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Neurofeedback Enhances Cortical Efficiency during Aging 20 th Annual World Congress on Anti Aging and Aesthetic Medicine December 13-15, 2012, Las Vegas,

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Presentation on theme: "Neurofeedback Enhances Cortical Efficiency during Aging 20 th Annual World Congress on Anti Aging and Aesthetic Medicine December 13-15, 2012, Las Vegas,"— Presentation transcript:

1 Neurofeedback Enhances Cortical Efficiency during Aging 20 th Annual World Congress on Anti Aging and Aesthetic Medicine December 13-15, 2012, Las Vegas, Nevada Thomas F. Collura, Ph.D., QEEG-D, BCN-A BrainMaster Technologies The Brain Enrichment Center Bedford, Ohio

2 Acknowledgement Elena Festa, Ph.D. Elena Festa, Ph.D. William Heindel, Ph.D. William Heindel, Ph.D. Department of Cognitive, Linguistic, and Psychological Sciences Department of Cognitive, Linguistic, and Psychological Sciences Brown University, Providence, Rhode Island Brown University, Providence, Rhode Island Alzheimer’s Association, USA Alzheimer’s Association, USA (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

3 Festa, E.K., Heindel, W.C., Connors, N.C., Hirschberg, L., & Ott, B.R. (2009). Festa, E.K., Heindel, W.C., Connors, N.C., Hirschberg, L., & Ott, B.R. (2009). Neurofeedback training enhances the efficiency of cortical processing in normal aging. Neurofeedback training enhances the efficiency of cortical processing in normal aging. Cognitive Neuroscience Society Annual Meeting Program, A11, p. 41. supplement of the Journal of Cognitive Neuroscience. Cognitive Neuroscience Society Annual Meeting Program, A11, p. 41. supplement of the Journal of Cognitive Neuroscience. (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

4 Validation Principles Controlled Conditions Controlled Conditions Record physiological & behavioral variables Record physiological & behavioral variables Demonstrate physiological change Demonstrate physiological change Demonstrate behavioral change Demonstrate behavioral change Confirm principles of operation Confirm principles of operation (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

5 Validation Specifics Metric based upon QEEG parameters Metric based upon QEEG parameters Live feedback of derived computations Live feedback of derived computations Operant learning of brain Operant learning of brain Demonstrable expected EEG changes Demonstrable expected EEG changes Demonstrable clinical / behavioral changes Demonstrable clinical / behavioral changes (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

6 Live Z-Score Principles Normalization of QEEG-based parameters Normalization of QEEG-based parameters Resulting change in brain function Resulting change in brain function “Normal” reference database “Normal” reference database Anatomy, Physiology, Logic Anatomy, Physiology, Logic Activation AND Connectivity changes Activation AND Connectivity changes “First Order” Changes – “expected” “First Order” Changes – “expected” Secondary / Compensating Changes Secondary / Compensating Changes (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

7 Single Subject - Within Session Individual Z-Scores (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

8 Single Subject – Within Session Aggregate (All) Z-Scores (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

9 EEG changes with Aging Deficits in cortical connectivity Deficits in cortical connectivity Occipital and Parietal integration Occipital and Parietal integration Manifested in EEG coherence reduction Manifested in EEG coherence reduction Corresponds with perceptual integration deficits Corresponds with perceptual integration deficits Hypothesis – reversing coherence deficits via neurofeedback will reduce cognitive decline Hypothesis – reversing coherence deficits via neurofeedback will reduce cognitive decline (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

10 Controlled Study Aging Population Aging Population Normal and Mild Alzheimer’s Normal and Mild Alzheimer’s N=79 N=79 Real NF: 4-channels: Cz C4 P3 P4 Real NF: 4-channels: Cz C4 P3 P4 Percent Z Scores (PZOK): 248 Z-Scores Percent Z Scores (PZOK): 248 Z-Scores Cognitive / Behavioral Measures Cognitive / Behavioral Measures (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

11 NFT Study in AD and Aging Train posterior sites to: Train posterior sites to: enhance cortical processing within posterior systems enhance cortical processing within posterior systems relieve burden of anterior systems to moderate deteriorated posterior system relieve burden of anterior systems to moderate deteriorated posterior system Investigate the short-term effects of NFT on neurocognitive measures of attention and sensory integration in healthy elderly and patients with early stage AD Investigate the short-term effects of NFT on neurocognitive measures of attention and sensory integration in healthy elderly and patients with early stage AD Compare performance of true-NFT vs. mock-NFT subjects Compare performance of true-NFT vs. mock-NFT subjects (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

12 Experimental Design Healthy elderly and AD patients assigned to either mock or true-NFT group Healthy elderly and AD patients assigned to either mock or true-NFT group Each mock-NFT subject demographically matched to a true-NFT subject Each mock-NFT subject demographically matched to a true-NFT subject 8 NFT sessions 8 NFT sessions 1-2 sessions/week over 4-6 weeks 1-2 sessions/week over 4-6 weeks Assessment battery pre & post NFT Assessment battery pre & post NFT Within 2 weeks of NFT sessions Within 2 weeks of NFT sessions (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

