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Low-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) Modulates Evoked-Gamma Frequency Oscillations in Autism Spectrum Disorder (ASD). 低频重复经颅磁刺激(rTMS)调节自闭症谱系障碍(ASD)的诱发伽马频率振荡。
Pub Date : 2010-07-01 DOI: 10.1080/10874208.2010.501500
Joshua M Baruth, Manuel F Casanova, Ayman El-Baz, Tim Horrell, Grace Mathai, Lonnie Sears, Estate Sokhadze

INTRODUCTION: It has been reported that individuals with Autism Spectrum Disorder (ASD) have abnormal reactions to the sensory environment and visuo-perceptual abnormalities. Electrophysiological research has provided evidence that gamma band activity (30-80 Hz) is a physiological indicator of the co-activation of cortical cells engaged in processing visual stimuli and integrating different features of a stimulus. A number of studies have found augmented and indiscriminative gamma band power at early stages of visual processing in ASD; this may be related to decreased inhibitory processing and an increase in the ratio of cortical excitation to inhibition. Low frequency or 'slow' (≤1HZ) repetitive transcranial magnetic stimulation (rTMS) has been shown to increase inhibition of stimulated cortex by the activation of inhibitory circuits. METHODS: We wanted to test the hypothesis of gamma band abnormalities at early stages of visual processing in ASD by investigating relative evoked (i.e. ~ 100 ms) gamma power in 25 subjects with ASD and 20 age-matched controls using Kanizsa illusory figures. Additionally, we wanted to assess the effects of 12 sessions of bilateral 'slow' rTMS to the dorsolateral prefrontal cortex (DLPFC) on evoked gamma activity using a randomized controlled design. RESULTS: In individuals with ASD evoked gamma activity was not discriminative of stimulus type, whereas in controls early gamma power differences between target and non-target stimuli were highly significant. Following rTMS individuals with ASD showed significant improvement in discriminatory gamma activity between relevant and irrelevant visual stimuli. We also found significant improvement in the responses on behavioral questionnaires (i.e., irritability, repetitive behavior) as a result of rTMS. CONCLUSION: We proposed that 'slow' rTMS may have increased cortical inhibitory tone which improved discriminatory gamma activity at early stages of visual processing. rTMS has the potential to become an important therapeutic tool in ASD treatment and has shown significant benefits in treating core symptoms of ASD with few, if any side effects.

简介:据报道,自闭症谱系障碍(ASD)患者对感觉环境的反应异常,视觉知觉异常。电生理学研究提供的证据表明,伽马波段活动(30-80 Hz)是参与处理视觉刺激和整合刺激不同特征的皮质细胞共同激活的生理指标。许多研究发现,在ASD的视觉处理的早期阶段,伽马波段功率增强和不加区分;这可能与抑制性加工减少和皮层兴奋与抑制之比增加有关。低频或“慢”(≤1HZ)重复经颅磁刺激(rTMS)已被证明通过激活抑制回路来增加受刺激皮层的抑制。方法:我们希望通过研究25名ASD患者和20名年龄匹配的对照者的相对诱发(即~ 100 ms)伽马功率,来验证ASD视觉加工早期阶段伽马带异常的假设。此外,我们希望通过随机对照设计评估12次双侧“慢速”rTMS对背外侧前额叶皮层(DLPFC)诱发的伽马活动的影响。结果:在ASD个体中,诱发的伽马活动对刺激类型没有区别,而在对照组中,目标和非目标刺激之间的早期伽马功率差异非常显著。rTMS后,ASD患者在相关和不相关视觉刺激之间的区别伽马活动有显著改善。我们还发现rTMS对行为问卷(即易怒、重复行为)的反应有显著改善。结论:我们提出“慢”rTMS可能增加了皮层抑制性张力,从而改善了早期视觉加工阶段的歧视性γ活动。rTMS有可能成为ASD治疗的重要治疗工具,并且在治疗ASD核心症状方面显示出显著的益处,而且几乎没有副作用。
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引用次数: 85
Neurofeedback Effects on Evoked and Induced EEG Gamma Band Reactivity to Drug-related Cues in Cocaine Addiction. 可卡因成瘾者诱发和诱导脑伽马带对药物相关线索反应的神经反馈效应。
Pub Date : 2010-07-01 DOI: 10.1080/10874208.2010.501498
