An effective Neurofeedback training, with cortisol correlates, in a clinical case of anxiety
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may 18, 2017
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Resumen
Neurofeedback treatments have shown successful results in anxiety disorders. The effectiveness of a beta1 Neurofeedback protocol was tested in a longitudinal clinical case study. A participant suffering from an anxiety syndrome underwent 10 sessions of Neurofeedback, in a protocol consisting of uptraining the beta1 rhythm (16-21 Hz) while downtraining the theta (4-8 Hz) band. State anxiety and salivary cortisol levels were measured during each of the 10 sessions following a pre/post design. Initial and final examinations of anxiety symptoms and sustained attention performance were also implemented. The final evaluation revealed that levels of anxiety fell within a normative range and that sustained attention had improved. A t-test for related samples disclosed a significant improvement of beta1 amplitude across the sessions, without modifications in untrained bands. A significant inverse correlation between beta1 amplitude and salivary cortisol was detected, suggesting that brain activity could be considered a marker of anxiety. The validation of the beta1 Neurofeedback protocol was assessed according to independence, trainability and interpretability criteria. We demonstrate the effectiveness of a neurofeedback protocol on anxiety and sustained attention, the success of which may lie in the reestablishment of an optimal cortical arousal capable of inhibiting elevated amygdalar activity
Keywords
Neurofeedback, ansiedad, cortisol, ritmo beta1, ritmo thetaneurofeedback, anxiety, cortisol, beta1 band, theta band.
References
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Spielberger, C.D., Gorsuch, R.L., & Lushene, R.E. (1982) STAI: Cuestionario de Ansiedad Estado-Rasgo. Manual. Madrid: TEA Ediciones, S.A.
Stalder, T., Tietze, A., Steudte, S., Alexander, N., Dettenborn, L., & Kirschbaum, C. (2014). Elevated hair cortisol levels in chronically stressed dementia caregivers. Psychoneuroendocrinology, 47, 26-30.
Tobal, J. J. M., & Vindel, A. R. C. (1994) ISRA: Inventario de Situaciones y Respuestas de Ansiedad: Manual. Madrid: TEA Ediciones.
Toulouse, E., & Pieron, H. (1986). Toulouse-Pieron: Prueba perceptiva y de atención: Manual. Madrid: TEA Ediciones.
Van Boxtel, G. J. M., & Gruzelier, J. H. (2014). Neurofeedback: Introduction to the special issue. Biological Psychology, 95, 1-3. Doi: 10.1016/j.biopsycho.2013.11.011
Van Honk, J., & Schutter, D. J. L. G. (2007). Testosterone reduces conscious detection of signals serving social correction: Implications for antisocial behaviour. Psychological Science, 18(8), 663-667.
Vasquez, M., Gadea, M., Garijo, E., Aliño, M., & Salvador, A. (2015). Efectos del entrenamiento asistido con neurofeedback sobre EEG, los procesos de función ejecutiva y el afecto en una muestra de población normal. Anales de Psicología, 31(1), 317-323. http://dx.doi.org/10.6018/analesps.31.1.167241
Vernon, D. (2005). Can Neurofeedback Training Enhance Performance? An Evaluation of the Evidence with Implications for Future Research. Applied Psychophysiology and Biofeedback, 30 (4), 347-364.
Wu, J., Cui, Y., Yang, Y., Kang, M., Jung, S., … & Eun, S. (2014). Modulatory effects of aromatherapy massage intervention on electroencephalogram, psychological assessments, salivary cortisol and plasma brain-derived neurotrophic factor. Complementary Therapies in Medicine, 22, 456-462.
Zoefel, B., Huster, R. J., & Herrmann, C. S. (2011). Neurofeedback training of the upper alpha frequency band in EEG improves cognitive performance. Neuroimage, 54(2), 1427-1431.
American Psychological Association (1992). Ethical principles of psychologists and code of conduct. American Psychologist, 47, 1597-1611.
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association.
