P50 suppression and desensitization with perceptual and cognitive features of "unreality" in schizotypy.

BACKGROUND: P50 suppression is an electrophysiologic index of early sensory gating and has consistently been found deficient in schizophrenic patients. This gating deficit is thought to lead to sensory overload and cognitive fragmentation, and correspondingly many symptoms of the disorder. However, the link between P50 suppression deficits and symptomatology is yet to be established, and so this study was designed to determine whether such a relation is present within a nonclinical population. METHODS: P50 suppression and schizotypy measures were obtained from 36 healthy volunteers, and correlation analyses determined whether measures of schizotypy were related to P50 suppression. RESULTS: Consistent with the view that P50 gating deficits are related to schizophrenic symptoms, subjects with poorer P50 suppression reported more perceptual anomalies and magical ideation--an unreality syndrome--in contrast to other positive symptoms and to withdrawal. This study also found a trend to P50 suppression desensitization, and that whereas subjects low on "unreality" demonstrated desensitization to the second of the paired clicks, subjects high on "unreality" demonstrated sensitization. CONCLUSIONS: It is concluded that early sensory gating deficits, in the form of poor P50 suppression, are related to unreality aspects of schizotypy. This supports the view that poor P50 suppression in schizophrenia is related to symptomatology.

Differentiation of hypnosis and relaxation by analysis of narrow band theta and alpha frequencies.

Narrow band theta and alpha activity were recorded over anterior and posterior sites before, during, and after hypnosis in high and low hypnotically susceptible subjects (N = 16). In theta, high susceptibles had greater activity posthypnosis, otherwise there were no group differences. These findings common to low and high susceptibles suggest that theta is an index of relaxation that continues after hypnosis in highs. In alpha in high susceptibles, posterior power increased from the prehypnosis to hypnosis conditions and decreased posthypnosis. Exactly the converse effects were seen in lows. Furthermore, highs had greater alpha power than lows during both prehypnosis and hypnosis conditions, demonstrating an association of alpha with hypnotic susceptibility. The results indicate that, whereas theta indexes relaxation, alpha indexes the hypnotic experience and susceptibility.

Short duration power changes in the EEG during recognition memory for words and faces.

Although memory has been widely studied using event-related potentials, memory-related changes in the electroencephalogram (EEG) have been relatively neglected. The aim of this study was to determine whether evidence could be found for memory-related changes in the EEG. EEG was recorded from a sample of healthy volunteers while they performed word and face recognition memory tasks. Data were analyzed using the method of event-related desynchronization. In the theta frequency range there was a short-duration increase in power that occurred in the first 250 ms that was maximal at temporal sites (T5/T6). For words, but not faces, there was a repetition effect in theta such that new words elicited greater synchronization than old words at the midline frontal electrode (Fz). In the alpha frequency range there was a lateralized repetition effect, which occurred from 750 ms. In upper alpha this effect was lateralized in the expected way with greater desynchronization at temporo-parietal sites on the left for words and on the right for faces. For lower alpha, the lateralization was reversed. The meanings of these findings are interpreted in the light of existing models of recognition memory.

Pathway-specific habituation of induced gamma oscillations in the hippocampal slice.

Brief tetanic stimulation (eight pulses at 100 Hz) of afferent fibers innervating area CA1 of the hippocampus produce gamma oscillations. When delivered every minute the oscillation habituated markedly after the first stimulus. This habituation could be transiently reversed by stimulating a different pathway to the recorded area. Gamma oscillation-induced beta frequency oscillations were only seen in response to the first (novel) stimulus and the gamma oscillation itself was markedly attenuated by on-going, non-oscillogenic, synaptic activity. The NMDA receptor antagonist ketamine abolished the response to novel stimuli but left the habituated response relatively unaffected. The pattern of habituation parallelled that seen for sensory induced gamma and beta oscillations in the clinical EEG.

Effects of pubertal timing on EEG coherence and P3 latency.

