Single session neurofeedback treatment alters theta/beta-1 and theta/alpha ratios but not sufficient to induce clinical enhancement in attention

Abstract

Background and Aims: Neurofeedback treatment (NFT) may enhance attention performance in healthy individuals. This study investigated the effects of single session NFT on attention in healthy individuals performing a visual attention task. Methods: This was an open-label single-blinded trial conducted on 14 healthy university students (n=14; mean=23.35±0.58 years) of a major medical university in Iran. The subjects underwent a single session NFT while performing attentional network task (ANT). The NFT protocol was theta suppression/beta-1enhancement applied at Cz for 20 min. Before and immediately after NFT, EEG signals were recorded in subjects while performing ANT. EEGs were recorded using a 19 channel device and 10-20 placement protocol. Results: The single session NFT increased the theta/beta-1 ratio in most of the electrode sites and the increase was statistically significant compared to the pre-intervention in the T6 site (p=0.011). The ratio decreased in just three sites of C3, Fz, and Cz, of them Fz showed a significant reduction (p=0.026). Contrary, the theta/alpha ratio decreased in most of the electrodes where the reductions were statistically significant in P3, P4, Cz, Pz (p<0.05), and C3 (p<0.01). The F7, F8, T3, and T4 showed no significant increased theta/alpha ratio. The central, temporal and occipital regions were involved in the NFT induced changes. Single NFT did not significantly change alerting, executive, or orienting networks of ANT. Conclusions: Theta/beta-1 and theta/alpha ratios can be reliably used to assess NFT induced attention enhancement. However, single NFT did not induce clinical outcomes and repeated sessions seem necessary to modulate alerting, executive, or orienting networks of ANT.