Emotional Regulation
Research Papers
Effects of Electroencephalogram Biofeedback on Emotion Regulation and Brain Homeostasis of Late Adolescents in the COVID-19 Pandemic
PURPOSE: The purpose of this study was to examine the effects of electroencephalogram (EEG) biofeedback training for emotion regulation and brain homeostasis on anxiety about COVID-19 infection, impulsivity, anger rumination, meta-mood, and self-regulation ability of late adolescents in the prolonged COVID-19 pandemic situation. METHODS: A non-equivalent control group pretest-posttest design was used. The participants included 55 late adolescents in the experimental and control groups. The variables were evaluated using quantitative EEG at pre-post time points in the experimental group. The experimental groups received 10 sessions using the three-band protocol for five weeks. The collected data were analyzed using the Shapiro-Wilk test, Wilcoxon rank sum test, Wilcoxon signed-rank test, t-test and paired t-test using the SAS 9.3 program. The collected EEG data used a frequency series power spectrum analysis method through fast Fourier transform. RESULTS: Significant differences in emotion regulation between the two groups were observed in the anxiety about COVID-19 infection (W = 585.50, p = .002), mood repair of meta-mood (W = 889.50, p = .024), self-regulation ability (t = -5.02, p < .001), self-regulation mode (t = -4.74, p < .001), and volitional inhibition mode (t = -2.61, p = .012). Neurofeedback training for brain homeostasis was effected on enhanced sensory-motor rhythm (S = 177.00, p < .001) and inhibited theta (S = -166.00, p < .001). CONCLUSION: The results demonstrate the potential of EEG biofeedback training as an independent nursing intervention that can markedly improve anxiety, mood-repair, and self-regulation ability for emotional distress during the COVID-19 pandemic.
View Full Paper →Emotion self-regulation training in major depressive disorder using simultaneous real-time fMRI and EEG neurofeedback
Simultaneous real-time fMRI and EEG neurofeedback (rtfMRI-EEG-nf) is an emerging neuromodulation approach, that enables simultaneous volitional regulation of both hemodynamic (BOLD fMRI) and electrophysiological (EEG) brain activities. Here we report the first application of rtfMRI-EEG-nf for emotion self-regulation training in patients with major depressive disorder (MDD). In this proof-of-concept study, MDD patients in the experimental group (n = 16) used rtfMRI-EEG-nf during a happy emotion induction task to simultaneously upregulate two fMRI and two EEG activity measures relevant to MDD. The target measures included BOLD activities of the left amygdala (LA) and left rostral anterior cingulate cortex (rACC), and frontal EEG asymmetries in the alpha band (FAA, [7.5-12.5] Hz) and high-beta band (FBA, [21-30] Hz). MDD patients in the control group (n = 8) were provided with sham feedback signals. An advanced procedure for improved real-time EEG-fMRI artifact correction was implemented. The experimental group participants demonstrated significant upregulation of the LA BOLD activity, FAA, and FBA during the rtfMRI-EEG-nf task, as well as significant enhancement in fMRI connectivity between the LA and left rACC. Average individual FAA changes during the rtfMRI-EEG-nf task positively correlated with depression and anhedonia severities, and negatively correlated with after-vs-before changes in depressed mood ratings. Temporal correlations between the FAA and FBA time courses and the LA BOLD activity were significantly enhanced during the rtfMRI-EEG-nf task. The experimental group participants reported significant mood improvements after the training. Our results suggest that the rtfMRI-EEG-nf may have potential for treatment of MDD.