Timothy Horrell, Ayman El-Baz, Joshua Baruth, Allan Tasman, Guela Sokhadze, Christopher Stewart, Estate Sokhadze

INTRODUCTION: Preoccupation with drug and drug-related items is a typical characteristic of cocaine addicted individuals. It has been shown in multiple accounts that prolonged drug use has a profound effect on the EEG recordings of drug addicts when compared to controls during cue reactivity tests. Cue reactivity refers to a phenomenon in which individuals with a history of drug abuse exhibit excessive psychophysiological responses to cues associated with their drug of choice. One of the aims of this pilot study was to determine the presence of an attentional bias to preferentially process drug-related cues using evoked and induced gamma reactivity measures in cocaine addicts before and after biobehavioral treatment based on neurofeedback. Another aim was to show that central SMR amplitude increase and frontal theta control is possible in an experimental outpatient drug users group over 12 neurofeedback sessions. METHOD: Ten current cocaine abusers participated in this pilot research study using neurofeedback combined with Motivational Interviewing sessions. Eight of them completed all planned pre- and post -neurofeedback cue reactivity tests with event-related EEG recording and clinical evaluations. Cue reactivity test represented a visual oddball task with images from the International Affective Picture System and drug-related pictures. Evoked and induced gamma responses to target and non-target drug cues were analyzed using wavelet analysis. RESULTS: Outpatient subjects with cocaine addiction completed the biobehavioral intervention and successfully increased SMR while keeping theta practically unchanged in 12 sessions of neurofeedback training. The addition of Motivational Interviewing helped retain patients in the study. Clinical evaluations immediately after completion of the treatment showed decreased self-reports on depression and stress scores, and urine tests collaborated reports of decreased use of cocaine and marijuana. Effects of neurofeedback resulted in a lower EEG gamma reactivity to drug-related images in a post-neurofeedback cue reactivity test. In particular, evoked gamma showed decreases in power to non-target and to a lesser extent target drug-related cues at all topographies (left, right, frontal, parietal, medial, inferior); while induced gamma power decreased globally to both target and non-target drug cues. Our findings supported our hypothesis that gamma band cue reactivity measures are sufficiently sensitive functional outcomes of neurofeedback treatment. Both evoked and induced gamma measures were found capable to detect changes in responsiveness to both target and non-target drug cues. CONCLUSION: Our study emphasizes the utility of cognitive neuroscience methods based on EEG gamma band measures for the assessment of the functional outcomes of neurofeedback-based biobehavioral interventions for cocaine use disorders. This approach may have significant potential for identifying both physiological and clinical

