Improving Functional Connectivity in Developmental Dyslexia through Combined Neurofeedback and Visual Training

Abstract

This study examined the effects of combined neurofeedback (NF) and visual training (VT) on children with developmental dyslexia (DD). Although NF is the first noninvasive approach to support neurological disorders, the mechanisms of its effects on the brain functional connectivity are still unclear. A key question is whether the functional connectivities of the EEG frequency networks change after the combined NF–VT training of DD children (postD). NF sessions of voluntary α/θ rhythm control were applied in a low-spatial-frequency (LSF) illusion contrast discrimination, which provides feedback with visual cues to improve the brain signals and cognitive abilities in DD children. The measures of connectivity, which are defined by small-world propensity, were sensitive to the properties of the brain electrical oscillations in the quantitative EEG-NF training. In the high-contrast LSF illusion, the z-NF reduced the α/θ scores in the frontal areas, and in the right ventral temporal, occipital–temporal, and middle occipital areas in the postD (vs. the preD) because of their suppression in the local hub θ-network and the altered global characteristics of the functional θ-frequency network. In the low-contrast condition, the z-NF stimulated increases in the α/θ scores, which induced hubs in the left-side α-frequency network of the postD, and changes in the global characteristics of the functional α-frequency network. Because of the anterior, superior, and middle temporal deficits affecting the ventral and occipital–temporal pathways, the z-NF–VT compensated for the more ventral brain regions, mainly in the left hemispheres of the postD group in the low-contrast LSF illusion. Compared to pretraining, the NF–VT increased the segregation of the α, β (low-contrast), and θ networks (high-contrast), as well as the γ2-network integration (both contrasts) after the termination of the training of the children with developmental dyslexia. The remediation compensated more for the dorsal (prefrontal, premotor, occipital–parietal connectivities) dysfunction of the θ network in the developmental dyslexia in the high-contrast LSF illusion. Our findings provide neurobehavioral evidence for the exquisite brain functional plasticity and direct effect of NF–VT on cognitive disabilities in DD children.