View Full Paper →Modulatory effects of dynamic fMRI-based neurofeedback on emotion regulation networks in adolescent females
Research has shown that difficulties with emotion regulation abilities in childhood and adolescence increase the risk for developing symptoms of mental disorders, e.g anxiety. We investigated whether functional magnetic resonance imaging (fMRI)-based neurofeedback (NF) can modulate brain networks supporting emotion regulation abilities in adolescent females. We performed three experiments (Experiment 1: N = 18; Experiment 2: N = 30; Experiment 3: N = 20). We first compared different NF implementations regarding their effectiveness of modulating prefrontal cortex (PFC)-amygdala functional connectivity (fc). Further we assessed the effects of fc-NF on neural measures, emotional/metacognitive measures and their associations. Finally, we probed the mechanism underlying fc-NF by examining concentrations of inhibitory and excitatory neurotransmitters. Results showed that NF implementations differentially modulate PFC-amygdala fc. Using the most effective NF implementation we observed important relationships between neural and emotional/metacognitive measures, such as practice-related change in fc was related with change in thought control ability. Further, we found that the relationship between state anxiety prior to the MRI session and the effect of fc-NF was moderated by GABA concentrations in the PFC and anterior cingulate cortex. To conclude, we were able to show that fc-NF can be used in adolescent females to shape neural and emotional/metacognitive measures underlying emotion regulation. We further show that neurotransmitter concentrations moderate fc-NF-effects.
View Full Paper →Review of EEG, ERP, and Brain Connectivity Estimators as Predictive Biomarkers of Social Anxiety Disorder
Social anxiety disorder (SAD) is characterized by a fear of negative evaluation, negative self-belief and extreme avoidance of social situations. These recurrent symptoms are thought to maintain the severity and substantial impairment in social and cognitive thoughts. SAD is associated with a disruption in neuronal networks implicated in emotional regulation, perceptual stimulus functions, and emotion processing, suggesting a network system to delineate the electrocortical endophenotypes of SAD. This paper seeks to provide a comprehensive review of the most frequently studied electroencephalographic (EEG) spectral coupling, event-related potential (ERP), visual-event potential (VEP), and other connectivity estimators in social anxiety during rest, anticipation, stimulus processing, and recovery states. A search on Web of Science provided 97 studies that document electrocortical biomarkers and relevant constructs pertaining to individuals with SAD. This study aims to identify SAD neuronal biomarkers and provide insight into the differences in these biomarkers based on EEG, ERPs, VEP, and brain connectivity networks in SAD patients and healthy controls (HC). Furthermore, we proposed recommendations to improve methods of delineating the electrocortical endophenotypes of SAD, e.g., a fusion of EEG with other modalities such as functional magnetic resonance imaging (fMRI) and magnetoencephalograms (MEG), to realize better effectiveness than EEG alone, in order to ultimately evolve the treatment selection process, and to review the possibility of using electrocortical measures in the early diagnosis and endophenotype examination of SAD.
View Full Paper →A Neurovisceral Approach to Autism: Targeting Self-Regulation and Core Symptoms Using Neurofeedback and Biofeedback
Mu Rhythm Synchrony Neurofeedback (MRS-NFB) has shown promise in improving electrophysiological and behavioral deficits in autism spectrum disorder (ASD). Heart rate variability biofeedback (HRV-BFB), a method for improving self-regulation of the autonomic nervous system (ANS), has yet to be tested as a clinical intervention for ASD. This study evaluated the impact of HRV-BFB on symptoms of ASD; and whether a combined HRV-BFB + MRS-NFB intervention would be more efficacious than HRV-BFB alone. Fifteen children with a verified diagnosis of ASD completed the study. Participants were assigned to either an HRV-BFB group (Group 1) or a combined HRV-BFB + MRS-NFB group (Group 2). All children underwent pre- and postassessments of electroencephalography (EEG), heart rate variability (HRV), and parent-reported behaviors. No significant between-groups differences were observed on any parent-reported behaviors. Group 1 showed significant pre-post improvements in emotion regulation and social behavior, while Group 2 showed significant pre-post improvements in emotional lability and autistic behaviors. Group 2 also showed significant improvements in RMSSD and lnHF (vagal tone) indices of HRV over time, while Group 1 displayed no significant changes in HRV over time. Group 1 showed an increase in mu suppression posttraining, and Group 2 showed a reduction in mu suppression posttraining. The results suggest that HRV-BFB, alone or in combination with MRSNFB, may improve behavioral features of autism. A combined approach may be more efficacious in enhancing HRV, while the implications of each approach on mu suppression are mixed. Neurovisceral approaches that teach self-regulation offer a novel treatment avenue for ASD.
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