Webinars
(IN PORTUGUESE) 2021: COVID-19: Effects on Brain, Behavior, and qEEG Correlates
(IN PORTUGUESE)
Abstract:
As of December, 2020, 69.1 million have been reported infected and 1.57 million deaths have resulted from COVID-19. Without question the primary focus of the resulting Pandemic has been to reduce the risk or death and the rapid contagion of the disease. Given that it has been recognized that this and other viruses do indeed enter the brain ( M. Desfordes, A. Le Coupanec, P. Dubeau et al, 2020; A.S. Zubair et al.,2020), studies are now being turned to understand possible residual effects on behavior and brain function. There are several routes in which the virus can influence brain function resulting in delayed demyelinating processes (L. Zanin et al., 2020) and general neuroinflammatory processes (J. Remsik et al. 2021) effecting frontal lobes and brainstem structures (G. De Santis, 2020; M. Dube et al. 2018; S. Gandhi et al. 2020). Initial structural neuroimaging studies have evidenced generalized encephalopathies and damage particularly to medial temporal regions (R.W. Paterson et al., 2020; S. Kramer et al., 2020). As might be expected, patients requiring more intensive care have more diverse anomalous findings in MRI studies (S. Kandemirli et al., 2020). Six months following discharge from hospitalization, studies are reporting that as many as over 30% of patients are experiencing decline in cognitive functioning (A. Pilotto et al., 2020) and over 20% of patients experience significant mood regulation problems (C. Huang et al., 2021). Functional neuroimaging studies have corroborated structural findings in noting dysfunction in the frontal regions (I. Cani et al. 2020)). EEG studies have also noted frontal regions increased delta corresponding to these findings (E. Pasini et al. 2020). COVID-19 patients with resultant seizures, focal areas have been identified in the temporal, frontotemporal, and central-parietal regions (N. Narula et al., 2020). In an effort to develop a database of QEEG correlates resulting from COVID infection, the authors are contributing EEG data with qEEG and sLORETA analyses that can potentially provide a method differentiating residual effects that can be attributable to COVID-19. Preliminary cases studies comparing pre to post COVID-19 exposure evidence increased delta and theta absolute power in bilateral frontal poles, fronto-temporal regions and central-parietal regions and an increase volumetric deviations in the frontal and temporal regions by sLORETA analyses with concomitant changes in aspects of cognition and mood regulation. Current vaccines being used to prevent more serious effects of the COVID-19 and potential variants can stimulant the immune system to trigger cytokine storms in some individuals and can trigger neuroinflammatory effects on the brain. Pre and post vaccination non-COVID positive subjects will be discussed. These early findings speak to the importance of using qEEG to provide biomarkers for individuals who may have cytokine storms by any of number of challenges to the immune system.
Presented by: David Cantor, Leslie Sherlin, Susan Blank, Robert Turner, Ronald Swatzyna, Barbara Minton, Harry Kerasidis, Britt Parramore, Adrian Van Deusen, Giuseppe Chiarenza & Tanju Surmeli
David Cantor, Leslie Sherlin, Susan Blank, Robert Turner, Ronald Swatzyna, Barbara Minton, Harry Kerasidis, Britt Parramore, Adrian Van Deusen, Giuseppe Chiarenza & Tanju Surmeli
30
(IN PORTUGUESE) 2021: Electroencephalogram: Linking Neurology, Psychiatry, and Neurofeedback
(IN PORTUGUESE)
Abstract:
Rarely do neurofeedback therapist see individuals who have not tried any psychiatric medicines. Normally, by the time most patients consider neurofeedback, they have failed multiple medication trials and non-medication treatments and are frustrated with the trial-and-error method. A 2015 a study linked psychiatric medication failure to four EEG phenotypes: focal slowing, spindling excessive beta, encephalopathy (EN), and isolated epileptiform discharges (IEDs). The significance of the focal or diffuse slowing and spindling excessive beta is easily discerned in qEEG brain mapping. However, IEDs are either artifacted out or averaged out in qEEG processing. Only neurologists, through visual interpretation of the EEG, can diagnose EN or identify the presence IEDs. This is beyond the scope of practice for PhD or masters level clinicians.
