International Hypnosis Research Institute - Neurofeedback

Acquired self-control of insula cortex modulates emotion recognition and brain network connectivity

Sat, 23 Mar 2013 16:30:00 -0500

Real-time functional magnetic resonance imaging (rtfMRI) is a novel technique that has allowed subjects to achieve self-regulation of circumscribed brain regions. Despite its anticipated therapeutic benefits, there is no report on successful application of this technique in psychiatric populations. The objectives of the present study were to train schizophrenia patients to achieve volitional control of bilateral anterior insula cortex on multiple days, and to explore the effect of learned self-regulation on face emotion recognition (an extensively studied deficit in schizophrenia) and on brain network connectivity. Nine patients with schizophrenia were trained to regulate the hemodynamic response in bilateral anterior insula with contingent rtfMRI neurofeedback, through a 2-weeks training. At the end of the training stage, patients performed a face emotion recognition task to explore behavioral effects of learned self-regulation. A learning effect in self-regulation was found for bilateral anterior insula, which persisted through the training. Following successful self-regulation, patients recognized disgust faces more accurately and happy faces less accurately. Improvements in disgust recognition were correlated with levels of self-activation of right insula. RtfMRI training led to an increase in the number of the incoming and outgoing effective connections of the anterior insula. This study shows for the first time that patients with schizophrenia can learn volitional brain regulation by rtfMRI feedback training leading to changes in the perception of emotions and modulations of the brain network connectivity. These findings open the door for further studies of rtfMRI in severely ill psychiatric populations, and possible therapeutic applications. Hum Brain Mapp, 2013. © 2011 Wiley Periodicals, Inc. Hum Brain Mapp. 2013 Jan;34(1):200-12. doi: 10.1002/hbm.21427. Epub 2011 Oct 22. Ruiz S, Lee S, Soekadar SR, Caria A, Veit R, Kircher T, Birbaumer N, Sitaram R. Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany; Department of Psychiatry, Faculty of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile; Graduate School of Neural and Behavioral Sciences, International Max Planck Research School, Tübingen, Germany. smruiz@med.puc.cl.

Integrative neuroimaging in mood disorders.

Sat, 09 Mar 2013 16:29:00 -0500

PURPOSE OF REVIEW: Neuroimaging has become a central technique of biological psychiatry and is uniquely suited to assess functional and structural brain changes in psychiatric patients in vivo. In this review, we highlight several recent developments that may enable the transition of psychiatric neuroimaging from laboratory to clinic. RECENT FINDINGS: We describe recent trends in refining imaging techniques for brain microstructure (diffusion imaging) and neurochemistry (magnetic resonance spectroscopy of neurotransmitters and metabolites) and their application to patients with mood disorders and individuals at risk, such as first-degree relatives. We also survey recent progress in imaging-guided deep brain stimulation (DBS), imaging-based (neurofeedback) therapies and studies looking at their convergent anatomical targets. These new interventional techniques, which aim to modulate brain circuits of emotion and motivation highlighted by functional imaging studies, have shown promising effects in several small studies. SUMMARY: The mapping of brain patterns associated with risk to develop mood disorders may pave the way for diagnostic/prognostic applications of neuroimaging. The neuromodulation techniques of DBS and neurofeedback, which target dysfunctional or compensatory circuits identified by functional imaging, may take neuroimaging into a new, therapeutic domain. Curr Opin Psychiatry. 2013 Jan;26(1):27-32. doi: 10.1097/YCO.0b013e32835a0b63. Keedwell PA, Linden DE. MRC Centre for Neuropsychiatric Genetics and Genomics and Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, UK.

Mind over chatter: Plastic up-regulation of the fMRI salience network...

