anxiety disorder

Research Papers

EEG Neurofeedback for Anxiety Disorders and Post-Traumatic Stress Disorders: A Blueprint for a Promising Brain-Based Therapy

Micoulaud-Franchi, J. A., Jeunet, C., Pelissolo, A., Ros, T. (2021) · Current Psychiatry Reports

PURPOSE OF REVIEW: This review provides an overview of current knowledge and understanding of EEG neurofeedback for anxiety disorders and post-traumatic stress disorders. RECENT FINDINGS: The manifestations of anxiety disorders and post-traumatic stress disorders (PTSD) are associated with dysfunctions of neurophysiological stress axes and brain arousal circuits, which are important dimensions of the research domain criteria (RDoC). Even if the pathophysiology of these disorders is complex, one of its defining signatures is behavioral and physiological over-arousal. Interestingly, arousal-related brain activity can be modulated by electroencephalogram-based neurofeedback (EEG NF), a non-pharmacological and non-invasive method that involves neurocognitive training through a brain-computer interface (BCI). EEG NF is characterized by a simultaneous learning process where both patient and computer are involved in modifying neuronal activity or connectivity, thereby improving associated symptoms of anxiety and/or over-arousal. Positive effects of EEG NF have been described for both anxiety disorders and PTSD, yet due to a number of methodological issues, it remains unclear whether symptom improvement is the direct result of neurophysiological changes targeted by EEG NF. Thus, in this work we sought to bridge current knowledge on brain mechanisms of arousal with past and present EEG NF therapies for anxiety and PTSD. In a nutshell, we discuss the neurophysiological mechanisms underlying the effects of EEG NF in anxiety disorder and PTSD, the methodological strengths/weaknesses of existing EEG NF randomized controlled trials for these disorders, and the neuropsychological factors that may impact NF training success.

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EEG-Based Anxious States Classification Using Affective BCI-Based Closed Neurofeedback System

Chen, Chao, Yu, Xuecong, Belkacem, Abdelkader Nasreddine, Lu, Lin, Li, Penghai, Zhang, Zufeng, Wang, Xiaotian, Tan, Wenjun, Gao, Qiang, Shin, Duk, Wang, Changming, Sha, Sha, Zhao, Xixi, Ming, Dong (2021) · Journal of Medical and Biological Engineering

Purpose: Anxiety disorder is one of the psychiatric disorders that involves extreme fear or worry, which can change the balance of chemicals in the brain. To the best of our knowledge, the evaluation of anxiety state is still based on some subjective questionnaires and there is no objective standard assessment yet. Unlike other methods, our approach focuses on study the neural changes to identify and classify the anxiety state using electroencephalography (EEG) signals. Methods: We designed a closed neurofeedback experiment that contains three experimental stages to adjust subjects’ mental state. The EEG resting state signal was recorded from thirty-four subjects in the first and third stages while EEG-based mindfulness recording was recorded in the second stage. At the end of each stage, the subjects were asked to fill a Visual Analogue Scale (VAS). According to their VAS score, the subjects were classified into three groups: non-anxiety, moderate or severe anxiety groups. Results: After processing the EEG data of each group, support vector machine (SVM) classifiers were able to classify and identify two mental states (non-anxiety and anxiety) using the Power Spectral Density (PSD) as patterns. The highest classification accuracies using Gaussian kernel function and polynomial kernel function are 92.48 ± 1.20% and 88.60 ± 1.32%, respectively. The highest average of the classification accuracies for healthy subjects is 95.31 ± 1.97% and for anxiety subjects is 87.18 ± 3.51%. Conclusions: The results suggest that our proposed EEG neurofeedback-based classification approach is efficient for developing affective BCI system for detection and evaluation of anxiety disorder states.

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Efficacy Evaluation of Neurofeedback-Based Anxiety Relief

Chen, Chao, Xiao, Xiaolin, Belkacem, Abdelkader Nasreddine, Lu, Lin, Wang, Xin, Yi, Weibo, Li, Penghai, Wang, Changming, Sha, Sha, Zhao, Xixi, Ming, Dong (2021) · Frontiers in Neuroscience

