Safety and Feasibility of neurofeedback training (NFB) during sleep in uncooperative child with Autism: case report
AbstractPurpose: Neurofeedback (NFB) training has demonstrated significant potential in achieving symptoms reduction in children with Autism Spectrum Disorder (ASD). However, children with low-functioning ASD are often uncooperative with the treatment. To evaluate whether NFB can eventually be administrated during sleep, a safety and feasibility pilot study was performed. Methods: A 9-year-old male patient diagnosed with ASD underwent NFB training for 30 min twice a week. This was operated at home during sleep by the parents. The NFB protocol aimed at increasing sensorimotor rhythm (SMR) while simultaneously decreasing theta activity over the sensorimotor strip. Results: NFB during sleep was feasible and did not yield adverse side effects. Parents reported improved behavioral and emotional symptoms and enhanced language development following NFB training. Subsequently, the patient could participate in regular sessions of NFB in wakefulness. Conclusion: Overall, parental reports suggest that applying NFB during sleep in low-functioning ASD is feasible and might offer promising therapeutic avenues.
EB system [Apparatus]. Bedford, OH: BrainMaster Technologies, Inc.
Arzi, A., Holtzman, Y., Samnon, P., Eshel, N., Harel, E., & Sobel, N. (2014). Olfactory aversive conditioning during sleep reduces cigarette-smoking behavior. The Journal of Neuroscience, 34(46), 15382–15393. http://dx.doi.org /10.1523/JNEUROSCI.2291-14.2014
Ayers, M. E. (1999). Assessing and treating open head trauma, coma, and stroke using real-time digital EEG neurofeedback. Introduction to Quantitative EEG and Neurofeedback, 203–222. http://dx.doi.org/10.1016/B978-012243790-8/50010-9
BrainMaster (Version 3.7i) [Computer software]. Bedford, OH: BrainMaster Technologies, Inc. Retrieved from: http://www.brainmaster.com/software/3.0/BMr30Setup3.7i.exe
Coben, R., Linden, M., & Myers, T. E. (2010). Neurofeedback for autistic spectrum disorder: A review of the literature. Applied Psychophysiology and Biofeedback, 35(1), 83–105. http://dx.doi.org/10.1007/s10484-009-9117-y
Coben, R., &Padolsky, I. (2007). Assessment-guided neurofeedback for autistic spectrum disorder. Journal of Neurotherapy, 11(1), 5–23. http://dx.doi.org/10.1300 /J184v11n01_02
Dudai, Y. (2012). The restless engram: Consolidations never end. Annual Review of Neuroscience, 35, 227–247. http://dx.doi.org/10.1146/annurev-neuro-062111-150500
Gruzelier, J., &Egner, T. (2005). Critical validation studies of neurofeedback. Child and Adolescent Psychiatric Clinics of North America, 14(1), 83–104. http://dx.doi.org/10.1016 /j.chc.2004.07.002
Gruzelier, J. H. (2014). EEG-neurofeedback for optimising performance. I: A review of cognitive and affective outcome in healthy participants. Neuroscience and Biobehavioral Reviews, 44, 124–141. http://dx.doi.org/10.1016 /j.neubiorev.2013.09.015
Hammond, D. C. (2005). Neurofeedback treatment of depression and anxiety. Journal of Adult Development, 12(2), 131–137. http://dx.doi.org/10.1007/s10804-005-7029-5
Hill, E. L., &Frith, U. (2003). Understanding autism: Insights from mind and brain. Philosophical Transactions of the Royal Society of London B: Biological Sciences, 358(1430), 281–289. http://dx.doi.org/10.1098/rstb.2002.1209
Hoedlmoser, K., Pecherstorfer, T., Gruber, G., Anderer, P., Doppelmayr, M., Klimesch, W., &Schabus, M. (2008). Instrumental conditioning of human sensorimotor rhythm (12–15 Hz) and its impact on sleep as well as declarative learning. Sleep, 31(10), 1401–1408.