简介:对毒品和与毒品有关的物品全神贯注是可卡因成瘾者的典型特征。多项研究表明,在线索反应性测试中,与对照组相比,长期吸毒对吸毒者的脑电图记录有着深远的影响。线索反应是指有药物滥用史的人对与其选择的药物相关的线索表现出过度的心理生理反应的现象。这项试点研究的目的之一是确定可卡因成瘾者在基于神经反馈的生物行为治疗前后,是否存在使用诱发和诱导的伽马反应性测量来优先处理与毒品有关的线索的注意偏向。另一个目的是表明,在12次神经反馈过程中,实验门诊吸毒者组的中心SMR振幅增加和额叶θ控制是可能的。方法:10名可卡因滥用者参与了这项试点研究,使用神经反馈和动机访谈相结合。他们中的8人完成了所有计划的神经反馈前和后线索反应性测试,包括事件相关的脑电图记录和临床评估。线索反应性测试是一项视觉上的古怪任务,使用来自国际情感图片系统的图像和与毒品有关的图片。使用小波分析来分析对靶向和非靶向药物线索的诱发和诱导的伽马反应。结果:可卡因成瘾的门诊受试者完成了生物行为干预,并成功地提高了SMR,同时在12次神经反馈训练中保持θ几乎不变。动机访谈的加入有助于在研究中留住患者。治疗结束后立即进行的临床评估显示,抑郁和压力评分的自我报告减少,尿液测试报告可卡因和大麻的使用减少。在神经反馈后线索反应性测试中,神经反馈的影响导致脑电图对药物相关图像的γ反应性降低。特别是,诱发伽马在所有地形图(左、右、额、顶叶、内侧、下侧)上显示出对非目标和较小程度的目标药物相关线索的功率降低;而对于靶向和非靶向药物线索,诱导的伽马能总体上降低。我们的发现支持了我们的假设,即伽马带线索反应性测量是神经反馈治疗的足够敏感的功能结果。诱发和诱导伽马测量都能够检测对靶向和非靶向药物线索的反应性变化。结论:我们的研究强调了基于EEG伽马能带测量的认知神经科学方法在评估基于神经反馈的可卡因使用障碍生物行为干预的功能结果方面的实用性。这种方法可能在识别治疗进展的生理和临床标志物方面具有重大潜力。结果证实了我们的预测,即通过神经反馈训练实现的脑电图变化将伴随着线索反应性和临床改善方面的积极脑电图结果。
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引用次数: 61
A Position Paper on Neurofeedback for the Treatment of ADHD 神经反馈治疗多动症的立场文件
Pub Date : 2010-05-18 DOI: 10.1080/10874201003773880
L. Sherlin, M. Arns, J. Lubar, E. Sokhadze
This position paper provides the current evidence supporting the use of neurofeedback in the treatment of ADHD and recommendations on the implementation of neurofeedback in clinical practice. The paper also provides basic information regarding the diagnosis and psychophysiological etiology of ADHD. The paper does not focus on a specific age range of a clinical population. Unless otherwise noted, we are referring to all subtypes of ADHD (inattentive, hyperactive only, and combined). Conclusions and recommendation are based on the most recent research; however, we also refer to relevant historical studies that support our position on neurofeedback. The readers are strongly advised to research behavioral diagnostic criteria and testing methods elsewhere. This paper is not intended as a comprehensive educational tool for diagnosis or treatment of ADHD. Our purpose is to demonstrate the rationale and to reference the necessary support for neurofeedback in order to be recognized as a legitimate, scientific, and evidence-based intervention for the treatment of ADHD.
本立场文件提供了目前支持使用神经反馈治疗多动症的证据和在临床实践中实施神经反馈的建议。本文还提供了ADHD的诊断和心理生理病因的基本信息。这篇论文没有关注临床人群的特定年龄范围。除非另有说明,我们指的是ADHD的所有亚型(注意力不集中、仅多动和合并多动症)。结论和建议是基于最新的研究;然而,我们也参考了相关的历史研究来支持我们对神经反馈的立场。强烈建议读者在其他地方研究行为诊断标准和测试方法。本文不打算作为ADHD诊断或治疗的综合教育工具。我们的目的是证明神经反馈的基本原理,并为其提供必要的支持,以使其成为一种合法的、科学的、以证据为基础的治疗多动症的干预手段。
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引用次数: 63
Validity and Reliability of Quantitative Electroencephalography 定量脑电图的效度和信度
Pub Date : 2010-05-18 DOI: 10.1080/10874201003773500
R. Thatcher
ABSTRACT Reliability and validity are statistical concepts that are reviewed and then applied to the field of quantitative electroencephalography (qEEG). The review of the scientific literature demonstrated high levels of split-half and test–retest reliability of qEEG and convincing content and predictive validity as well as other forms of validity. QEEG is distinguished fromnonquantitative EEG (“eyeball” examination of EEG traces), with the latter showing low reliability (e.g., 0.2–0.29) and poor interrater agreement for nonepilepsy evaluation. In contrast, qEEG is greater than 0.9 reliable with as little as 40-s epochs and remains stable with high test–retest reliability over many days and weeks. Predictive validity of qEEG is established by significant and replicable correlations with clinical measures and accurate predictions of outcome and performance on neuropsychological tests. In contrast, non-qEEG or eyeball visual examination of the EEG traces in cases of nonepilepsy has essentially zero predict...
