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Mar 29, 2006

Effects of visual feedback therapy on postural control after stroke

Effects of visual feedback therapy on postural control in bilateral standing after stroke: a systematic review.

J Rehabil Med. 2006 Jan;38(1):3-9

Authors: Van Peppen RP, Kortsmit M, Lindeman E, Kwakkel G

OBJECTIVE: To establish whether bilateral standing with visual feedback therapy after stroke improves postural control compared with conventional therapy and to evaluate the generalization of the effects of visual feedback therapy on gait and gait-related activities. DESIGN: A systematic review. METHODS: A computer-aided literature search was performed. Randomized controlled trials and controlled clinical trials, comparing visual feedback therapy with conventional balance treatments were included up to April 2005. The methodological quality of each study was assessed with the the Physiotherapy Evidence Database scale. Depending on existing heterogeneity, studies with a common variable of outcome were pooled by calculating the summary effect-sizes using fixed or random effects models. RESULTS: Eight out of 78 studies, presenting 214 subjects, were included for qualitative and quantitative analysis. The methodological quality ranged from 3 to 6 points. The meta-analysis demonstrated non-significant summary effect-sizes in favour of visual feedback therapy for weight distribution and postural sway, as well as balance and gait performance, and gait speed. CONCLUSION: The additional value of visual feedback therapy in bilateral standing compared with conventional therapy shows no statistically significant effects on symmetry of weight distribution between paretic and non-paretic leg, postural sway in bilateral standing, gait and gait-related activities. Visual feedback therapy should not be favoured over conventional therapy. The question remains as to exactly how asymmetry in weight distribution while standing is related to balance control in patients with stroke.

Mar 28, 2006

Attention rehabilitation following stroke and traumatic brain injury

Attention rehabilitation following stroke and traumatic brain injury. A review.

Eura Medicophys. 2006 Mar;42(1):59-67

Authors: Michel JA, Mateer CA

Attentional capacities, which are frequently impaired following brain injury, have also been found to be amenable to rehabilitation. This review discusses various approaches to attention rehabilitation in adult clients following stroke and traumatic brain injury. Attention process training has been accepted by many as a practice standard in postacute clients, however, its ability to generalize to new situations and to functional capacities is unclear. There is evidence for the use of psychostimulant medication, which may be most helpful when prescribed in combination with attention training. Biofeedback is a new avenue for intervention and is beginning to show some promising RESULTS: Rather than train underlying processes, another approach which shows promising results in a few small studies is training clients on specific functional skills, such as driving or vocational duties. Finally, modifications to the environment, implementation of strategies, provision of emotional support, and introduction of external supports/aids are important parts of a rehabilitation program, especially as the client returns to their home environment.

Mar 27, 2006

Mantra Mouse

From Medgadget 

There is a small, hand-held and self contained GSR2 which has sold a half a million units and is already the largest selling Galvanic Skin Response monitoring device for home biofeedback. The GSR2 precisely monitors your stress levels by translating tiny tension-related changes in skin pores into a rising or falling tone. By resting two fingers on the sensing plates you learn to lower the pitch and your stress level.

What's My Mantra?

The GSR Temp 2X also includes a temperature sensor for monitoring heat levels in extremities. Stress also reduces blood flow to the hands, causing cooling. The GSR/Temp 2X home biofeedback system allows you to do "hand warming" biofeedback in addition to training with the GSR2 monitor, temperature sensor, body sensors for hands-free use, dual-sensitivity meter, earphone, instruction manual and a cassette with a short relaxation program.

Mar 23, 2006

Functional Magnetic Resonance Imaging Investigation of the Effects of Neurofeedback Training on Children

Functional Magnetic Resonance Imaging Investigation of the Effects of Neurofeedback Training on the Neural Bases of Selective Attention and Response Inhibition in Children with Attention-Deficit/Hyperactivity Disorder.

