Neurofeedback: An Examination of Attentional Processes in Adults with Self-Reported PTSD Symptoms

  • Lelah S Villalpando
  • Connie J McReynolds California State University, San Bernardino
  • Grace Lee
  • Susanne Montgomery
  • David Vermeersch
Keywords: posttraumatic post disorder (PTSD), auditory processing, visual processing, neurofeedback, IVA-2 Continuous Performance Test

Abstract

Novel, effective, and accessible therapeutic interventions for treating posttraumatic stress disorder (PTSD) symptoms are in demand given the significant physical and psychosocial impairment associated with the disorder.  Although PTSD is largely treated with cognitive behavioral therapy (CBT), treatment resistance, or nonresponse rates, continues to remain high.  Research has shown talk therapies can trigger the limbic system, keeping it in a continual state of fight or flight.  Consequently, many trauma survivors seek alternative treatments, such as EEG neurofeedback training.  This study explored the relationship between trauma-related symptoms (i.e., inattention and impulsivity) and visual and auditory functioning in a population of veterans and nonmilitary adults who reported previously being diagnosed with PTSD by a mental health clinician.  Results suggest that EEG neurofeedback therapy is clinically effective for improving visual and auditory attentional functioning in both veterans and nonmilitary adults.  Improved attentional functioning is believed to boost organizational skills, decision-making, frustration tolerance, and comprehension.  This is important given that two-thirds of veterans who complete CBT programs remain in the clinical range for PTSD with notable attention deficits.  Treatment outcome research, such as this study, is vital to improve the effectiveness of therapeutic interventions for persons diagnosed with PTSD, particularly within specific populations that have high nonresponse rates, such as veterans.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Arnsten, A. (2009). Stress signalling pathways that impair prefrontal cortex structure and function. Nature Reviews Neuroscience, 10(6), 410–422. https://doi.org/10.1038/nrn2648

Bomyea, J., & Lang, A. J. (2012). Emerging interventions for PTSD: Future directions for clinical care and research. Neuropharmacology, 62(2), 607–616. https://doi.org/10.1016/j.neuropharm.2011.05.028

Boscariol, M., Garcia, V. L., Guimarães, C. A., Montenegro, M. A., Hage, S. R. V., Cendes, F., & Guerreiro, M. M. (2010). Auditory processing disorder in perisylvian syndrome. Brain and Development, 32(4), 299–304. https://doi.org/10.1016/j.braindev.2009.04.002

Broderick, P. C. (2015). The life span: Human development for helping professionals (4th ed.). New York, NY: Pearson.

Butko, N. J., & Triesch, J. (2007). Learning sensory representations with intrinsic plasticity. Neurocomputing, 70(7–9), 1130–1138. https://doi.org/10.1016/j.neucom.2006.11.006

Choudhury, M., & Sanju, H. K. (2019). Central auditory processing disorder (CAPD) in schoolgoing children. Otolaryngology Open Journal, SE(1), S15–S19. https://doi.org/10.17140/OTLOJ-SE-1-104

Cloitre, M., Courtois, C. A., Ford, J. D., Green, B. L., Alexander, P., Briere, J., … van der Hart, O. (2012). The ISTSS expert consensus treatment guidelines for complex PTSD in adults. Journal of Traumatic Stress, 24(6), 615–627.

Crocq, M. A., & Crocq, L. (2000). From shell shock and war neurosis to posttraumatic stress disorder: A history of psychotraumatology. Dialogues in Clinical Neuroscience, 2(1), 47–55. https://doi.org/10.31887/dcns.2000.2.1/macrocq

da Silva-Sauer, L., de la Torre-Luque, A., Silva, J. S. C., & Fernández-Calvo, B. (2019). New perspectives for cognitive rehabilitation: Could brain-computer interface systems benefit people with dementia? Psychology and Neuroscience, 12(1), 25–37. https://doi.org/10.1037/pne0000154

DeAngelis, T. (2018). Tuning in to our amazing auditory system. Monitor on Psychology, 49(7), 64.

