Upper Alpha Based Neurofeedback Training in Chronic Stroke: Brain Plasticity Processes and Cognitive Effects

Abstract

In the present study, we investigated the effects of upper alpha based neurofeedback (NF) training on electrical brain activity and cognitive functions in stroke survivors. Therefore, two single chronic stroke patients with memory deficits (subject A with a bilateral subarachnoid hemorrhage; subject B with an ischemic stroke in the left arteria cerebri media) and a healthy elderly control group (N = 24) received up to ten NF training sessions. To evaluate NF training effects, all participants performed multichannel electroencephalogram (EEG) resting measurements and a neuropsychological test battery assessing different cognitive functions before and after NF training. Stroke patients showed improvements in memory functions after successful NF training compared to the pre-assessment. Subject B had a pathological delta (0.5–4 Hz) and upper alpha (10–12 Hz) power maximum over the unaffected hemisphere before NF training. After NF training, he showed a more bilateral and “normalized” topographical distribution of these EEG frequencies. Healthy participants as well as subject A did not show any abnormalities in EEG topography before the start of NF training. Consequently, no changes in the topographical distribution of EEG activity were observed in these participants when comparing the pre- and post-assessment. Hence, our results show that upper alpha based NF training had on the one hand positive effects on memory functions, and on the other hand led to cortical “normalization” in a stroke patient with pathological brain activation patterns, which underlines the potential usefulness of NF as neurological rehabilitation tool.

Acute single channel EEG predictors of cognitive function after stroke

“…a file drawer effect). Abnormal delta index post-stroke may influence attentional capacity [ 12 , 51 , 52 ], which appears to be a key determinant of functional and cognitive outcomes [ 14 , 16 , 17 ]. Abnormal theta activity post-stroke may be related to delayed verbal recall [ 53 , 54 ], reduced language processing and comprehension [ 54 , 55 ], as well as problems with attention [ 44 , 48 ], memory [ 43 , 44 ] and executive function [ 45 ].…”

Cardiorespiratory feedback training as a non-pharmacological intervention and its application in stroke patients

“…The most common biofeedback therapeutic targets in stroke patients are gait biomechanics and upper limb and lower limb sensorimotor deficits. Recent research also investigates the effects of neurofeedback on brain plasticity and cognitive processes (Kober et al 2017).…”

Neurofeedback for Tinnitus Treatment – Review and Current Concepts

“…For ADHD, neurofeedback already found acceptance as alternative to established medication based treatment, due to its non-invasive character, the almost complete absence of any side-effects and high self-efficacy experienced by the subjects ( Lubar et al, 1995 ; Lévesque et al, 2006 ; Arns et al, 2009 ; Gevensleben et al, 2009 ; Strehl et al, 2017 ). Apart from that, effectiveness and feasibility of neurofeedback are more and more investigated in the context of many other psychological disorders and neurological conditions ranging from the treatment of depression ( Kelley et al, 2017 ), anxiety ( Mennella et al, 2017 ), or autism ( Datko et al, 2017 ) to stroke patients ( Kober et al, 2017 ) and prevention of Alzheimer’s disease ( Jiang et al, 2017 ). Today, quality control is an important aspect in the neurofeedback field.…”