Appl Psychophysiol Biofeedback. 2006 Mar 22;

Authors: Beauregard M, Lévesque J

Two functional magnetic resonance imaging (fMRI) experiments were undertaken to measure the effect of neurofeedback training (NFT), in AD/HD children, on the neural substrates of selective attention and response inhibition. Twenty unmedicated AD/HD children participated to these experiments. Fifteen children were randomly assigned to the Experimental (EXP) group whereas the other five children were randomly assigned to the Control (CON) group. Only subjects in the EXP group underwent NFT. EXP subjects were trained to enhance the amplitude of the SMR (12-15 Hz) and beta 1 activity (15-18 Hz), and decrease the amplitude of theta activity (4-7 Hz). Subjects from both groups were scanned one week before the beginning of NFT (Time 1) and 1 week after the end of NFT (Time 2), while they performed a "Counting Stroop" task (Experiment 1) and a Go/No-Go task (Experiment 2). At Time 1, in both groups, the Counting Stroop task was associated with significant activation in the left superior parietal lobule. For the Go/No-Go task, no significant activity was detected in the EXP and CON groups. At Time 2, in both groups, the Counting Stroop task was associated with significant activation of the left superior parietal lobule. This time, however, there were significant loci of activation, in the EXP group, in the right ACC, left caudate nucleus, and left substantia nigra. No such activation loci were seen in CON subjects. For the Go/No-Go task, significant loci of activation were noted, in the EXP group, in the right ventrolateral prefrontal cortex, right ACcd, left thalamus, left caudate nucleus, and left substantia nigra. No significant activation of these brain regions was measured in CON subjects. These results suggest that NFT has the capacity to functionally normalize the brain systems mediating selective attention and response inhibition in AD/HD children.

Mar 17, 2006

USA Today: computer games and neurofeedback as a treatment

Via Mind Hacks

USA Today has an article about the use of computer games and neurofeedback as a treatment:

Whether speeding down a virtual street in Sony's Gran Turismo or slaying Spyro the Dragon, researchers hope games such as these will improve the lives of those with attention-deficit hyperactivity disorder, commonly known as ADHD, or cognitive-processing difficulties.

People with these disorders experience "constant frustration," says Henry Owens, a Melbourne, Fla., clinical psychologist who recently began offering a patented video game system, which evolved from NASA technology, to some of his patients.

"If they just play video games on their own, they will zone out," he says. "When they play on this system, if they zone out, the video game doesn't respond any more," acting as an incentive to improve focus and concentration.

 

Mar 09, 2006

How psychotherapy changes the brain

How psychotherapy changes the brain - the contribution of functional neuroimaging.

Mol Psychiatry. 2006 Mar 7;

Authors: Linden DE

A thorough investigation of the neural effects of psychotherapy is needed in order to provide a neurobiological foundation for widely used treatment protocols. This paper reviews functional neuroimaging studies on psychotherapy effects and their methodological background, including the development of symptom provocation techniques. Studies of cognitive behavioural therapy (CBT) effects in obsessive-compulsive disorder (OCD) were consistent in showing decreased metabolism in the right caudate nucleus. Cognitive behavioural therapy in phobia resulted in decreased activity in limbic and paralimbic areas. Interestingly, similar effects were observed after successful intervention with selective serotonin reuptake inhibitors (SSRI) in both diseases, indicating commonalities in the biological mechanisms of psycho- and pharmacotherapy. These findings are discussed in the context of current neurobiological models of anxiety disorders. Findings in depression, where both decreases and increases in prefrontal metabolism after treatment and considerable differences between pharmacological and psychological interventions were reported, seem still too heterogeneous to allow for an integrative account, but point to important differences between the mechanisms through which these interventions attain their clinical effects. Further studies with larger patient numbers, use of standardised imaging protocols across studies, and ideally integration with molecular imaging are needed to clarify the remaining contradictions. This effort is worthwhile because functional imaging can then be potentially used to monitor treatment effects and aid in the choice of the optimal therapy. Finally, recent advances in the functional imaging of hypnosis and the application of neurofeedback are evaluated for their potential use in the development of psychotherapy protocols that use the direct modulation of brain activity as a way of improving symptoms.

