Uniklinikum Tübingen

Biological Feedback

The institute is internationally leading in biological feedback (biofeedback) research and its clinical applications, particularly involving brain processes and cortical oscillations. Over the last 20 years techniques were developed for the self regulation of parameters of brain activity. Since then, biofeedback of brain activity has been applied to several clinical disorders:

The latest topic of research is self regulation of local brain activity using real-time functional magnetic resonance imaging (fMRI) and Near Infrared Spectroscopy (NIRS).

 

Drug resistant epilepsy is successfully treated with neurofeedback of slow cortical potentials

In two controlled studies epileptic patients with focal epilepsies were treated with neurofeedback of slow cortical potentials. Most of these patients suffered from temporal lobe epilepsy which is known to be resistant to drug management in about two thirds of the patients. In 35 sessions patients learned to regulate their cortical potentials with a neurofeedback device. Drug-resistant patients with focal epilepsy were instructed to produce either negative or positive shifts of their slow cortical potentials (SCPs) at vertex during 20-35 sessions of biofeedback training. Feedback trials were interspersed with transfer trials in which only a discriminative stimulus (signalising whether positivity or negativity was required) was presented. This training was integrated into a behavioral therapy treatment package whose objectives were, first, to increase the patients' sensitivity to the earliest precursors of seizures, second, to provide transfer of the skill acquired in the course of training into the conditions of patients' everyday life, and third, to change seizure reinforcing contingencies. During the 18-month follow-up more than one half of the patients showed significant improvement in terms of the decrement of seizure frequency. "Booster" sessions six and twelve months after the end of training demonstrated that the acquired self-regulation skill remained stable over the time. Patients who displayed extremely large negative slow waves in all conditions at the beginning of training, did not reduce seizure frequency even if they were able to influence their EEG.

Ute Strehl, Boris Kotchoubey

 

Strehl, U., Kotchoubey, B., Trevorrow, T., Birbaumer, N. (2005). Predictors of seizure reduction after self regulation of slow cortical potentials as a treatment of drug resistant epilepsy. Epilepsy and behavior, 6, 156-166.

Kotchoubey, B., Strehl, U., Uhlmann, C., Holzapfel, S., König, M., Fröscher, W., Blankenhorn, V. and Birbaumer, N. (2001). Modification of Slow Cortical Potentials in Patients with Refractory Epilepsy: A Controlled Outcome Study. Epilepsia, 42 (3), 406-416.

 Strehl, U. (1998). Epilepsie und Verhalten. Entwicklung und Prüfung eines psychophysiologischen Behandlungsprogramms zur Selbstkontrolle epileptischer Anfälle. Lengerich: Pabst Science Publishers.

 

Operant conditioning of electrophysiological signs in the EEG of children with benign epilepsy

Schröder, M., Bogdan, M., Rosenstiel, W., Hinterberger, T., Strehl, U. and Birbaumer, N. Online Classification of EEG Signals Using Artificial Neural Networks For Biofeedback Training of Patients with Epilepsy. In: Proceedings of the 9th International Workshop on Systems, Signals and Image Processing. Series: Recent Trends in Multimedia Information Processing. Manchester 7-8 November 2002. World Scientific,pp. 438-446.

 

Neurofeedback in children with ADHD (Attention Deficit / Hyperactivity Disorder)

The primary symptoms of ADHD ? inattentiveness, impulsiveness, and hyperactivity ? are secondary consequences resulting from an underlying neuropsychological disorder. The symptoms of this disorder may be decreased cortical arousal, e.g. increased theta-activity, decreased beta-activity and decreased amplitudes of slow cortical potentials.

Therefore, we designed a pilot-study with two neurofeedback paradigms to enhance and to decrease certain types of EEG-activity. One group received feedback of their slow cortical potentials (SCP-group), the other of their theta- and beta-rhythms (Theta/Beta-group). Both groups should learn to activate and deactivate their brain activity, that means, to produce positive and negative SCP-shifts or to change the relative frequencies of theta and beta-rhythms. respectively. While the Theta/Beta-training is rather common in the US, this was one of the very first studies with SCP-feedback training in ADHD children up to now.

Both groups succeeded in influencing their EEG. However, the time course of learning and the learning progress differed between the groups and depended on whether the children should activate or deactivate their brain activity. Both groups improved in attention and reduced hyperactivity, impulsivity and frequency of conflicts at home. There were positive trends regarding intelligence, academic achievement and intensity of conflicts at home and in school. Parental expectations and evaluations did not influence the therapy effect.

Ute Strehl

Leins, U., Goth, G., Hinterberger, T., Klinger, C., Rumpf, N. & Strehl, U. (2007). Neurofeedback for Children with ADHD: A Comparison of SCP and Theta/Beta Protocols. Applied Psychophysiology and Biofeedback, 32 (2), 73 - 88.

Strehl, U., Leins, U., Goth, G., Klinger, C., Hinterberger, T. & Birbaumer, N. (2006). Self-regulation of slow cortical potentials - a new treatment for children with ADHD. Pediatrics, 118, e1530 -1540.

Strehl, U., Leins, U., Heinrich, H. Neurofeedback bei einer Aufmerksamkeits-/Hyperaktivitätsstörung. In: Rief, B., Birbaumer, N. Biofeedback-Therapie. Stuttgart: Schattauer, 2006. 2.Auflage.