Sat, 16 Feb 2013 16:28:00 -0500

Full title: Mind over chatter: Plastic up-regulation of the fMRI salience network directly after EEG neurofeedback. Neurofeedback (NFB) involves a brain-computer interface that allows users to learn to voluntarily control their cortical oscillations, reflected in the electroencephalogram (EEG). Although NFB is being pioneered as a noninvasive tool for treating brain disorders, there is insufficient evidence on the mechanism of its impact on brain function. Furthermore, the dominant rhythm of the human brain is the alpha oscillation (8-12Hz), yet its behavioral significance remains multifaceted and largely correlative. In this study with 34 healthy participants, we examined whether during the performance of an attentional task, the functional connectivity of distinct fMRI networks would be plastically altered after a 30-min session of voluntary reduction of alpha rhythm (n=17) versus a sham-feedback condition (n=17). We reveal that compared to sham-feedback, NFB induced an increase of connectivity within regions of the salience network involved in intrinsic alertness (dorsal anterior cingulate), which was detectable 30min after termination of training. The increase in salience network (default-mode network) connectivity was negatively (positively) correlated with changes in 'on task' mind-wandering as well as resting state alpha rhythm. Crucially, we observed a causal dependence between alpha rhythm synchronization during NFB and its subsequent change at resting state, not exhibited by the SHAM group. Our findings provide neurobehavioral evidence for the brain's exquisite functional plasticity, and for a temporally direct impact of NFB on a key cognitive control network, suggesting a promising basis for its use to treat cognitive disorders under physiological conditions. Neuroimage. 2013 Jan 15;65:324-35. doi: 10.1016/j.neuroimage.2012.09.046. Epub 2012 Sep 26. Ros T, Théberge J, Frewen PA, Kluetsch R, Densmore M, Calhoun VD, Lanius RA. Department of Psychiatry, University of Western Ontario, London, Ontario, Canada; Laboratory for Neurology and Imaging of Cognition, Department of Neurosciences, University of Geneva, Switzerland. Electronic address: dr.t.ros@gmail.com.

Improving Visual Perception through Neurofeedback.

Sat, 09 Feb 2013 16:30:00 -0500

Perception depends on the interplay of ongoing spontaneous activity and stimulus-evoked activity in sensory cortices. This raises the possibility that training ongoing spontaneous activity alone might be sufficient for enhancing perceptual sensitivity. To test this, we trained human participants to control ongoing spontaneous activity in circumscribed regions of retinotopic visual cortex using real-time functional MRI-based neurofeedback. After training, we tested participants using a new and previously untrained visual detection task that was presented at the visual field location corresponding to the trained region of visual cortex. Perceptual sensitivity was significantly enhanced only when participants who had previously learned control over ongoing activity were now exercising control and only for that region of visual cortex. Our new approach allows us to non-invasively and non-pharmacologically manipulate regionally specific brain activity and thus provide "brain training" to deliver particular perceptual enhancements. J Neurosci. 2012 Dec 5;32(49):17830-41. doi: 10.1523/JNEUROSCI.6334-11.2012. Scharnowski F, Hutton C, Josephs O, Weiskopf N, Rees G. Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, and UCL Institute of Cognitive Neuroscience, University College London, London WC1N 3AR, United Kingdom, Institute of Bioengineering, Swiss Institute of Technology (EPFL), CH-1015 Lausanne, Switzerland, and Department of Radiology and Medical Informatics, Center for Biomedical Imaging (CIBM), University of Geneva, CH-1211 Geneva 14, Switzerland.

Neuroimaging resolution of the altered state hypothesis.

Thu, 03 Jan 2013 13:48:00 -0500

A controversy in the field of hypnosis has centered on the question of whether there is a uniquely hypnotic state of consciousness and, if so, whether it is causally related to responsiveness to suggestion. Evidence from brain imaging studies has been used to support claims for various altered state hypotheses, without resolving the debate. The designs of many neuroimaging studies confound the induction of hypnosis with the suggestions that can be given in or out of hypnosis, thus rendering them incapable of resolving the controversy. Brain imaging studies that do not have this confound support the hypothesis that hypnotic inductions produce changes in brain activity, but also indicate that these changes are not required for the experience of hypnotic suggestions or their neural correlates. The data remain equivocal as to whether there is a causal relation between the changes in brain activity produced by hypnotic inductions and those produced by other suggestions. It also remains uncertain whether the changes in activation produced by hypnotic inductions reflect a uniquely hypnotic state as opposed to more mundane processes. Cortex. 2012 Sep 6. pii: S0010-9452(12)00244-4. doi: 10.1016/j.cortex.2012.08.005. Mazzoni G, Venneri A, McGeown WJ, Kirsch I. Department of Psychology, University of Hull, UK.

