Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-26T06:25:15.666Z Has data issue: false hasContentIssue false

A New Neurofeedback Protocol for Depression

Published online by Cambridge University Press:  10 January 2013

Álvaro Machado Dias*
Affiliation:
Universidade Federal de São Paulo (Brazil)
Adrian van Deusen
Affiliation:
ITALLIS Communication Llc (USA)
*
Correspondence concerning this article should be addressed to Álvaro Machado Dias. Laboratory of Psychiatric Neuroimaging (LIM-21). Department and Institute of Psychiatry. University of São Paulo. Av. Prof. Mello Moraes, 1721. CEP 05508-030 Butantan. São Paulo. (Brazil). E-mail: alvaromd@usp.br.

Abstract

Context: Neurofeedback represents an exciting complementary option in the treatment of depression that builds upon a huge body of research on electroencephalographic correlates of depression. Objective: The objectives of this article are threefold: review the literature on neurofeedback protocols for depression; introduce a new protocol, which aims to synthesize the best qualities of the currently available protocols; and present the results of a small clinical experiment with the new protocol. Method: Structured survey of the literature; software development; clinical trial with one subject, submitted to ten sessions of neurofeedback (one hour each). Results: Currently there are twenty-one articles in neurofeedback for depression, among which only six present original experimental results. All of them report positive results with the technique. The most used protocols focus on Alpha inter-hemispheric asymmetry, and Theta/Beta ratio within the left prefrontal cortex. Our new protocol integrates both dimensions in a single circuit, adding to it a third programming line, which divides Beta frequencies and reinforces the decrease of Beta-3, in order to reduce anxiety. The favorable outcome of our clinical experiment, suggests that new research with this protocol is worthwhile.

