cognitive impairment
Research Papers
Benefits of a 12-Week Non-Drug “Brain Fitness Program” for Patients with Attention-Deficit/Hyperactive Disorder, Post-Concussion Syndrome, or Memory Loss
Background: Non-pharmacologic interventions can potentially improve cognitive function, sleep, and/or mood in patients with attention-deficit/hyperactive disorder (ADHD), post-concussion syndrome (PCS), or memory loss. Objective: We evaluated the benefits of a brain rehabilitation program in an outpatient neurology practice that consists of targeted cognitive training, lifestyle coaching, and electroencephalography (EEG)-based neurofeedback, twice weekly (90 minutes each), for 12 weeks. Methods: 223 child and adult patients were included: 71 patients with ADHD, 88 with PCS, and 64 with memory loss (mild cognitive impairment or subjective cognitive decline). Patients underwent a complete neurocognitive evaluation, including tests for Verbal Memory, Complex Attention, Processing Speed, Executive Functioning, and Neurocognition Index. They completed questionnaires about sleep, mood, diet, exercise, anxiety levels, and depression—as well as underwent quantitative EEG—at the beginning and the end of the program. Results: Pre-post test score comparison demonstrated that all patient subgroups experienced statistically significant improvements on most measures, especially the PCS subgroup, which experienced significant score improvement on all measures tested (p≤0.0011; dz≥0.36). After completing the program, 60% to 90% of patients scored higher on cognitive tests and reported having fewer cognitive and emotional symptoms. The largest effect size for pre-post score change was improved executive functioning in all subgroups (ADHD dz= 0.86; PCS dz= 0.83; memory dz= 1.09). Conclusion: This study demonstrates that a multimodal brain rehabilitation program can have benefits for patients with ADHD, PCS, or memory loss and supports further clinical trials in this field.
View Full Paper →Cognitive training based on functional near-infrared spectroscopy neurofeedback for the elderly with mild cognitive impairment: a preliminary study
Introduction Mild cognitive impairment (MCI) is often described as an intermediate stage of the normal cognitive decline associated with aging and dementia. There is a growing interest in various non-pharmacological interventions for MCI to delay the onset and inhibit the progressive deterioration of daily life functions. Previous studies suggest that cognitive training (CT) contributes to the restoration of working memory and that the brain-computer-interface technique can be applied to elicit a more effective treatment response. However, these techniques have certain limitations. Thus, in this preliminary study, we applied the neurofeedback paradigm during CT to increase the working memory function of patients with MCI. Methods Near-infrared spectroscopy (NIRS) was used to provide neurofeedback by measuring the changes in oxygenated hemoglobin in the prefrontal cortex. Thirteen elderly MCI patients who received CT-neurofeedback sessions four times on the left dorsolateral prefrontal cortex (dlPFC) once a week were recruited as participants. Results Compared with pre-intervention, the activity of the targeted brain region increased when the participants first engaged in the training; after 4 weeks of training, oxygen saturation was significantly decreased in the left dlPFC. The participants demonstrated significantly improved working memory compared with pre-intervention and decreased activity significantly correlated with improved cognitive performance. Conclusion Our results suggest that the applications for evaluating brain-computer interfaces can aid in elucidation of the subjective mental workload that may create additional or decreased task workloads due to CT.
View Full Paper →One-Year Follow-Up of Healthy Older Adults with Electroencephalographic Risk for Neurocognitive Disorder After Neurofeedback Training
Background: In healthy older adults, excess theta activity is an electroencephalographic (EEG) predictor of cognitive impairment. In a previous study, neurofeedback (NFB) treatment reinforcing reductions theta activity resulted in EEG reorganization and cognitive improvement. Objective: To explore the clinical applicability of this NFB treatment, the present study performed a 1-year follow-up to determine its lasting effects. Methods: Twenty seniors with excessive theta activity in their EEG were randomly assigned to the experimental or control group. The experimental group received an auditory reward when the theta absolute power (AP) was reduced. The control group received the reward randomly. Results: Both groups showed a significant decrease in theta activity at the training electrode. However, the EEG results showed that only the experimental group underwent global changes after treatment. These changes consisted of delta and theta decreases and beta increases. Although no changes were found in any group during the period between the posttreatment evaluation and follow-up, more pronounced theta decreases and beta increases were observed in the experimental group when the follow-up and pretreatment measures were compared. Executive functions showed a tendency to improve two months after treatment which became significant one year later. Conclusion: These results suggest that the EEG and behavioral benefits of this NFB treatment persist for at least one year, which adds up to the available evidence contributing to identifying factors that increase its efficacy level. The relevance of this study lies in its prophylactic features of addressing a clinically healthy population with EEG risk of cognitive decline.