Mar 07, 2006

Effects of Biofeedback in Phonatory Disorders and Phonatory Performance

Effects of Biofeedback in Phonatory Disorders and Phonatory Performance: A Systematic Literature Review.

Appl Psychophysiol Biofeedback. 2006 Mar 3;

Authors: Maryn Y, De Bodt M, Van Cauwenberge P

The purpose of this article was to systematically review the literature on the effects of biofeedback therapy in the domain of phonatory disorders and phonatory performance, using studies in peer-reviewed journals. An extensive definition of biofeedback is given and its place in voice treatment is defined. Eighteen group or case studies or reports considering the effects of electromyographic, laryngoscopic and acoustic biofeedback in dysphonic patients (hyperfunctional voice disorders, hypofunctional voice disorders, psychogenic voice disorder, laryngeal trauma, total laryngectomy, vocal cord dysfunction) and participants with normal voices are included and an analysis of procedure as well as research design and results is presented. The usefulness of biofeedback in phonatory disorders and performance was to be interpreted based on tendencies, since there is a lack of randomized controlled efficacy studies. In only 3 of 18 studies (16.7%) did biofeedback therapy fail to improve voice quality or not result in better results than other forms of therapy. Recommendations for improved methodologies are made, which include the use of acoustic voice quality parameters.

Feb 28, 2006

Can neurofeedback training enhance performance?

Can neurofeedback training enhance performance? An evaluation of the evidence with implications for future research.

Appl Psychophysiol Biofeedback. 2005 Dec;30(4):347-64

Authors: Vernon DJ

There have been many claims regarding the possibilities of performance enhancement training. The aim of such training is for an individual to complete a specific function or task with fewer errors and greater efficiency, resulting in a more positive outcome. The present review examined evidence from neurofeedback training studies to enhance performance in a particular area. Previous research has documented associations between specific cortical states and optimum levels of performance in a range of tasks. This information provides a plausible rationale for the use of neurofeedback to train individuals to enhance their performance. An examination of the literature revealed that neurofeedback training has been utilised to enhance performance from three main areas; sport, cognitive and artistic performance. The review examined evidence from neurofeedback training studies within each of these three areas. Some suggestive findings have been reported with regard to the use of neurofeedback training to enhance performance. However, due to a range of methodological limitations and a general failure to elicit unambiguous changes in baseline EEG activity, a clear association between neurofeedback training and enhanced performance has yet to be established. Throughout, the review highlights a number of recommendations to aid and stimulate future research.

Attention rehabilitation following stroke and traumatic brain injury

Attention rehabilitation following stroke and traumatic brain injury. A review.

Eura Medicophys. 2006 Feb 1;

Authors: Michel JA, Mateer CA

Attentional capacities, which are frequently impaired following brain injury, have also been found to be amenable to rehabilitation. This review discusses various approaches to attention rehabilitation in adult clients following stroke and traumatic brain injury. Attention process training has been accepted by many as a practice standard in postacute clients, however, its ability to generalize to new situations and to functional capacities is unclear. There is evidence for the use of psychostimulant medication, which may be most helpful when prescribed in combination with attention training. Biofeedback is a new avenue for intervention and is beginning to show some promising RESULTS: Rather than train underlying processes, another approach which shows promising results in a few small studies is training clients on specific functional skills, such as driving or vocational duties. Finally, modifications to the environment, implementation of strategies, provision of emotional support, and introduction of external supports/aids are important parts of a rehabilitation program, especially as the client returns to their home environment.

Feb 26, 2006

Mind-operated devices: mental control of a computer using biofeedback

Mind-operated devices: mental control of a computer using biofeedback.

