Effects of a Theta/Sensorimotor Rhythm Neurofeedback Training Protocol on Measures of Impulsivity, Drug Craving, and Substance Abuse in Forensic Psychiatric Patients With Substance Abuse: Randomized Controlled Trial

Abstract

BackgroundForensic psychiatric patients are often diagnosed with psychiatric disorders characterized by high levels of impulsivity as well as comorbid substance use disorders (SUD). The combination of psychiatric disorders and SUD increases the risk of future violence. Chronic substance abuse can lead to a structural state of disinhibition, resulting in more drug taking and eventually loss of control over drug intake. When treating SUD, it is crucial to address high levels of impulsivity and lack of inhibitory control.ObjectiveThis study set out to investigate the effects of a theta/sensorimotor rhythm (SMR) neurofeedback training protocol on levels of impulsivity, levels of drug craving, and actual drug intake in a population of forensic psychiatric patients with a diagnosis of SUD.MethodsA total of 21 participants received 20 sessions of theta/SMR neurofeedback training in combination with treatment-as-usual (TAU). Results of the intervention were compared with results from 21 participants who received TAU only.ResultsSMR magnitude showed a significant (P=.02) increase post training for patients in the neurofeedback training group, whereas theta magnitude did not change (P=.71). Levels of drug craving as well as scores on the motor subscale of the Barratt Impulsivity Scale-11 decreased equally for patients in the neurofeedback training group and the TAU group. Other measures of impulsivity as well as drug intake did not change posttreatment (P>.05). Therefore, neurofeedback+TAU was not more effective than TAU only.ConclusionsThis study demonstrated evidence that forensic psychiatric patients are able to increase SMR magnitude over the course of neurofeedback training. However, at the group level, the increase in SMR activity was not related to any of the included impulsivity or drug craving measures. Further research should focus on which patients will be able to benefit from neurofeedback training at an early stage of the employed training sessions.Trial RegistrationDutch National Trial Register: NTR5386; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5386 (Archived by WebCite at http://www.webcitation.org/6nXLQuoLl).

Theta/SMR Neurofeedback Training Works Well for Some Forensic Psychiatric Patients, But Not for Others: A Sham-Controlled Clinical Case Series

“…As there are no clear guidelines about the necessary number of neurofeedback training sessions to achieve significant effects in terms of increase or decrease in magnitude of the targeted frequency bands, it is possible that the employed eight sessions of training were simply not enough to result in a significant decrease in mean SMR and/or theta amplitude. Common neurofeedback protocols range from 12 to 30 sessions (see, for review, Fielenbach et al, 2018); hence, a decrease in mean magnitude of the targeted frequency band might take more than eight sessions to manifest. However, previous research has shown that performance in early neurofeedback training sessions predicts performance in later training sessions (Weber, Köberl, Frank, & Doppelmayr, 2011).…”

“…These patients do not show the assumed effects within the trained frequency bands, with as many as 25% of participants being categorized as so-called "non-responders" (Enriquez-Geppert et al, 2013;Zoefel, Huster, & Herrman, 2011). Other studies show that patients do achieve regulation of deviant brain frequencies, but without showing improvements in clinical symptoms posttraining (Fielenbach et al, 2018). It can be argued that successful regulation of brain activity is a necessary (but not sufficient) condition for achieving behavioral symptom improvement.…”

EEG Parameter Selection Reflecting the Characteristics of Internet Gaming Disorder While Playing League of Legends

“…The independent variable was set as the addiction status of the group determined by the questionnaire score. For dependent variables, 15 EEG parameters, including 6 frequency domain parameters and 9 additional composite parameters, were used: the relative power of the Theta, Alpha, Beta, sensorimotor rhythm (SMR), MidBeta, HighBeta, Theta/Beta, Beta/Theta, Alpha/MidBeta, Theta/MidBeta, MidBeta/Alpha, Alpha/Theta, (SMR+MidBeta)/Theta, Beta/Alpha, and MidBeta/Theta [ 20 , 21 , 22 , 23 , 24 , 25 ]. These parameters were measured in 16 lobes of the brain, resulting in a total of 240 dependent parameters in this study.…”

Werkt forensische behandeling?

“…Voor toekomstig onderzoek is het van 40 Neijmeijer et al (2019). 41 Bernstein et al (2023); Fielenbach et al (2018); Zwets et al (2016). 42 Zie ook Papalia et al (2019); De Vogel et al (2023).…”

“…Bernstein et al (2023);Klein Tuente et al (2020). 26Van Alphen et al (2019);Bloemers & De Vogel (2020);Fielenbach et al (2018);Zwets et al (2016). 27Bernstein et al (2023).…”