Neurofeedback of SMR and Beta1 Frequencies: An Investigation of Learning Indices and Frequency-Specific Effects.

Despite evidence that Sensorimotor Rhythm (SMR) and beta1 neurofeedback have distinct cognitive enhancement effects, it remains unclear whether their amplitudes can be independently enhanced. Furthermore, demands for top-down attention control, postural restraint and maintenance of cognitive set processes, all requiring low-beta frequencies, might masquerade as learning and confound interpretation. The feasibility of selectively enhancing SMR and beta1 amplitudes was investigated with the addition of a random frequency control condition that also requires the potentially confounding cognitive processes. A comprehensive approach to assessing neurofeedback learning was undertaken through the calculation of learning indices within- and across-session and pre-to-post baseline. Herein we provide the first demonstration of beta1 within-session amplitude learning that was not attributable to extraneous cognitive processes, for it was not found with random frequency training. On the other hand, within-session SMR learning might have been obscured by high interindividual variability and methodological limitations such as the type of feedback screen, the insufficient number of sessions, and the exclusion of simultaneous theta and high-beta inhibition. Interestingly, SMR and beta1 amplitude increased across sessions in the three groups suggesting unspecific effects of neurofeedback in the low beta frequency band. Moreover, there was no clear evidence of frequency specificity associated with either SMR or beta1 training. Some methodological limitations may underpin the divergent results with previous studies.

Short-term Beneficial Effects of 12 Sessions of Neurofeedback on Avoidant Personality Accentuation in the Treatment of Alcohol Use Disorder.

This study evaluated the effects of alpha/theta neurofeedback on Clinical Personality Accentuations in individuals with alcohol use disorder. Twenty-five males were investigated using a pre-test/post-test design with a waiting-list control group. Participants were randomly assigned either to an experimental group (n = 13) receiving 12 sessions of neurofeedback twice a week as a treatment adjunct over a period of 6 weeks, or to a control group (n = 12) receiving treatment as usual. The Inventory of Clinical Personality Accentuations and the NEO-Five-Factor Inventory were applied at pre- and post-test. The neurofeedback protocol focused on enhancement of the EEG alpha (8-12 Hz) and theta (4-7 Hz) and used a visual feedback paradigm. Analyses of covariance showed improvements in Avoidant Personality Accentuation within the experimental group. Our data suggest that 12 sessions of this neurofeedback intervention might be effective in reducing avoidant and stress-related personality traits in patients with alcohol use disorder.

The Effectiveness of Visual Short-Time Neurofeedback on Brain Activity and Clinical Characteristics in Alcohol Use Disorders: Practical Issues and Results.

The present study was carried out to examine the efficacy of alpha/theta neurofeedback (NF) with a new visual paradigm in a cohort of alcohol use disordered (AUD) patients (n = 25) treated in an Austrian therapeutic community center. The experimental study design focused on changes in absolute and relative resting EEG band power as well as in clinical variables, including depression (Beck Depresion Inventory [BDI-V]), psychiatric symptoms (Brief Symptom Inventory [BSI], coping (Freiburg Questionnaire on Coping with Illness [FKV-lis]), psychotherapy motivation (Therapy Motivation Questionnaire [FPTM-23]), sense of coherence (Sense of Coherence Scale [SOC-13]), posttraumatic growth (Posttraumatic Growth Inventory [PPR]), and alcohol cravings (Alcohol Craving Questionnaire [ACQ]). For measuring training effects, participants were randomly allocated to 2 groups: an experimental group (EG, n = 13) and a control group (CG, n = 12). Patients in EG received 12 sessions of visual NF training over a period of 6 weeks to enhance alpha (8-12 Hz) and theta (4-7 Hz) frequency band power in addition to the standard treatment program of the rehabilitation center. Participants in CG received no additional NF intervention. The multivariate analysis of covariance (MANCOVA) showed a change by trend in absolute alpha and theta power in the EG. Even though no MANCOVA effects were found in the clinical scales, AUD patients reported increasing control of their brain activity during the course of NF. However, changes in several clinical scales (BDI-V, BSI, FKV-lis, PPR) from pre- to posttest were observed only in the EG contrary to the CG. The findings of this pilot study provide first evidence for the practicality and effectiveness of visual short-term NF as an additive intervention in the therapeutic community.