13 Healthy Elderly Participants GROUP N (m,f) AGEEDMMSERBANS NFT 20 (5,15) 71.6(8.1)16.0(3.3)28.8(1.1)108.2(12.2) Mock NFT 19 (3,16) 72.2(8.3)16.0(2.6)28.8(1.2)108.5(13.1) MMSE: Mini-Mental State Examination RBANS: Repeatable Battery for the Assessment of Neuropsychological Status (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

14 Mild AD Participants GROUP N (m,f) AGEEDMMSERBANS NFT 18 (8,10) 78.0(5.0)14.0(3.1)24.4(1.1)74.7(13.1) Mock NFT 12 (6,6) 77.5(6.4)14.0(2.6)25.4(1.2)79.3(9.7) MMSE: Mini-Mental State Examination RBANS: Repeatable Battery for the Assessment of Neuropsychological Status (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

15 NFT sessions NFT sessions Electrode sites: C3, C4, P3, P4 Electrode sites: C3, C4, P3, P4 10 min. % z-score ok training 10 min. % z-score ok training 5 min. baseline (eyes closed) pre & post 5 min. baseline (eyes closed) pre & post Brainwave activity recorded with 4-channel EEG Brainwave activity recorded with 4-channel EEG Real-time z-score neurofeedback training using normative database Real-time z-score neurofeedback training using normative database Methods (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

16 Training Regimen Training Regimen Sessions 1-4 Sessions 1-4 75% of z-scores within 1 STD of normative range 75% of z-scores within 1 STD of normative range Sessions 5-8 Sessions 5-8 80% of z-scores within 1 STD of normative range 80% of z-scores within 1 STD of normative range Audiovisual feedback provided through continuous modulation of the picture contrast of an IMAX nature movie and organ tones when reward criterion sustained for 500 ms Audiovisual feedback provided through continuous modulation of the picture contrast of an IMAX nature movie and organ tones when reward criterion sustained for 500 ms Mock-NFT subjects received feedback in each NFT session based on the recorded brainwave activity across each NFT session of the matched true-NFT subjects Mock-NFT subjects received feedback in each NFT session based on the recorded brainwave activity across each NFT session of the matched true-NFT subjects Methods (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

17 Assessment Battery Assessment Battery Several standardized neuropsychological tests of cognitive functions and emotional well-being (RBANS, CAD, GDS) Several standardized neuropsychological tests of cognitive functions and emotional well-being (RBANS, CAD, GDS) Resting brainwave activity 64-channel EEG recording (eyes closed) Resting brainwave activity 64-channel EEG recording (eyes closed) Behavioral and EEG measures of neurocognitive tests assessing specific component attentional processes Behavioral and EEG measures of neurocognitive tests assessing specific component attentional processes Methods (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

18 Neurocognitive Measures Alerting, Orienting, & Executive Control Alerting, Orienting, & Executive Control Spatial Orienting/Simon Interference task Spatial Orienting/Simon Interference task Selective Attention & Sensory Integration Selective Attention & Sensory Integration Visual Search task Visual Search task (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

19 Visual Search: Selective Attention and Sensory Integration Set Size 1Set Size 3Set Size 5 (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

20 Visual Search and Sensory Integration: Healthy Elderly (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

21 Visual Search and Sensory Integration: Mild AD (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

22 Results: Visual Search Healthy Elderly Healthy Elderly Real NFT decreased RTs for both sensory binding conditions Real NFT decreased RTs for both sensory binding conditions Mock NFT had no effect on RTs for either binding conditions Mock NFT had no effect on RTs for either binding conditions Mild AD Mild AD Real NFT had no effect on RTs for either binding conditions Real NFT had no effect on RTs for either binding conditions Mock NFT had no effect on RTs for either binding conditions Mock NFT had no effect on RTs for either binding conditions (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

23 Simon Interference Congruent Covert Orienting/Simon Interference LEFT Incongruent (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

24 Orienting Alerting Double Invalid LEFT Valid No Cue LEFT (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

25 Effects of NFT on Simon Interference Healthy ElderlyMild AD (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

26 Results: Simon Interference Healthy Elderly Healthy Elderly Real NFT had no effect on RTs for either Congruent or Incongruent trials Real NFT had no effect on RTs for either Congruent or Incongruent trials Mock NFT increased RTs for both Congruent and Incongruent trials Mock NFT increased RTs for both Congruent and Incongruent trials Mild AD Mild AD Real NFT had no significant effect on RTs for either Congruent or Incongruent trials Real NFT had no significant effect on RTs for either Congruent or Incongruent trials Mock NFT had no significant effect on RTs for either Congruent or Incongruent trials Mock NFT had no significant effect on RTs for either Congruent or Incongruent trials (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

27 Effects of NFT on Spatial Orienting Healthy ElderlyMild AD (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

28 Results: Spatial Orienting Healthy Elderly Healthy Elderly Real NFT reduced RTs for both Valid and Invalid Cue trials Real NFT reduced RTs for both Valid and Invalid Cue trials Mock NFT increased RTs for both Valid and Invalid Cue trials Mock NFT increased RTs for both Valid and Invalid Cue trials Mild AD Mild AD Real NFT selectively reduced RTs for Invalid Cue trials Real NFT selectively reduced RTs for Invalid Cue trials Mock NFT had no effect on RTs for either Valid or Invalid Cue trials Mock NFT had no effect on RTs for either Valid or Invalid Cue trials (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