Encephalopathy is a term for any diffuse disease of the brain that alters brain function or structure. EN may be caused by infectious agent (bacteria, virus, or prion), metabolic or mitochondrial dysfunction, brain tumor, or increased pressure in the skull, prolonged exposure to toxic elements (including solvents, drugs, radiation, paints, industrial chemicals, and certain metals), chronic progressive trauma, poor nutrition, or lack of oxygen or blood flow to the brain. Symptoms include progressive loss of memory and cognitive abilities, over time subtle personality change, inability to concentrate, and fatigue. How to differentiate encephalopathic features from drowsy and sleep states including case examples of encephalopathies, metabolic, neurodegenerative, and structural disorders will be discussed.
Isolated Epileptiform Discharges refers to spike and wave or sharp and slow activity in nonepileptic individuals. Various terms have been used to describe epileptiform activity such as IEDs, subclinical epileptiform activity, epileptiform discharges, and interictal epileptiform discharges. The importance of differentiating normal features of EEG from epileptiform features will be discussed as well as the ever- present danger of over interpretation or under interpretation of EEG abnormalities, with multiple examples of both errors.
This workshop with cover the early work on phenotypes and vigilance modeling, including the trait and state of the four primary categories that predict treatment failure. We will discuss the vital nature of identifying EN and IEDs and how the EEG can be useful to guide neurotherapy protocol development. The ethical considerations for the neurotherapist will be delineated with an emphasis on the importance of collaboration among ourselves, neurologist, psychiatrists, and other mental health providers. Lastly, we will discuss how to collect and categorize clinical electrographic data for the purpose of joining an international collaborative effort to further the research in our field.
Presented by: Joe Castellano, Ron Swatzyna, Harry Kerasidis & Robert "Rusty" Turner
Joe Castellano, Ron Swatzyna, Harry Kerasidis & Robert "Rusty" Turner
60
(IN PORTUGUESE) 2021: Good Vibrations (Plenary)
(IN PORTUGUESE)
Abstract:
This presentation is an EEG Spectral analysis of passive listening to Native American Flute pentatonic scales, plus a review of audioanalgesia healing literature. In the last twenty years, this area of science has exploded with research related to the effect of sound and music on brain functions, Trimble, M., & Hesdorffer, D. (2017), Pantev, Oostenvel, Engelien, Ross, Roberts & Hoke, (1998), Peretz & Zatorre, (2005), Zatorre, (2007). Non-invasive procedures have allowed science to observe the areas of the brain which are activated by music and has shown that music activates more areas of the brain than nearly any other stimuli. At the same time, quantum physics has explored the theory that everything is made of vibrations. The theory suggests that solid matter is really an illusion and that everything vibrates or "resonates" at a particular frequency, including human cells (McTaggart, L. (2001).
Some consider music a gateway to the awakening of the spiritual, because, again, frequency is an activator of the brain, Kunkkullaya, K. U. (2020), (Riley, L. (2000). This is one of the reasons chanting and toning have traditionally been used in every major religion of the world to enhance prayerful, meditative, super-aware states of mind. When a person is in a relaxed state, beta-endorphins are produced, which promote healing.
When this state is brought on by exposure to music, the result is called “audioanalgesia”. Music's healing effects are described as three-fold: emotional, spiritual, and physical, Cvetkovic, D. & Cosic, I. (2011).
Music comprises pitch, timbre, vibrato, intensity, beat tracking, tempo or velocity, contour or intonation, rhythm variation or timing, and melody and harmonic features, all of which can drive and entrain neural, respiratory and cardiac activity, Goss, C. and Miller, E. B. (2014), Miller, E.B. & Goss. C.F. (2014), Miller, E.B. & Goss. C.F. (2015).
This presentation explores the interface of captured brain activity and the implied emotional/spiritual realm of “healing” as defined by the metaphysical literature, Riley, L. 2000). Metaphysical healing is not necessarily curing; it is an aspect of the spirit, while curing is an alteration of the body. One can experience healing without curing, but some research suggests that curing rarely occurs without prior healing. This presentation examines the results of participants passive listening to different octaves of solo Native American pentatonic flute music, including:
1. a comparison between a “baseline” period of silent relaxation and brain response to flute music.
