SMR training
Research Papers
Showing 6 of 7Behavioral effects of neurofeedback in adolescents with ADHD: a randomized controlled trial
Neurofeedback has been proposed as a potentially effective intervention for reducing Attention Deficit Hyperactivity Disorder (ADHD) symptoms. However, it remains unclear whether neurofeedback is of additional value to treatment as usual (TAU) for adolescents with clinical ADHD symptoms. Using a multicenter parallel-randomized controlled trial design, adolescents with ADHD symptoms were randomized to receive either a combination of TAU and neurofeedback (NFB + TAU, n = 45) or TAU-only (n = 26). Randomization was computer generated and stratified for age group (ages 12 through 16, 16 through 20, 20 through 24). Neurofeedback treatment consisted of approximately 37 sessions of theta/sensorimotor rhythm (SMR)-training on the vertex (Cz). Primary behavioral outcome measures included the ADHD-rating scale, Youth Self Report, and Child Behavior Checklist all assessed pre- and post-intervention. Behavioral problems decreased equally for both groups with medium to large effect sizes, range of partial η2 = 0.08–0.31, p < 0.05. Hence, the combination of NFB + TAU was not more effective than TAU-only on the behavioral outcome measures. In addition, reported adverse effects were similar for both groups. On behavioral outcome measures, the combination of neurofeedback and TAU was as effective as TAU-only for adolescents with ADHD symptoms. Considering the absence of additional behavioral effects in the current study, in combination with the limited knowledge of specific treatment effects, it is questionable whether theta/SMR neurofeedback for adolescents with ADHD and comorbid disorders in clinical practice should be used. Further research is warranted to investigate possible working mechanisms and (long-term) specific treatment effects of neurofeedback.
View Full Paper →Beneficial outcome from EEG-neurofeedback on creative music performance, attention and well-being in school children
We earlier reported benefits for creativity in rehearsed music performance from alpha/theta (A/T) neurofeedback in conservatoire studies (Egner & Gruzelier, 2003) which were not found with SMR, Beta1, mental skills, aerobics or Alexander training, or in standby controls. Here the focus was the impact on novice music performance. A/T and SMR training were compared in 11-year old school children along with non-intervention controls with outcome measures not only of rehearsed music performance but also of creative improvisation, as well as sustained attention and phenomenology. Evidence of effective learning in the school setting was obtained for A/T and SMR/beta2 ratios. Preferential benefits from A/T for rehearsed music performance were replicated in children for technique and communication ratings. Benefits extended to creativity and communication ratings for creative improvisation which were shared with SMR training, disclosing an influence of SMR on unrehearsed music performance at a novice level with its greater cognitive demands. In a first application of A/T for improving sustained attention (TOVA), it was found to be more successful than SMR training, with a notable reduction in commission errors in the children, 15/33 of whom had attention indices in the ADHD range. Phenomenological reports were in favour of neurofeedback and well-being benefits. Implementing neurofeedback in the daily school setting proved feasible and holds pedagogic promise.
View Full Paper →Effects of Neurofeedback Training on Attention in Children with Intellectual Disability
This study investigated effects of neurofeedback (NFB) training on attention in children with intellectual disability (ID). Twenty-one children with ID were assigned to an NFB training group (n = 7), to a visual perception (VP) training group (n = 7), or to a no-treatment group (n = 7). Two groups received 36 sessions of NFB or VP training, respectively, over 12 weeks. Children's Color Trails Test-2, Stroop Color and Word Test, and Digit Span were administered to all participants before and after training. The follow-up study was conducted with both the NFB and VP groups in the same way after 3 months. The EEGs of the NFB group also were measured. The NFB group showed significantly improved scores on the all tests compared to the 2 control groups. The brainwaves of the frontal lobes of the NFB group declined significantly in theta wave amplitude and theta-to-beta ratio. The NFB results were maintained in the follow-up study. Beta/SMR uptraining seemed to be an effective way to enhance attention in children with ID.
