SMR neurofeedback
Research Papers
Effects of SMR Neurofeedback on Cognitive Functions in an Adult Population with Sleep Problems: A Tele-neurofeedback Study
A good night's sleep is vital for normal human cognitive performance. We earlier reported that a home-based tele-neurofeedback program effectively reduced sleep problems (Krepel et al. in Appl Psychophysiol Biofeedback, https://doi.org/10.1007/s10484-021-09525-z , 2021). The present article presents a follow-up on this earlier study and investigates improvements in cognitive functions after sensory-motor rhythm (SMR) neurofeedback. Thirty-seven participants reporting sleep problems received SMR neurofeedback. Cognitive measures were assessed pre- and post-treatment. Measurements included a continuous performance/working memory (CPT/WM) task, Stroop task, and Trailmaking A and B test (from the IntegNeuro cognitive test battery). For neurofeedback-Learners relative to non-Learners significantly improved CPT/WM response time (d = 0.50), omission errors (d = 0.67), and Stroop incongruent performance (d = 0.72) were found. A significant time effect for both groups were found for the Stroop, the Trailmaking test part B (d = 0.52), and the Stroop interference score (d = 0.55). No significant correlations between changes in sleep and changes in cognition (p > 0.05) were found for the sample. SMR neurofeedback specifically improved measures of attention (response time and omission errors in a CPT/WM test) and working memory (Stroop incongruent) for SMR Learners compared to non-Learners with medium effect sizes. Furthermore, overall improvements for the whole sample were found on measures of executive function and visual attention, possibly reflecting non-specific or practice effects. Future better powered randomized control trials are needed to investigate if cognitive improvements are a direct effect of SMR neurofeedback or mediated by sleep improvements.
View Full Paper →A Single Session of SMR-Neurofeedback Training Improves Selective Attention Emerging from a Dynamic Structuring of Brain–Heart Interplay
Research on sensorimotor rhythms (SMR) based on neurofeedback (NFb) emphasizes improvements in selective attention associated with SMR amplification. However, the long-term training proposed in most studies posed the question of acceptability, which led to the evaluation of the potential of a single NFb session. Based on cognitive and autonomic controls interfering with attention processes, we hypothesized changes in selective attention after a single SMR-NFb session, along with changes in brain–heart interplay, which are reflected in the multifractality of heartbeat dynamics. Here, young healthy participants (n = 35, 20 females, 21 ± 3 years) were randomly assigned either to a control group (Ctrl) watching a movie or to a neurofeedback (NFb) group performing a single session of SMR-NFb. A headset with EEG electrodes (positioned on C3 and C4) connected to a smartphone app served to guide and to evaluate NFb training efficacy. A Stroop task was performed for 8 min by each group before and after the intervention (movie vs. SMR-NFb) while collecting heart rate variability and C4-EEG for 20 min. When compared to Ctrl, the NFb group exhibited better Stroop performance, especially when facing incongruent trials. The multifractality and NFb training efficacy were identified as strong predictors of the gain in global Stroop performance, while multifractality was the only predictor regarding incongruent trials. We conclude that a single session of SMR-NFb improves selective attention in healthy individuals through the specific reorganization of brain–heart interplay, which is reflected in multifractal heartbeat dynamics.
View Full Paper →Differential effects of theta/beta and SMR neurofeedback in ADHD on sleep onset latency
Recent studies suggest a role for sleep and sleep problems in the etiology of attention deficit hyperactivity disorder (ADHD) and a recent model about the working mechanism of sensori-motor rhythm (SMR) neurofeedback, proposed that this intervention normalizes sleep and thus improves ADHD symptoms such as inattention and hyperactivity/impulsivity. In this study we compared adult ADHD patients (N = 19) to a control group (N = 28) and investigated if differences existed in sleep parameters such as Sleep Onset Latency (SOL), Sleep Duration (DUR) and overall reported sleep problems (PSQI) and if there is an association between sleep-parameters and ADHD symptoms. Secondly, in 37 ADHD patients we investigated the effects of SMR and Theta/Beta (TBR) neurofeedback on ADHD symptoms and sleep parameters and if these sleep parameters may mediate treatment outcome to SMR and TBR neurofeedback. In this study we found a clear continuous relationship between self-reported sleep problems (PSQI) and inattention in adults with- and without-ADHD. TBR neurofeedback resulted in a small reduction of SOL, this change in SOL did not correlate with the change in ADHD symptoms and the reduction in SOL only happened in the last half of treatment, suggesting this is an effect of symptom improvement not specifically related to TBR neurofeedback. SMR neurofeedback specifically reduced the SOL and PSQI score, and the change in SOL and change in PSQI correlated strongly with the change in inattention, and the reduction in SOL was achieved in the first half of treatment, suggesting the reduction in SOL mediated treatment response to SMR neurofeedback. Clinically, TBR and SMR neurofeedback had similar effects on symptom reduction in ADHD (inattention and hyperactivity/impulsivity). These results suggest differential effects and different working mechanisms for TBR and SMR neurofeedback in the treatment of ADHD
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