2. a comparison between the first half and the second half of the five-minute period of flute listening, and
3. a comparison between the periods of listening to lower-pitched flute compared to higher-pitched flute. The presentation will also provide live examples of shifts in brain wave patterns suggested for:
1. Pre-operation calming protocols
2. Post-operation protocols to promote alertness,
3. Pain relief relaxation progression, and
4. Near death music recommendations.
Presented by: Ronald Bonnstetter
Ronald Bonnstetter
30
(IN PORTUGUESE) 2021: International Panel: Common Challenges and Ethical Concerns in Neuroregulation Practices
(IN PORTUGUESE)
Abstract:
This presentation will focus on a comprehensive treatment approach of neurofeedback and body psychotherapy (NFB) with individuals who experienced primarily transgenerational trauma of 3rd and 4th generation of Holocaust survivors by review case-studies and explore the framework of NFB.
What is Body-Psychotherapy (BP)?
BP is a field in psychology and psychotherapy that evolved over the last 100 years. Progress in neuroscience, medicine, psychology and trauma work created waves of insight which are now further underpinning the empirical understanding of BP, as an integrated approach that brings mind, emotion, body and spirit into deeper connection and re-awakening individual wellbeing. Biodynamic BP (BBP), a modality of BP is a humanistic approach that supports the processes of natural movement toward health (salutogenesis) by using body awareness, emotional expression, verbal understanding and attuned touch. It involves a dynamic assessment process that can provide a framework to integrate Neurofeedback (NF) into the psychotherapeutic process.
Transgenerational trauma in descendants of Holocaust survivors:
The Holocaust and its aftermath still have a fundamental impact on the mind, body and soul of many descendants of Holocaust survivors. More than half a century ago the most unthinkable and unimaginable horror has happened, and the descendants generations of Holocaust survivors are left to deal with one of the most devastating, brutal and dehumanizing experiences in human history. We are confronted by a complex traumatic phenomenon that has multiple facets, including national, political, sociological and relational, as well as psychological and biological effects which became part of descendants lives and of the embodied psyche. The shadow of the Holocaust impacts the development of self-identities, the deep sense of selves and the capacity to express affective states. Normal sensations like pain and pleasure as well as emotions such as anger, playfulness, grief and love were suppressed and led to the creation of a relational crypt that contains traumatic experiences.
During Biodynamic Body-Psychotherapy sessions we explore past traumatic responses at different developmental levels, as well as the treatment implications of these findings. Traumatic memories are often dissociated and may be inaccessible to verbal recall or processing. Therefore, one of BBP working hypotheses is the essential need for emotional and physiological self-regulation at a subcortical level outside of awareness.
This key hypothesis enables integration of NF with BBP enhancing the psychotherapeutic process. For example, in a Biodynamic Body-Psychotherapy session, I may support integration of sensory input with motoric output to enable effective movement in perceived life-threatening situations or finding an internal framework which enables self- regulation of hyperarousal state on a bodily level. In both situations when the individual can be in hyperarousal and/or hypoarousal states I found it useful to integrate NF training into the BBP session, i.e. NFB.
Moderated by: Tanya Morosoli
30
(IN PORTUGUESE) 2021: Music-Based Interventions for Cognitive and Brain Health
IN PORTUGUESE
Abstract:
Music is an art form that is found in every culture and at every stage in life. While there is much anecdotal evidence supporting the therapeutic effects of making and listening to music, the science of music for cognitive and brain health is still in its infancy. I will describe recent studies from my lab on music and the brain, especially focusing on music-based interventions for reducing stress and loneliness, and improving working memory. Results point to the role of the brain’s dopaminergic reward system in mediating the beneficial effects of music. I will conclude with some evidence-based recommendations for adopting music as a lifestyle factor to stay cognitively and neurologically healthy in old age. Music therapy is an evidence-based practice, but the needs and constraints of various stakeholders pose challenges towards providing the highest standards of evidence for each clinical application. First, what is the best path from clinical need to multi-site, widely adopted intervention for a given disease or disorder? Secondly, how can we inform policy makers that what we do matters for public health––what evidence do we have, and what evidence do we need? I will review the multiple forms of evidence for music-based interventions in the context of neurological disorders, from large-scale randomized controlled trials (RCT) to smaller-scale experimental studies, and make the case that evidence at multiple levels continues to be necessary for informing the selection of active ingredients of interest in effective musical interventions. I will review some of the existing literature on music-based interventions for neurodegenerative disorders, with particular focus on neural structures and networks that are targeted by specific therapies for disorders including Alzheimer’s Disease, Parkinson’s Disease, and aphasia. This is followed by a focused discussion of principles that are gleaned from studies in cognitive and clinical neuroscience, which may inform the active ingredients of music-based interventions. Therapies that are driven by a deeper understanding of the musical elements that target specific disease mechanisms are more likely to succeed, and to increase the chances of widespread adoption. I will conclude with some recommendations for future research.