View Full Paper →Comparison of Discrete-Trial-Based SMR and SCP Training and the Interrelationship Between SCP and SMR Networks: Implications for Brain–Computer Interfaces and Neurofeedback
Background. Operant conditioning of one's slow cortical potential (SCP) or sensorimotor rhythm (SMR) can be used to control epilepsy or to manipulate external devices, as applied in BCI (Brain-Computer Interface). A commonly accepted view that both SCP and SMR are reflections of central arousal suggests a functional relationship between SCP and SMR networks. Method. The operant conditioning of SCP or SMR was tested with a single electroencephalographic (EEG) channel wireless biofeedback system. A series of trainings taught 19 participants to control SCP or SMR over vertex during 20 neurofeedback sessions. Each session consisted of 96 trials to decrease cortical arousal (SCP positivity/SMR enhancement) and 64 trials to increase cortical arousal (SCP negativity/SMR suppression). In each trial, participants were required to exceed an individual threshold level of the feedback parameter relative to a 500-msec prefeedback baseline and to hold this level for 2 sec (SCP) or 0.5 sec (SMR) to obtain reinforcement. Results. Ten of the 19 participants achieved control over their EEG. In the SCP-trained group, 4 of 9 participants increased the differentiation between their SCP responses on positivity-required versus negativity-required trials. SMR suppression and enhancement was achieved by 3 and 4 of the 10 SMR-trained participants. The SMR-trained responders did not show differentiation in their SMR responses, but did show a differentiation in their SCP response—while trained on SMR. Conclusions. The results showed the proposed method was successful to teach control of SCP or SMR. Bidirectional control was very difficult to achieve with the present SMR training procedure. SCP positivity and SMR enhancement were easier to learn. The results suggest that SMR training modulates excitability thresholds in the striatal-thalamocortical motor loop, whereas changes in the loop's excitability thresholds by SCP training do not affect the thalamic bursting that underlies the SMR.
View Full Paper →ERPs correlates of EEG relative beta training in ADHD children
Eighty-six children (ages 9–14) with attention deficit hyperactivity disorder (ADHD) participated in this study. Event-related potentials (ERPs) were recorded in auditory GO/NOGO task before and after 15–22 sessions of EEG biofeedback. Each session consisted of 20 min of enhancing the ratio of the EEG power in 15–18 Hz band to the EEG power in the rest of spectrum, and 7–10 min of enhancing of the ratio of the EEG power in 12–15 Hz to the EEG power in the rest of spectrum with C3-Fz electrodes' placements for the first protocol and C4-Pz for the second protocol. On the basis of quality of performance during training sessions, the patients were divided into two groups: good performers and bad performers. ERPs of good performers to GO and NOGO cues gained positive components evoked within 180–420 ms latency. At the same time, no statistically significant differences between pre- and post-training ERPs were observed for bad performers. The ERP differences between post- and pretreatment conditions for good performers were distributed over frontal–central areas and appear to reflect an activation of frontal cortical areas associated with beta training.
View Full Paper →Interhemispheric EEG Training
Early clinical experience in this field with what has been commonly called beta/SMR training, as opposed to alpha/theta, primarily involved training on the central (sensorimotor) strip. Our initial EEG training beginning in 1988 followed the work of Margaret Ayers, Barry Sterman, Joel Lubar and Michael Tansey by training either beta (nominally 15-18 Hz) or SMR (nominally 12-15 Hz) left, right or center on the central strip. Our experience with training left and right hemispheres separately with different reward frequencies actually led us to resist interhemispheric training for some time. Even though we were aware of the work of Quirk and Von Hilsheimer with C3-C4 SMR, we could not see how two hemispheres that needed to train at different frequencies could be trained together effectively with one reward frequency. Over time we developed the approach of balancing left-side beta and right-side SMR training for each individual in every session. It was clear that left-side training was more effective and more comfortable with a slightly higher frequency reward than that for right-side training. There emerged an identification of left-side deficits with under-activation and right-side deficits with overarousal. Since there was also an arousal shift for the entire physiology as we rewarded higher (beta) or lower (SMR) frequencies, we found that we needed to balance left-side activation with right-side calming for each individualaccordingtoarousallevel,symptomsandsensitivitytotraining.
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