Conference PaperPDF Available

Neurofeedback training content for treatment of stress

December 2016

DOI:10.1109/IECBES.2016.7843429

Conference: 2016 IEEE EMBS Conference on Biomedical Engineering and Sciences (IECBES)

Authors:

Yasir Hafeez

Universiti Teknologi Petronas

Syed Saad Azhar Ali

King Fahd University of Petroleum and Minerals

Aamir Malik

Brno University of Technology

Stress is one of the major problems in society and is being treated using medicine and neurofeedback therapy. Neurofeedback therapy is usually successful. The contents as stimuli for neurofeedback training are not available for stress and anxiety. This paper focuses on giving a comprehensive and critical summary of available contents for neurofeedback training. It also establishes a need for the development of content as a stimulus for neurofeedback which trains the subject on how to control his brain activity, especially in stress condition. The developed content consists of audio and game. The game is used to reduce the power of high-beta brain activity and the audio is used to enhance the amplitude of alpha brainwaves in left-prefrontal lobe. The experimental results show significant improvement in reducing stress level. The outcome is a proposed content for neurofeedback training to reduce stress, and it also improves the neurofeedback training efficacy.

Neurofeedback process

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Neurofeedback Experiment Procedure

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The alpha brainwaves increases during neurofeedback training. The subject is able to increase his alpha brainwaves in right−prefrontal lobe (Fp2). 18 samples (mean) of alpha at Fp2 are calculated and drawn as; no. of sessions = 3, each session is of 3 periods, every period is 3 minutes long. The sampling frequency of the device is 256, 719 samples are taken in each period, and mean is calculated for every 118 samples.

…

The high−beta brainwaves inhibits during neurofeedback training, the subject is able to reduce high−beta level brainwave at motor cortex (C3). 18 samples (mean) are calculated and drawn as; no. of sessions = 3 (9 minutes), sampling frequency = 256, samples (mean) = (719 × 3)/118).

…

Figures - uploaded by Yasir Hafeez

Content may be subject to copyright.

Content uploaded by Yasir Hafeez

Content may be subject to copyright.

Neurofeedback Training Content For Treatment Of

Stress

Yasir Hafeez, Syed Saad Azhar Ali1, Aamir Saeed Malik

Centre for Intelligent Signal and Imaging Research (CISIR)

Department of Electrical and Electronic Engineering,

Universiti Teknologi PETRONAS, Malaysia

Email: 1saad.azhar@utp.edu.my

Abstract—Stress is one of the major problems in society and

is being treated using medicine and neurofeedback therapy.

Neurofeedback therapy is usually successful. The contents as

stimuli for neurofeedback training is not available for stress and

anxiety. This paper focuses on giving a comprehensive and critical

summary of available contents for neurofeedback training. It also

establishes a need for the development of content as a stimulus

for neurofeedback which trains the subject on how to control

his brain activity, especially in stress condition. The developed

content consists of audio and game. The game is used to reduce

the power of high−beta brain power and the audio is used to

enhance the amplitude of alpha brainwaves in right−prefrontal

lobe. The experimental results show signiﬁcant improvement in

reducing stress level. The outcome is a proposed content for

neurofeedback training to reduce stress, and it also improves the

neurofeedback training efﬁcacy.

Index Terms—neurofeedback, content development, stress.

I. INT ROD UC TI ON

STRESS is one of the major issues in todays world. It

can be deﬁned as, Stress is a feeling that we have under

pressure. Sometimes the way of response to a challenge may

also be a type of stress [1]. In the case of stress, the amplitude

of alpha (8−12 Hz) brainwaves in right−prefrontal lobe is low.

When the relative amplitude of alpha brainwaves in right pre-

frontal is low as compared to alpha power in left−prefrontal;

the subject is in the state of stress [2]. High−beta (22−30 Hz)

brainwaves power over the sensorimotor cortex also causes

stress [3], [4]. Brainwaves and their associated functions are

presented in Table I.