The mirror neuron system under hypnosis - Brain substrates of voluntary and involuntary...

Mon, 17 Dec 2012 16:17:00 -0500

Full title: The mirror neuron system under hypnosis - Brain substrates of voluntary and involuntary motor activation in hypnotic paralysis. The neurobiological basis of non-organic movement impairments is still unknown. As conversion disorder and hypnotic states share many characteristics, we applied an experimental design established in conversion disorder to investigate hypnotic paralysis. Movement imitation and observation were investigated by functional magnetic resonance imaging (fMRI) in 19 healthy subjects with and without hypnotically induced paralysis of their left hand. Paralysis-specific activation changes were explored in a multivariate model and functional interdependencies of brain regions by connectivity analysis. Hypnotic paralysis during movement imitation induced hypoactivation of the contralateral sensorimotor cortex (SMC) and ipsilateral cerebellum and increased activation of anterior cingulate cortex (ACC), frontal gyrus and insula. No paralysis-specific effects were revealed during movement observation. Hyperactivation of ACC, middle frontal gyrus (MFG), and insula might reflect attention (MFG), conflict-detection (ACC) and self-representation processes (insula) during hypnotic paralysis. The lack of effects in movement observation suggests that early motor processes are not disturbed due to the transient nature of the hypnotic impairment. Cortex. 2012 Jun 20. [Epub ahead of print] Burgmer M, Kugel H, Pfleiderer B, Ewert A, Lenzen T, Pioch R, Pyka M, Sommer J, Arolt V, Heuft G, Konrad C. Department of Psychosomatics and Psychotherapy, University Hospital Münster, Münster, Germany.

Increased sensory feedback in Tourette syndrome.

Sun, 02 Dec 2012 17:38:00 -0500

Tourette syndrome (TS) is a neuro-psychiatric disorder being characterized by motor and phonic tics typically preceded by sensory urges. Given the latter the role of the sensory system and sensorimotor interaction in TS has recently gained increased attention. 12 TS patients and 12 matched control subjects performed two tasks, requiring simple finger movements: a Go/NoGo task and a self paced movement task. Neurophysiological data was recorded using magnetoencephalography (MEG). Event related responses around movement onset, i.e. motor field (MF) occurring directly prior to the movement and movement evoked field (MEF) immediately after movement onset were analyzed using dipole modeling. MF peak amplitudes did not differ between groups in either task. In contrast, in both tasks MEF peak amplitudes were increased in TS patients. Moreover, larger MEF amplitudes during self paced movements were inversely correlated with motor tic frequency and severity. Enlarged MEF amplitudes as a marker of early sensory feedback of one's own movements probably represent enlarged sensory input from the periphery resulting from altered subcortical gating. We conclude that TS patients exhibit altered sensory-motor processing involved in voluntary movement control, which might also be successful in tic control. Neuroimage. 2012 Oct 15;63(1):119-25. Epub 2012 Jul 6. Biermann-Ruben K, Miller A, Franzkowiak S, Finis J, Pollok B, Wach C, Südmeyer M, Jonas M, Thomalla G, Müller-Vahl K, Münchau A, Schnitzler A. Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany.