Benvenuti, S. M., Buodo, G., Leone, V., & Palomba, D. (2011). Neurofeedback training for Tourette Syndrome: An uncontrolled single case study. Applied Psychophysiology and Biofeedback, 36(4), 281-288.
Brennan, A. R. & Arnsten, A. F. (2008). Neuronal mechanisms underlying attention deficit hyperactivity disorder: The influence of arousal on prefrontal cortical function. Annals of the New York Academy of Sciences, 1129, 236-245.
Cheon, E. J., Koo, B. H., & Choi, J. H. (2016). The efficacy of neurofeedback in patients with major depressive disorder: An open labelled prospective study. Applied Psychophysiology and Biofeedback, [Epub ahead of print] doi: 10.1007/s10484-015-9315-8.
Dedovic, K., Giebl, S., Duchesne, A., Lue, S. D., Andrews, J. … & Pruessner, J. C. (2016). Psychological, endocrine and neural correlates of attentional bias in subclinical depression, Anxiety, Stress, & Coping, 29 (5), 479-496. Doi: 10.1080/10615806.2015.1101457
Egner, T., & Gruzelier, J. H. (2004). EEG biofeedback of low beta band components: frequency specific effects on variables of attention and event-related brain potentials. Clinical Neurophysiology, 115(1), 131-9.
Elkins, G., Rajab, M. H., & Marcus, J. (2005). Complementary and alternative medicine use by psychiatric inpatients. Psychological Reports, 96, 163-166.
Etkin, A., Egner, T., Peraza, D.M., Kandel, E.R., & Hirsch, J. (2006). Resolving emotional conflict: A role for the rostral anterior cingulate cortex in modulating activity in the amygdale. Neuron, 51(6), 871-882.
Goldin, P.R., McRae, K., Ramel, W., & Gross, J.J. (2008). The neural bases of emotion regulation: reappraisal and suppression of negative emotion. Biological Psychiatry, 63(3), 577-586.
Gruzelier, J.H., Egner, T., & Vernon, D. (2006). Validating the efficacy of neurofeedback for optimising performance. Progress in Brain Research, 159, 421-431.
Hammond D. (2005). Neurofeedback with anxiety and affective disorders. Child & Adolescent Psychiatric Clinics of North America, 14(1), 105-123.
Hellhammer, D. H., Wüst, S., & Kudielka, B. G. (2009). Salivary cortisol as a biomarker in stress research. Psychoneuroendocrinology, 34(2), 163-171.
Hewig, J., Schlotz, W., Gerhards, F., Breitenstein, C., Lürken, A., & Naumann, E. (2008). Associations of the cortisol awakening response (CAR) with cortical activation asymmetry during the course of an exam stress period. Psychoneuroendocrinology, 33(1), 83-91.
Hull, A.M. (2002). Neuroimaging findings in post-traumatic stress disorder. Systematic review. The British Journal of Psychiatry, 181, 102-110.
Karlén, J., Ludvigsson, J., Frostell, A., Theodorsson, E., & Faresjö, T. (2011). Cortisol in hair measured in young adults – a biomarker of major life stressors? BMC Clinical Pathology, 11, 12.
Knyazev, G. G. (2007). Motivation, emotion, and their inhibitory control mirrored in brain oscillations. Neuroscience & Biobehavioral Reviews, 31(3), 377-395.
Kumar, A., Rinwa, P., Kaur, G., & Machawal, L. (2013). Stress: Neurobiology, consequences and management. Journal of Pharmacy and Bioallied Sciences, 5(2), 91-97.
Lubar, J.F. (1991). Discourse on the development of EEG diagnostics and biofeedback for attention-deficit/hyperactivity disorders. Biofeedback and Self-Regulation Journal, 16(3), 201-225.
MacNamara, A., & Proudfit, G. H. (2014). Cognitive load and emotional processing in generalized anxiety disorder: electrocortical evidence for increased distractibility. Journal of Abnormal Psychology, 123(3), 557-565.