Neurofeedback training is one of the treatments of stress

which enables the subject to train himself to control his brain

activity during stress and anxiety [5]. Neurofeedback trains

the subject to control his brainwaves, also in the case of

stress. Mostly, audio is used as content for neurofeedback

training to increase alpha power in right−prefrontal lobe [5],

[6]. Neurofeedback is also used to decrease the high−beta

using the game as content [7]. Generally, there is no content

available as a stimulus for neurofeedback training which

effectively increases the alpha power in right−prefrontal cortex

and decreases high−beta in sensorimotor cortex.

Content is developed for neurofeedback training which

consists of soothing music (audio) and game. This content is

helpful during neurofeedback training to increase alpha power

in right−prefrontal and reduce high−beta activity over motor

cortex. The content is an effective stimulus for neurofeedback

which trains the subject to control his brain activity.

The proposed content for neurofeedback will assist the

therapist by auto selecting the threshold, the right audio

(soothing music), and game level for the subject. The selection

of threshold, audio, and game level depends on the previous

training scores and current power of alpha and high−beta

brainwave.

The neurofeedback content will also improve the training

efﬁcacy by including the multiple electrode placements over

scalp and reduce the number of training sessions.

II. NE URO FE ED BAC K TRE ATME NT

The Neurofeedback involves recording, analysing, and pre-

senting results of measured electroencephalogram (EEG) anal-

yses to the subject in the form of reward (play/pause of the

content) to show the changes in brain electrical activity [4].

The basic principle of the Neurofeedback is to measure the

brain activity (EEG signals) using electrodes connected on

the scalp. It identiﬁes the brainwaves by using quantitative

EEG analysis and then provides the subject with feedback

(play/pause of content) as a reward, depending on the desired

levels of the brainwaves. In neurofeedback systems, the most

used recording technique for the brainwaves is the EEG.

EEG data are used to monitor real−time brain activities [8].

The feedback is provided to the user in the form of visual,

audio, game, reading, or spell checking. It can be imple-

mented as colour change, bar increase/decrease, vibration,

and sound. It can be integrated into the Neurofeedback game

as character/object appearance, etc. The feedback determines

the condition of the brain state whether brainwaves power is

in the desired level of threshold or not [9]. Several studies

uncover the fact that the Neurofeedback training has restorative

impacts of treating some neurological and psychological issues

such as attention deﬁcit hyperactivity disorder (ADHD) [10],

epilepsy [11], and some addictive cognitive disorders [6].

The Neurofeedback is also found useful for the treatment

of anxiety, stress, affective disorders [12], depression [13],

ﬁbromyalgia [14], and obsessive−compulsive disorder [15].

The Neurofeedback is also being used to enhance attention

and memory performance in healthy subjects [16]. The Neu-

rofeedback training has also been applied to healthy users.

This training has demonstrated its ability to improve certain

2016 IEEE EMBS Conference on Biomedical Engineering and Sciences (IECBES)

Fig. 1: Neurofeedback process

cognitive aptitudes [8], [17]. The latter studies targeted the

enhancement of the upper section of the alpha band (10 −12

Hz), which is traditionally linked to performance [18].

The most used neurofeedback content for training the sub-

jects in the treatment of ADHD is a game and video [19].It

is normally observed that theta increases [20], [21] and beta

decreases [21] in the youngsters with ADHD as compared to

the developing youngsters. Increased theta (4−7 Hz) is asso-

ciated with lower vigilance, and decreased beta (13−30 Hz) is

associated with reduced attention [22]. Also, behavioural in-

habitation is related to the sensorimotor rhythm (SMR; 12−15

Hz) [23]. As Neurofeedback aims to reduce ADHD symptoms

such as diminished vigilance, attention, and inhibition, most

Neurofeedback protocols train to inhibit theta (4−8Hz) and

increase beta (12 −20 Hz) or SMR (12 −15 Hz) over the

vertex Cz [20], [24]. A complete Neurofeedback intervention

typically comprises 20−40 training sessions [20]. Effective

Neurofeedback treatment for ADHD is debated in [25].

