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Having trouble paying attention? MIT neuroscientists may have a solution for you: Turn down your alpha brain waves. In a new study, the researchers found that people can enhance their attention by controlling their own alpha brain waves based on neurofeedback they receive as they perform a particular task.
The study found that when subjects learned to suppress alpha waves in one hemisphere of their parietal cortex, they were able to pay better attention to objects that appeared on the opposite side of their visual field. This is the first time that this cause-and-effect relationship has been seen, and it suggests that it may be possible for people to learn to improve their attention through neurofeedback.
Desimone is the senior author of the paper, which appears in Neuron on Dec. 4. McGovern Institute postdoc Yasaman Bagherzadeh is the lead author of the study. Daniel Baldauf, a former McGovern Institute research scientist, and Dimitrios Pantazis, a McGovern Institute principal research scientist, are also authors of the paper.
There are billions of neurons in the brain, and their combined electrical signals generate oscillations known as brain waves. Alpha waves, which oscillate in the frequency of 8 to 12 hertz, are believed to play a role in filtering out distracting sensory information.
Previous studies have shown a strong correlation between attention and alpha brain waves, particularly in the parietal cortex. In humans and in animal studies, a decrease in alpha waves has been linked to enhanced attention. However, it was unclear if alpha waves control attention or are just a byproduct of some other process that governs attention, Desimone says.
To test whether alpha waves actually regulate attention, the researchers designed an experiment in which people were given real-time feedback on their alpha waves as they performed a task. Subjects were asked to look at a grating pattern in the center of a screen, and told to use mental effort to increase the contrast of the pattern as they looked at it, making it more visible.
During the task, subjects were scanned using magnetoencephalography (MEG), which reveals brain activity with millisecond precision. The researchers measured alpha levels in both the left and right hemispheres of the parietal cortex and calculated the degree of asymmetry between the two levels. As the asymmetry between the two hemispheres grew, the grating pattern became more visible, offering the participants real-time feedback.
Although subjects were not told anything about what was happening, after about 20 trials (which took about 10 minutes), they were able to increase the contrast of the pattern. The MEG results indicated they had done so by controlling the asymmetry of their alpha waves.
Although the subjects were not consciously aware of how they were manipulating their brain waves, they were able to do it, and this success translated into enhanced attention on the opposite side of the visual field. As the subjects looked at the pattern in the center of the screen, the researchers flashed dots of light on either side of the screen. The participants had been told to ignore these flashes, but the researchers measured how their visual cortex responded to them.
One group of participants was trained to suppress alpha waves in the left side of the brain, while the other was trained to suppress the right side. In those who had reduced alpha on the left side, their visual cortex showed a larger response to flashes of light on the right side of the screen, while those with reduced alpha on the right side responded more to flashes seen on the left side.
After the neurofeedback training session ended, the researchers asked subjects to perform two additional tasks that involve attention, and found that the enhanced attention persisted. In one experiment, subjects were asked to watch for a grating pattern, similar to what they had seen during the neurofeedback task, to appear. In some of the trials, they were told in advance to pay attention to one side of the visual field, but in others, they were not given any direction.
When the subjects were told to pay attention to one side, that instruction was the dominant factor in where they looked. But if they were not given any cue in advance, they tended to pay more attention to the side that had been favored during their neurofeedback training.
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The lifetime prevalence of low back pain is 83%. Since there is a lack of evidence for therapeutic effect by cognitive behavioral therapy (CBT) or physical therapy (PT), it is necessary to develop objective physiological indexes and effective treatments. We conducted a prospective longitudinal study to evaluate the treatment effects of CBT, PT, and neurofeedback training (NFT) during alpha wave NFT. The early-chronic cases within 1 year and late-chronic cases over 1 year after the diagnosis of chronic low back pain were classified into six groups: Controls, CBTs, PTs, NFTs, CBT-NFTs, PT-NFTs. We evaluated the difference in EEG, psychosocial factors, scores of low back pain before/after the intervention. Therapeutic effect was clearly more effective in the early-chronic cases. We found that the intensity of alpha waves increased significantly after therapeutic intervention in the NFT groups, but did not have the main effect of reducing low back pain; the interaction between CBT and NFT reduced low back pain. Factors that enhance therapeutic effect are early intervention, increased alpha waves, and self-efficacy due to parallel implementation of CBT/PT and NFT. A treatment protocol in which alpha wave neurofeedback training is subsidiarily used with CBT or PT should be developed in the future.
It has been reported that both cognitive-behavioral therapy and physical therapy have a certain effect size3. Although evidence can be found in support of CBT4, the pain-relief effects might be minimal and short lived. Alternatively, a greater effect could be gained for emotional and life disorders5, but less so in pain reduction. Because there is a lack of evidence regarding the effectiveness of PT6,7,8,9,10,11, patients may discontinue therapy in many cases as a consequence of unsuccessful therapy. It is necessary to develop a new treatment strategy that is more effective for chronic low back pain.
Therefore, we focused on alpha wave neurofeedback training. The study of neurofeedback on the basis of functional Magnetic Resonance Imaging (fMRI) and EEG has made remarkable progress as an objective evaluation index. Neurofeedback is a method used to visualize brain activity with use of biological signals through fMRI and brain waves, and then control the activity while monitoring function in real time. Among them, a method utilizing alpha brain waves can be widely used in neurofeedback12.Previous reports have pointed out the correlation between alpha and beta attenuation and pain intensity13. Alpha brain waves neurofeedback may have a clinically meaningful effect on pain intensity in short-term, in recent years, alpha brain waves neurofeedback has been utilized to regulate abnormal brain activity associated with chronic pain14.
For these reasons, we conducted an intervention study aimed at examining the difference in efficacy by combining alpha-wave neurofeedback training with treatments usually given to patients with chronic low back pain such as oral administration, CBT, and PT. In addition, since it is important to treat CBT and PT at an early stage3, the difference in therapeutic effect will be examined separately for the early stage and the chronic stage.
The treatment of chronic low back pain has been shown to have some effect on CBT and PT, but the evidence is not yet strong. In recent years, the pain treatment effect of alpha wave neurofeedback training has also been reported. Therefore, in this study, we conducted a prospective longitudinal study to evaluate whether the combination of CBT and PT with NFT is more effective than simple treatment and differences between early-chronic cases within 1 year and the late-chronic cases over 1 year after diagnosis of chronic low back pain.
Table 1 shows the attributes of the research collaborators. The present study targeted 97 patients with chronic low back pain but no surgical history of low back pain who were referred to the Department of Orthopedics/Anesthesiology and Pain Center at our institution for low back pain after April 2020. Those patients were also recommended to receive CBT and PT since they were diagnosed as no primary organic cause for low back pain on the basis of MRI and neurological symptoms according to four spinal surgeons. The patients were also resistant to standard orthopedic treatments such as medication (i.e., NSAIDs, opioids, gabapentinoids, and anti-depressants) and various block injections. For the registered cases, senior physicians confirmed that MRI findings were not consistent with patient symptoms during a Pain Center conference. The application of CBT and PT was evaluated with the Brief Scale for evaluation of Psychiatric problems in Orthopedic Patients (BS-POP)15 and Locomo 2516. Standard orthopedic treatments were continued during the intervention trial, but there were no changes in oral medication.
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