neurophysiology
Research Papers
Showing 6 of 8Neurophysiological Approach by Self-Control of Your Stress-Related Autonomic Nervous System with Depression, Stress and Anxiety Patients
BACKGROUND: Heart Rate Variability Biofeedback (HRVB) is a treatment in which patients learn self-regulation of a physiological dysregulated vagal nerve function. While the therapeutic approach of HRVB is promising for a variety of disorders, it has not yet been regularly offered in a mental health treatment setting. AIM: To provide a systematic review about the efficacy of HRV-Biofeedback in treatment of anxiety, depression, and stress related disorders. METHOD: Systematic review in PubMed and Web of Science in 2020 with terms HRV, biofeedback, Post-Traumatic Stress Disorder (PTSD), depression, panic disorder, and anxiety disorder. Selection, critical appraisal, and description of the Random Controlled Trials (RCT) studies. Combined with recent meta-analyses. RESULTS: The search resulted in a total of 881 studies. After critical appraisal, nine RCTs have been selected as well as two other relevant studies. The RCTs with control groups treatment as usual, muscle relaxation training and a "placebo"-biofeedback instrument revealed significant clinical efficacy and better results compared with control conditions, mostly significant. In the depression studies average reduction at the Beck Depression Inventory (BDI) scale was 64% (HRVB plus Treatment as Usual (TAU) versus 25% (control group with TAU) and 30% reduction (HRVB) at the PSQ scale versus 7% (control group with TAU). In the PTSD studies average reduction at the BDI-scale was 53% (HRV plus TAU) versus 24% (control group with TAU) and 22% (HRVB) versus 10% (TAU) with the PTSD Checklist (PCL). In other systematic reviews significant effects have been shown for HRV-Biofeedback in treatment of asthma, coronary artery disease, sleeping disorders, postpartum depression and stress and anxiety. CONCLUSION: This systematic review shows significant improvement of the non-invasive HRVB training in stress related disorders like PTSD, depression, and panic disorder, in particular when combined with cognitive behavioral therapy or different TAU. Effects were visible after four weeks of training, but clinical practice in a longer daily self-treatment of eight weeks is more promising. More research to integrate HRVB in treatment of stress related disorders in psychiatry is warranted, as well as research focused on the neurophysiological mechanisms.
View Full Paper →Healing the Neurophysiological Roots of Trauma: A Controlled Study Examining LORETA Z-Score Neurofeedback and HRV Biofeedback for Chronic PTSD
Introduction: Posttraumatic stress disorder (PTSD) has been linked to abnormalities within three neural networks: default mode (DMN), salience (SN), and central executive (CEN). This study examined the effectiveness of LORETA z-score neurofeedback (LZNF) training for altering current source within these networks and reducing symptoms associated with PTSD. Methods: Twenty-three adults with chronic PTSD were randomly assigned to 15 sessions of either LZNF (n = 12) or heart rate variability biofeedback (HRVB; n = 11). Psychosocial and physiological assessments were completed at baseline and postintervention. Results: The LZNF group showed very large, statistically significant decreases in symptoms on the PTSD Checklist for DSM-V (PCL-5; p = .003, d = 2.09) and Beck Anxiety Inventory (BAI; p = .003, d = 2.13). The HRVB group also showed very large decreases on the PCL-5 (p = .006, d = 1.40) and medium effects on the BAI (p = .018, d = 0.76). Between-group comparisons showed medium to large effects of group type in favor of LZNF (PCL-5 d = 0.57; BAI d = 0.94), although not statistically significant. LZNF Responders (n = 9) demonstrated very large, statistically significant decreases in abnormal z-scores within all targeted networks (DMN p = .012, d = 0.96; SN p = .008, d = 1.32; CEN p = .008, d = 1.33). Conclusion: The positive outcomes of this study provide preliminary evidence to support LZNF training as a specific, effective, and tolerable intervention for adults with chronic PTSD
View Full Paper →Infra-Low Frequency Neurofeedback in Depression: Three case studies
Electroencephalographic (EEG) findings on depressive patients indicate theta and alpha activity higher than in normal controls. Extensive literature reports on the effectiveness of neurofeedback techniques in the treatment of cognitive and behavioral disorders by training the patients to modulate their brain activities, as reflected in their electroencephalogram. Three unmedicated, depressed individuals participated in this study of infra-low frequency neurofeedback (ILF NF) training. Along with the pre- and posttreatment Depression Rating Scales assessment, quantitative EEGs (qEEG) were recorded in eyes-open and eyes-closed resting states and during the visual cued Go/NoGo task before and after 20 sessions of training. Along with remission of the clinical symptoms of depression, significant decrease of theta power over frontal and central areas was observed in all three patients under all test conditions. These qEEG dynamics might be a correlate of ILF NF-related recovery of the appropriate level of frontal cortical activation.