Neurofeedback training has been done by some researchers

to train their subjects to mitigate their stress level [26]. Benio-

dakis [5] and Peniston [27] have used audio as neurofeedback

stimulus to reduce the stress level. They found out that subjects

are effectively able to reduce their stress levels.

Neurofeedback has been observed as an effective treatment

for depression [7], [28]. Choobforoushzadeh [7] used game

and audio to decrease the alpha/theta ratio in frontal lobe

but has not included multiple brain parts. Choi [28] used

audio to decrease the alpha near the vertex in frontal lobe

to increase left brain activity. The factors include in the

cause of depression can be a biochemical element, biogenetic

element, psychosocial element, mental element and/or natural

element. The victims can be alerted before going deep

into depression by measuring EEG brainwave pattern [29].

TABLE I: Brain lobes and associated functions

Brain Lobes Associated Functions

Frontal Lobe Movement, thinking initiation, reasoning

(judgement), behaviour (emotions), memory,

speaking.

Temporal Lobe

(left side)

Analysis of speech, monitoring speech, read-

ing and writing, verbal memory, letter recog-

nition.

Temporal Lobe

(right side)

Decoding non-verbal patterns, visual decod-

ing, Interpreting and remembering visual in-

formation.

Parietal Lobe (left

side)

Smooth speech, writing skills, understanding

math, reading skills, naming of objects, ver-

bal memory.

Parietal Lobe

(right side)

Drawing skills.

Occipital Lobe

(left side)

Object recognition, visual recognition, read-

ing numbers and letters, memory for written

information.

Occipital Lobe

(right side)

Attending to left visual ﬁeld.

A. Neurofeedback Softwares

Therapists and researchers use Brain Computer Interface

systems (BCI) world widely. BCI can offer a new way for

playing video games in 2D or 3D virtual environments (VE).

In VE, it is easy to navigate, modify the selection, and

manipulate the virtual objects [3].

VE feedback games include sports, puzzles, or training.

Nowadays, universities and laboratories are developing games

and interactive puzzle in BCI to provide more interaction with

the virtual world. For example, the alertness level of car drivers

is increased by using virtual driving environment. The project

is done by researchers at the University of Tokyo. In this

project, BCI hearing system monitors the state of alertness

of drivers and warns them if they lose their concentration.

The researchers at University College Dublin in collabora-

tion with Media Lab Europe, have developed MIND BAL-

ANCE 3D video game using BCI−VE. In this game, the

subject has to control the balance of an animated object

moving on the thin rope by using EEG−neurofeedback.

INRIA designs several BCI systems for neurofeedback in

VE. Use−the−force is one of them in which user has to control

the launch of a virtual spacecraft, and his response is studied

in challenging environments [30].

III. DIS CU SS IO N

It is inferred that the neurofeedback is clinically proved

treatment for ADHD [19], [24], [31] and epilepsy, while

2016 IEEE EMBS Conference on Biomedical Engineering and Sciences (IECBES)

it has an effective treatment for stress [5], [32], [33] and

depression [34]. On average, two sessions of neurofeedback

training per week are performed. So, 6−8 weeks (30−40

sessions) are required to ﬁnd the efﬁcacy of treatment.

Different contents are being used during neurofeedback

training to train the subject so that he can control his stress

and anxiety level. There is, generally, not a single content

for the neurofeedback training which effectively reduces the

high−beta in motor cortex along with the increase of alpha in

right−prefrontal.

High brain activity in left−frontal is responsible for

good memories and thoughts. While high brain activity

in right−frontal is responsible for bad memories [2].