Presented by: Dr. Psyche Loui
Dr. Psyche Loui
30
(IN PORTUGUESE) 2021: Neurofeedback and Body Psychotherapy (Keynote)
IN PORTUGUESE
Abstract:
This presentation will focus on a comprehensive treatment approach of neurofeedback and body psychotherapy (NFB) with individuals who experienced primarily transgenerational trauma of 3rd and 4th generation of Holocaust survivors by review case-studies and explore the framework of NFB.
What is Body-Psychotherapy (BP)?
BP is a field in psychology and psychotherapy that evolved over the last 100 years. Progress in neuroscience, medicine, psychology and trauma work created waves of insight which are now further underpinning the empirical understanding of BP, as an integrated approach that brings mind, emotion, body and spirit into deeper connection and re-awakening individual wellbeing. Biodynamic BP (BBP), a modality of BP is a humanistic approach that supports the processes of natural movement toward health (salutogenesis) by using body awareness, emotional expression, verbal understanding and attuned touch. It involves a dynamic assessment process that can provide a framework to integrate Neurofeedback (NF) into the psychotherapeutic process.
Transgenerational trauma in descendants of Holocaust survivors:
The Holocaust and its aftermath still have a fundamental impact on the mind, body and soul of many descendants of Holocaust survivors. More than half a century ago the most unthinkable and unimaginable horror has happened, and the descendants generations of Holocaust survivors are left to deal with one of the most devastating, brutal and dehumanizing experiences in human history. We are confronted by a complex traumatic phenomenon that has multiple facets, including national, political, sociological and relational, as well as psychological and biological effects which became part of descendants’ lives and of the embodied psyche. The shadow of the Holocaust impacts the development of self-identities, the deep sense of selves and the capacity to express affective states. Normal sensations like pain and pleasure as well as emotions such as anger, playfulness, grief and love were suppressed and led to the creation of a relational crypt that contains traumatic experiences.
Implementation of NFB in the treatment process
During Biodynamic Body-Psychotherapy sessions we explore past traumatic responses at different developmental levels, as well as the treatment implications of these findings. Traumatic memories are often dissociated and may be inaccessible to verbal recall or processing. Therefore, one of BBP working hypotheses is the essential need for emotional and physiological self-regulation at a subcortical level outside of awareness.
This key hypothesis enables integration of NF with BBP enhancing the psychotherapeutic process. For example, in a Biodynamic Body-Psychotherapy session, I may support integration of sensory input with motoric output to enable effective movement in perceived life-threatening situations or finding an internal framework which enables self- regulation of hyperarousal state on a bodily level. In both situations when the individual can be in hyperarousal and/or hypoarousal states I found it useful to integrate NF training into the BBP session, i.e. NFB.
