Konstanz, Univ., Diplomarbeit, 2007.

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2017-02-16T15:02:15Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Thiago Nunes de Azevedo Ferraz de Carvalho-MESTRADO-UFPE-06_09_16_VERSÃO FINAL (8).pdf: 1548235 bytes, checksum: 82080c12d5957b065b2228463993993b (MD5) / Made available in DSpace on 2017-02-16T15:02:15Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Thiago Nunes de Azevedo Ferraz de Carvalho-MESTRADO-UFPE-06_09_16_VERSÃO FINAL (8).pdf: 1548235 bytes, checksum: 82080c12d5957b065b2228463993993b (MD5) Previous issue date: 2016-06-28 / CNPq / Introdução: A migrânea (Mi) é caracterizada por manifestações álgicas de intensidade moderada a forte, acompanhada por sintomas como náuseas e/ou vômitos, sendo frequentemente incapacitante para crianças e adolescentes, limitando inclusive suas atividades de vida diária. É durante a juventude que as manifestações referidas pelos jovens que sofrem de Mi se apresentam com maior intensidade, frequência e duração. A Mi representa uma das principais causas de queixa entre crianças e adolescentes em Neurologia Pediátrica e é a dor mais comum referida na Infância. Objetivo: Avaliar os resultados obtidos com o treinamento cerebral utilizando o NFB em adolescentes e adultos jovens com diagnóstico de migrânea como alternativa terapêutica não-farmacológica. Método: Ensaio clínico aberto com caráter analítico, descritivo e de intervenção. Foram triados 21 participantes que sofriam de migrânea com e sem aura para realizar treinamento cerebral com neurofeedback seguindo a eletroencefalografia quantitativa + hemoencefalografia. Além disso, foi descrito todo o processo de pesquisa envolvendo o uso do neurofeedback e dificuldades encontradas na adesão ao tratamento. Resultados: Dos 21 participantes, 10 eram do sexo masculino e 11 do sexo feminino. Para relatar as dificuldades encontradas no grupo de não respondedores, ou seja, o grupo que não aderiu ao treinamento cerebral envolvendo o neurofeedback, propusemos uma entrevista guiada por questionário. Após 20 sessões propostas os participantes treinados apresentaram estabilidade das crises e das queixas com relação a frequência, intensidade e duração da dor. Conclusão: O presente estudo demonstra um importante significado clínico observando a melhoria da população estudada, vinculada à modalidade terapêutica escolhida. É positivo pensar nesse estudo como gerador de interesse em realizar estudos de larga escala, controlados e randomizados na neuroterapia não invasiva para tratar a migrânea e outras doenças crônicas ou desordens progressivas. / Introduction: Migraine (Mi) is characterized by painful manifestations of moderate to strong intensity, often being disabling for children and adolescents. Mi may, limit their activities of daily living, including other symptoms such as nausea and / or vomit. It is during youth that the events referred to by young people suffering from Mi show up with greater intensity, frequency and duration. Mi is the most frequent cause of complaint among children and adolescents in Pediatric Neurology and is the most common pain reported in Childhood. Objective: Evaluate the results obtained with the brain training using the NFB as non-pharmacological therapeutic alternative in adolescents and young adults diagnosed with migraine. Method: It is an open clinical trial with analytical, descriptive and intervention purposes. Were screened 21 participants who suffered from migraine with and without aura to perform brain training with neurofeedback and quantitative electroencephalography + hemoencephalography. Moreover, it was analyzed the whole research process involving the use of neurofeedback and also the difficulties in treatment adherence. Results: The group of 21 participants has included patients with genders of male (10) and female (11). It was used a questionnaire to identify the difficulties reported by the non-responsive group (that not adhered the brain training with the neurofeedback equipment). The study participants showed stability of crises and complaints regarding to frequency, intensity and duration of pain after 20 sessions of brain training. Conclusion: This study demonstrates the positive potential of the use of the neurofeedback as a non-pharmacologic alternative to treat Mi in adolescents and young adults. Its results showed the importance of carry out randomized and large-scale studies to evaluate the effectiveness of this kind of non-invasive neurotherapy to treat migraine and other chronic and/or progressive disorders.