Alpha reinforcement may result in anxiety and stress

reduction. High−beta (22−30 Hz) is responsible for

agitation, restlessness, stress and anxiety. The relative

increase in alpha amplitude in left−prefrontal causes

dominance of right−prefrontal brain activity. It results

in bad thoughts and memories which increase the

stress and anxiety [2]. The brain parts, brainwaves,

and associated functions are shown in Table II.

TABLE II: Brain lobes and associated functions

EEG type Occupied

frequency

bandwidth

mental states conditions

Delta 0.1 Hz−4Hz Dreamless sleep,

unconscious.

Theta 4Hz−8Hz Intuitive, recall fantasy,

imaginary, creative,

dreamlike, switching

thoughts, drowsy.

Alpha 8Hz−12Hz Eyes closed, relaxed, not ag-

itated, tranquil conscious.

Low Beta / SMR 12Hz−15Hz Relaxed yet focused, inte-

grated.

Midrange Beta 16Hz−20Hz Thinking, aware of self &

surrounding.

High Beta 21Hz−30Hz Alertness, agitation.

It is also observed that some subjects left or discontinued

their neurofeedback training. The number of training sessions

are 16−20 to ﬁnd out the training efﬁcacy and approximately

30−40 sessions for neurofeedback treatment [28].

There is a need to develop content for the neurofeedback

training to help the subject to train himself on how to reduce

the stress level. The developed content for the neurofeedback

helps the subject to train himself how to enhance the amplitude

of the alpha (8−12 Hz) brainwaves in the right−prefrontal and

inhibit the high−beta (22−30 Hz). The algorithm to implement

the content for the neurofeedback training could decide the

level of difﬁculty in the content. After some neurofeedback

sessions and depending on the performance of the subject brain

activity, the algorithm could decide the difﬁculty level and

Fig. 2: Neurofeedback Experiment Procedure

threshold level of content for further neurofeedback training

sessions. The content for neurofeedback especially designed

for stress, could improve the training efﬁcacy and reduce

the training time for neurofeedback. The total duration of

neurofeedback training could also be reduced.

IV. MET HO DS

A. Participants

Participants will be recruited who fulﬁl the inclusion criteria

for the experiment. The inclusion criteria are that the partici-

pants should have normal or corrected to normal hearing and

visual capability, and they ﬁll the stress level questionnaire

form and consent form. There should not any discrimination

among gender (both male and female should be recruited).

The age of participants should not be less than 16 years.

B. Experiment

The participants will be demonstrated about EEG neuro-

feedback and experiment. The participant will sit on comfort-

able chair three feet away from the 24 inches monitor screen

in a sound proof room. Two electrodes will be placed on

the scalp at Fp2 and C3 according to International 10−20

system of electrode placement. Brain Trainer NFS1182AC

ampliﬁer along with software BT11.vb will be used. The

built-in game Troi with a soothing music will be used as

content for neurofeedback training. The participants will have

a keyboard/joystick to control the movement of an object in

the game and headphone for the music. The threshold for alpha

at Fp2 and high−beta at C3 will be set at 6µV and 10 µV

respectively. The duration of each session of neurofeedback

training will be 20 minutes. Two sessions per week will be

performed and total eight (8) sessions will be done.

2016 IEEE EMBS Conference on Biomedical Engineering and Sciences (IECBES)

Fig. 3: The alpha brainwaves increases during neurofeedback

training. The subject is able to increase his alpha brainwaves in

right−prefrontal lobe (Fp2). 18 samples (mean) of alpha at Fp2 are

calculated and drawn as; no. of sessions = 3, each session is of 3

periods, every period is 3 minutes long. The sampling frequency of

the device is 256, 719 samples are taken in each period, and mean

is calculated for every 118 samples.

Fig. 4: The high−beta brainwaves inhibits during neurofeedback

training, the subject is able to reduce high−beta level brainwave at

motor cortex (C3). 18 samples (mean) are calculated and drawn as;

no. of sessions = 3 (9 minutes), sampling frequency = 256, samples

(mean) = (719 ×3)/118).