Contexto: El neurofeedback representa una excitante opción complementaria para el tratamiento de la depresión que se basa en un enorme cuerpo de investigación sobre los correlatos electroencefalográficos de la depresión. Objetivo: Los objetivos de este artículo son varios: revisar la literatura sobre los protocolos de neurofeedback para depresión; introducir un nuevo protocolo que pretende sintetizar las mejores cualidades de los protocolos actualmente disponibles; y presentar los resultados de un pequeño experimento clínico con el nuevo protocolo. Método: Inspección estructurada de la literatura; desarrollo de software; ensayo clínico con un participante sometido a diez sesiones de neurofeedback (una hora cada sesión). Resultados: Actualmente hay veintiún artículos sobre neurofeedback en depresión, entre los cuales solo seis presentan resultados experimentales originales. Todos ellos reportan resultados positivos con la técnica. Los protocolos más usados se centran en la asimetría inter-hemisférica de Alpha, y la razón Theta/Beta dentro del cortex prefrontal izquierdo. Nuestro nuevo protocolo integra ambas dimensiones en un solo circuito, añadiendo a una tercera línea de programación, que divide las frecuencias Beta y refuerza el decremento de Beta-3, con objeto de reducir la ansiedad. La consecuencia favorable de nuestro experimento clínico sugiere que nueva investigación con este protocolo es aconsejable.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Angelakis, E., Stathopoulou, S., Frymiare, J., Green, D., Lubar, J., & Kounios, J. (2007). EEG neurofeedback: a brief overview and an example of peak alpha frequency training for cognitive enhancement in the elderly. The Clinical Neuropsychologist, 21(1), 110129. doi:10.1080/13854040600744839CrossRefGoogle Scholar
Arns, M., de Ridder, S., Strehl, U., Breteler, M., & Coenen, A. (2009). Efficacy of neurofeedback treatment in ADHD: the effects on inattention, impulsivity and hyperactivity: a meta-analysis. Clinical EEG and Neuroscience, 40(3), 180189.CrossRefGoogle ScholarPubMed
Baehr, E., & Baehr, R. (1997). The use of neurofeedback as adjunctive therapeutic treatment for depression: Three case studies. Biofeedback, 25, 1011.Google Scholar
Baehr, E., Rosenfeld, J., & Baehr, R. (1997). The clinical use of an alpha asymmetry protocol in the neurofeedback treatment of depression. Journal of Neurotherapy, 2(3), 1023. doi:10.1300/J184v02n03_02CrossRefGoogle Scholar
Baehr, E., Rosenfeld, J. P., & Baehr, R. (2001). Clinical use of an alpha asymmetry neurofeedback protocol in the treatment of mood disorders -follow-up study one to five years post therapy. Journal of Neurotherapy, 4(4), 1118. doi:10.1300/J184v04n04_03CrossRefGoogle Scholar
Bruder, G. E., Sedoruk, J. P., Stewart, J. W., McGrath, P. J., Quitkin, F. M., & Tenke, C. E. (2008). Electroencephalographic alpha measures predict therapeutic response to a selective serotonin reuptake inhibitor antidepressant: pre- and post-treatment findings. Biological Psychiatry, 63(12), 11711177. doi:10.1016/j.biopsych.2007.10.009CrossRefGoogle ScholarPubMed
Coan, J. A., & Allen, J. J. B. (2003). Frontal EEG asymmetry and the behavioral activation and inhibition systems. Psychophysiology, 40(1), 106114. doi:10.1111/1469-8986.00011CrossRefGoogle ScholarPubMed
Coan, J. A., & Allen, J. J. B. (2004). Frontal EEG asymmetry as a moderator and mediator of emotion. Biological Psychology, 67(1–2), 750. doi:10.1016/j.biopsycho.2004.03.002CrossRefGoogle ScholarPubMed
Delgado, P. L. (2000). Depression: the case for a monoamine deficiency. Journal of clinical Psychiatry, 61, 711.Google ScholarPubMed
DeRubeis, R. J., Siegle, G. J., & Hollon, S. D. (2008). Cognitive therapy versus medication for depression: treatment outcomes and neural mechanisms. Nature Reviews Neuroscience, 9, 788796. doi:10.1038/nrn2345CrossRefGoogle ScholarPubMed
Deslandes, A. C., de Moraes, H., Pompeu, F. A. M. S., Ribeiro, P., Cagy, M., Capitão, C., … Laks, J. (2008). Electroencephalographic frontal asymmetry and depressive symptoms in the elderly. Biological Psychology, 79(3), 317322. doi:10.1016/j.biopsycho.2008.07.008CrossRefGoogle ScholarPubMed
Diego, M. A., Field, T., & Hernandez-Reif, M. (2001). CES-D depression scores are correlated with frontal EEG alpha asymmetry. Depression and Anxiety, 13(1), 3237. doi:10.1002/15203.0.CO;2-G>CrossRefGoogle ScholarPubMed
Earnest, C. (1999). Single case study of EEG asymmetry biofeedback for depression - an independent replication in an adolescent. Journal of Neurotherapy, 3(2), 2835. doi:10.1300/J184v03n02_04CrossRefGoogle Scholar
Egner, T., Zech, T. F., & Gruzelier, J. H. (2004). The effects of neurofeedback training on the spectral topography of the electroencephalogram. Clinical Neurophysiology, 115(11), 24522460. doi:10.1016/j.clinph.2004.05.033CrossRefGoogle ScholarPubMed