EEG-neurofeedback for optimising performance. III: a review of methodological and theoretical considerations.

In continuing this three-part review on validation of EEG-neurofeedback for optimal performance evidence is first provided for feedback influences on the CNS, the integration of EEG with fMRI methodology as well as anatomical correlates. Then whereas Parts I and II reviewed the considerable behavioural outcome gains and evidence for their feedback causation, part III lays bare the not inconsiderable methodological and theoretical conundrums. Cardinal assumptions amongst practitioners about specificity of topography, behavioural outcome and frequency bands are critically examined. The hitherto mostly neglected nature of feedback learning is reviewed including evidence of within- and between-session and successive baseline learning; the enduring impact on the tonic EEG; implications for experimental design, individual differences and the trainer-participant interface; distinguishing between the learning and mastery of self-regulation; connectivity, ratio, unidirectional and multimodal feedback protocols. A thorough grounding in human neuroscience plus interpersonal skills are considered prerequisites for scientific advancement and ethically sound practice.

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.

EEG-neurofeedback for optimising performance. II: creativity, the performing arts and ecological validity.

As a continuation of a review of evidence of the validity of cognitive/affective gains following neurofeedback in healthy participants, including correlations in support of the gains being mediated by feedback learning (Gruzelier, 2014a), the focus here is on the impact on creativity, especially in the performing arts including music, dance and acting. The majority of research involves alpha/theta (A/T), sensory-motor rhythm (SMR) and heart rate variability (HRV) protocols. There is evidence of reliable benefits from A/T training with advanced musicians especially for creative performance, and reliable benefits from both A/T and SMR training for novice music performance in adults and in a school study with children with impact on creativity, communication/presentation and technique. Making the SMR ratio training context ecologically relevant for actors enhanced creativity in stage performance, with added benefits from the more immersive training context. A/T and HRV training have benefitted dancers. The neurofeedback evidence adds to the rapidly accumulating validation of neurofeedback, while performing arts studies offer an opportunity for ecological validity in creativity research for both creative process and product.

Differential effects on mood of 12-15 (SMR) and 15-18 (beta1) Hz neurofeedback.

The common assumption in EEG-neurofeedback is one of functional specificity of the trained spectral bands, though it has been posited that only a nonspecific generalised learning process may be engaged. Earlier we reported differential effects on attention in healthy participants measured with continuous performance tests and the P300, following training of the sensory-motor rhythm band (SMR, 12-15 Hz) compared with the adjacent beta1 (15-18 hz) band. Here previously unreported results are presented with phenomenological data from an activation checklist in support of the putative calming effect of SMR neurofeedback. While within sessions both protocols induced tiredness, this was paralleled by an increase in calmness only following SMR training. The differential effect on mood was theoretically consistent and extends evidence of cognitive functional specificity with neurofeedback to affective processes.

Dynamic changes of ICA-derived EEG functional connectivity in the resting state.

An emerging issue in neuroscience is how to identify baseline state(s) and accompanying networks termed "resting state networks" (RSNs). Although independent component analysis (ICA) in fMRI studies has elucidated synchronous spatiotemporal patterns during cognitive tasks, less is known about the changes in EEG functional connectivity between eyes closed (EC) and eyes open (EO) states, two traditionally used baseline indices. Here we investigated healthy subjects (n = 27) in EC and EO employing a four-step analytic approach to the EEG: (1) group ICA to extract independent components (ICs), (2) standardized low-resolution tomography analysis (sLORETA) for cortical source localization of IC network nodes, followed by (3) graph theory for functional connectivity estimation of epochwise IC band-power, and (4) circumscribing IC similarity measures via hierarchical cluster analysis and multidimensional scaling (MDS). Our proof-of-concept results on alpha-band power demonstrate five statistically clustered groups with frontal, central, parietal, occipitotemporal, and occipital sources. Importantly, during EO compared with EC, graph analyses revealed two salient functional networks with frontoparietal connectivity: a more medial network with nodes in the mPFC/precuneus which overlaps with the "default-mode network" (DMN), and a more lateralized network comprising the middle frontal gyrus and inferior parietal lobule, coinciding with the "dorsal attention network" (DAN). Furthermore, a separate MDS analysis of ICs supported the emergence of a pattern of increased proximity (shared information) between frontal and parietal clusters specifically for the EO state. We propose that the disclosed component groups and their source-derived EEG functional connectivity maps may be a valuable method for elucidating direct neuronal (electrophysiological) RSNs in healthy people and those suffering from brain disorders.

