The covariation of independent and dependant variables in neurofeedback: A proposal framework to identify cognitive processes and brain activity variables

This methodological article proposes a framework for analysing the relationship between cognitive processes and brain activity using variables measured by neurofeedback (NF) carried out by functional Magnetic Resonance Imagery (fMRI NF). Cognitive processes and brain activity variables can be analysed as either the dependant variable or the independent variable. Firstly, we propose two traditional approaches, defined in the article as the “neuropsychological” approach (NP) and the “psychophysiology” approach (PP), to extract dependent and independent variables in NF protocols. Secondly, we suggest that NF can be inspired by the style of inquiry used in neurophenomenology. fMRI NF allows participants to experiment with his or her own cognitive processes and their effects on brain region of interest (ROI) activations simultaneously. Thus, we suggest that fMRI NF could be improved by implementing “the elicitation interview method”, which allows the investigator to gather relevant verbatim from participants’ introspection on subjective experiences.     

Clinical efficacy and potential mechanisms of neurofeedback

Although many psychological disorders have significant basis in neurobiological dysfunction, most treatment approaches either neglect biological aspects of the problem, or approach dysfunction through pharmacological treatment alone, which may expose individuals to negative side effects. In recent decades, neurofeedback has been promoted as an alternative approach to treating neurobiological dysfunction. Neurofeedback helps individuals gain control over subtle brain activity fluctuations through real-time rewards for pre-established target brainwave frequencies at specific cortical locations. This paper reviews the effectiveness of neurofeedback in a range of conditions, including ADHD, autism spectrum disorders, substance use, PTSD, and learning difficulties. Neurofeedback has emerged as superior or equivalent to either alternative or no treatment in many of the examined studies, suggesting it produces some effects worthy of further examination. In light of its potential to address neurobiological dysfunction directly, future research is suggested in order to refine protocols, as well as to establish effectiveness and efficacy. Potential mechanisms of neurofeedback are discussed, including global connectivity, neuroplasticity, and reinforcement of the default mode network, central executive network, and salience network.     

Effect of neurofeedback on hemispheric word recognition

We applied SMR/theta neurofeedback (NF) training at central sites of 20 Israeli children aged 10-12 years, half boys and half girls. Half of the subjects received C3 training and the other half C4 training, consisting of 20 half-hour sessions. We assessed the effects of training on lateralized lexical decision in Hebrew. The lateralized lexical decision test reveals an independent contribution of each hemisphere to word recognition (Barnea, Mooshagian, & Zaidel, 2003). Training increased accuracy and sensitivity. It increased left hemisphere (LH) specialization under some conditions but it did not affect interhemispheric transfer. Training did affect psycholinguistic processing in the two hemispheres, differentially at C3 and C4. Training also increased hemispheric independence. There were surprising sex differences in the effects of training. In boys, C4 training improved LH accuracy, whereas in girls C3 training improved LH accuracy. The results suggest that the lateralized NF protocol activates asymmetric hemispheric control circuits which modify distant hemispheric networks and are organized differently in boys and girls.     

Influence of electroencephalography neurofeedback training on episodic memory: A randomized,sham-controlled,double-blind study

The relationships between memory processes and oscillatory electroencephalography (EEG) are well established. Neurofeedback training (NFT) may cause participants to better regulate their brain EEG oscillations. The present study is a double-blind sham-controlled design investigating the effect of NFT on memory. NFT included up-training upper alpha (UA) band, up-training sensory-motor rhythm (SMR) band and sham protocol. Thirty healthy adult volunteers were randomly divided into three treatment groups. NFT sessions (30 min each) took place twice weekly for a total of 10 sessions while memory testing took place pre- and post-training. The results indicate dissociation between SMR and UA NFT and different memory processes. While the SMR protocol resulted in improving automatic, item-specific and familiarity-based processes in memory, the UA protocol resulted in improved strategic and controlled recollection. The implications of the results are discussed.     

Neurofeedback Treatment of Depression and Anxiety

A robust body of research documents that there are biological predispositions that often exist for depression, anxiety, and obsessive–compulsive disorder. However, new research has shown that medication is only mildly more effective than placebo in the treatment of these problems. In treating these conditions, neurofeedback (EEG biofeedback) may offer an alternative to invasive treatments such as medication, ECT, and intense levels of transcrancial magnetic stimulation. This paper reviews the neurofeedback literature with these problems, finding particularly positive research support for the treatment of anxiety disorders. New findings on the neurofeedback treatment of depression are presented.     

Generalization of skills between operant control and discrimination of EEG alpha

While biofeedback is often said to increase self-control of physiological states by increasing awareness of their subjective correlates, relatively few studies have analyzed the relationship between control (standard biofeedback) and awareness (a discrimination paradigm). We hypothesized that the two skills would generalize and facilitate each other for 8–12 Hz EEG amplitude (alpha). Participants were given 7 sessions of training to either control or discriminate Pz alpha followed by 3 sessions of the other paradigm. Another group was given 7 sessions with time divided equally between the two types of training. The control-training first group showed significant generalization of skills to the discrimination task. However, the reverse was not true, and the combined task group did no better in either task than the other two groups. These results provide ambivalent support for the role of awareness in biofeedback, and suggest possible improvements in the discrimination paradigm.     

Advances in functional brain imaging technology and developmental neuro‐psychology: their applications in the Jungian analytic domain

Analytical psychology shares with many other psychotherapies the important task of repairing the consequences of developmental trauma. The majority of analytic patients come from compromised early developmental backgrounds: they may have experienced neglect, abuse, or failures of empathic resonance from their carers. Functional brain imagery techniques including Quantitative Electroencephalogram (QEEG), and functional Magnetic Resonance Imagery (fMRI), allow us to track mental processes in ways beyond verbal reportage and introspection. This independent perspective is useful for developing new psychodynamic hypotheses, testing current ones, providing diagnostic markers, and monitoring treatment progress. Jung, with the Word Association Test, grasped these principles 100 years ago. Brain imaging techniques have contributed to powerful recent advances in our understanding of neurodevelopmental processes in the first three years of life. If adequate nurturance is compromised, a range of difficulties may emerge. This has important implications for how we understand and treat our psychotherapy clients. The paper provides an overview of functional brain imaging and advances in developmental neuropsychology, and looks at applications of some of these findings (including neurofeedback) in the Jungian psychotherapy domain.