Take away message
BP interventions led by DA could easily integrated into NF sessions
The use of NFB can provide multiple benefits, including, enhancing self-organisation and self-regulation. NFB can enhance the capacity for interoceptive awareness
NFB can facilitate process in individuals who suffer transgenerational trauma
Presented by: Elya Steinberg
Elya Steinberg
30
(IN PORTUGUESE) 2021: Neurofeedback as an Assisting Tool to Analytically Oriented Psychotherapeutic Clinic
IN PORTUGUESE Abstract:
Since its inception, psychoanalytic clinic has struggled with concerns raised about its scientificity. Freud, when establishing studies on the psyche, groped about an area totally unknown to medicine in the late 19th century. Many of his hypotheses were built empirically, based on the doctor-patient relationship. Originally a medical clinician, Freud focused on issues of the psyche and brought to the public, in a daring way, his impressions, his findings, and mainly, his clinical results – therefore, Psychoanalysis came to life. Over the years his legacy has been followed by countless clinicians, expanding research and corroborating his results. Freudian discoveries, although overwhelming, always had to rely on a dose of credulity on the part of their practitioners. Coming up against the argument of the lack of validity of scientific evidence, since the analytical setting occurs in conditions of uncontrolled environments, psychoanalysis has been partially considered as a field of belief rather than science. However, recent work from neuroscience has shown that Freud's findings ended up being ratified. What Freud as a neurophysiologist pointed out has now found reverberations in the results of controlled scientific research. Thus, these new findings call into question the possibility of a new perception of Freud's discoveries. Both his topographic and dynamic theories of mind structuring unveiled processes of mental development which are presently acknowledged. In this field, Neurofeedback with its active view on the electrical aspect of the brain, through its frequencies, provides a perception that can complement and shed a light on psychoanalytic discoveries. In this Workshop we will establish a parallel between the first and the second Freudian topics, demonstrating their relationship with brain frequencies and mental states that are observed in a Neurofeedback training session. We aim at demonstrating that Neurofeedback is an effective technique that can be coupled to the psychotherapeutic clinic of analytical orientation, in order to bring greater clarity and assertiveness to the professional who conducts treatments within this current. (IN PORTUGUESE)
Presented by: Cinara Ferreira Soares
Cinara Ferreira Soares
60
(IN PORTUGUESE) 2021: Neurorehabilitation Program Using Biophoto/Electromagnetic Stimulation Wearable
IN PORTUGUESE
Abstract:
Twenty-four clients, 10-86 years old, volunteered for this study: participants previously diagnosed and treated by their own physicians or psychologists for a variety of conditions such as Attention Deficit and Hyperactive Disorder (ADHD), Learning Disorders, fibromyalgia and other pain syndromes, sleep disorders, post stroke, post-concussion syndrome, asthma, Chronic Obstructive Pulmonary Disorder (COPD) and memory dysfunctions. Before the study commenced, a battery of subjective tests (DSM-5, Amen ADD questionnaires) were completed and medical history collected. Prior to the beginning of the study, clients were evaluated cognitively with the Integrated Visual and Auditory (IVA-QS) continuous performance test. In most cases, parents, spouses or close family members completed bi-weekly evaluations, to monitor specific changes in the client’s overall health condition and progress. After each session participants completed a questionnaire. Neuro-stimulation sessions were offered three times per week, half an hour each session, for 20 – 40 consecutive sessions. The cognitive functions were re-evaluated with the same IVA-QS battery, as used at the start of the study, after 20 and after 40 consecutive sessions of Neuro-Stimulation. Majority of the participants benefited from the Neuro-Stimulation program obtaining remarkable physical, emotional and cognitive improvements. Objectively, the IVA-QS showed significant and continuous improvements. No negative side effects have been reported from this training. Conclusion: The Neurodynamic Activator™, as a unique standalone brain trainer, shown to be a useful device that benefited all the participants and the benefits obtained and reported at the end of the study, continued to be sustained 18 months and longer, after the completion of the Bio-photo-Stimulation. Other light/ bio-photo-stimulation methods will be compared and discussed. We had to adapt to this special isolated life during the pandemic time that we experienced for a year. The importance of integrating the bio-photostimulation devices in brain training without any negative consequences will be a part of our discussion.
Presented by: Victoria L. Ibric, Michele Owes, & Liviu G. Dragomirescu
Victoria L Ibric, Michele Owes, & Liviu G. Dragomirescu
30
(IN PORTUGUESE) 2021: Nurturing Awareness: Neurofeedback and Psychedelic Therapies
(IN PORTUGUESE) Abstract:
Neurophenomenological studies are increasingly exploring the brain mechanisms through which psychedelic substances exert their mind-altering effects. A provocative question is whether such knowledge might be harnessed as a means of self-inducing altered states of consciousness by non-pharmacological means, for example through the combination of meditation practices and EEG neurofeedback. Ross et al., (2013) demonstrated that down-regulation of the amplitude of EEG alpha oscillations recorded from midline posterior cortex (Pz electrode) is possible in healthy volunteers via neurofeeedback, with correlated effects observed for FMRI in the precuneus as well as with the experience of mind-wandering. Recently, DMT literature related to cortical travelling waves further highlights the importance of the alpha decreases and increased signal diversity, also known as entropy as indicative of the psychedelic state (Alamia et al., 2020).