Moore, N.C. (2000). A review of EEG Biofeedback treatment of anxiety disorders. Clinical electroencephalography, 31 (1), 1- 6.
Moradi, A., Pouladi, F., Pishva, N., Rezaei, B., Torshabi, M., & Mehrjerdi, Z. (2011). Treatment of Anxiety Disorder with Neurofeedback: case study. Procedia-Social and Behavioral Sciences 30, 103-107.
Parker, R. I. & Vannest, K. J. (2009). An improved effect size for single case research: NonOverlap of All Pairs (NAP). Behavior Therapy, 40, 357-367.
Putman, P., van Peer, J., Maimari, I., & van der Werff, S. (2010). EEG theta/beta ratio in relation to fear-modulated response-inhibition, attentional control, and affective traits. Biological Psychology, 83(2), 73-78.
Sanz, J. & García-Vera, M.P. (2015). Técnicas para el análisis de diseños de caso único en la práctica clínica: ejemplos de aplicación en el tratamiento de víctimas de atentados terroristas. Clínica y Salud, 26, 167-180.
Schutter, D. J. L. G., & Knyazev, G. G. (2012). Cross-frequency coupling of brain oscillations in studying motivation and emotion. Motivation and Emotion Journal, 36(1), 46-54.
Spielberger, C.D., Gorsuch, R.L., & Lushene, R.E. (1982) STAI: Cuestionario de Ansiedad Estado-Rasgo. Manual. Madrid: TEA Ediciones, S.A.
Stalder, T., Tietze, A., Steudte, S., Alexander, N., Dettenborn, L., & Kirschbaum, C. (2014). Elevated hair cortisol levels in chronically stressed dementia caregivers. Psychoneuroendocrinology, 47, 26-30.
Tobal, J. J. M., & Vindel, A. R. C. (1994) ISRA: Inventario de Situaciones y Respuestas de Ansiedad: Manual. Madrid: TEA Ediciones.
Toulouse, E., & Pieron, H. (1986). Toulouse-Pieron: Prueba perceptiva y de atención: Manual. Madrid: TEA Ediciones.
Van Boxtel, G. J. M., & Gruzelier, J. H. (2014). Neurofeedback: Introduction to the special issue. Biological Psychology, 95, 1-3. Doi: 10.1016/j.biopsycho.2013.11.011
Van Honk, J., & Schutter, D. J. L. G. (2007). Testosterone reduces conscious detection of signals serving social correction: Implications for antisocial behaviour. Psychological Science, 18(8), 663-667.
Vasquez, M., Gadea, M., Garijo, E., Aliño, M., & Salvador, A. (2015). Efectos del entrenamiento asistido con neurofeedback sobre EEG, los procesos de función ejecutiva y el afecto en una muestra de población normal. Anales de Psicología, 31(1), 317-323. http://dx.doi.org/10.6018/analesps.31.1.167241
Vernon, D. (2005). Can Neurofeedback Training Enhance Performance? An Evaluation of the Evidence with Implications for Future Research. Applied Psychophysiology and Biofeedback, 30 (4), 347-364.
Wu, J., Cui, Y., Yang, Y., Kang, M., Jung, S., … & Eun, S. (2014). Modulatory effects of aromatherapy massage intervention on electroencephalogram, psychological assessments, salivary cortisol and plasma brain-derived neurotrophic factor. Complementary Therapies in Medicine, 22, 456-462.
Zoefel, B., Huster, R. J., & Herrmann, C. S. (2011). Neurofeedback training of the upper alpha frequency band in EEG improves cognitive performance. Neuroimage, 54(2), 1427-1431.
Cómo citar
Aliño Costa, M., Gadea, M., Hidalgo, V., Pérez, V., & Sanjuán, J. (2017). An effective Neurofeedback training, with cortisol correlates, in a clinical case of anxiety. Universitas Psychologica, 15(5). https://doi.org/10.11144/Javeriana.upsy15-5.entc
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