Shutting Down Sensorimotor Interferences after Stroke: A Proof-of-Principle SMR Neurofeedback Study

Abstract

Introduction: Neurofeedback training aims at learning self-regulation of brain activity underlying cognitive, emotional or physiological functions. Despite of promising investigations on neurofeedback as a tool for cognitive rehabilitation in neurological diseases, such as after stroke, there is still a lack of research on feasibility and efficiency of neurofeedback in this field.Methods: The present study aimed at investigating behavioral and electrophysiological effects of 10 sessions of sensorimotor rhythm (SMR) neurofeedback in a 74-years-old stroke patient (UG20). Based on previous results in healthy young participants, we hypothesized that SMR neurofeedback leads to a decrease in sensorimotor interferences and improved stimulus processing, reflected by changes in event-related potentials (ERPs) and electrophysiological coherence. To assess whether UG20 benefited from the training as much as healthy persons of a similar age, a healthy control group of N = 10 elderly persons was trained as well. Before and after neurofeedback training, participants took part in a multichannel electroencephalography measurement conducted during a non-verbal and a verbal learning task.Results: Both UG20 and the healthy controls were able to regulate their SMR activity during neurofeedback training. Moreover, in a non-verbal learning task, changes in ERPs and coherence were observed after training: UG20 showed a better performance in the non-verbal learning task and a higher P3 amplitude after training than before, and coherence between central and parietal electrodes decreased after training. The control group also showed a behavioral improvement in the non-verbal learning task and tendencies for higher P3 amplitudes and decreased central-parietal coherence after training. Single-case analyses indicated that the changes observed in UG20 were not smaller than the changes in healthy controls.Conclusion: Neurofeedback can be successfully applied in a stroke patient and in healthy elderly persons. We suggest that SMR neurofeedback leads to a shutting-down of sensorimotor interferences which benefits semantic encoding and retrieval.

The potential of real-time fMRI neurofeedback for stroke rehabilitation: A systematic review

“…This postulation is also confirmed by studies aiming at modulating brain activity and connectivity in stroke with fNIRS ( Mihara et al., 2012 , Mihara et al., 2013 ), MEG ( Boe et al., 2014 , Buch et al., 2012 ), or EEG ( Ramos-Murguialday et al., 2014 , Shindo et al., 2011 , Young et al., 2014 ). Notably, evidence exists for a successful use of EEG neurofeedback for cognitive and motor rehabilitation in stroke, but the effects are not consistent across participants ( Bearden et al., 2003 , Cannon et al., 2010 , Doppelmayr et al., 2007 , Reichert et al., 2016 , Rozelle and Budzynski, 1995 ). We posit that, thanks to its superior spatial resolution, rt-fMRI can provide more accurate feedback than EEG/MEG and fNIRS to the participants, who may more easily learn to control their brain activity or connectivity.…”

SMR/Theta Neurofeedback Training Improves Cognitive Performance and EEG Activity in Elderly With Mild Cognitive Impairment: A Pilot Study

“…It was suggested that SMR NF training might facilitate thalamic inhibitory mechanisms and block motor activity that interferes with information processing (Sterman, 1996). SMR NF training improved declarative memory (Hoedlmoser et al, 2008;Gruzelier, 2014;Schabus et al, 2014;Kober et al, 2015;Cho et al, 2016;Reichert et al, 2016) and attention (Vernon et al, 2003;Egner and Gruzelier, 2004;Lecomte and Juhel, 2011;Kober et al, 2015) in elderly patients. Theta rhythm (4-7 Hz) is associated with neurological and psychological functions in the limbic system.…”

Late auditory event-related potential changes after sensorimotor rhythm neurofeedback training

“…Increasing the amplitude of N200 and P300 indicates the normalization of neural circuits associated with discrimination of stimuli and updating of attention 17 . In a study by Reichert et al (2016), an increase in N100 and P300 amplitude was observed in a post-stroke patient in an experimental group who had SMR training, whereas the control group showed no difference 18 . This finding is in line with our study that found no differences in N100 and P300 amplitude in healthy participants after SMR NFB training.…”