Cyberpsychol Behav. 2006 Feb;9(1):1-4

Authors: Parente A, Parente R

This study investigated whether people could learn to control a computer using a biofeedback interface that integrated their galvanic skin response (GSR), heart rate, and temperature. Twenty participants played a computer game using the biofeedback device, both individually and in pairs. Results indicated that most people learned to control the game after a single training session. The GSR measure was the most sensitive means of control. Pairs of participants controlled the device more effectively than single individuals did.

Feb 20, 2006

Exploring spike transfer through the thalamus using hybrid artificial-biological neuronal networks

Exploring spike transfer through the thalamus using hybrid artificial-biological neuronal networks.

J Physiol Paris. 2004 Jul-Nov;98(4-6):540-58

Authors: Debay D, Wolfart J, Le Franc Y, Le Masson G, Bal T

We use dynamic clamp to construct "hybrid" thalamic circuits by connecting a biological neuron in situ to silicon- or software-generated "neurons" through artificial synapses. The purpose is to explore cellular sensory gating mechanisms that regulate the transfer efficiency of signals during different sleep-wake states. Hybrid technology is applied in vitro to different paradigms such as: (1) simulating interactions between biological thalamocortical neurons, artificial reticular thalamic inhibitory interneurons and a simulated sensory input, (2) grafting an artificial sensory input to a wholly biological thalamic network that generates spontaneous sleep-like oscillations, (3) injecting in thalamocortical neurons a background synaptic bombardment mimicking the activity of corticothalamic inputs. We show that the graded control of the strength of intrathalamic inhibition, combined with the membrane polarization and the fluctuating synaptic noise in thalamocortical neurons, is able to govern functional shifts between different input/output transmission states of the thalamic gate.

Feb 18, 2006

Effect of age and timing of augmented feedback on learning muscle relaxation

Effects of age and timing of augmented feedback on learning muscle relaxation while performing a gross motor task

Am J Phys Med Rehabil. 2006 Feb;85(2):148-55; quiz 156-8

Authors: van Dijk H, Hermens HJ

OBJECTIVE: To examine the combined effect of age and timing of augmented feedback on learning muscle relaxation. Performing a gross motor task, subjects had to lower their trapezius muscle activity using the electromyographic signal as visual myofeedback. DESIGN: Healthy subjects (16 young adults: 20-35 yrs; and 16 older adults: 55-70 yrs) were randomly assigned to one of two timing conditions of myofeedback: concurrent (feedback was provided immediately during the trial) and terminal (feedback was provided delayed after the trial) condition. RESULTS: The results indicated that young adults had a higher level of motor performance (i.e., lower muscle activity) compared with older adults when myofeedback was provided. These effects persisted during short- (after 10 mins) and long-term retention (after 1 wk) when no myofeedback was provided. In contrast to young adults, older adults did not improve their performance throughout the experiment. There were no interactions of age with the timing conditions of myofeedback during acquisition and retention. CONCLUSIONS: Either timing condition of augmented feedback was equally helpful to young adults, whereas neither was helpful for older adults in learning muscle relaxation.

Feb 09, 2006

Train your brain with neurofeedback

The new edition of Scientific American Mind includes an interesting article on the use of neurofeedback to improve cognitive performance. I quote here an excerpt from the article

Such "mind reading" offers many possible applications. It has, for instance, enabled "locked-in" patients--who cannot speak or gesture--to communicate with caregivers [see "Thinking Out Loud," by Nicola Neumann and Niels Birbaumer; Scientific American Mind, Premier Issue, Vol. 14, No. 5, 2004]. By controlling their brain waves, the patients manipulate letters and words on a computer screen. Practice with neurofeedback may also benefit those who suffer from epilepsy, attention deficits, depression and other debilitating mental disorders. The experimental therapy, also called EEG biofeedback, may even help rev up healthy brains, improving cognitive performance.

Feb 07, 2006

Neurofeedback improves cognitive performance

Increasing individual upper alpha power by neurofeedback improves cognitive performance in human subjects.