View Full Paper →The effect of EEG biofeedback on reducing postcancer cognitive impairment
BACKGROUND AND HYPOTHESES: Postcancer cognitive impairment (PCCI) is observed in a substantial number of breast cancer survivors, persisting for as long as 20 years in some subgroups. Although compensatory strategies are frequently suggested, no restorative interventions have yet been identified. This study examined the feasibility of EEG biofeedback ("neurofeedback") and its potential effectiveness in reducing PCCI as well as the fatigue, sleep disturbance, and psychological symptoms that frequently accompany PCCI. STUDY DESIGN: This was a 6-month prospective study with a waitlist control period followed by an active intervention. Participants were female breast cancer survivors (n = 23), 6 to 60 months postchemotherapy, with self-reported cognitive impairment. METHODS: Four self-report outcome measures (Functional Assessment of Cancer Therapy-Cognitive Function [FACT-Cog], Functional Assessment of Chronic Illness Therapy-Fatigue [FACIT-Fatigue], Pittsburgh Sleep Quality Index [PSQI], and Brief Symptom Inventory [BSI]-18) were administered 3 times during a 10-week waitlist control period, 3 times during a 10-week (20-session) neurofeedback training regimen, and once at 4 weeks postneurofeedback. RESULTS: All 23 participants completed the study, demonstrating the feasibility of EEG biofeedback in this population. Initially, the sample demonstrated significant dysfunction on all measures compared with general population norms. Repeated-measures ANOVAs revealed strongly significant improvements (P < .001) on all 4 cognitive measures (perceived cognitive impairment, comments from others, perceived cognitive abilities, and impact on quality of life [QOL]), the fatigue scale, and the 4 psychological scales (somatization, depression, anxiety and global severity index) as well as on 3 of 8 sleep scales (quality, daytime dysfunction, and global). Two of the other sleep scales (latency and disturbance) were significant at P < .01, and 1 (use of medication) at P < .05; 2 were not significant. Improvements were generally linear across the course of training, and were maintained at the follow-up testing. At the follow-up testing, the sample no longer differed significantly from normative populations on 3 of the 4 FACT-Cog measures (impairment, impact on QOL, and comments), FACIT-Fatigue, PSQI sleep quality and habitual efficiency, or any of the BSI-18 measures of psychological disturbance. CONCLUSIONS: Data from this limited study suggest that EEG biofeedback has potential for reducing the negative cognitive and emotional sequelae of cancer treatment as well as improving fatigue and sleep patterns.
View Full Paper →Neurofeedback Training to Enhance Learning and Memory in Patients with Cognitive Impairment
The brain tumours can make cognitive impairment especially when they involve the limbic system, the frontal or temporal lobes. The aim of the present study was to examine neurofeedback training (NFT) to enhance learning and memory in patients with cognitive impairment. Single case pre- and post-intervention study was adopted. The qEEG WISC-IV and CBCL test was compared pre and post NFT. Patient was given 40 sessions of NFT, 45 min / day, 3 days a week. The training incorporated video feedback to increase the frequency of Beta waves (15-18 Hz) and to decrease theta waves (3-7 Hz) in T3 and F3. Also, SMR training was performed in Cz to decrease the seizure attacks. qEEG showed prominent different in the brain activity. Results indicated decrease in theta and increase in Beta waves. The present study puts forward that NFT should be taken into account to plan for rehabilitation of patients with cognitive impairment for enhancement of performance in the school or university.
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