The scientists highlighted importance of further research on electroencephalographic treatment

Researches of therapeutic Electroencephalographic neurofeedback (EEG NFB)
Researches of therapeutic Electroencephalographic neurofeedback (EEG NFB)

Alarming global mental health provides an important motive for the research and usage of alternative and new forms of treatment. One of these new treatment methods is also electroencephalographic neurofeedback (EEG NFB).

This method has been applied for a variety of neuropsychological disorders, predominantly for the children diagnosed with attention deficit hyperactivity disorder (ADHD). Nevertheless, it may also be used in healthy subjects to boost their cognitive, emotional and physical capabilities.

The basic assumption behind the EEG NFB is the reflectance of electrical brain activity in the behavior of an individual. The final goal of the EEG NFB therapy is to translate the changes in electrical brain activity created by the user, in the changes of the user’s mental state and behavior.

Types of NFB

Furthermore, we tried to describe the types of EEG NFB and to critically assess its therapeutic potential. Although the method is already available in many private practices, our literature-based conclusion is that the therapeutic value of the EEG NFB method for specific clinical conditions has not yet been confirmed. Overall, many find its theoretical basis intriguing, but the scarcity of high-quality research data prohibits them to draw reliable conclusions. Majority of experiments are challenged by the methodological limitations, such as a low number of the neurofeedback training subjects as well as the non-randomized, non-double-blind control design. Moreover, there are many parameters that need to be adjusted. However, without a valid generic protocol for a specific mental disorder or condition, it is upon a therapist or software to decide on a certain procedure. Such decisions can have a substantial effect on the outcome of the treatment, making it less reliable.

How effective is the EEG NFB

Probably the most critical reason for questioning the effectiveness of the method is the fundamental, yet so far unanswered question, to what extent a direct modulation of specific brain activity can affect changes in everyday behavior. Finally, the long term effects of the therapy have not yet been confirmed. A limited number of studies have shown conflicting results of the neurofeedback training as for the enduring effects on brain activity as well as the enduring behavioral improvements.

In conclusion, mentioned shortcomings of the method are most likely the reason the EEG NFB is not yet introduced in the public health services worldwide. With that in mind, individuals interested in the therapy within private practices should make sure of the expertise and experience of the EEG NFB therapists.

Slovenian language summary

Zaskrbljujoče globalno duševno stanje je eden izmed pomembnejših vzrokov za raziskovanje in uporabo novih oblik zdravljenja, med katerimi je tudi nevrofeedback z elektroencefalografom ali metoda nevrobiološke povratne zanke z elektroencefalografom (EEG NFB), ki se uporablja za obravnavo nekaterih nevropsiholoških motenj.V največjem obsegu se metodo uporablja za motnje pozornosti in hiperaktivnosti pri otrocih (ADHD), pa tudi na zdravi populaciji z namenom izboljšanja kognitivnih, čustvenih ali fizičnih sposobnosti posameznika.

Temeljna predpostavka v ozadju EEG NFB je, da se individualne značilnosti električne možganske aktivnosti odražajo v vedenju posameznika. Končni cilj terapije je, da spremembe v možganski aktivnosti, ki jih dolgoročno skozi treninge ustvarja uporabnik, vodijo v spremembe na ravni notranjega duševnega stanja in vedenja.

V preglednem članku smo opisali vrste EEG NFB in kritično ocenili njegovo terapevtsko učinkovitost. Sklenili smo, da navkljub široki uporabi metode v privatnih terapevtskih klinikah, terapevtska vrednost EEG NFB metode za posamezna klinična stanja še ni potrjena. Praktično vsi pregledni članki govorijo o metodi kot o potencialno učinkoviti, a s premalo kakovostnimi raziskavami, ki bi omogočale dobro analizo podatkov in zanesljive zaključke. Temu botruje dejstvo, da se veliko raziskav sooča z metodološkimi pomanjkljivostmi, kot so prenizko število udeležencev in treningov na posameznika ter redkost dvojno slepih, randomiziranih zasnov študije. Vprašljiva je tudi zanesljivost posameznega terapevta v praksi, saj se je, brez splošno veljavnega postopka za posamezne duševne motnje, potrebno individualno opredeliti za množico faktorjev, ki potencialno vplivajo na uspešnost treninga.

Še bolj ključen razlog za dvom v učinkovitost metode pa je temeljno, a do sedaj neodgovorjeno vprašanje, v kolikšni meri lahko direktna modulacija specifične možganske aktivnosti vpliva na spremembe v vsakdanjem vedenju. Tudi dolgoročni učinki terapije niso znani, saj maloštevilne raziskave podajajo različne zaključke, tako o spremembah izbrane možganske aktivnosti kot o vedenju.

Naštete pomanjkljivosti metode so najverjetneje razlog, da po svetu EEG NGB terapija še ni del javnih zdravstvenih storitev. Pomembno je, da se starši ali posamezniki, ki si želijo poskusiti terapijo v okviru privatnih praks, prepričajo o strokovnem znanju in izkušnjah EEG NFB terapevta.

Reference

Nina Omejc, Bojan Rojc, Piero Paolo Battaglini, Uros Marusic. Review of the therapeutic neurofeedback method using electroencephalography: EEG Neurofeedback. Bosn J Basic Med Sci. 2018 Nov 20. doi: 10.17305/bjbms.2018.3785. [Epub ahead of print]

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