motor control
Research Papers
The Potential of Functional Near-Infrared Spectroscopy-Based Neurofeedback—A Systematic Review and Recommendations for Best Practice
Background: The effects of electroencephalography (EEG) and functional magnetic resonance imaging (fMRI)-neurofeedback on brain activation and behaviors have been studied extensively in the past. More recently, researchers have begun to investigate the effects of functional near-infrared spectroscopy-based neurofeedback (fNIRS-neurofeedback). FNIRS is a functional neuroimaging technique based on brain hemodynamics, which is easy to use, portable, inexpensive, and has reduced sensitivity to movement artifacts. Method: We provide the first systematic review and database of fNIRS-neurofeedback studies, synthesizing findings from 22 peer-reviewed studies (including a total of N = 441 participants; 337 healthy, 104 patients). We (1) give a comprehensive overview of how fNIRS-neurofeedback training protocols were implemented, (2) review the online signal-processing methods used, (3) evaluate the quality of studies using pre-set methodological and reporting quality criteria and also present statistical sensitivity/power analyses, (4) investigate the effectiveness of fNIRS-neurofeedback in modulating brain activation, and (5) review its effectiveness in changing behavior in healthy and pathological populations. Results and discussion: (1–2) Published studies are heterogeneous (e.g., neurofeedback targets, investigated populations, applied training protocols, and methods). (3) Large randomized controlled trials are still lacking. In view of the novelty of the field, the quality of the published studies is moderate. We identified room for improvement in reporting important information and statistical power to detect realistic effects. (4) Several studies show that people can regulate hemodynamic signals from cortical brain regions with fNIRS-neurofeedback and (5) these studies indicate the feasibility of modulating motor control and prefrontal brain functioning in healthy participants and ameliorating symptoms in clinical populations (stroke, ADHD, autism, and social anxiety). However, valid conclusions about specificity or potential clinical utility are premature. Conclusion: Due to the advantages of practicability and relatively low cost, fNIRS-neurofeedback might provide a suitable and powerful alternative to EEG and fMRI neurofeedback and has great potential for clinical translation of neurofeedback. Together with more rigorous research and reporting practices, further methodological improvements may lead to a more solid understanding of fNIRS-neurofeedback. Future research will benefit from exploiting the advantages of fNIRS, which offers unique opportunities for neurofeedback research.
View Full Paper →EEG Biofeedback on a Female Stroke Patient with Depression: A Case Study
Background. This single case concerns the treatment of a 71-year-old female stroke patient. The patient's MRI revealed that the location of the stroke was in the right side basal ganglia with damage extending into the anterior limb of the internal capsule. She presented with a virtual paralysis of the left side of her body (hemiplegia with immobilized left arm, contracted fist, minimal motor control over left leg, absence of muscle tonus in left side of face and slurred, monotonic speech). Method. The client was provided with EEG biofeedback training on a one to two half-hour sessions per week schedule. Bipolar montages were used along with single site protocols. This was based largely on the idea of reciprocal communication loops between widely separated cortical generators. It was thought that encouraging communication between cortical sites would have a beneficial impact on impairments related to both functional and structural damage. EEG training protocols included SMR (12-15 Hz) enhancement at C4, C4-Pz and T3-T4 with theta suppression; beta (15-18 Hz) enhancement with theta suppression at C3, C3-Fpz and at C3-Fp1. Results. Patient showed significant improvement in gross motor control and range of movement of left arm and leg. The most dramatic improvement was observed in speech (articulation, strength and tone). While substantial improvements were observed in motor ability, restoration of mood stability proved somewhat more elusive. Since she was receiving additional treatment (physical therapy and medication management), it is impossible to attribute the improvement in functioning solely to the EEG training. However, the consensus among the attending medical personnel was that the improvements noted above took place with unusual expeditiousness. Discussion. When performing EEG biofeedback it may be most practical to adopt an “exercise model” approach in which the regulatory mechanisms in the brain are challenged through the sequential use of multiple protocol configurations. In this case several different training protocols proved useful in her ongoing recovery. While improvements in functioning were a result of a concerted effort involving multiple therapeutic interventions, it is likely that neurofeedback played a vital synergistic role.
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