The studies reported in this dissertation demonstrate that low-cost hardware is capable of detecting neural responses to stimuli in the user’s focus of attention, and that these responses increase in magnitude with training. Neurofeedback is a sub-category of biofeedback that is concerned with using brain signals as the source of training data in a feedback loop. The neurofeedback training procedures in this dissertation focused on the P300 component, a time-locked event-related potential (ERP) that reflects the cognitive processes of attention and context updating. The current work provides preliminary evidence that neurofeedback based on rewarding a P300-like ERP is effective in increasing the magnitude of this response. Three main questions were examined: 1. Is the Emotiv Epoc, as an example of a low-cost consumer EEG, capable of reliably detecting the P300 component? 2. Is there a training effect whereby the P300 response gets stronger with practice? 3. To what extent is the P300 response affected by cognitive factors such as memory load and self-generation of prompts? The studies employed an open source software framework—open source tools provide a transparent, crowd-supported means of conducting research, but are often difficult to initially use and the current dissertation provides a guide within this content domain. The Emotiv Epoc headset was capable of detecting P300-like ERP in a P3 speller task. The P3 speller is a well-studied paradigm in which users spell letters using only their thoughts as input, while the system determines the letter to be spelled by analyzing the strength and timing of the ERP. Although the analyzed ERP behaved functionally like a P300, and the timing was consistent, the spatial localization of the signal was more frontally dominant than a standard P300. In the training study, 12 participants completed five P3 spelling sessions. Although an ERP training effect was observed, participant motivation and fatigue modulated this effect. In an attempt to improve motivation and increase interest in the task, a novel card game task was introduced. In this task—a variant of the card game “Concentration,” where players turn cards face-up one at a time to match pairs—the participants used an attentional mechanism to select cards. This allowed for attentional training while offering a task whereby cognitive difficulty could be manipulated. In these studies, the P300-like ERP proved itself to be robust in regards to changes in cognitive difficulty, as well as internal versus external generation of prompts. This led to confidence in the separation of underlying cognitive and attentional processes and validated the focus of the P300 ERP on the attentional process. The results indicated that ERP-specific neurofeedback is effective in increasing ERP magnitude. This dissertation does not involve any clinical populations as study participants, but the long-term potential of this research is to directly train a brain response relevant to clinical conditions. The paradigm can be implemented using low-cost hardware as opposed to research-grade instruments, which increases the likelihood of further research by the clinical community and lowers the barrier of entry for future exploration of the techniques. / Graduate / 0633 / derekja@uvic.ca

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Improving stroke recovery is a topic of considerable interest in the developed world. Motor deficits following stroke can significantly impact quality of life, and motor rehabilitation strategies are urgently needed to promote brain recovery. One technique that has had therapeutic success in other domains is neurofeedback (NF), a strategy whereby a person is trained to gain volitional control of their neurological activity. The NF technique has proven efficacious in disorders ranging from epilepsy to attention deficit disorders based on feedback of electroencephalography (EEG) signals, and the potential exists for NF applications in the recovery of motor function following stroke. Using functional magnetic resonance imaging (fMRI), NF can be applied to precisely defined regions of interest (ROIs), facilitating the targeted treatment of affected functional areas. The combination of fMRI and NF is still relatively new, and much work remains in the characterization and optimization of fMRI NF strategies. In a two-pronged approach, this thesis focuses on the application of ROI-based NF to the motor system using traditional fMRI measurements and also the development and analysis of acquisition strategies intended for use in ROI-based NF. First, a study of the mechanisms governing the successful application of NF in primary motor cortex ROIs is presented, using kinaesthetic motor imagery (imagining the sensation and execution of movement) to engage the motor system. Second, an investigation of fMRI signal contrast enhancement properties using multi-echo fMRI acquisition methods in dense sampling regimes is considered. Third, a novel acquisition method is introduced, designed using parallel MRI principles to provide fast and detailed sampling of fMRI signals in selected ROIs, called Constrained Source Space Imaging (CSSI). To conclude, the potential future directions for fMRI NF research and the CSSI technique are discussed, including thoughts toward the continued development of NF as a potential motor therapy for stroke patients.

