Brain Injuries Clinical Trial
Official title:
The Effect of Neurofeedback Training on Sustained Attention and Mind Wandering Events in Patients With Brain Injury: A Pilot Randomised Controlled Trial
Difficulty to sustain attention over a prolonged period of time is one of the core
difficulties experienced by people who have undergone traumatic brain injury. Rehabilitation
of attention is often based on compensatory strategies, because of the limited impact of
cognitive training on improving attentional capacity after brain injury. New therapeutic
approaches to explore the plastic recovery of the brain after injury, and consequent
performance improvement, are warranted.
Neurofeedback (NFB) allows the self-regulation of brain activity using visual feedback. Very
recently, it has been demonstrated that NFB training targeted at reducing alpha power (alpha
desynchronization NFB), can induce initial plastic changes in brain networks associated with
attention. It has been proposed that NFB can improve cognitive performance by tuning
oscillatory activity of the brain towards a more healthy balance between neural network
flexibility and stability. It is speculated that the use of alpha desynchronization NFB
training, with people who present with brain injury, can enhance sustained attention in as
much as the training promotes neural variability during resting state (i.e. more flexible
network configuration) and neural stability during a sustained attention task (i.e. more
stable network configuration).
However, before assessing the effectiveness of the intervention, it is necessary to evaluate
the feasibility and acceptability thereof. This study will recruit 14 participants and
randomly assign them to two groups: a NFB group and a video games control group. Long-term
changes will be evaluated at two time points for both groups: baseline and post-intervention.
The NFB group will have a follow-up session one week after the intervention, to evaluate
whether there are long lasting changes after NFB training. In addition, short-term changes of
NFB will be evaluated for the experimental group, contrasting EEG activity immediately before
and after the last NFB session.
Participants taking part in the neurofeedback group will undertake sixteen 30-minute sessions
of neurofeedback training, from Tuesday to Friday, distributed over the course of four weeks.
Sessions will be performed at the same time each day. Each 30-min NFB session will consist of
7 x 3-minute blocks of training flanked by a 3-minute resting state block with eyes-open.
During the training blocks participants will seat in front of a laptop screen displaying an
image that will change according the brain activity produced by the participant. One
electrode will be located at the centro parietal region of the scalp (Pz) and another one in
the earlobe as a reference. Participants taking part in the control group will play video
games for 30 minutes during the same number of sessions, also distributed across four weeks.
The same experimental set-up will be used, but EEG activity will not be recorded.
Participants will follow the same structure as the NFB group, playing video games during 7 x
3-minute blocks flanked by a 3-minute seated relaxation.
Each participant will be involved in the study for a maximum of 5 weeks. The NFB training and
control sessions for all participants are expected to be completed over the course of five
months.
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