信度和效度是对统计概念的回顾,然后应用于定量脑电图(qEEG)领域。科学文献的回顾表明,qEEG具有较高的分半信度和重测信度、令人信服的内容和预测效度以及其他形式的效度。QEEG与非定量EEG(脑电图痕迹的“眼球”检查)不同,后者可靠性较低(如0.2-0.29),对非癫痫评估的判据一致性较差。相比之下,qEEG在40-s epoch的可靠性大于0.9,并且在许多天或几周内保持稳定的高重测信度。qEEG的预测有效性是通过与临床测量和神经心理测试结果和表现的准确预测的显著和可复制的相关性来建立的。相比之下,非癫痫病例的非qeeg或眼球视觉检查的脑电图痕迹基本上为零预测。
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引用次数: 119
Are the Effects of rTMS in Parkinson's Disease Clinically Relevant? rTMS治疗帕金森病有临床意义吗?
Pub Date : 2010-05-18 DOI: 10.1080/10874201003766793
Floortje Thomassen, M. Arns
ABSTRACT Introduction. Earlier studies have shown that brain stimulation by means of repetitive Transcranial Magnetic Stimulation (rTMS) over the primary motor cortex can decrease the motor impairments in Parkinson's disease (PD). The present study focused on the clinical relevance of rTMS in the treatment of PD. Method. Thirteen PD patients received a minimum of 10 sessions of 2,000 pulses 5 Hz rTMS over the hand and leg area over the primary motor cortex, with a stimulation intensity of 120% of the motor threshold. In our analysis an effect could be considered as clinically relevant if the quality of life (QoL) improved with 30% or more. Results. Paired-sample t-tests revealed a significant improvement of Unified Parkinson's Disease Rating Scale score, walking speed, and mood. A minority of the patients (38%) who underwent rTMS showed an improvement in QoL of greater than 30%. The improvements on QoL correlated significantly to scores of motor improvements on the Unified Parkinson's Disease Rating Scale...
摘要介绍。早期的研究表明,通过重复经颅磁刺激(rTMS)对初级运动皮层的脑刺激可以减少帕金森病(PD)的运动损伤。本研究的重点是rTMS在PD治疗中的临床意义。方法。13名PD患者在初级运动皮层的手和腿区域接受了至少10次的2000次5 Hz rTMS脉冲,刺激强度为运动阈值的120%。在我们的分析中,如果生活质量(QoL)改善30%或更多,则可以认为效果具有临床相关性。结果。配对样本t检验显示,统一帕金森病评定量表得分、步行速度和情绪有显著改善。少数接受rTMS的患者(38%)的生活质量改善超过30%。生活质量的改善与帕金森病统一评定量表的运动改善得分显著相关。
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引用次数: 1
QEEG Evaluation of the LENS Treatment of TBI LENS治疗TBI的QEEG评价
Pub Date : 2010-05-18 DOI: 10.1080/10874201003767163
D. Hammond, Ecns, Qeeg-D, Bcia-Eeg
Previous publications have reported encouraging preliminary clinical outcomes in the treatment of a variety of problems with the Low Energy Neurofeedback System (LENS). However, no previous publication has evaluated outcomes with quantitative EEG (QEEG) comparisons to normative databases. This article presents outcomes from the LENS treatment of a patient who suffered a serious traumatic brain injury 9 years earlier. After 42 sessions of treatment, the patient, now 16 years old, had very significant clinical improvements as well as documented changes in QEEG measures. Further outcome studies involving pre- and posttreatment QEEG evaluations are needed.