Obsessive compulsive disorder and the efficacy of qEEG-guided neurofeedback treatment: a case series

Sun, 15 Jan 2012 16:08:00 -0500

While neurofeedback (NF) has been extensively studied in the treatment of many disorders, there have been only three published reports, by D.C. Hammond, on its clinical effects in the treatment of obsessive compulsive disorder (OCD). In this paper the efficacy of qEEG-guided NF for subjects with OCD was studied as a case series. The goal was to examine the clinical course of the OCD symptoms and assess the efficacy of qEEG guided NF training on clinical outcome measures. Thirty-six drug resistant subjects with OCD were assigned to 9-84 sessions of QEEG-guided NF treatment. Daily sessions lasted 60 minutes where 2 sessions with half-hour applications with a 30 minute rest given between sessions were conducted per day. Thirty-three out of 36 subjects who received NF training showed clinical improvement according to the Yale-Brown obsessive-compulsive scale (Y-BOCS). The Minnesota multiphasic inventory (MMPI) was administered before and after treatment to 17 of the subjects. The MMPI results showed significant improvements not only in OCD measures, but all of the MMPI scores showed a general decrease. Finally, according to the physicians' evaluation of the subjects using the clinical global impression scale (CGI), 33 of the 36 subjects were rated as improved. Thirty-six of the subjects were followed for an average of 26 months after completing the study. According to follow-up interviews conducted with them and/or their family members 19 of the subjects maintained the improvements in their OCD symptoms. This study provides good evidence for the efficacy of NF treatment in OCD. The results of this study encourage further controlled research in this area. Clin EEG Neurosci. 2011 Jul;42(3):195-201. Sürmeli T, Ertem A. Healthy Living Center for Research and Education, Istanbul, Turkey. neuropsychiatry@yahoo.com

Neurofeedback in ADHD: a single-blind randomized controlled trial.

Mon, 31 Oct 2011 16:11:00 -0500

Neurofeedback treatment has been demonstrated to reduce inattention, impulsivity and hyperactivity in children with attention deficit/hyperactivity disorder (ADHD). However, previous studies did not adequately control confounding variables or did not employ a randomized reinforcer-controlled design. This study addresses those methodological shortcomings by comparing the effects of the following two matched biofeedback training variants on the primary symptoms of ADHD: EEG neurofeedback (NF) aiming at theta/beta ratio reduction and EMG biofeedback (BF) aiming at forehead muscle relaxation. Thirty-five children with ADHD (26 boys, 9 girls; 6-14 years old) were randomly assigned to either the therapy group (NF; n = 18) or the control group (BF; n = 17). Treatment for both groups consisted of 30 sessions. Pre- and post-treatment assessment consisted of psychophysiological measures, behavioural rating scales completed by parents and teachers, as well as psychometric measures. Training effectively reduced theta/beta ratios and EMG levels in the NF and BF groups, respectively. Parents reported significant reductions in primary ADHD symptoms, and inattention improvements in the NF group were higher compared to the control intervention (BF, d (corr) = -.94). NF training also improved attention and reaction times on the psychometric measures. The results indicate that NF effectively reduced inattention symptoms on parent rating scales and reaction time in neuropsychological tests. However, regarding hyperactivity and impulsivity symptoms, the results imply that non-specific factors, such as behavioralcontingencies, self-efficacy, structured learning environment and feed-forward processes, may also contribute to the positive behavioural effects induced by neurofeedback training. Eur Child Adolesc Psychiatry. 2011 Sep;20(9):481-91. Epub 2011 Aug 13. Bakhshayesh AR, Hänsch S, Wyschkon A, Rezai MJ, Esser G. Department of Psychology, Faculty of Humanities, Yazd University, Yazd, Iran.

A new neurofeedback protocol for depression.