Improving stroke recovery is a topic of considerable interest in the developed world. Motor deficits following stroke can significantly impact quality of life, and motor rehabilitation strategies are urgently needed to promote brain recovery. One technique that has had therapeutic success in other domains is neurofeedback (NF), a strategy whereby a person is trained to gain volitional control of their neurological activity. The NF technique has proven efficacious in disorders ranging from epilepsy to attention deficit disorders based on feedback of electroencephalography (EEG) signals, and the potential exists for NF applications in the recovery of motor function following stroke. Using functional magnetic resonance imaging (fMRI), NF can be applied to precisely defined regions of interest (ROIs), facilitating the targeted treatment of affected functional areas. The combination of fMRI and NF is still relatively new, and much work remains in the characterization and optimization of fMRI NF strategies. In a two-pronged approach, this thesis focuses on the application of ROI-based NF to the motor system using traditional fMRI measurements and also the development and analysis of acquisition strategies intended for use in ROI-based NF. First, a study of the mechanisms governing the successful application of NF in primary motor cortex ROIs is presented, using kinaesthetic motor imagery (imagining the sensation and execution of movement) to engage the motor system. Second, an investigation of fMRI signal contrast enhancement properties using multi-echo fMRI acquisition methods in dense sampling regimes is considered. Third, a novel acquisition method is introduced, designed using parallel MRI principles to provide fast and detailed sampling of fMRI signals in selected ROIs, called Constrained Source Space Imaging (CSSI). To conclude, the potential future directions for fMRI NF research and the CSSI technique are discussed, including thoughts toward the continued development of NF as a potential motor therapy for stroke patients.

Objective: The aim of this paper was to review all randomized published trials and unpublished conference presentations on the neurofeedback (NF) treatment of pediatric ADHD, and their relevance, strengths, and limitations. Method: Via PsychInfo and Medline searches and contacts with NF researchers 14 studies were identified and reviewed. Results: The majority were conducted from 1994 to 2010, with 5- to 15-year-olds, usually male and White with the combined type of ADHD. Most studies used theta/beta NF with a unipolar-electrode placement at Cz and demonstrated, where reported, an overall ADHD mean effect size of d = 0.69, a medium effect. Main study strengths, within some studies, include use of randomization, treatment control conditions, Diagnostic and Statistical Manual of Mental Disorders criteria, evidence-based assessment of ADHD, standard treatment outcome measures, multidomain assessment, and, for some studies, moderate sample size, some type of blind and the identification of medication as a concomitant treatment. Main study limitations (and directions for future research) include the lack of adequate blinding of participants, raters and NF trainers, a sham-NF/blinded control treatment condition, posttreatment follow-up, generalizability, specific details about delivery of NF, identification and control of comorbidity, and the identification, measurement, and control of concomitant treatments and potential side effects. Conclusion: Based on the results and methodologies of published studies, this review concludes that NF for pediatric ADHD can be currently considered as "probably efficacious."

