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Advanced Spatially Specific Neurofeedback for Symptoms of Depression and Its Electroencephalographic Correlates

Chamandeep Kaur, M.Tech; Chetna Punia, MSc; Sukhtej Sahni, MD; Preeti Singh, PhD

Background • Biofeedback is a type of neurofeedback that delivers a graphical knowledge rich in multimedia for the brain waves and produces a feedback signal on brain activity using the multimedia skills of computers and, thus, teaches self-regulation. It has been examined as potential treatment in recent years. Primary Study Objective • The aim of the present study was to recognize variations in symptoms of depression in terms of electroencephalogram (EEG) neuronal mechanisms underlying quantitative electroencephalography (QEEG) neurofeedback. Methods • An analytical study is presented that describes effective results for symptoms of depression corresponding to z-score standardized low-resolution electromagnetic tomography (sLORETA) neurofeeedback training. Participants • The pre and post Neurofeedback EEG changes were analyzed for the EEG data corresponding to single subject whose primary complaint was depressive mood. Intervention • The z score sLORETA neurofeedback was concluded for total of 16 sessions. Where the protocol included surface z score training followed by sLORETA z- score training with identified region of interest. Primary Outcome Measures • This investigation was focused on examining the changes in brain activities for 16 sessions of neurofeedback using the EEG measures of relative power variations in frequency bands, frontal alpha asymmetry, and QEEG analysis of EEG brain waves. Results • Even though impressive results were observed for neurofeedback in terms of power variations and QEEG analysis, no clear conclusions could be made about frontal alpha variations. Augmented alpha activity and reduced beta activity were observed, which accounts for the relaxation. A clear linear relation is noticeable for changes across the sessions as compared within changes within the sessions. Also, low-resolution electromagnetic tomography (LORETA) showed current sources improved toward a normative range, specifically in the insula and anterior cingulate. However, frontal alpha symmetry variations produced no significant conclusions. This may be due to medication effects, the single case design of research, to unsatisfactory denoising techniques followed in signal processing. Conclusion • This exploratory study in terms of EEG measurements may eventually expand the eminence of neurofeedback as an alternative to treatment of depression. The present report demonstrates the need to further investigate tomographic neurofeedback with a more rigorous randomized controlled trial with a large effect size and using other EEG measures.

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