Beneficial effects of electrostimulation contingencies on sustained attention and electrocortical activity.

INTRODUCTION: Chinese acupuncture therapy has been practiced for more than 3000 years. According to neuroimaging studies, electroacupuncture has been demonstrated to be effective via control of the frequency parameter of stimulation, based on the theory of frequency modulation of brain function. AIMS: To investigate the following: (1) possible sustained effects of acustimulation in improving perceptual sensitivity in attention by comparing before, during, and 5 min following stimulation; (2) relations between commission errors and the motor inhibition event-related potential (ERP) component measured with independent component analysis (ICA); (3) whether habituation would be demonstrated in the sham control group and would be militated by acustimulation in the experimental groups. RESULTS: Twenty-seven subjects were divided into three groups (n = 9). d-Prime (d') derived from signal detection theory was used as an index of perceptual sensitivity in the visual continuous performance attention test. Increased d' was found during both alternating frequency (AE) and low frequency (LE) stimulation, but with no change in the sham control group (SE). However, only following AE was there a sustained poststimulation effect. Spatial filtration-based independent components (ICs) in the AE group revealed significantly decreased amplitudes of the motor inhibition ICs both during and poststimulation. There was a significant habituation effect from task repetition in the sham group with decreased amplitudes of ICs as follows: the visual comparison component difference between go (correct response) and nogo cues (correct withheld response), the P400 action monitoring and the working memory component in the nogo condition, and the passive auditory component on control trials. CONCLUSION: The results showed associations between acustimulation and improved perceptual sensitivity with sustained improvements following AE, but not LE stimulation. Improvements in commission errors in the AE group were related to the motor inhibition IC. The activational effects of acustimulation apparently attenuated the across-task habituation that characterized the control group.

Endogenous control of waking brain rhythms induces neuroplasticity in humans.

This study explores the possibility of noninvasively inducing long-term changes in human corticomotor excitability by means of a brain-computer interface, which enables users to exert internal control over the cortical rhythms recorded from the scalp. We demonstrate that self-regulation of electroencephalogram rhythms in quietly sitting, naive humans significantly affects the subsequent corticomotor response to transcranial magnetic stimulation, producing durable and correlated changes in neurotransmission. Specifically, we show that the intrinsic suppression of alpha cortical rhythms can in itself produce robust increases in corticospinal excitability and decreases in intracortical inhibition of up to 150%, which last for at least 20 min. Our observations may have important implications for therapies of brain disorders associated with abnormal cortical rhythms, and support the use of electroencephalogram-based neurofeedback as a noninvasive tool for establishing a causal link between rhythmic cortical activities and their functions.

Optimizing microsurgical skills with EEG neurofeedback.

BACKGROUND: By enabling individuals to self-regulate their brainwave activity in the field of optimal performance in healthy individuals, neurofeedback has been found to improve cognitive and artistic performance. Here we assessed whether two distinct EEG neurofeedback protocols could develop surgical skill, given the important role this skill plays in medicine. RESULTS: National Health Service trainee ophthalmic microsurgeons (N = 20) were randomly assigned to either Sensory Motor Rhythm-Theta (SMR) or Alpha-Theta (AT) groups, a randomized subset of which were also part of a wait-list 'no-treatment' control group (N = 8). Neurofeedback groups received eight 30-minute sessions of EEG training. Pre-post assessment included a skills lab surgical procedure with timed measures and expert ratings from video-recordings by consultant surgeons, together with state/trait anxiety self-reports. SMR training demonstrated advantages absent in the control group, with improvements in surgical skill according to 1) the expert ratings: overall technique (d = 0.6, p < 0.03) and suture task (d = 0.9, p < 0.02) (judges' intraclass correlation coefficient = 0.85); and 2) with overall time on task (d = 0.5, p = 0.02), while everyday anxiety (trait) decreased (d = 0.5, p < 0.02). Importantly the decrease in surgical task time was strongly associated with SMR EEG training changes (p < 0.01), especially with continued reduction of theta (4-7 Hz) power. AT training produced marginal improvements in technique and overall performance time, which were accompanied by a standard error indicative of large individual differences. Notwithstanding, successful within session elevation of the theta-alpha ratio correlated positively with improvements in overall technique (r = 0.64, p = 0.047). CONCLUSION: SMR-Theta neurofeedback training provided significant improvement in surgical technique whilst considerably reducing time on task by 26%. There was also evidence that AT training marginally reduced total surgery time, despite suboptimal training efficacies. Overall, the data set provides encouraging evidence of optimised learning of a complex medical specialty via neurofeedback training.