Holtmann, M., Bölte, S., &Poustka, F. (2007). Autism spectrum disorders: Sex differences in autistic behaviour domains and coexisting psychopathology. Developmental Medicine and Child Neurology, 49(5), 361–366.http://dx.doi.org /10.1111/j.1469-8749.2007.00361.x
Holtmann, M., Steiner, S., Hohmann, S., Poustka, L., Banaschewski, T., &Bölte, S. (2011). Neurofeedback in autism spectrum disorders. Developmental Medicine and Child Neurology, 53(11), 986–993. http://dx.doi.org /10.1111/j.1469-8749.2011.04043.x
Keller, I., &Garbacenkaite, R. (2015). Neurofeedback in Three Patients in the State of Unresponsive Wakefulness. Applied Psychophysiology and Biofeedback, 40(4), 349–356. http://dx.doi.org/10.1007/s10484-015-9296-7
Kouijzer, M. E. J., de Moor, J. M. H., Gerrits, B. J. L., Buitelaar, J. K., & van Schie, H. T. (2009). Long-term effects of neurofeedback treatment in autism. Research in Autism Spectrum Disorders, 3(2), 496–501. http://dx.doi.org/10.1016 /j.rasd.2008.10.003
Kouijzer, M. E. J., de Moor, J. M. H., Gerrits, B. J. L., Congedo, M., & van Schie, H. T. (2009). Neurofeedback improves executive functioning in children with autism spectrum disorders. Research in Autism Spectrum Disorders, 3(1), 145–162. http://dx.doi.org/10.1016/j.rasd.2008.05.001
Lubar, J. F. (1997). Neocortical dynamics: Implications for understanding the role of neurofeedback and related techniques for the enhancement of attention. Applied Psychophysiology and Biofeedback, 22(2), 111–126.
Marshall, L., Mölle, M., Hallschmid, M., & Born, J. (2004). Transcranial direct current stimulation during sleep improves declarative memory. The Journal of Neuroscience, 24(44), 9985–9992. http://dx.doi.org/10.1523/JNEUROSCI.2725-04.2004
Rogel, A., Guez, J., Getter, N., Keha, E., Cohen, T., Amor, T., &Todder, D. (2015). Transient Adverse Side Effects During Neurofeedback Training: A Randomized, Sham-Controlled, Double Blind Study. Applied Psychophysiology and Biofeedback, 40(3), 209–218. http://dx.doi.org/10.1007 /s10484-015-9289-6
Sajith, S. G., & Clarke, D. (2007). Melatonin and sleep disorders associated with intellectual disability: A clinical review. Journal of Intellectual Disability Research, 51(1), 2–13. http://dx.doi.org/10.1111/j.1365-2788.2006.00893.x
Sterman, M. B. (2000). Basic concepts and clinical findings in the treatment of seizure disorders with EEG operant conditioning. Clinical EEG and Neuroscience, 31(1), 45–55. http://dx.doi.org/10.1177/155005940003100111
Sterman, M. B., & Bowersox, S. S. (1981). Sensorimotor electroencephalogram rhythmic activity: a functional gate mechanism. Sleep, 4(4), 408–422.
Sterman, M. B., &Egner, T. (2006). Foundation and practice of neurofeedback for the treatment of epilepsy. Applied Psychophysiology and Biofeedback, 31(1), 21–35. http://dx.doi.org/10.1007/s10484-006-9002-x
Tononi, G., &Cirelli, C. (2006). Sleep function and synaptic homeostasis. Sleep Medicine Reviews, 10(1), 49–62. http://dx.doi.org/10.1016/j.smrv.2005.05.002
Tuchman, R. (2000). Treatment of seizure disorders and EEG abnormalities in children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 30(5), 485–489. http://dx.doi.org/10.1023/A:1005572128200
Copyright (c) 2016 Keren Avirame, Limor Nuss, Doron Todder
This work is licensed under a Creative Commons Attribution 4.0 International License.Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC-BY) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).