Prediction of Treatment Response and the Effect of Independent Component Neurofeedback in Obsessive-Compulsive Disorder: A Randomized, Sham-Controlled, Double-Blind Study

Abstract

Aims: The goal of this study was to assess the effect of independent component neurofeedback (NFB) on EEG and clinical symptoms in patients with obsessive-compulsive disorder (OCD). Subsequently, we explored predictors of treatment response and EEG correlates of clinical symptoms. Methods: In a randomized, double-blind, parallel design, 20 inpatients with OCD underwent 25 sessions of NFB or sham feedback (SFB). NFB aimed at reducing EEG activity in an independent component previously reported abnormal in this diagnosis. Resting-state EEG recorded before and after the treatment was analyzed to assess its posttreatment changes, relationships with clinical symptoms and treatment response. Results: Overall, clinical improvement in OCD patients was not accompanied by EEG change as assessed by standardized low-resolution electromagnetic tomography and normative independent component analysis. Pre- to posttreatment comparison of the trained component and frequency did not yield significant results; however, in the NFB group, the nominal values at the downtrained frequency were lower after treatment. The NFB group showed significantly higher percentage reduction of compulsions compared to the SFB group (p = 0.015). Pretreatment higher amount of delta (1-6 Hz) and low alpha oscillations as well as a lower amount of high beta activity predicted a worse treatment outcome. Source localization of these delta and high beta oscillations corresponded with previous EEG resting-state findings in OCD patients compared to healthy controls. Conclusion: Independent component NFB in OCD proved useful in percentage improvement of compulsions. Based on our correlation analyses, we hypothesize that we targeted a network related to treatment resistance.

Validity of Quinpirole Sensitization Rat Model of OCD: Linking Evidence from Animal and Clinical Studies

“…Interestingly, a recent human DBS study in OCD patients showed that NAc-DBS reduced low-frequency EEG oscillations recorded over the frontal cortex during symptom provocation as well as resting-state functional connectivity (fMRI) between NAc and the prefrontal cortex (Figee et al, 2013a). Our previous as well as other studies reported medial frontal low frequency EEG excess in OCD patients (e.g., Kopřivová et al, 2011, 2013a,b). These findings support the predictive validity of the QSM because similar to DBS, quinpirole sensitization probably inhibits NAc.…”

“…The ACC is of particular interest in this context. Functional hyperactivity and decreased volume in this area has been shown repeatedly by converging evidence from different methods (Kopřivová et al, 2011, 2013a,b) yet no study has been aimed to assess the effects of cingulotomy in the QSM.…”

The efficacy of biofeedback approaches for obsessive-compulsive and related disorders: A systematic review and meta-analysis

“…Two multicentric studies were conducted in Germany, Italy, USA, and Chile (Buyukturkoglu et al, 2015), and the Czech Republic and France Table 1 Summary of demographic and clinical information of the studies included for systematic reviewing. ( Koprivová et al, 2013). The other works were performed in Turkey (Sürmeli and Ertem, 2011), Iran (Barzegary et al, 2011), Canada (Mills and Solyom, 1974), China (Deng et al, 2014), and USA (Hammond, 2004(Hammond, , 2003LeVine, 1983;Scheinost et al, 2014).…”

Therapeutic applications of BCI technologies

“…EEG neurofeedback training in generalized anxiety disorder (GAD) [98-99], and obsessive-compulsive disorder (OCD) [100] has shown increased effectiveness compared to relaxation biofeedback and “placebo” neurofeedback, respectively. However, it is unclear whether neurofeedback has any therapeutic effect in alleviating disease-specific symptoms in anxiety disorders.…”