Wed, 28 Sep 2011 15:08:00 -0500

CONTEXT: Neurofeedback represents an exciting complementary option in the treatment of depression that builds upon a huge body of research on electroencephalographic correlates of depression. OBJECTIVE: The objectives of this article are threefold: review the literature on neurofeedback protocols for depression; introduce a new protocol, which aims to synthesize the best qualities of the currently available protocols; and present the results of a small clinical experiment with the new protocol. METHOD: Structured survey of the literature; software development; clinical trial with one subject, submitted to ten sessions of neurofeedback (one hour each). RESULTS: Currently there are twenty-one articles in neurofeedback for depression, among which only six present original experimental results. All of them report positive results with the technique. The most used protocols focus on Alpha inter-hemispheric asymmetry, and Theta/Beta ratio within the left prefrontal cortex. Our new protocol integrates both dimensions in a single circuit, adding to it a third programming line, which divides Beta frequencies and reinforces the decrease of Beta-3, in order to reduce anxiety. The favorable outcome of our clinical experiment, suggests that new research with this protocol is worthwhile. Span J Psychol. 2011 May;14(1):374-84. Dias AM, van Deusen A. Universidade Federal de São Paulo, Brazil. alvaromd@usp.br

Psychobiosocial interventions for autism.

Wed, 21 Sep 2011 15:08:00 -0500

A multitude of interventions is offered for the treatment of autism spectrum disorders (ASD). However, only few have demonstrated scientific evidence, and even the evaluated methods need further examination of their mechanisms and scope. This article provides a brief summary of the premises and principles of successful psychobiosocial ASD intervention. ABA, TEACCH, PECS, social skills and cognitive training are described as examples for established approaches to ASD. Training of µ-suppression using neurofeedback and reanimation of the fusiform gyrus and amygdala using computer-aided facial affect recognition training are introduced as neurobiologically based ASD interventions. Nervenarzt. 2011 May;82(5):590-596. Bölte S. Department of Women's and Children's Health, Karolinska Institutet Center of Neurodevelopmental Disorders (KIND), Astrid Lindgren Children's Hospital (Q2:07), 17176, Stockholm, Schweden, sven.bolte@ki.se.

Neurofeedback in children with ADHD: specific event-related potential findings...

Wed, 14 Sep 2011 15:07:00 -0500

Full title: Neurofeedback in children with ADHD: specific event-related potential findings of a randomized controlled trial. OBJECTIVE: In a randomized controlled trial, we could demonstrate clinical efficacy of neurofeedback (NF) training for children with ADHD (Gevensleben et al., 2009a). The present investigation aimed at learning more about the neuronal mechanisms of NF training. METHODS: Children with ADHD either completed a NF training or a computerized attention skills training (ratio 3:2). NF training consisted of one block of theta/beta training and one block of slow cortical potential (SCP) training, each comprising 18 training units. At three times (pre-training, between the two training blocks and at post-training), event-related potentials (ERP) were recorded during the Attention Network Test. ERP analysis focused on the P3, reflecting inter alia attentional resources for stimulus evaluation, and the contingent negative variation (CNV), primarily related to cognitive preparation. RESULTS: After NF training, an increase of the CNV in cue trials could be observed, which was specific for the SCP training. A larger pre-training CNV was associated with a larger reduction of ADHD symptomatology for SCP training. CONCLUSIONS: CNV effects reflect neuronal circuits underlying resource allocation during cognitive preparation. These distinct ERP effects are closely related to a successful NF training in children with ADHD. In future studies, neurophysiological recordings could help to optimize and individualize NF training. SIGNIFICANCE: The findings contribute to a better understanding of the mechanisms underlying NF training in children with ADHD. Clin Neurophysiol. 2011 May;122(5):942-50. Epub 2010 Sep 16. Wangler S, Gevensleben H, Albrecht B, Studer P, Rothenberger A, Moll GH, Heinrich H. Dept. of Child and Adolescent Mental Health, University of Erlangen-Nürnberg, Schwabachanlage 6+10, D-91054 Erlangen, Germany. Comment in Clin Neurophysiol. 2011 May;122(5):856-7.

Computer-Based Attention Training in the Schools for Children With Attention Deficit/Hyperactivity..

