Intensive Neurofeedback-based Training to Improve Impaired Attention and Executive Functions Secondary to Resection of Tuberculum Sellae Meningioma: A Case Study

  • Gianvito Lagravinese, MsC Clinical and Scientific Institutes Maugeri IRCCS, Bari, Italy
  • Rodolfo Sardone, MPh Unit of Research Methodology and Data Sciences for Population Health, “Salus in Apulia Study,” National Institute of Gastroenterology “Saverio de Bellis,” Research Hospital, Castellana Grotte, Italy
  • Stefania De Trane, MD Clinical and Scientific Institutes Maugeri IRCCS, Bari, Italy
  • Fabiana Montenegro, BSc Clinical and Scientific Institutes Maugeri IRCCS, Bari, Italy
  • Ernesto Losavio, MD Clinical and Scientific Institutes Maugeri IRCCS, Bari, Italy
  • Pietro Fiore, MD Clinical and Scientific Institutes Maugeri IRCCS, Bari, Italy
  • Petronilla Battista, PhD Global Brain Health Institute, University of California, San Francisco, (UCSF) - USA
Keywords: EEG biofeedback, qEEG, neurorehabilitation, brain tumor, cognitive functions


Introduction. The present study aimed to evaluate the effectiveness of neurofeedback (NFB) for the treatment of acquired cognitive impairment after brain tumor surgery. Methods. The patient was a 49-year-old bilingual African woman who underwent surgical craniotomy after a tuberculum sellae meningioma was diagnosed. Cognitive deficits were evident following post-surgical recovery, and therefore intensive NFB training consisting of 15 sessions was carried out over a period of three weeks. Full neuropsychological testing and quantitative EEG analysis were performed before and after the training for outcome measurements. Results. The treatment resulted in improved attention and executive functions; specifically sustained, focused, and divided attentional abilities; cognitive flexibility, access to the lexical vocabulary, and a better processing speed. Analysis of the qEEG revealed an increased alpha peak frequency value and reduced delta/alpha ratio in frontal areas. The EEG examination revealed interhemispheric asymmetry after treatment. Conclusion. These findings suggest that a delta/alpha decrease might account for some clinical effects on cognitive abilities seen in a brain tumor resection survivor, reducing cognitive symptoms that can have a significant impact on daily life functions. Future studies on larger patients’ samples should clarify the feasibility of NFB protocols for patients with brain tumors.

Author Biography

Pietro Fiore, MD, Clinical and Scientific Institutes Maugeri IRCCS, Bari, Italy

Clinical and Scientific Institutes Maugeri IRCCS, Bari, Italy
Department of Clinical and Experimental Medicine, University of Foggia, Italy


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