29 Effects of NFT on Alerting Healthy ElderlyMild AD (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

30 Results: Alerting Healthy Elderly Healthy Elderly Real NFT had no effect on RTs for either Double or No Cue trials Real NFT had no effect on RTs for either Double or No Cue trials Mock NFT selectively increased RTs for No Cue Cue trials Mock NFT selectively increased RTs for No Cue Cue trials Mild AD Mild AD Real NFT reduced RTs for both Double and No Cue Trials Real NFT reduced RTs for both Double and No Cue Trials Mock NFT increased RTs for both Double and No Cue Trials Mock NFT increased RTs for both Double and No Cue Trials (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

31 Summary: Real NFT Healthy Elderly Healthy Elderly No effect on cross-cortical sensory integration, but enhanced selective attention in the visual search task No effect on cross-cortical sensory integration, but enhanced selective attention in the visual search task Generalized enhancement of response times in spatial orienting Generalized enhancement of response times in spatial orienting No effect on either alerting measures or response inhibition in Simon interference No effect on either alerting measures or response inhibition in Simon interference Mild AD Mild AD No effect on either cross-cortical sensory integration or selective attention measures in the visual search task No effect on either cross-cortical sensory integration or selective attention measures in the visual search task Selective improvement in disengagement in spatial orienting Selective improvement in disengagement in spatial orienting Enhanced phasic and tonic alerting Enhanced phasic and tonic alerting No effect on response inhibition in Simon interference No effect on response inhibition in Simon interference (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

32 Summary: Mock NFT Healthy Elderly Healthy Elderly No effect on cross-cortical sensory integration or selective attention in the visual search task No effect on cross-cortical sensory integration or selective attention in the visual search task Generalized slowing of response times for spatial orienting, alerting and Simon interference measures Generalized slowing of response times for spatial orienting, alerting and Simon interference measures Mild AD Mild AD No effect on cross-cortical sensory integration or selective attention in the visual search task No effect on cross-cortical sensory integration or selective attention in the visual search task No effect on response times for spatial orienting or Simon interference measures No effect on response times for spatial orienting or Simon interference measures Generalized slowing of response times for the alerting measures Generalized slowing of response times for the alerting measures (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

33 Non-Memory Impairments in AD Attention Attention Cognitive operations involved in the detection and selection of sensory information Cognitive operations involved in the detection and selection of sensory information Automatic (stimulus-driven) Automatic (stimulus-driven) Voluntary (controlled, goal-directed) Voluntary (controlled, goal-directed) Different attentional processes mediated by distinct neural subsystems Different attentional processes mediated by distinct neural subsystems Sensory Integration Sensory Integration The “Binding Problem” The “Binding Problem” Moment-by-moment ability to combine distinct sensory inputs related to a single object into a coherent, unified representation Moment-by-moment ability to combine distinct sensory inputs related to a single object into a coherent, unified representation Dependent upon effective interactions across cortical areas Dependent upon effective interactions across cortical areas (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

34 Non-Memory Impairments in AD (and Aging) Posterior Cortical Processing Systems Posterior Cortical Processing Systems Alerting (cortical tonus) Alerting (cortical tonus) Orienting Orienting Sensory Integration Sensory Integration Inefficient cortical processing in Aging Inefficient cortical processing in Aging Corticocortical disconnectivity in AD Corticocortical disconnectivity in AD Anterior Executive Control Processes Anterior Executive Control Processes Changes in frontal cortex with age and AD results in less efficient controlled attentional processes Changes in frontal cortex with age and AD results in less efficient controlled attentional processes Greater demands placed on anterior executive processes to moderate deterioration in posterior attentional and sensory systems Greater demands placed on anterior executive processes to moderate deterioration in posterior attentional and sensory systems (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

35 Conclusion: Brown University Study These results indicate that neurofeedback training can be effective in inducing changes in cortical processing associated with improvements in specific aspects of cognitive functioning. These results indicate that neurofeedback training can be effective in inducing changes in cortical processing associated with improvements in specific aspects of cognitive functioning. (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

36 Peak Alpha and Aging Angelakis, E., Stathopoulou, S., Frymiare, J.I., Green, D.L., Lubar, J.F., and Kounios, J. (2006) EEG neurofeedback: a brief review and an example of peak alpha frequency training for cognitive enhancement in the elderly. The Clinical Neuropsychologist. www.psypress.com/tcn/print/1744-4144. (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

37 Peak Alpha and Aging PAF is the frequency of the (posterior) alpha wave Normal is 10 Hz; slower in children Range typically from 8 to 12 Hz PAF correlates positively with cognitive performance PAF correlates negatively with age after childhood (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

38 Peak Alpha and Aging Controlled study, double-blind PAF neurofeedback improved cognitive processing speed and executive function No effect on memory (C) 2011 -12 Thomas F. Collura, Ph.D. &/or E. Festa, Brown University

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