Neurofeedback in post-stroke patients

EEG based biofeedback, referred to as neurofeedback (NF) is receiving attention in the research literature for it’s successful application with stroke patients.  In this approach the activity of the brain is modulated directly in a safe approach that relies on a learning process.

 RehaCom and neurofeedback rely on the brain's ability to learn

RehaCom and neurofeedback rely on the brain's ability to learn

Approximately two-thirds of stroke patients experience cognitive impairment following stroke including failures in executive functions, memory, language, visuo-spatial abilities, or global cognitive functioning. 

Therapy often applies a mix of resititution strategies (such as using RehaCom software to recover what can be recovered) along with compensation strategies.

Effective therapy fpr cognition should use both restitution and compensation strategies as neccessary. RehaCom and neurofeedback are examples of restitution approaches

Neurofeedback is a form of EEG biofeedback with a long history of application across a number of fields. Interest in this has grown as the technology to access and process the EEG signals has improved.

In an article by Kober et al (reference below) they investigated the ability of stroke patients to control their own brain activity via neurofeedback and evaluated specific effects of different protocols on memory aspects of cognition.

Modern Biofeedback systems such as the NeXus provide a great start for neurofeedback applcations

The study involved 17 stroke patients who received by to 10 sessions of either “SMR”  (sensorimotor rhythm) or “Upper Alpha” forms of neurofeedback training.  Seven stroke patients received the usual treatment as a control condition and a further 40 healthy volunteers performed neurofeedback training also.

To assess the volunteers’ status, before and after assessments of cognitive function were performed

About 70 % of both patients and controls achieved distinct gains in performance leading to improvements in verbal short - and long-term memory, independent of the neurofeedback protocol which was used.

The SMR patient group showed specific improvements in visuo-spatial short-term memory performance, whereas the Upper Alpha patient group specifically improved their working memory performance.

The neurofeedback training effects were even stronger than the effects of “traditional” cognitive training methods in stroke patients. The neurofeedback training showed no effects on other cognitive functions than memory.

The authors conclude that post-stroke individuals with memory deficits could benefit from neurofeedback training as much as healthy controls. The protocols used in the study (SMR, Upper Alpha) had specific as well as unspecific effects on memory.

Reference

Silvia Erika Kober, Daniela Schweiger, Matthias Witte, Johanna Louise Reichert, Peter Grieshofer, Christa Neuper, and Guilherme Wood
"Specific effects of EEG based neurofeedback training on memory functions in post-stroke victims"
J Neuroeng Rehabil. 2015; 12: 107.
Published online 2015 Dec 1. doi:  10.1186/s12984-015-0105-6
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4666277/