EMG feedback

Research Papers

Neurofeedback of Slow Cortical Potentials in Children with Attention-Deficit/Hyperactivity Disorder: A Multicenter Randomized Trial Controlling for Unspecific Effects

Strehl, Ute, Aggensteiner, Pascal, Wachtlin, Daniel, Brandeis, Daniel, Albrecht, Björn, Arana, Maria, Bach, Christiane, Banaschewski, Tobias, Bogen, Thorsten, Flaig-Röhr, Andrea, Freitag, Christine M., Fuchsenberger, Yvonne, Gest, Stephanie, Gevensleben, Holger, Herde, Laura, Hohmann, Sarah, Legenbauer, Tanja, Marx, Anna-Maria, Millenet, Sabina, Pniewski, Benjamin, Rothenberger, Aribert, Ruckes, Christian, Wörz, Sonja, Holtmann, Martin (2017) · Frontiers in Human Neuroscience

Background: Neurofeedback (NF) in children with attention-deficit/hyperactivity disorder (ADHD) has been investigated in a series of studies over the last years. Previous studies did not unanimously support NF as a treatment in ADHD. Most studies did not control for unspecific treatment effects and did not demonstrate that self-regulation took place. The present study examined the efficacy of NF in comparison to electromyographic (EMG) feedback to control for unspecific effects of the treatment, and assessed self-regulation of slow cortical potentials (SCPs). Methods: A total of 150 children aged 7–9 years diagnosed with ADHD (82% male; 43% medicated) were randomized to 25 sessions of feedback of SCPs (NF) or feedback of coordination of the supraspinatus muscles (EMG). The primary endpoint was the change in parents’ ratings of ADHD core symptoms 4 weeks after the end of treatment compared to pre-tests. Results: Children in both groups showed reduced ADHD-core symptoms (NF 0.3, 95% CI -0.42 to -0.18; EMG 0.13, 95% CI -0.26 to -0.01). NF showed a significant superiority over EMG (treatment difference 0.17, 95% CI 0.02–0.3, p = 0.02). This yielded an effect size (ES) of d = 0.57 without and 0.40 with baseline observation carried forward (BOCF). The sensitivity analysis confirmed the primary result. Successful self-regulation of brain activity was observed only in NF. As a secondary result teachers reported no superior improvement from NF compared to EMG, but within-group analysis revealed effects of NF on the global ADHD score, inattention, and impulsivity. In contrast, EMG feedback did not result in changes despite more pronounced self-regulation learning. Conclusions: Based on the primary parent-rated outcome NF proved to be superior to a semi-active EMG feedback treatment. The study supports the feasibility and efficacy of NF in a large sample of children with ADHD, based on both specific and unspecific effects. Trial Register: Current controlled trials ISRCTN76187185, registered 5 February 2009.

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Near-infrared spectroscopy (NIRS) neurofeedback as a treatment for children with attention deficit hyperactivity disorder (ADHD)—a pilot study

Marx, Anna-Maria, Ehlis, Ann-Christine, Furdea, Adrian, Holtmann, Martin, Banaschewski, Tobias, Brandeis, Daniel, Rothenberger, Aribert, Gevensleben, Holger, Freitag, Christine M., Fuchsenberger, Yvonne, Fallgatter, Andreas J., Strehl, Ute (2015) · Frontiers in Human Neuroscience

In this pilot study near-infrared spectroscopy (NIRS) neurofeedback was investigated as a new method for the treatment of Attention Deficit-/Hyperactivity Disorder (ADHD). Oxygenated hemoglobin in the prefrontal cortex of children with ADHD was measured and fed back. 12 sessions of NIRS-neurofeedback were compared to the intermediate outcome after 12 sessions of EEG-neurofeedback (slow cortical potentials, SCP) and 12 sessions of EMG-feedback (muscular activity of left and right musculus supraspinatus). The task was either to increase or decrease hemodynamic activity in the prefrontal cortex (NIRS), to produce positive or negative shifts of SCP (EEG) or to increase or decrease muscular activity (EMG). In each group nine children with ADHD, aged 7–10 years, took part. Changes in parents’ ratings of ADHD symptoms were assessed before and after the 12 sessions and compared within and between groups. For the NIRS-group additional teachers’ ratings of ADHD symptoms, parents’ and teachers’ ratings of associated behavioral symptoms, childrens’ self reports on quality of life and a computer based attention task were conducted before, 4 weeks and 6 months after training. As primary outcome, ADHD symptoms decreased significantly 4 weeks and 6 months after the NIRS training, according to parents’ ratings. In teachers’ ratings of ADHD symptoms there was a significant reduction 4 weeks after the training. The performance in the computer based attention test improved significantly. Within-group comparisons after 12 sessionsof NIRS-, EEGand EMG-training revealed a significant reduction in ADHD symptoms in the NIRS-group and a trend for EEG and EMG-groups. No significant differences for symptom reduction were found between the groups. Despite the limitations of small groups and the comparison of a completed with two uncompleted interventions, theresults of this pilot study are promising. NIRS-neurofeedback could be a time-effective treatment for ADHD and an interesting new option to consider in the treatment of ADHD

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Physiological and Psychological Effects of Alpha and Emg Feedback Training with College Drug Users a Pilot Study*

Lamontagne, Yves, Hand, Iver, Annable, Lawrence, Gagnon, Marc-André (1975) · Canadian Psychiatric Association Journal

Twenty four volunteer college students who were regular drug users were randomly allocated to three training groups of equal size: alpha feedback, EMG feedback and a joked control group. The subjects were unaware of which feedback condition they received and were asked to practise at home during a six month follow up period in order to achieve a relaxed state similar to that experienced during training. No group was successful in retaining gains made in their alpha levels during each session, but the EMG group significantly reduced their muscular activity during training and retained the improvement during follow up. The alpha and joked groups did not greatly improve their EMG during training but at follow up achieved the same levels as the EMG group. There was evidence to suggest that a reduction in drug use among light and medium users was maintained during follow up. Significant and lasting improvements were made by each group in the duration and quality of their sleep and anxiety levels were reduced.

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