先前的出版物报道了使用低能量神经反馈系统(LENS)治疗各种问题的令人鼓舞的初步临床结果。然而,之前没有出版物评估定量脑电图(QEEG)与规范数据库的比较结果。这篇文章介绍了LENS治疗9年前遭受严重创伤性脑损伤的患者的结果。经过42个疗程的治疗,患者(现在16岁)有了非常显著的临床改善,QEEG测量也有了记录上的变化。需要进一步的结果研究,包括治疗前和治疗后QEEG评估。
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引用次数: 2
Case Report: Impaired Memory and Disorientation Induced by Delta Band Down-Training Over the Temporal Brain Regions by Neurofeedback Treatment 病例报告:神经反馈治疗颞叶区三角洲波段下行训练引起的记忆和定向障碍
Pub Date : 2010-05-18 DOI: 10.1080/10874201003766785
D. Todder, J. Levine, T. Dwolatzky, Z. Kaplan
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引用次数: 10
LENS Neurofeedback Treatment of Anger: Preliminary Reports 愤怒的LENS神经反馈治疗:初步报告
Pub Date : 2010-05-18 DOI: 10.1080/10874201003767213
D. Hammond
ABSTRACT There has been no neurofeedback outcome research on anger control. Problems with anger cut across numerous diagnostic categories and represent a serious societal problem. Two case reports are presented involving significant traumatic brain injuries and histories of chronic anger and violent behavior. The Low Energy Neurofeedback System (LENS) was usedas sole treatment in both cases. Significant improvements were reported in a variety of symptoms and changes in anger were evaluated with the State-Trait Anger Expression Inventory–2. Although the case reports are uncontrolled and represent only very preliminary evidence, the results support the potential of LENS neurofeedback to produce significant improvements in anger control, which has implications with many diagnoses, including traumatic brain injury, juvenile and adult correctional populations, and domestic violence. Clinicians and researchers need to begin using objective pre- and posttreatment outcome measures of anger and aggressiveness.
目前尚无关于愤怒控制的神经反馈结果研究。愤怒问题跨越了许多诊断类别,代表了一个严重的社会问题。两个案例报告提出了严重的创伤性脑损伤和历史的慢性愤怒和暴力行为。低能神经反馈系统(LENS)是两种情况下的唯一治疗方法。各种症状均有显著改善,并用状态-特质愤怒表达量表- 2评估愤怒的变化。尽管这些病例报告是不受控制的,只代表了非常初步的证据,但结果支持LENS神经反馈在愤怒控制方面的潜力,这对许多诊断都有影响,包括创伤性脑损伤,青少年和成人矫正人群,以及家庭暴力。临床医生和研究人员需要开始使用客观的治疗前和治疗后的愤怒和攻击性结果测量。
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引用次数: 5
Impaired Error Monitoring and Correction Function in Autism. 自闭症的错误监测和纠正功能受损。
Pub Date : 2010-04-01 DOI: 10.1080/10874201003771561
Estate Sokhadze, Joshua Baruth, Ayman El-Baz, Timothy Horrell, Guela Sokhadze, Thomas Carroll, Allan Tasman, Lonnie Sears, Manuel F Casanova

INTRODUCTION: Error monitoring and correction is one of the executive functions and is important for effective goal directed behavior. Deficient executive functioning, including reduced error monitoring ability, is one of the typical features of such neurodevelopmental disorders as autism, probably related to perseverative responding, stereotyped repetitive behaviors, and an inability to accurately monitor ongoing behavior. Our prior studies of behavioral and event-related potential (ERP) measures during performance on visual oddball tasks in high-functioning autistic (HFA) children showed that despite only minor differences in reaction times HFA children committed significantly more errors. METHODS: This study investigated error monitoring in children with autism spectrum disorder (ASD) with response-locked event-related potentials - the Error-related Negativity (ERN) and Error-related Positivity (Pe) recorded at fronto-central sites. The ERN reflects early error detection processes, while the Pe has been associated with later conscious error evaluation and attention re-allocation. Reaction times (RT) in correct trials and post-error slowing in reaction times were measured. In this study fourteen subjects with ASD and 14 age- and IQ- matched controls received a three-category visual oddball task with novel distracters. RESULTS: ERN had a lower amplitude and longer latency in the ASD group but was localized in the caudal part of anterior cingulate cortex (ACC) in both groups. The Pe component was significantly prolonged in the ASD group but did not reach significance in amplitude differences compared to controls. We found significant post-error slowing in RTs in controls, and post-error acceleration in RTs in the ASD group. CONCLUSIONS: The reduced ERN and altered Pe along with a lack of post-error RT slowing in autism might be interpreted as insensitivity in the detection and monitoring of response errors and a reduced ability of execute corrective actions. This might result in reduced error awareness and failure in adjustment when dealing with situations where erroneous responses may occur. This deficit might be manifested in the perseverative behaviors often seen in individuals with ASD. The results are discussed in terms of a general impairment in self-monitoring and other executive functions underlying behavioral and social disturbances in ASD.