Feduccia, A. A., & Mithoefer, M. C. (2018). MDMA-assisted psychotherapy for PTSD: Are memory reconsolidation and fear extinction underlying mechanisms? Progress in Neuro-Psychopharmacology and Biological Psychiatry, 84(Part A), 221–228. https://doi.org/10.1016/j.pnpbp.2018.03.003

Fisher, S. F., Lanius, R. A., & Frewen, P. A. (2016). EEG neurofeedback as adjunct to psychotherapy for complex developmental trauma-related disorders: Case study and treatment rationale. Traumatology, 22(4), 255–260. https://doi.org/10.1037/trm0000073

Ghazanfar, A. A., & Schroeder, C. E. (2006). Is neocortex essentially multisensory? Trends in Cognitive Sciences, 10(6), 278–285. https://doi.org/10.1016/j.tics.2006.04.008

Haagen, J. F. G., Smid, G. E., Knipscheer, J. W., & Kleber, R. J. (2015). The efficacy of recommended treatments for veterans with PTSD: A metaregression analysis. Clinical Psychology Review, 40, 184–194. https://doi.org/10.1016/j.cpr.2015.06.008

Hammond, D. C. (2011). What is neurofeedback: An update. Journal of Neurotherapy, 15(4), 305–336. https://doi.org/10.1080/10874208.2011.623090

Herwig, U., Lutz, J., Scherpiet, S., Scheerer, H., Kohlberg, J., Opialla, S., … Brühl, A. B. (2019). Training emotion regulation through real-time fMRI neurofeedback of amygdala activity. NeuroImage, 184, 687–696. https://doi.org/10.1016/j.neuroimage.2018.09.068

Institute of Medicine. (2014). Treatment for posttraumatic stress disorder in military and veteran populations: Final assessment. Washington, DC: The National Academies Press. https://doi.org/10.17226/18724

Janarthanan, S. D. (2017). Visual processing disorder in children. Ophthalmology Open Journal, 2(2), 45–47. https://doi.org/10.17140/ooj-2-113

La Marca, J. P., Cruz, D., Fandino, J., Cacciaguerra, F. R., Fresco, J. J., & Guerra, A. T. (2018). Evaluation of artifact-corrected electroencephalographic (EEG) training: A pilot study. Journal of Neural Transmission, 125(7), 1087–1097. https://doi.org/10.1007/s00702-018-1877-1

Li, K., Kadohisa, M., Kusunoki, M., Duncan, J. A., Bundesen, C., & Ditlevsen, S. (2018). Distinguishing between parallel and serial processing in visual attention from neurobiological data. bioRxiv, 383596. https://doi.org/10.1101/383596

Litz, B. T., Berke, D. S., Kline, N. K., Grimm, K., Rusowicz-Orazem, L., Resick, P. A., … Peterson, A. L. (2019). Patterns and predictors of change in trauma-focused treatments for war-related posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 87(11), 1019–1029. https://doi.org/10.1037/ccp0000426

McReynolds, C. J., Bell, J., & Lincourt, T. M. (2017). Neurofeedback: A noninvasive treatment for symptoms of posttraumatic stress disorder in veterans. NeuroRegulation, 4(3–4), 114–124. https://doi.org/10.15540/nr.4.3-4.114

McReynolds, C., Britt, C., & Villalpando, L. (2019). Identifying auditory and visual processing difficulties in school-aged children with ADHD. In P. Cook (Ed.), Discovering New Educational Trends (V3): A Symposium in Belize, Central America (pp. 2–37). Newcastle upon Tyne, UK: Cambridge Scholars Publishing.

McReynolds, C. J., Villalpando, L. S., & Britt, C. E. (2018). Using neurofeedback to improve ADHD symptoms in school-aged children. NeuroRegulation, 5(4), 109–128. https://doi.org/10.15540/nr.5.4.109

Musiek, F. E., Baran, J. A., Bellis, T. J., Chermak, G. D., Hall III, J. W., Keith, R. W., … Nagle, S. (2010). Guidelines for the Diagnosis, Treatment and Management of Children and Adults with Central Auditory Processing Disorder. Reston, VA: American Academy of Audiology. Retrieved from https://audiology-web.s3.amazonaws.com/migrated/CAPD Guidelines 8-2010.pdf_539952af956c79.73897613.pdf