This research explores the application of neuro-cognitive feedback in enhancing the ideation phase of engineering design. Brainstorming is identified as a dominant method for ideation, relying on cognitive processes linked to memory. Neuro-cognitive feedback is introduced as a technique to maintain high cognitive responses during ideation by providing information about brain states, aiding in semantic processing and attention. The study employs functional near-infrared spectroscopy (fNIRS) for neuro-cognitive feedback (NF), showing its advantages in spatial and temporal resolution, mobility, and cost over EEG and fMRI. This feedback method involves placing sensors in a headband on the forehead to measure cortical activity and provide real-time feedback to participants. The technique has been validated in various fields, including medicine, sports, and the arts, for enhancing cognitive and creative performance. A key focus of the research is on the effects of neuro-cognitive feedback on ideation and brain behavior. The research method involved recruiting engineering graduate students, employing various design tasks, and using fNIRS for data collection and analysis. It reveals differences in brain behavior between the baseline and neuro-cognitive feedback sessions, particularly in the right dorsolateral prefrontal cortex (DLPFC), which is associated with generating new ideas. Multiple neurofeedback sessions showed performance improvements in engineering design tasks, with changes in task-related oxygenation in the prefrontal cortex. The study concludes that neuro-cognitive feedback enhances ideation by providing a sustained high cognitive response, aiding in self-regulatory control of brain activity, and improving performance in various cognitive tasks. The results indicate significant improvements in ideation fluency and time spent on tasks with neurofeedback, suggesting its effectiveness in enhancing cognitive functions in engineering design. / Master of Science / This study investigates how neuro-cognitive feedback can improve the brainstorming phase of engineering design. Brainstorming, a method in design ideation, provides concrete quantitative results to compare idea production. The research evaluates neuro-cognitive feedback to boost cognitive activity during brainstorming by monitoring brain states to assist in understanding and attention. It utilizes a technology called functional near-infrared spectroscopy (fNIRS) for this purpose. This technique, which has proven benefits in fields such as athletics and the arts, involves a headband with sensors that measure brain activity and provide immediate feedback. The research focused on civil engineering graduate students, using various design tasks and fNIRS for data gathering and analysis. It found that neuro-cognitive feedback impacts a brain area that contributes to the creation of new ideas and the cohort saw improved performance in engineering tasks. The results highlight that the multiple interventions help manage brain activity and improve task performance. The findings suggest that this method significantly boosts the efficiency and duration of brainstorming sessions in engineering design, showing its potential to enhance cognitive skills.

In this study, 24 adults without any psychological or neurological disorders participated either in 10 neurofeedback training sessions to increase the amplitude of a frequency band between 12 and 15 Hz (sensorimotor rhythm - SMR) or in ten mock neurofeedback sessions. Pre and post training measures of memory and executive functions were completed, along with quantitative electroencephalography (QEEG) measurements in order to detect changes after the training course. Furthermore, measures of SMR amplitude were taken within and across sessions to determine whether self-regulation of SMR had been achieved. The data analysis performed shows no significant differences in cognitive performance between the group who underwent neurofeedback training and the group who underwent mock neurofeedback training. The groups did not show electrophysiological changes after the training. Additionally, no significant changes in SMR amplitude or percent time above threshold across or within the 10 sessions were found in the experimental group. Moreover, the data showed a tendency, which indicates that the higher the baseline amplitude and absolute power of SMR the less time was spent above threshold during the training and the less increase in SMR amplitude between baseline and training periods. The findings obtained indicate that neurofeedback training did not affect memory, executive functions or the QEEG. The absence of significant changes in SMR amplitude across sessions might reflect failure in learning the neurofeedback task and may account for the lack of cognitive improvement and QEEG changes. The fact that the ability to self-regulate SMR might be dependent on baseline amplitude has important implications in setting thresholds. Setting thresholds according to baseline levels might increase the difficulty in maintaining SMR above threshold when the baseline is higher. Future research should also address whether baseline amplitude has a predictive value in determining successful self-regulation of brain activity.

Decreases in overall well-being and daily functioning result from unpleasant and uncomfortable symptoms associated with physical health and mental health disorders. Neurofeedback training, rooted in the theory of operant conditioning, presents the possibility of increasing brain wave regulation, decreasing symptoms experienced from abnormal brain wave activity, and increasing overall well-being and daily functioning. The efficacy of neurofeedback for physical and mental health outcomes is unclear, contributing to confusion about the treatment and any potential benefits. In order to assess the efficacy of neurofeedback in the alleviation of physical health and mental health symptoms, a systematic review and meta-analysis of neurofeedback using a random effects model to generate the effect sizes was conducted on 21 studies with 22 comparisons that used neurofeedback to treat patients. The results showed that neurofeedback can be effective for physical and mental health outcomes, including for autism with an effect size of 0.29, tinnitus with an effect size of 0.77, schizophrenia with an effect size of 0.76, depression with an effect size of 0.28, insomnia with an effect size of 0.52, obesity with an effect size of 0.40, intellectual disability with an effect size of 0.73, and pain with an effect size of 0.30. Well-being and daily functioning for those with physical and mental health disorders can be improved. These findings have implications for clinical practice to help patients in treatment for physical and mental health problems, and also for social change by providing evidence for alternative health care options.