V. RE SU LTS

The neurofeedback training by using soothing music

and game shows signiﬁcant improvement. The alpha and

high−beta brain activity will be observed in each session.

The results can be compared from the ﬁrst session to last

session that the subjects train themselves to increase their

alpha brain activity in the right−prefrontal lobe and decrease

high−beta in motor cortex. The results after experiment show

improvement in the alpha brain activity at Fp2, Fig. 3 and

high−beta brainwave inhabitation at C3, Fig. 4.

VI. CO NC LU SI ON

To summarise the discussion, the developed content of

neurofeedback could assist the therapist during neurofeed-

back training for the treatment of stress. The subject train

himself on how to inhibit the power of high−beta (22−30

Hz) brainwave and enhances the power of alpha (8−12 Hz)

in right−prefrontal. The expected outcome of this paper is

the knowledge about neurofeedback contents and their ap-

plications for different treatments and a proposed content

that improves the training efﬁcacy of the neurofeedback and

reduces the duration of neurofeedback session, training time,

and total duration of neurofeedback training.

VII. AC KN OWLEDGEMENT

The authors are thankful to Centre for Intelligent Signal

and Imaging Research (CISIR), Department of Electrical

and Electronic Engineering, Universiti Teknologi PETRONAS,

Malaysia for funding this research project.

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2016 IEEE EMBS Conference on Biomedical Engineering and Sciences (IECBES)

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Full-text available

Apr 2024

Introduction Electroencephalographic neurofeedback (NFB), as a non-invasive form of brainwave training, has been shown to be effective in the treatment of various mental health disorders. However, only few results regarding manualised and standardised NFB trainings exist. This makes comparison as well as replication of studies difficult. Therefore, we developed a standard manual for NFB training in patients with mental health disorders attending a psychosomatic outpatient clinic. The current study aims at investigating the conduction of a standardised manual for NFB training in patients with mental health disorders. If successful, the study provides new opportunities to investigate NFB in a more controlled and comparable manner in clinical practice. Methods and analysis 30 patients diagnosed with a mental health disorder will be included. After the educational interview, patients will undergo baseline diagnostics (T0). The subsequent intervention consists of 10 sessions of NFB training aiming at increasing sensorimotor rhythm and alpha-frequency amplitudes and decreasing theta-frequency and high beta-frequency amplitudes to induce relaxation and decrease subjective stress. All patients will undergo a post-treatment diagnostic assessment (T1) and a follow-up assessment 8 weeks following the closing session (T2). Changes in amplitude bands (primary outcome) will be recorded with electroencephalography during pre-assessments, post-assessments and follow-up assessments and during NFB sessions. Physiological (respiratory rate, blood volume pulse, muscle tension) and psychometric parameters (distress, perceived stress, relaxation ability, depressive and anxiety symptoms, insomnia, self-efficacy and quality of life) will be assessed at T0, T1 and T2. Moreover, satisfaction, acceptance and usability will be assessed at T1 after NFB training. Further, qualitative interviews about the experiences with the intervention will be conducted with NFB practitioners 6 months after the study starts. Quantitative data will be analysed using repeated measures analysis of variance as well as mediation analyses on mixed linear models. Qualitative data will be analysed using Mayring’s content analysis. Ethics and dissemination The study was approved by the ethics committee of the Medical Faculty of the University of Duisburg-Essen (23–11140-BO) and patient enrolment began in April 2023. Before participation, written informed consent by each participant will be required. Results will be published in peer-reviewed journals and conference presentations. Trial registration number Prospectively registered on 28 March 2023 in the German clinical trials register, DRKS00031497.