Panisch, L. S., & Hai, A. H. (2020). The effectiveness of using neurofeedback in the treatment of post-traumatic stress disorder: A systematic review. Trauma, Violence, & Abuse, 21(3), 541–550. https://doi.org/10.1177/1524838018781103

Quevedo, K., Liu, G., Teoh, J. Y., Ghosh, S., Zeffiro, T., Ahrweiler, N., … Paret, C. (2019). Neurofeedback and neuroplasticity of visual self-processing in depressed and healthy adolescents: A preliminary study. Developmental Cognitive Neuroscience, 40, 100707. https://doi.org/10.1016/j.dcn.2019.100707

Recanzone, G. H., & Cohen, Y. E. (2010). Serial and parallel processing in the primate auditory cortex revisited. Behavioural Brain Research, 206(1), 1–7. https://doi.org/10.1016/j.bbr.2009.08.015

Sandford, J., & Sandford, S. (2015). IVA-2 Integrated Visual and Auditory Continuous Performance Test manual. North Chesterfield, VA: BrainTrain, Inc.

Schaefer, M. L., Wong, S. T., Wozniak, D. F., Muglia, L. M., Liauw, J. A., Zhuo, M., … Muglia, L. J. (2000). Altered stress-induced anxiety in adenylyl cyclase type VIII-deficient mice. The Journal of Neuroscience, 20(13), 4809–4820. https://doi.org/10.1523/jneurosci.20-13-04809.2000

Serafini, G., Engel-Yeger, B., Vazquez, G. H., Pompili, M., & Amore, M. (2017). Sensory processing disorders are associated with duration of current episode and severity of side effects. Psychiatry Investigation, 14(1), 51–57. https://doi.org/10.4306/pi.2017.14.1.51

Shete, S., Beasley, T. M., Etzel, C. J., Fernández, J. R., Chen, J., Allison, D. B., & Amos, C. I. (2004). Effect of winsorization on power and type 1 error of variance components and related methods of QTL detection. Behavior Genetics, 34(2), 153–159. https://doi.org/10.1023/B:BEGE.0000013729.26354.da

Solberg Økland, H., Todorović, A., Lüttke, C. S., McQueen, J. M., & de Lange, F. P. (2018). Predicting audiovisual speech: Early combined effects of sentential and visual constraints. BioRxiv, 360578. https://doi.org/10.1101/360578

Taneja, N. (2017a). A mini review on differential overview of central auditory processing disorder (CAPD) and attention deficit hyperactivity disorder (ADHD). Otolaryngology Open Journal, SE(1), S20–S23. https://doi.org/10.17140/OTLOJ-SE-1-105

Taneja, N. (2017b). Comprehensive CAPD intervention approaches. Otolaryngology Open Journal, SE(1), S24–S28. https://doi.org/10.17140/OTLOJ-SE-1-106

Thomas, J., & Mack, M. (2010). Auditory processing disorder and reading difficulties. Victoria, Australia: Listen and Learn Centre. Retrieved from https://www.listenandlearn.com.au/wp-content/uploads/2014/10/research_APD1.pdf

Thorne, J. D., & Debener, S. (2014). Look now and hear what’s coming: On the functional role of cross-modal phase reset. Hearing Research, 307, 144–152. https://doi.org/10.1016/j.heares.2013.07.002

van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. New York, NY: Viking.

van der Kolk, B. A., Hodgdon, H., Gapen, M., Musicaro, R., Suvak, M. K., Hamlin, E., & Spinazzola, J. (2016). A randomized controlled study of neurofeedback for chronic PTSD. PLoS ONE, 11(12), e0166752. https://doi.org/10.1371/journal.pone.0166752

Van Eylen, L., Boets, B., Steyaert, J., Wagemans, J., & Noens, I. (2015). Executive functioning in autism spectrum disorders: Influence of task and sample characteristics and relation to symptom severity. European Child & Adolescent Psychiatry, 24(11), 1399–1417. https://doi.org/10.1007/s00787-015-0689-1

Vignoud, G., Venance, L., & Touboul, J. D. (2018). Interplay of multiple pathways and activity-dependent rules in STDP. PLoS Computational Biology, 14(18), e1006184. https://doi.org/10.1371/journal.pcbi.1006184

Published
2020-12-28
Section
Research Papers