Relaxation strategies and enhancement of hypnotic susceptibility: EEG neurofeedback, progressive muscle relaxation and self-hypnosis.

Hypnosis has been shown to be efficacious in a range of clinical conditions, including the management of chronic pain. However, not all individuals are able to enter a hypnotic state, thereby limiting the clinical utility of this technique. We sought to determine whether hypnotic susceptibility could be increased using three methods thought to facilitate relaxation, with particular interest in an EEG neurofeedback protocol which elevated the theta to alpha ratio. This was compared with progressive muscle relaxation and self-hypnosis. Ten subjects with moderate levels of susceptibility (2-7/12) were randomly assigned to each condition and assessed for hypnotic susceptibility prior to and upon completion of 10 sessions of training. Hypnotic susceptibility increased post-training in all groups, providing further evidence that operant control over the theta/alpha ratio is possible, but contrary to our predictions, elevation of the theta/alpha ratio proved no more successful than the other interventions. Nonetheless, all three techniques successfully enhanced hypnotic susceptibility in over half of the participants (17/30), a similar incidence to that reported using other methods. As previously reported, the majority who were not susceptible to modification were at the lower levels of susceptibility, and the greater increases tended to occur in the more susceptible subjects. However, here enhancement was disclosed in some at low levels, and capability was found of reaching high levels, both features not typically reported. Further research is warranted.

The influence of 10 min of the Johrei healing method on laboratory stress.

OBJECTIVE: Johrei has been shown to decrease exam stress responses but its immediate effects have not been assessed. DESIGN: In a randomised, blinded, counter-balanced design, 33 medical students were asked to calculate mental arithmetic in the Paced Auditory Serial Addition Task (PASAT), which served as an acute stressor prior to two conditions, 10 min of Johrei or a control resting condition involving 10 min without Johrei in a cross-over trial; after each, saliva was collected and mood tested. SETTING: University EEG laboratory. INTERVENTION: Johrei, a non-touch healing method. MAIN OUTCOME MEASURES: Profile of mood states (POMS-Bi); state anxiety (STAI); salivary variables: cortisol, DHEA, IgA. RESULTS: Mood scores on 5/6 of the POMS-Bi subscales were slightly but significantly more positive in the Johrei condition. State anxiety was similarly decreased. IgA levels were unchanged but cortisol levels were found to be slightly but non-significantly lower after Johrei than after the control condition and DHEA levels slightly but non-significantly raised, with a negative correlation between cortisol and DHEA levels. CONCLUSIONS: This study gives some indication that Johrei can reduce negative mood and increase positive mood states after the acute effects of a laboratory stressor in comparison to a resting control condition.

Investigating evoked and induced electroencephalogram activity in task-related alpha power increases during an internally directed attention task.

This study sought to explore whether the so-called 'paradoxical' task-related increases in the alpha bandwidth of the human electroencephalogram result from increases in evoked (phase locked), as opposed to induced (non-phase locked), activity. The electroencephalograms of 18 participants were recorded while they engaged in both auditory sensory-intake tasks (listening to randomly generated 'tunes') and internally directed attention tasks (imagining the same randomly generated tunes) matched for auditory input. Measures of evoked (phase locked) and induced (non-phase locked) activity were compared between tasks. Increases in induced alpha power were found during internal attention. No experimental effects were observed for evoked activity. These results are not entirely consistent with proposals that 'paradoxical' alpha indexes the evoked inhibition of task irrelevant processing.

Event-related brain potential correlates of human auditory sensory memory-trace formation.