Appl Psychophysiol Biofeedback. 2005 Mar;30(1):1-10

Authors: Hanslmayr S, Sauseng P, Doppelmayr M, Schabus M, Klimesch W

The hypothesis was tested of whether neurofeedback training (NFT)--applied in order to increase upper alpha but decrease theta power--is capable of increasing cognitive performance. A mental rotation task was performed before and after upper alpha and theta NFT. Only those subjects who were able to increase their upper alpha power (responders) performed better on mental rotations after NFT. Training success (extent of NFT-induced increase in upper alpha power) was positively correlated with the improvement in cognitive performance. Furthermore, the EEG of NFT responders showed a significant increase in reference upper alpha power (i.e. in a time interval preceding mental rotation). This is in line with studies showing that increased upper alpha power in a prestimulus (reference) interval is related to good cognitive performance.

Can neurofeedback training enhance performance?

Can neurofeedback training enhance performance? An evaluation of the evidence with implications for future research.

Appl Psychophysiol Biofeedback. 2005 Dec;30(4):347-64

Authors: Vernon DJ

There have been many claims regarding the possibilities of performance enhancement training. The aim of such training is for an individual to complete a specific function or task with fewer errors and greater efficiency, resulting in a more positive outcome. The present review examined evidence from neurofeedback training studies to enhance performance in a particular area. Previous research has documented associations between specific cortical states and optimum levels of performance in a range of tasks. This information provides a plausible rationale for the use of neurofeedback to train individuals to enhance their performance. An examination of the literature revealed that neurofeedback training has been utilised to enhance performance from three main areas; sport, cognitive and artistic performance. The review examined evidence from neurofeedback training studies within each of these three areas. Some suggestive findings have been reported with regard to the use of neurofeedback training to enhance performance. However, due to a range of methodological limitations and a general failure to elicit unambiguous changes in baseline EEG activity, a clear association between neurofeedback training and enhanced performance has yet to be established. Throughout, the review highlights a number of recommendations to aid and stimulate future research.

Feb 02, 2006

Effect of neurofeedback training on the neural substrates of selective attention

Effect of neurofeedback training on the neural substrates of selective attention in children with attention-deficit/hyperactivity disorder: A functional magnetic resonance imaging study.

Neurosci Lett. 2006 Feb 20;394(3):216-21

Authors: Lévesque J, Beauregard M, Mensour B

Attention Deficit Hyperactivity Disorder (AD/HD) is a neurodevelopmental disorder mainly characterized by impairments in cognitive functions. Functional neuroimaging studies carried out in individuals with AD/HD have shown abnormal functioning of the anterior cingulate cortex (ACC) during tasks involving selective attention. In other respects, there is mounting evidence that neurofeedback training (NFT) can significantly improve cognitive functioning in AD/HD children. In this context, the present functional magnetic resonance imaging (fMRI) study was conducted to measure the effect of NFT on the neural substrates of selective attention in children with AD/HD. Twenty AD/HD children-not taking any psychostimulant and without co-morbidity-participated to the study. Fifteen children were randomly assigned to the Experimental (EXP) group (NFT), whereas the other five children were assigned to the Control (CON) group (no NFT). Subjects from both groups were scanned 1 week before the beginning of the NFT (Time 1) and 1 week after the end of this training (Time 2), while they performed a Counting Stroop task. At Time 1, for both groups, the Counting Stroop task was associated with significant loci of activation in the left superior parietal lobule. No activation was noted in the ACC. At Time 2, for both groups, the Counting Stroop task was still associated with significant activation of the left superior parietal lobule. This time, however, for the EXP group only there was a significant activation of the right ACC. These results suggest that in AD/HD children, NFT has the capacity to normalize the functioning of the ACC, the key neural substrate of selective attention.

Control over brain activation and pain learned by using real-time functional MRI

Control over brain activation and pain learned by using real-time functional MRI.