Development of Enhanced Stimulus Content to Improve the Treatment Efficacy of EEG–Based Frontal Alpha Asymmetry Neurofeedback for Stress Mitigation

Article

Full-text available

Sep 2021

The neurofeedback stimulus content has direct implications for the efficacy of the psychophysiological applications for neurofeedback modality. In particular, enhancements of neurofeedback stimulus content can facilitate improvements in the efficacy of neurofeedback applications in clinical practice. To further elaborate on this aspect, this study introduced systematic enhancements in neurofeedback stimulus content by developing enhanced neurofeedback stimulus content for stress mitigation. The enhancements included the automatic selection of color of neurofeebdack stimulus content environment and instruction messages, as well as, the adaptive selection of threshold of quantitative electroencephalogram (QEEG) features, such as frontal alpha power and frontal alpha asymmetry. The enhancements were based on the outcomes from previous research on the selection of neurofeedback stimulus content for stress mitigation. The improvement in the efficacy of neurofeedback stimulus content was measured statistically by comparing the QEEG and topographic maps. In this study, electroencephalogram data from 20 participants were acquired during multiple sessions of neurofeedback. Analysis of variance and a post hoc test were used to verify the improvement in the efficacy of the neurofeedback application for stress mitigation after the enhancements of the neurofeedback stimulus content; a t–test was used to verify the statistical significance of the stress mitigation by the neurofeedback p < 0.05. The results indicate that the enhancement of the developed neurofeedback stimulus content facilitated stress mitigation during the early sessions of neurofeedback. In conclusion, the efficacy of neurofeedback can be improved using the developed stimulus content with enhancements.

Workplace Mental State Monitoring during VR-Based Training for Offshore Environment

Article

Full-text available

Jul 2021
SENSORS-BASEL

Adults are constantly exposed to stressful conditions at their workplace, and this can lead to decreased job performance followed by detrimental clinical health problems. Advancement of sensor technologies has allowed the electroencephalography (EEG) devices to be portable and used in real-time to monitor mental health. However, real-time monitoring is not often practical in workplace environments with complex operations such as kindergarten, firefighting and offshore facilities. Integrating the EEG with virtual reality (VR) that emulates workplace conditions can be a tool to assess and monitor mental health of adults within their working environment. This paper evaluates the mental states induced when performing a stressful task in a VR-based offshore environment. The theta, alpha and beta frequency bands are analysed to assess changes in mental states due to physical discomfort, stress and concentration. During the VR trials, mental states of discomfort and disorientation are observed with the drop of theta activity, whilst the stress induced from the conditional tasks is reflected in the changes of low-alpha and high-beta activities. The deflection of frontal alpha asymmetry from negative to positive direction reflects the learning effects from emotion-focus to problem-solving strategies adopted to accomplish the VR task. This study highlights the need for an integrated VR-EEG system in workplace settings as a tool to monitor and assess mental health of working adults.

Effect of Enhanced Neurofeedback Stimulus Content on Frontal Alpha Asymmetry

Conference Paper

Aug 2022

Real-Time Health Monitoring System with Hybrid Wearable Suit

Article

Nov 2019

Dr. A.P. Nautiyal

Fractal dimension based neurofeedback training to improve cognitive abilities

Conference Paper

Full-text available

Sep 2015

Currently, neurofeedback training can be used not only to treat the patients with attention deficit hyperactivity disorder, learning difficulties, etc. but also to improve cognitive abilities of healthy people. Training protocols based on alpha, theta, or theta/beta power calculated from Electroencephalogram (EEG) are commonly used in the neurofeedback training. However, when the standard neurofeedback protocols are used, the EEG recording is required before the training to obtain the training threshold for each subject. In this paper, we propose a fractal dimension (FD)-based neurofeedback training protocol with adaptive algorithm, which does not need any before-training recording. The algorithm is integrated in the Shooting game. The efficiency of the FD-based neurofeedback training in comparison with traditional individual theta/beta based neurofeedback training is assessed using Psychology Experiment Building Language (PEBL) tests such as matrix rotation (for spatial ability), change detection (for focused attention), math processing (for cognitive abilities) and test of attentional vigilance (for attention of vigilance). 40 subjects participated in the study. They were divided randomly into FD-based neurofeedback training group and theta/beta ratio-based training group. The results show that after neurofeedback training participants from FD-based training group has similar or better test performance than the one from ratio-based group.