Emphasis will be placed on how neuro and biofeedback technologies can help highlight, assess and support the various states of awareness that underlie the positive outcomes associated with meditative practices and psychedelic therapies. By reframing neurofeedback modalities as tools to encourage "state awareness" there is great potential to combine neurofeedback with the emerging psychedelic renaissance. Psychedelics are "state" shifting medicines; therefore, the use of neurofeedback inspired therapies within the psychedelic framework can help both therapist and client better acquaint themselves with the human capacity to state shift. Meditation and psychedelic inspired neurofeedback modalities offer a direct experience of how attention alters states, which can offer support toward preparing individuals for the psychedelic experiences, by helping to reduce the preoccupation often associated with challenging psychedelic experiences, while simultaneously increasing a state experience of embodied allowing, associated with an increase in long term therapeutic change. We will discuss how neurofeedback therapies are well poised to offer a method to support the integration of psychedelic sessions, as the afterglow state can sometimes become dimmed and lost if not rehearsed and therefore maintained via state therapy support.
Presented by: Heather Hargraves
Heather Hargraves
30
(IN SPANISH) 2021: A New Way to Simply Disseminate Four Effective Neurofeedback Protocols to Many in Need (Plenary)
IN SPANISH:
We have created a method that will easily allow product developers to add four highly effective protocols to their software by inserting an SDK (software library) developed from our previous published research.
There is a genuine need for a simple way to spread easy-to-use neurofeedback technology with face validity to a wide variety of professional and school training markets that are currently not reached by manufacturers. One of the most important for the field is the addition of modules on neurofeedback in high school and college physiology courses. This will spread knowledge about the field more quickly. In addition, there is a huge market for neurofeedback in the home which can be performed inexpensively for issues such as focus, happiness, depression, and cognitive decline, after appropriate training. There are major potential markets involving incorporating appropriate EEG measurements in fitness tracking devices such as smart watches, smart glasses, and phone apps.
For many years, my colleagues and I have been working to develop four simple protocols for monitoring and training EEG. Each of them is understandable within three minutes of testing following instructions and produces remarkably fast training results.
The presentation will first review the four protocols and the research behind them:
1. Single-pointed focus--the Inhibit All protocol unfortunately nicknamed "squash" (Collura, 2017)
2. Alertness or Arousal (Hillard et al. 2013)
3. Neureka!--The clarified 40 Hz. thalamocortical rhythm which enhances attention and memory, and produces positive feelings as a reward for this effort. (Sokhadze & Daniels, 2016). It also improves autistic issues (Wang et al. 2016; Sokhadze et al. 2019).
4. Mood Elevator--an adaptation of Walker's (Walker & Lawson, 2013) system for improving treatment-resistant depression in six sessions.
We developed all of these protocols using BioExplorer, which has been basically abandoned by its developer, who has not provided reliable supplies or support for years.
The current effort involved reproducing the combination of standardized EEG processing functions, which are not patented, in BioExplorer, using original code, not from BioExplorer. This was done according to our algorithms outside of Bio Explorer, by creating independent software libraries in C++ and translating them into Windows, Android, and iOS, so that they can easily be inserted and implemented in platforms by many other companies. The input to these libraries is the raw EEG from our headband or from other sources. The output for each protocol is a series of floating point double precision numbers which are displayed in a Demo program from 0-100. We will show videos of this, and also the development stage where we were able to compare the waveforms of the BioExplorer outputs and the new ones and generally obtain sequential correlations of over .95.We believe that this justifies the conclusion that the new libraries will be just as effective. Although all of our research was performed on single-channel systems and we do not see the need to offer anything more complex to a manufacturer seeking effective neurofeedback, we are interested in developing a multichannel research version through collaboration.