Proc Natl Acad Sci USA. 2005 Dec 20;102(51):18626-31

Authors: deCharms RC, Maeda F, Glover GH, Ludlow D, Pauly JM, Soneji D, Gabrieli JD, Mackey SC

If an individual can learn to directly control activation of localized regions within the brain, this approach might provide control over the neurophysiological mechanisms that mediate behavior and cognition and could potentially provide a different route for treating disease. Control over the endogenous pain modulatory system is a particularly important target because it could enable a unique mechanism for clinical control over pain. Here, we found that by using real-time functional MRI (rtfMRI) to guide training, subjects were able to learn to control activation in the rostral anterior cingulate cortex (rACC), a region putatively involved in pain perception and regulation. When subjects deliberately induced increases or decreases in rACC fMRI activation, there was a corresponding change in the perception of pain caused by an applied noxious thermal stimulus. Control experiments demonstrated that this effect was not observed after similar training conducted without rtfMRI information, or using rtfMRI information derived from a different brain region, or sham rtfMRI information derived previously from a different subject. Chronic pain patients were also trained to control activation in rACC and reported decreases in the ongoing level of chronic pain after training. These findings show that individuals can gain voluntary control over activation in a specific brain region given appropriate training, that voluntary control over activation in rACC leads to control over pain perception, and that these effects were powerful enough to impact severe, chronic clinical pain.

Jan 19, 2006

Can neurofeedback training enhance performance?

Can neurofeedback training enhance performance? An evaluation of the evidence with implications for future research

Appl Psychophysiol Biofeedback. 2005 Dec;30(4):347-64

Authors: Vernon DJ

There have been many claims regarding the possibilities of performance enhancement training. The aim of such training is for an individual to complete a specific function or task with fewer errors and greater efficiency, resulting in a more positive outcome. The present review examined evidence from neurofeedback training studies to enhance performance in a particular area. Previous research has documented associations between specific cortical states and optimum levels of performance in a range of tasks. This information provides a plausible rationale for the use of neurofeedback to train individuals to enhance their performance. An examination of the literature revealed that neurofeedback training has been utilised to enhance performance from three main areas; sport, cognitive and artistic performance. The review examined evidence from neurofeedback training studies within each of these three areas. Some suggestive findings have been reported with regard to the use of neurofeedback training to enhance performance. However, due to a range of methodological limitations and a general failure to elicit unambiguous changes in baseline EEG activity, a clear association between neurofeedback training and enhanced performance has yet to be established. Throughout, the review highlights a number of recommendations to aid and stimulate future research.

Jan 18, 2006

Neurofeedback treatment for Attention Deficit Hyperactivity Disorder

Neurofeedback: an alternative and efficacious treatment for Attention Deficit Hyperactivity Disorder.

Appl Psychophysiol Biofeedback. 2005 Dec;30(4):365-73

Authors: Fox DJ, Tharp DF, Fox LC

Current research has shown that neurofeedback, or EEG biofeedback as it is sometimes called, is a viable alternative treatment for Attention Deficit Hyperactivity Disorder (ADHD). The aim of this article is to illustrate current treatment modalities(s), compare them to neurofeedback, and present the benefits of utilizing this method of treatment to control and potentially alleviate the symptoms of ADHD. In addition, this article examines the prevalence rates and possible etiology of ADHD, the factors associated with ADHD and brain dysfunction, the current pharmacological treatments of ADHD, Ritalin, and the potential risks and side effects. Behavior modification and cognitive behavioral treatment for ADHD is discussed as well. Lastly, a brief history of the study of neurofeedback, treatment successes and clinical benefits, comparisons to medication, and limitations are presented.

Jan 17, 2006

Computerized balance retraining

Physical and occupational therapists at Rush University Medical Center are using diagnostic technology and computerized balance retraining device for patients with disequilibrium, dizziness, orthopedic or head injuries regain their stability.
The computerized balance retraining device uses visual biofeedback, coupled with sensitive, real-time monitoring of patient movement on a force platform. According to Rush UMC rehabilitation professionals, the method improves a patient’s overall balance through motivating protocols that can be progressed as the patient‘s capabilities improve.