Decrease alpha waves in depression: An electroencephalogram(EEG) study

Article

Full-text available

May 2015

P.F. Lee

There was no affirm study that differentiates the brainwaves between depression subjects and healthy subjects until today. Hyperactivity and low activity of the brain activities in various parts and regions could be evaluated and studied though the brainwaves measured from the electroencephalogram (EEG). The losing ability of the brain to transmit signals and information that caused a person to be depressed makes a person influences their normal daily activities. Depression is a mood disorder which may affect our daily work, sleep, eating habits and general health. Therefore, it is a general term and commonly infected by anyone. The aim of this study was to determine the differences of alpha waves between normal and depression groups. Throughout the research, depression screening measurements of Patient Health Questionnaire-9 (PHQ-9) and Depression Anxiety Stress Scale-21 (DASS-21) were taken into accounts in order to identify the normal and depression groups. A total of 4 normal subjects and 4 depressed subjects participated in this study. A 32 channels EEG was used to detect the difference of alpha waves in depression and normal groups. The alpha waves in depression group were found out to be lower compared to the normal group in both close eyes and open eyes conditions. The T-Test statistical analysis shown that there were significant differences in the alpha-1 waves in close eyes condition and alpha 1 and alpha-2 waves in the open eyes condition for depression group. In addition, the frontal lobe, parietal lobe, occipital lobe and temporal lobe had found out to have much lower alpha waves in the depression group compared to the normal group. In short, by measuring the alpha waves of a person using EEG may be a biomarker in differentiating a healthy or depressed person in the future.

Methodological Note: Neurofeedback: A Comprehensive Review on System Design, Methodology and Clinical Applications

Article

Full-text available

Mar 2016

Neurofeedback is a kind of biofeedback, which teaches self-control of brain functions to subjects by measuring brain waves and providing a feedback signal. Neurofeedback usually provides the audio and or video feedback. Positive or negative feedback is produced for desirable or undesirable brain activities, respectively. In this review, we provided clinical and technical information about the following issues: (1) Various neurofeedback treatment protocols i.e. alpha, beta, alpha/theta, delta, gamma, and theta; (2) Different EEG electrode placements i.e. standard recording channels in the frontal, temporal, central, and occipital lobes; (3) Electrode montages (unipolar, bipolar); (4) Types of neurofeedback i.e. frequency, power, slow cortical potential, functional magnetic resonance imaging, and so on; (5) Clinical applications of neurofeedback i.e. treatment of attention deficit hyperactivity disorder, anxiety, depression, epilepsy, insomnia, drug addiction, schizophrenia, learning disabilities, dyslexia and dyscalculia, autistic spectrum disorders and so on as well as other applications such as pain management, and the improvement of musical and athletic performance; and (6) Neurofeedback softwares. To date, many studies have been conducted on the neurofeedback therapy and its effectiveness on the treatment of many diseases. Neurofeedback, like other treatments, has its own pros and cons. Although it is a non-invasive procedure, its validity has been questioned in terms of conclusive scientific evidence. For example, it is expensive, time-consuming and its benefits are not long-lasting. Also, it might take months to show the desired improvements. Nevertheless, neurofeedback is known as a complementary and alternative treatment of many brain dysfunctions. However, current research does not support conclusive results about its efficacy.