Neurodevelopmental approaches to schizophrenia emphasise the role of late brain maturational events. Abnormalities here may account for both the putative cortico-cortical underconnectivity in schizophrenia and its typical onset in late adolescence. Saugstad hypothesised that maturational rate at puberty may lead to an extension of normal maturational processes such as synaptic pruning. In extreme late maturers pruning was thought to be prolonged, leading to reduced numbers of synapses and an increased risk for schizophrenia. Here we assessed the effects of pubertal timing extremes on EEG coherence and P3 latency as putative measures of brain development in N = 37 healthy adults. During photic stimulation late maturing males showed increased left-hemispheric coherence compared with male early maturers. This was in line with earlier findings (Kaiser, J., Gruzelier, J.H., 1996. Timing of puberty and EEG coherence during photic stimulation. Int. J. Psychophysiol. 21, 135-149). As expected, P3 latency was shorter in late compared with early maturers. However, this was true only for females, whereas there was no difference in males. These results are consistent with the notion of an exaggeration of normal maturational changes in slow maturation, whereby the underlying process appears to be different for males and females.

Timing of puberty and syndromes of schizotypy: a replication.

The view of schizophrenia as a neurodevelopmental disorder involving an abnormality in the programmed elimination of excitatory synapses during puberty has been supported by recent neuroimaging studies suggesting disordered functional connectivity in schizophrenia. We investigated a model predicting dysfunctionally high or low synaptic density in extreme early or late maturers at puberty, respectively (Saugstad, L.F., 1989. Clin. Genet. 36, 156-167; Saugstad, L.F., 1994. Int. J. Psychophysiol. 18, 189-203). In an earlier study (Gruzelier, J.H., Kaiser, J., 1996. Schizophr. Res. 21, 183-194), we found increased psychosis proneness scores in both extremes of the pubertal timing spectrum in the normal population. Here we present a replication study where N = 100 healthy adults completed a retrospective pubertal timing scale and the 'Personality Syndrome Questionnaire' measuring schizotypy syndromes. The following relationships were replicated: (1) elevated scores on scales of the total Unreality syndrome and the Ideas of Reference subscale in both maturation extremes; and (2) a trend for a positive correlation between the Withdrawal scale and the composite maturation score in males. Cognitive Unreality and Suspiciousness were higher in early than late maturing females. Social Anxiety was elevated in female extreme maturers compared with average maturers, but the opposite was found for males, where average maturers had higher scores than early or late maturers. Active syndrome findings were confined to the male subsample with late maturing males showing higher scores on the Cognitive Failures and Odd Speech subscales than early maturers. As in the previous study, there was no relationship between a global psychosis proneness scale and maturational rate. These findings support a neurodevelopmental model of psychosis-proneness and show the importance of adopting a syndromal view.

Laterality changes accompanying symptom remission in schizophrenia following treatment with eicosapentaenoic acid.

INTRODUCTION: A patient with severe intractable symptoms of schizophrenia was treated for 6 months with a fatty acid supplement, primarily as a test of the hypothesis that membrane phospholipid metabolism is abnormal in schizophrenia. His symptomatology was predominantly positive, consistent with an 'Active' syndrome thought to reflect a relative imbalance of left over right hemispheric activation. Longitudinal studies have previously shown changes in functional lateralisation with symptom remission in schizophrenia, hence this was examined at intervals over the 6-month period. METHOD: The subject was a 30-year-old male with DSM-IV schizophrenia. For 2 years prior to this study his clinical profile had not changed and he had remained free of neuroleptic medication. Treatment with 30 ml/day of emulsion rich in eicosapentaenoic acid was started, and clinical ratings were made at monthly intervals for 6 months. Motor laterality had been assessed using Annett's handedness scale and pegboard task 1 year pre-baseline, and this was repeated at 0, 3 and 6 months from the start of treatment. RESULTS: As measured by the Schedules for the Assessment of Positive Symptoms and Negative Symptoms, a marked reduction in his symptoms was first apparent at 2-month follow-up; further improvement followed, so that at the 6-month point few symptoms remained. Corresponding to his clinical improvement, the patient's performance on the pegboard task at 3-month follow-up had shifted from a strong right-hand advantage to near symmetry, owing to a marked improvement in his left-hand scores. On retest at 6 months this change in asymmetry was also maintained. CONCLUSIONS: These findings suggest that treatment with certain fatty acids may have significant benefits in the management of schizophrenia. They are also consistent with existing evidence that an Active syndrome of schizophrenia reflects a left over right hemispheric imbalance which is functional in nature, and can therefore change with symptom remission.