View Full Paper →The clinical use of quantitative EEG in cognitive disorders
The primary diagnosis of most cognitive disorders is clinically based, but the EEG plays a role in evaluating, classifying and following some of these disorders. There is an ongoing debate over routine use of qEEG. Although many findings regarding the clinical use of quantitative EEG are awaiting validation by independent investigators while confirmatory clinical follow-up studies are also needed, qEEG can be cautiously used by a skilled neurophysiologist in cognitive dysfunctions to improve the analysis of background activity, slow/fast focal activity, subtle asymmetries, spikes and waves, as well as in longitudinal follow-ups.
View Full Paper →Foundation and Practice of Neurofeedback for the Treatment of Epilepsy
This review provides an updated overview of the neurophysiological rationale, basic and clinical research literature, and current methods of practice pertaining to clinical neurofeedback. It is based on documented findings, rational theory, and the research and clinical experience of the authors. While considering general issues of physiology, learning principles, and methodology, it focuses on the treatment of epilepsy with sensorimotor rhythm (SMR) training, arguably the best established clinical application of EEG operant conditioning. The basic research literature provides ample data to support a very detailed model of the neural generation of SMR, as well as the most likely candidate mechanism underlying its efficacy in clinical treatment. Further, while more controlled clinical trials would be desirable, a respectable literature supports the clinical utility of this alternative treatment for epilepsy. However, the skilled practice of clinical neurofeedback requires a solid understanding of the neurophysiology underlying EEG oscillation, operant learning principles and mechanisms, as well as an in-depth appreciation of the ins and outs of the various hardware/software equipment options open to the practitioner. It is suggested that the best clinical practice includes the systematic mapping of quantitative multi-electrode EEG measures against a normative database before and after treatment to guide the choice of treatment strategy and document progress towards EEG normalization. We conclude that the research literature reviewed in this article justifies the assertion that neurofeedback treatment of epilepsy/seizure disorders constitutes a well-founded and viable alternative to anticonvulsant pharmacotherapy.
View Full Paper →The neurophysiology of dyslexia: A selective review with implications for neurofeedback remediation and results of treatment in twelve consecutive patients
Dyslexia is a common and important problem in all industrial societies, with a prevalence rate of five to ten percent, for which no consistently effective treatment is available. Recent advances in imaging (morphometric MRI, functional MRI, PET, regional cerebral blood flow), as well as in neurophysiology (evoked potentials, QEEG, event-related desynchronization, coherence studies, magnetic source imaging, reading difference topography) have clarified our understanding of the normal circuitry involved in reading and differences seen in individuals who have trouble learning to read. These studies have important implications for the use of neurofeedback to help dyslexic individuals learn to read more easily. First, we obtain a QEEG and a reading difference topograph. We then train down any abnormalities that are significantly increased and train up any abnormalities that are significantly decreased. Increasing 16–18 Hz activity at T3 (left mid-temporal area) has also proved quite helpful in improving reading speed and comprehension. These combined approaches have been helpful in all cases of dyslexia we have treated, dramatically so in some cases. Each of the 12 individuals treated improved by at least two grade levels after 30 to 35 sessions.
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