Evans, J. (2007). Handbook of neurofeedback: dynamics and clinical applications. New York, NY: Haworth Medical PressGoogle Scholar
First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1996). Structured clinical interview for DSM-IV axis I disorders, patient edition (SCID-P, Version 2.0). New York: New York State Psychiatric Institute.Google Scholar
Gruzelier, J., & Egner, T. (2005). Critical validation studies of neurofeedback. Child and Adolescent Psychiatric Clinics of North America, 14(1), 83104. doi:10.1016/j.chc.2004.07.002CrossRefGoogle ScholarPubMed
Hamilton, M. (1960). A rating scale for depression. British Medical Journal, 23(1), 5662. doi:10.1136/jnnp.23.1.56Google ScholarPubMed
Hamilton, J. P., & Gotlib, I. H. (2008). Neural substrates of increased memory sensitivity for negative stimuli in major depression. Biological Psychiatry, 63(12), 11551162.CrossRefGoogle ScholarPubMed
Hammond, D. (2000). Neurofeedback treatment of depression with the Roshi. Journal of Neurotherapy, 4(2), 4556. doi:10.1300/J184v04n02_06CrossRefGoogle Scholar
Hammond, D. (2005). Neurofeedback with anxiety and affective disorders. Child and Adolescent Psychiatric Clinics of North America, 14(1), 105123. doi:10.1016/j.chc.2004.07.008CrossRefGoogle ScholarPubMed
Harmon-Jones, E. (2003). Clarifying the emotive functions of asymmetrical frontal cortical activity. Psychophysiology, 40, 838848.CrossRefGoogle ScholarPubMed
Hunter, A. M., Leuchter, A. F., Morgan, M. L., & Cook, I. A. (2006). Changes in brain function (Quantitative EEG Cordance) during placebo lead-in and treatment outcomes in clinical trials for major depression. American Journal of Psychiatry, 163(8), 14261432. doi:10.1176/appi.ajp.163.8.1426CrossRefGoogle ScholarPubMed
Klimesch, W., Sauseng, P., & Hanslmayr, S. (2007). EEG alpha oscillations: The inhibition-timing hypothesis. Brain Research Reviews, 53(1), 6388. doi:10.1016/j.brainresrev.2006.06.003CrossRefGoogle ScholarPubMed
Levesque, J., Beauregard, M., & Mensour, B. (2006). Effect of neurofeedback training on the neural substrates of selective attention in children with attention-deficit/hyperactivity disorder: A functional magnetic resonance imaging study. Neuroscience Letters, 394(3), 216221. doi:10.1016/j.neulet.2005.10.100CrossRefGoogle ScholarPubMed
Lewis, A. J. (1934). Melancholia: a clinical survey of depressive states. Journal of Mental Science, 80(329), 277378. doi:10.1192/bjp.80.329.277CrossRefGoogle Scholar
Michael, A., Krishnaswamy, S., & Mohamed, J. (2005). An open label study of the use of EEG biofeedback using beta training to reduce anxiety for patients with cardiac events. Neuropsychiatric Disease and Treatment, 1(4), 357.Google ScholarPubMed
Murck, H., Nickel, T., Kunzel, H., Antonijevic, I. A., Schill, J., Zobel, A., … Holsboer, F. (2003). State markers of depression in sleep EEG: Dependency on drug and gender in patients treated with tianeptine or paroxetine. Neuropsychopharmacology, 28(2), 348358. doi:10.1038/sj.npp.1300029CrossRefGoogle ScholarPubMed
Ros, T., Munneke, M. A. M., Ruge, D., Gruzelier, J. H., & Rothwell, J. C. (2010). Endogenous control of waking brain rhythms induces neuroplasticity in humans. European Journal of Neuroscience, 31(4), 770778. doi:10.1111/j.1460-9568.2010.07100.xCrossRefGoogle ScholarPubMed
Rosenfeld, J. (1996). U.S. Patent No. 5280793. Method and system for treatment of depression with biofeedback using left-right brain wave asymmetry. Retrieved from: http://www.freepatentsonline.com/5450855.html.Google Scholar
Saxby, E., & Peniston, E. G. (1995). Alpha-theta brainwave neurofeedback training: an effective treatment for male and female alcoholics with depressive symptoms. Journal of Clinical Psychology, 51(5), 685693. doi:10.1002/1097-4679(199509)51:5<685::AID-JCLP2270510514>3.0.CO;2-K3.0.CO;2-K>CrossRefGoogle ScholarPubMed
Schmidt, B., & Hanslmayr, S. (2009). Resting frontal EEG alpha-asymmetry predicts the evaluation of affective musical stimuli. Neuroscience Letters, 460(3), 237240. doi:10.1016/j.neulet.2009.05.068CrossRefGoogle ScholarPubMed
Thatcher, R. W. (2000). EEG operant conditioning (biofeedback) and traumatic brain injury. Clin Electroencephalogr, 31(1), 3844.CrossRefGoogle ScholarPubMed
Thibodeau, R., Jorgensen, R. S., & Kim, S. (2006). Depression, anxiety, and resting frontal EEG asymmetry: a meta-analytic review. Journal of Abnormal Psychology, 115(4), 715729. doi:10.1037/0021-843x.115.4.715CrossRefGoogle ScholarPubMed
Thompson, L., & Thompson, M. (1998). Neurofeedback combined with training in metacognitive strategies: effectiveness in students with ADD. Applied Psychophysiology and Biofeedback, 23(4), 243263. doi:10.1023/A:1022213731956CrossRefGoogle ScholarPubMed