The event-related potential (ERP) component mismatch negativity (MMN) is a neural marker of human echoic memory. MMN is elicited by deviant sounds embedded in a stream of frequent standards, reflecting the deviation from an inferred memory trace of the standard stimulus. The strength of this memory trace is thought to be proportional to the number of repetitions of the standard tone, visible as the progressive enhancement of MMN with number of repetitions (MMN memory-trace effect). However, no direct ERP correlates of the formation of echoic memory traces are currently known. This study set out to investigate changes in ERPs to different numbers of repetitions of standards, delivered in a roving-stimulus paradigm in which the frequency of the standard stimulus changed randomly between stimulus trains. Normal healthy volunteers (n = 40) were engaged in two experimental conditions: during passive listening and while actively discriminating changes in tone frequency. As predicted, MMN increased with increasing number of standards. However, this MMN memory-trace effect was caused mainly by enhancement with stimulus repetition of a slow positive wave from 50 to 250 ms poststimulus in the standard ERP, which is termed here "repetition positivity" (RP). This RP was recorded from frontocentral electrodes when participants were passively listening to or actively discriminating changes in tone frequency. RP may represent a human ERP correlate of rapid and stimulus-specific adaptation, a candidate neuronal mechanism underlying sensory memory formation in the auditory cortex.

Changes in mismatch negativity across pre-hypnosis, hypnosis and post-hypnosis conditions distinguish high from low hypnotic susceptibility groups.

The role of alterations in mismatch negativity (MMN) in hypnosis was examined by recording MMN of the auditory ERP at frontal (F3, Fz, and F4) and mastoid (M1 and M2) placements. Frontal MMN is believed to reflect activity in right anterior cortical generators, whereas MMN at mastoid leads reflects generators located bilaterally in the temporal auditory cortex. MMN recordings were obtained in 11 low and 12 high hypnotically susceptible participants in three successive blocks; pre-hypnosis, hypnosis and post-hypnosis. Frontal (but not temporal) MMN showed a significant quadratic trend across testing conditions. It increased during hypnosis and then dropped post-hypnosis for both susceptibility groups. Linear trends for frontal and temporal MMN showed directly opposite patterns of change in the interaction between hypnotic susceptibility and testing blocks. Frontal MMN built up linearly over the test blocks in high relative to low susceptibility participants. Temporal MMN showed the reverse pattern and increased linearly across test conditions in those with low relative to high hypnotic susceptibility.

Is the P300 wave an endophenotype for schizophrenia? A meta-analysis and a family study.

INTRODUCTION: We assessed the usefulness of the P300 wave as endophenotype for schizophrenia by means of a meta-analysis of the literature as well as our own family study. METHOD: Meta-analysis: We conducted a systematic search for articles published between 1983 and 2003 that reported P300 measures in non-psychotic relatives of schizophrenic patients and in healthy controls. Meta-regression analyses were performed using a random effects procedure. The pooled standardized effect size (PSES) was calculated as the difference between the means of the two groups divided by the common standard deviation. Local study: We examined the P300 wave with a standard two-tone oddball paradigm in 30 patients with schizophrenia, 40 non-psychotic relatives, and 40 controls using linear mixed models. RESULTS: Meta-analysis: We pooled 472 relatives and 513 controls. The P300 amplitude was significantly reduced in relatives (PSES = 0.61; 95% CI: 0.30 to 0.91; P < 0.001). The P300 latency was significantly delayed in relatives (PSES of -0.50; 95% CI: -0.88 to -0.13; P = 0.009]. Local study: The patients showed a trend for amplitude reductions (P = 0.06) and significant latency delays (P < 0.01). The relatives displayed normal amplitude but had significant latency delays (P = 0.01). The P300 amplitude and especially the P300 latency are promising alternative phenotypes for genetic research into schizophrenia.

Biofeedback and dance performance: a preliminary investigation.

Alpha-theta neurofeedback has been shown to produce professionally significant performance improvements in music students. The present study aimed to extend this work to a different performing art and compare alpha-theta neurofeedback with another form of biofeedback: heart rate variability (HRV) biofeedback. Twenty-four ballroom and Latin dancers were randomly allocated to three groups, one receiving neurofeedback, one HRV biofeedback and one no intervention. Dance was assessed before and after training. Performance improvements were found in the biofeedback groups but not in the control group. Neurofeedback and HRV biofeedback benefited performance in different ways. A replication with larger sample sizes is required.