Wed, 07 Sep 2011 15:06:00 -0500

Full title: Computer-Based Attention Training in the Schools for Children With Attention Deficit/Hyperactivity Disorder: A Preliminary Trial. Objective. This study examined the efficacy of 2 computer-based training systems to teach children with attention deficit/hyperactivity disorder (ADHD) to attend more effectively. Design/methods. A total of 41 children with ADHD from 2 middle schools were randomly assigned to receive 2 sessions a week at school of either neurofeedback (NF) or attention training through a standard computer format (SCF), either immediately or after a 6-month wait (waitlist control group). Parents, children, and teachers completed questionnaires pre- and postintervention. Results. Primary parents in the NF condition reported significant (P < .05) change on Conners's Rating Scales-Revised (CRS-R) and Behavior Assessment Scales for Children (BASC) subscales; and in the SCF condition, they reported significant (P < .05) change on the CRS-R Inattention scale and ADHD index, the BASC Attention Problems Scale, and on the Behavioral Rating Inventory of Executive Functioning (BRIEF). Conclusion. This randomized control trial provides preliminary evidence of the effectiveness of computer-based interventions for ADHD and supports the feasibility of offering them in a school setting. Clin Pediatr (Phila). 2011 May 10. Steiner NJ, Sheldrick RC, Gotthelf D, Perrin EC. Floating Hospital for Children, Boston, MA, USA.

Decoding fMRI brain states in real-time.

Wed, 31 Aug 2011 15:05:00 -0500

This article reviews a technological advance that originates from two areas of ongoing neuroimaging innovation-(1) the use of multivariate supervised learning to decode brain states and (2) real-time functional magnetic resonance imaging (rtfMRI). The approach uses multivariate methods to train a model capable of decoding a subject's brain state from fMRI images. The decoded brain states can be used as a control signal for a brain computer interface (BCI) or to provide neurofeedback to the subject. The ability to adapt the stimulus during the fMRI experiment adds a new level of flexibility for task paradigms and has potential applications in a number of areas, including performance enhancement, rehabilitation, and therapy. Multivariate approaches to real-time fMRI are complementary to region-of-interest (ROI)-based methods and provide a principled method for dealing with distributed patterns of brain responses. Specifically, a multivariate approach is advantageous when network activity is expected, when mental strategies could vary from individual to individual, or when one or a few ROIs are not unequivocally the most appropriate for the investigation. Beyond highlighting important developments in rtfMRI and supervised learning, the article discusses important practical issues, including implementation considerations, existing resources, and future challenges and opportunities. Some possible future directions are described, calling for advances arising from increased experimental flexibility, improvements in predictive modeling, better comparisons across rtfMRI and other BCI implementations, and further investigation of the types of feedback and degree to which interface modulation is obtainable for various tasks. Neuroimage. 2011 May 15;56(2):440-54. Epub 2010 Jun 30. LaConte SM. Department of Neuroscience, Baylor College of Medicine, Houston, TX 77030, USA. slaconte@cpu.bcm.edu

Clinical Neurofeedback: Case Studies, Proposed Mechanism, and Implications for Pediatric Neurology..

Wed, 24 Aug 2011 15:04:00 -0500

Full title: Clinical Neurofeedback: Case Studies, Proposed Mechanism, and Implications for Pediatric Neurology Practice. Trends in alternative medicine use by American health care consumers are rising substantially. Extensive literature exists reporting on the effectiveness of neurofeedback in the treatment of autism, closed head injury, insomnia, migraine, depression, attention deficit hyperactivity disorder, epilepsy, and posttraumatic stress disorder. We speculated that neurofeedback might serve as a therapeutic modality for patients with medically refractory neurological disorders and have begun referring patients to train with clinical neurofeedback practitioners. The modality is not always covered by insurance. Confident their child's medical and neurological needs would continue to be met, the parents of 3 children with epilepsy spectrum disorder decided to have their child train in the modality. The children's individual progress following neurofeedback are each presented here. A proposed mechanism and practice implications are discussed. J Child Neurol. 2011 May 16. Legarda SB, McMahon D, Othmer S, Othmer S. Georgetown University Medical Center, Departments of Pediatrics and Neurology, Washington, DC.