Presented by Jonathan Cowan and Tato Sokhadze
Jonathan Cowan and Tato Sokhadze
30
(IN SPANISH) 2021: Foundations of Heart Rate Variability Biofeedback
(IN SPANISH)
Abstract:
Heart rate variability (HRV) is the time difference in between adjacent heart beats (Shaffer et al., 2014). In the past years, HRV has emerged as an indicator not only of autonomic balance, but it is also considered an indicator of internal self-regulation mechanisms related to behavior, emotions, and cognition (Reynard et al., 2011; Zahn et al., 2016). It has been stablished that reduced HRV is not only associated with physical impairment but with difficulties in emotional regulation and poor cognitive performance (Forte, Favieri & Cassagrande, 2019). For instance, low vagally-mediated HRV has been associated with biomarkers of glycemic, inflammation and lipid status in a proof-of- concept level study according to AHA guidelines (Jarczok et al., 2019). A recent metanalysis provides statistic data supporting the idea that HRV biofeedback (HRVB) improves emotional, and physical health and performance (Leher et al., 2020). HRVB is an standardized and relatively easy method (Leher et al., 2013) with rare side effects and is based on the in-phase relationship between heart rate and breathing; since HRVB stimulates baroreflex (BR) and respiratory sinus arrhythmia (RSA), and it increases parasympathetic activity (Mather & Thayer, 2018), it is believed that HRVB helps to cope with respiratory disorders such as asthma, helps control blood pressure, produce a well-being and relaxation sense as well as reduced anxiety and depression symptoms (Leher & Gevirtz, 2014; Leher et al; 2020). It has been described a complex network of central structures that may explain the link between physiological, emotion, and cognitive regulation processes (Thayer et al; 2009). Recent hemodynamics studies suggest that slow oscillations in heart rate potentially strengthen brain dynamics within this network, particularly in medial prefrontal cortex and cingulate cortex (Mather & Thayer, 2018). Although this finding, more studies are needed to explain in a higher-level the dynamic between heart-brain communication and why does HRVB helps to cope with disorders as those described above. For instance, more studies about HRVB alone, in comparison and in combination with other interventions or placebo are needed.
In this workshop HRV as an indicator of well-being will be discussed. An overview of main HRV sources and oscillators will be provided. The importance of resonance breathing will be highlighted. The neurovisceral integration model will be reviewed to explain heart-brain communication. There will be a very brief review of HRV instrumentation, as well as HRV evaluation methods, metrics, and standardized protocol.
Presented by: Miriam Sanchez-Gama & Dolores Gaxiola
Miriam Sanchez-Gama & Dolores Gaxiola
60
(IN SPANISH) 2021: Infra-Slow EEG Neurofeedback training for pain management in people with knee osteoarthritis: A pilot and feasibility clinical trial (Panel)
(IN SPANISH)
Abstract:
Background and Objective: Mental illnesses are increasing worldwide with the internalising disorders (IDs; i.e. anxiety disorders, depressive disorders, post-traumatic stress disorder, obsessive-compulsive disorder) being the most prevalent. Current first-line therapies (e.g. pharmacotherapy) offer high failure rates and substantial side-effects.
Electroencephalogram neurofeedback (EEG-NFB) has been shown to be an effective and safe treatment for these conditions, however, there remains much doubt regarding the existence of specificity (i.e. clinical effects specific to the modulation of the EEG variable(s) of interest). We undertook a quantitative review in an attempt to determine if there is evidence for EEG-NFB specificity in the treatment of IDs. Methods: We considered all published and unpublished randomised, double-blind (i.e. trainees and raters), sham/placebo-controlled (i.e. feedback contingent on a random signal, the activity from a different person’s brain, or an unrelated signal from the trainees own brain) trials involving humans with at least one ID diagnosis without exclusion by language, locality, ethnicity, age, or sex. Outcomes of interest included self/parent/teacher reports and clinician ratings. Effect sizes were calculated for individual studies and combined in a meta- analysis. Results: Three trials met our criteria (2 published, 1 unpublished) encompassing a total of 102 participants. Effect sizes ranged from 0.12 to 0.59 with an overall small effect size (cohen's d=0.36, 95% confidence interval=-0.04 to 0.75). Heterogeniety was low (Chi²=0.81, df=2, p=0.67; I² = 0%), however, there were serious concerns regarding the risk of bias and imprecision leading us to rate the overall certainty of the evidence as low. Conclusion: This quantitative review was undertaken to assess for evidence of EEG-NFB specificity in the treatment of IDs. Our analysis suggests that EEG-NFB does have specific effects in the treatment of IDs, however, the overall certainty of the evidence is low. More randomised, double-blind, sham-controlled trials are needed. Registration: This review was registered with the International Prospective Register of Systematic Reviews (PROSPERO; registration number: CRD42020159702)
Presented by: Tyson Perez, Paul Glue , Dirk De Ridder, Divya Adhia & Jerin Mathew
Tyson Perez, Paul Glue , Dirk De Ridder, Divya Adhia & Jerin Mathew
30

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