1-year follow-up of neurofeedback treatment in adolescents with attention-deficit hyperactivity disorder: Randomised controlled trial

Article

Full-text available

Mar 2016

Background: Estimates of the effectiveness of neurofeedback as a treatment for attention-deficit hyperactivity disorder (ADHD) are mixed. Aims: To investigate the long-term additional effects of neurofeedback (NFB) compared with treatment as usual (TAU) for adolescents with ADHD. Method: Using a multicentre parallel-randomised controlled trial design, 60 adolescents with a DSM-IV-TR diagnosis of ADHD receiving NFB+TAU (n=41) or TAU (n=19) were followed up. Neurofeedback treatment consisted of approximately 37 sessions of theta/sensorimotor rhythm (SMR)-training on the vertex (Cz). Outcome measures included behavioural self-reports and neurocognitive measures. Allocation to the conditions was unmasked. Results: At 1-year follow-up, inattention as reported by adolescents was decreased (range ηp(2)=0.23-0.36, P<0.01) and performance on neurocognitive tasks was faster (range ηp(2)=0.20-0.67, P<0.005) irrespective of treatment group. Conclusions: Overall, NFB+TAU was as effective as TAU. Given the absence of robust additional effects of neurofeedback in the current study, results do not support the use of theta/SMR neurofeedback as a treatment for adolescents with ADHD and comorbid disorders in clinical practice. Declaration of interest: None. Copyright and usage: © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.

Neurofeedback and Neuromodulation Techniques and Applications

Book

Jan 2011

The study of neurofeedback and neuromodulation offer a window into brain physiology and function, suggesting innovative approaches to the improvement of attention, anxiety, pain, mood and behavior. Resources for understanding what Neurofeedback and neuromodulation are, how they are used, and to what disorders and patients they can be applied are scarce, and this volume serves as an ideal tool for clinical researchers and practicing clinicians in both neuroscience and psychology, to understand techniques, analysis, and their applications to specific patient populations and disorders. The top scholars in the field have been enlisted and contributions offer both the breadth needed for an introductory scholar and the depth desired by a clinical professional. Includes the practical application of techniques to use with patients Includes integration of neurofeedback with neuromodulation techniques Discusses what the technique is, for which disorders it is effective, and the evidence basis behind its use Written at an appropriate level for clinicians and researchers.

The Stress Reaction: A Historical Perspective

Article

Feb 2016
ADV EXP MED BIOL

The history of stress research - milestones and people. Definitions and modern concepts of stress as well as the conflict between Hans Selye and the psychologists are described in this review. The molecular and physiological mechanisms of stress and their possible pharmacological intervention are introduced. The cycle of stress is presented as a new concept of the stress reaction, trying to bridge the gap between physiology and psychology. The cycle is a circular event in life, composed of 4 phases: (1) the resting ground phase, (2) the tension phase, (3) the response phase, and (4) the relief phase. In each phase, both physiological and psychological components can be assessed. These components are the basis for the proper handling of each phase and provide a unified model for the psycho-biological response to stress. In addition, parameters of the cycle such as frequency, duration, and intensity can be measured, providing an effective tool for stress management. Finally, modern techniques and mechanisms for coping with stress are discussed like the Norwegian Gate Theory and Lazarus Dichotomy Model for the Stress Reaction. In the above models, specific examples of how people respond to the first time encounter of stressful events and how soldiers cope with stress are presented.

Can Neurofeedback Decrease Anxiety and Fear in Cancer Patients? A Case Study

Article

Dec 2015

Anxiety and depression are very widespread among cancer patients. The state of anxiety covers a wide range of symptoms connected to fear, restlessness and changes in the autonomy of the patient. Neurofeedback is a behavioral technique of operant learning, in which participants learn to effect the electric activity of their brain, through a dynamic process of visual and auditory feedback. This training seeks to change the frequency of subjects’ electroencephalogram (EEG), something achieved by the majority of participants. Neurofeedback is a technique which has been successfully used in recent decades as a tool for treating a number of clinical cases. Amongst the clinical cases studied are autism, epilepsy, chronic pain, cases of major depression and also the effects of cancer upon different psychological parameters and the quality patients’ lives. Pelvic cancer and its medical treatment seem to increase anxiety and depression, which affect patients’ daily lives.

Neurofeedback Games to Improve Cognitive Abilities

Article