错误监测和纠正是执行功能之一,对有效的目标导向行为很重要。执行功能缺陷,包括错误监测能力下降,是自闭症等神经发育障碍的典型特征之一,可能与持续性反应、刻板重复行为和无法准确监测正在进行的行为有关。我们之前对高功能自闭症(HFA)儿童在执行视觉怪任务时的行为和事件相关电位(ERP)测量的研究表明,尽管高功能自闭症儿童在反应时间上只有微小的差异,但他们犯的错误却明显更多。方法:本研究调查了具有反应锁定事件相关电位的自闭症谱系障碍(ASD)儿童的错误监测-错误相关负性(ERN)和错误相关正性(Pe)记录在额-中心部位。ERN反映了早期的错误检测过程,而Pe则与后来的有意识错误评估和注意力重新分配有关。测量正确试验的反应时间(RT)和错误后反应时间的减慢。在这项研究中,14名ASD患者和14名年龄和智商匹配的对照组接受了一项带有新奇干扰物的三类视觉怪任务。结果:ASD组ERN振幅较低,潜伏期较长,但两组均位于前扣带皮层(ACC)尾侧。与对照组相比,ASD组Pe分量明显延长,但幅度差异未达到显著性。我们发现对照组的RTs在错误后显著减慢,而ASD组的RTs在错误后加速。结论:自闭症患者的ERN降低和Pe改变以及错误后RT缺乏减慢可能被解释为对反应错误的检测和监测不敏感以及执行纠正措施的能力降低。在处理可能发生错误响应的情况时,这可能导致错误意识降低和调整失败。这种缺陷可能表现在ASD患者经常出现的坚持行为上。研究结果讨论了ASD的行为和社会障碍背后的自我监控和其他执行功能的一般损害。
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引用次数: 74
Neurofeedback Treatment of Chronic Inpatient Schizophrenia 慢性住院精神分裂症的神经反馈治疗
Pub Date : 2010-02-26 DOI: 10.1080/10874200903543971
Angelo S. Bolea
ABSTRACT This is a study on the effect of neurofeedback on chronic inpatient complex paranoid schizophrenics. The purpose of this research was twofold: first, to determine the effects of the application of neurofeedback to very chronic cases of schizophrenia that had been resistant to years of inpatient medical and psychological treatment and second, to propose a connection paradigm of schizophrenia. The author obtained progress using neurofeedback with more than 70 hospital inpatients with chronic schizophrenia. Improvements were seen in the EEG patterns and in cognitive, affective and behavioral patterns that often resulted in successful release from the hospital to live in the community. A 2-year follow up found that positive changes were sustained. It is the author's impression that reinforcement of right parietal alpha and inhibiting frontal delta and fast beta activity obtained the best results.
本研究旨在探讨神经反馈对慢性住院复杂偏执型精神分裂症患者的影响。这项研究的目的有两个:第一,确定将神经反馈应用于多年住院医疗和心理治疗无效的非常慢性的精神分裂症病例的效果;第二,提出精神分裂症的联系范式。作者对70余例住院慢性精神分裂症患者应用神经反馈技术取得进展。脑电图模式以及认知、情感和行为模式都有所改善,这往往导致患者成功出院,回到社区生活。2年的随访发现积极的变化是持续的。笔者的印象是,增强右脑顶叶α和抑制额叶δ和快速β活动的效果最好。
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引用次数: 37
期刊
Journal of neurotherapy
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