Anxiety disorder is a mental illness that involves extreme fear or worry, which can alter the balance of chemicals in the brain. This change and evaluation of anxiety state are accompanied by a comprehensive treatment procedure. It is well-known that the treatment of anxiety is chiefly based on psychotherapy and drug therapy, and there is no objective standard evaluation. In this paper, the proposed method focuses on examining neural changes to explore the effect of mindfulness regulation in accordance with neurofeedback in patients with anxiety. We designed a closed neurofeedback experiment that includes three stages to adjust the psychological state of the subjects. A total of 34 subjects, 17 with anxiety disorder and 17 healthy, participated in this experiment. Through the three stages of the experiment, electroencephalography (EEG) resting state signal and mindfulness-based EEG signal were recorded. Power spectral density was selected as the evaluation index through the regulation of neurofeedback mindfulness, and repeated analysis of variance (ANOVA) method was used for statistical analysis. The findings of this study reveal that the proposed method has a positive effect on both types of subjects. After mindfulness adjustment, the power map exhibited an upward trend. The increase in the average power of gamma wave indicates the relief of anxiety. The enhancement of the wave power represents an improvement in the subjects’ mindfulness ability. At the same time, the results of ANOVA showed that P < 0.05, i.e., the difference was significant. From the aspect of neurophysiological signals, we objectively evaluated the ability of our experiment to relieve anxiety. The neurofeedback mindfulness regulation can effect on the brain activity pattern of anxiety disorder patients.

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Connectome-wide search for functional connectivity locus associated with pathological rumination as a target for real-time fMRI neurofeedback intervention

Misaki, Masaya, Tsuchiyagaito, Aki, Al Zoubi, Obada, Paulus, Martin, Bodurka, Jerzy (2020) · NeuroImage: Clinical

Real-time fMRI neurofeedback (rtfMRI-nf) enables noninvasive targeted intervention in brain activation with high spatial specificity. To achieve this promise of rtfMRI-nf, we introduced and demonstrated a data-driven framework to design a rtfMRI-nf intervention through the discovery of precise target location associated with clinical symptoms and neurofeedback signal optimization. Specifically, we identified the functional connectivity locus associated with rumination symptoms, utilizing a connectome-wide search in resting-state fMRI data from a large cohort of mood and anxiety disorder individuals (N = 223) and healthy controls (N = 45). Then, we performed a rtfMRI simulation analysis to optimize the online functional connectivity neurofeedback signal for the identified functional connectivity. The connectome-wide search was performed in the medial prefrontal cortex and the posterior cingulate cortex/precuneus brain regions to identify the precise location of the functional connectivity associated with rumination severity as measured by the ruminative response style (RRS) scale. The analysis found that the functional connectivity between the loci in the precuneus (-6, −54, 48 mm in MNI) and the right temporo-parietal junction (RTPJ; 49, −49, 23 mm) was positively correlated with RRS scores (depressive, p < 0.001; brooding, p < 0.001; reflective, p = 0.002) in the mood and anxiety disorder group. We then performed a rtfMRI processing simulation to optimize the online computation of the precuneus-RTPJ connectivity. We determined that the two-point method without a control region was appropriate as a functional connectivity neurofeedback signal with less dependence on signal history and its accommodation of head motion. The present study offers a discovery framework for the precise location of functional connectivity targets for rtfMRI-nf intervention, which could help directly translate neuroimaging findings into clinical rtfMRI-nf interventions.

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Effectiveness of Neurofeedback Therapy in Children with Separation Anxiety Disorder

Sadjadi, Seyed Alireza, Hashemian, P (2014) · Journal of Psychiatry

Background: Anxiety disorders are one of the most common psychiatric disorders in children. Its incidence is 2-5% of children and adolescents under age 18. Anxiety disorders are more common in girls than boys. It may start in pre-school, but mostly are in age of 7 to 8 years old. Method: The main objective of this article was to find out the effect of neurofeedback therapy in children with separation-anxiety disorder. Study population was Children from 7 to 12 years old with separation anxiety disorder who were referred to the child psychiatric clinic and they were divided randomly into two groups of 12. One group (N=12) received neurofeedback therapy and the other group (N=12) received sham neurofeedback therapy (placebo). Data was analyzed with t- test by 21th version SPSS software. Results: According to calculated t-test in neurofeedback group (8.18), neurofeedback was effective in reducing separation anxiety and the efficacy of treatment was great. But according to calculated t-test in sham group (4.42), reduction of separation anxiety was moderate. Therefore the efficacy of treatment in neurofeedback and sham groups was different. Conclusion: The results revealed that the efficacy of treatment of neurofeedback and sham groups on separation anxiety in children is different. Comparison of efficacy shows that effectiveness of neurofeedback treatment on separation anxiety was much more in the group treated with Neurofeedback than in the sham group.

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