Effect of Neurofeedback Training on Depression and Fatigue in Patients with Multiple Sclerosis
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Depression and fatigue are common symptoms of multiple sclerosis (MS) and are the primary determinants of impaired quality of life in this demyelinating neurological disease. Untreated depression is associated with suicidal ideation, impaired cognitive function and poor adherence to immunomodulatory treatment. For these reasons, systematic screening and management of depressive symptoms and fatigue is recommended for all patients with MS. The objective of this study was to evaluate the effectiveness of neurofeedback in treating depression and fatigue in persons with MS. We conducted a randomized trial with 24 MS patients with primary fatigue and depression. Participants were randomized into two groups: neurofeedback training group (16 sessions of NFB) or treatment as usual. Participants were evaluated at 3 time points (baseline, end of the treatment, and 2-month follow-up) using the Fatigue Severity Scale and Depression subscale of the Hospital Anxiety and Depression Scale as outcome measures. A repeated measures analysis of variance was used to examine differences between the groups. NFB significantly reduced symptoms of depression and fatigue in patients with MS patients, compared to treatment as usual (p < .05), and these effects were maintained the 2-month follow-up (p < .05).
KeywordsMultiple sclerosis Fatigue Depression Neurofeedback Fatigue Severity Scale Hospital Anxiety and Depression Scale
The authors would like to thank all the patients for their participation, the Editor-in-Chief and the anonymous reviewers for their constructive and detailed comments that helped improve very much the quality of this paper.
- Baehr, E., Miller, L., Rosenfeld, J., & Baehr, R. (2004). Changes in frontal brain asymmetry associated with premenstrual dysphoric disorder: A single case study. Journal of Neurofeedback, 8(1), 29–42.Google Scholar
- Baehr, E., Rosenfeld, J., & Baehr, R. (1997). The clinical use of an alpha asymmetry protocol in the neurofeedback treatment of depression: Two case studies. Journal of Neurofeedback, 2(3), 10–23.Google Scholar
- Baehr, E., Rosenfeld, J., & Baehr, R. (2001). The clinical use of an alpha asymmetry protocol in the treatment of mood disorders: Follow-up study one to five years post therapy. Journal of Neurofeedback, 4(4), 11–18.Google Scholar
- Baehr, E., Rosenfeld, J. P., Baehr, R., & Earnest, C. (1999). Clinical use of an alpha asymmetry neurofeedback protocol in the treatment of mood disorders. In J. R. Evans & A. Abarbanel (Eds.), Introduction to quantitative EEG and neurofeedback (pp. 181–200). New York: Academic Press.CrossRefGoogle Scholar
- Bjelland, I., Dahl, A. A., Haug, T. T., & Neckelmann, D. (2002). The validity of the Hospital Anxiety and Depression Scale: An updated review. Journal of Psychiatric Research, 52, 69–77.Google Scholar
- Comi, G., Leocani, L., Rossi, P., & Colombo, B. (2001). Physiopathology and treatment of fatigue in multiple sclerosis. Journal of Neurology, 248(174), 9.Google Scholar
- Davidson, R. J. (1995). Cerebral asymmetry, emotion and affective style. In R. J. Davidson & K. Hugdahl (Eds.), Brain asymmetry (pp. 361–387). Boston: MIT Press.Google Scholar
- Egner, T., Strawson, E., & Gruzelier, J. H. (2002). EEG signature and phenomenology of alpha-theta neurofeedback training versus mock feedback. Applied Psychophysiology and Biofeedback, 27, 261–270.Google Scholar
- Foong, J., & Ron, M. A. (2003). Neuropsychiatry: cognition and mood disorders. In W. I. McDonald & J. H. Noseworthy (Eds.), Multiple sclerosis—2 (pp. 115–124). Philadelphia: Butterworth-Heinemann Publishers.Google Scholar
- Freal, J., Kraft, G. H., & Coryell, J. (1984). Symptomatic fatigue in multiple sclerosis. Archive of Neurology, 53, 185–188.Google Scholar
- Hauser, S. L., & Goodkin, D. E. (2001). MS & demyelinating disease. In T. R. Harrison, E. Brown, A. S. Fauci, D. L. Kasper, S. L. Hauser, & D. L. Longo (Eds.), Harrison’s principles of internal medicine (15th ed., Vol. 4, pp. 2452–2460). New York: McGraw- Hill.Google Scholar
- Heron, R., McCann, G., & O’Leary, C. P. (1999). The influence of multiple sclerosis on fatigue levels and physical activity levels. Multiple Sclerosis, 5, 37.Google Scholar
- How long do the effects of neurofeedback training last?(2010). http://www.aboutneurofeedback.com/.
- Minden, S. L., Orav, J., & Reich, P. (1987). Depression in multiple sclerosis. General Hospital Psychiatry, 9, 426–434.Google Scholar
- Muller, H. H., Donaldson, C. C. S., Nelson, D. V., & Layman, M. (2001). Treatment of fibromyalgia incorporating EEG-driven stimulation: a clinical study. Journal of Clinical Psychology, 57(7), 925–933.Google Scholar
- Multiple Sclerosis Council for Clinical Practice Guidelines. (1998). Fatigue and multiple sclerosis: Evidence-based management strategies for fatigue in multiple sclerosis. Multiple Sclerosis Council for Clinical Practice Guidelines.Google Scholar
- Neurofeedback and multiple sclerosis.(2009).http://www.sinhaclinic.com/ .
- Salehpoor, G. H., Rezaei, S., & Hossininezhad, M. (2013). Psychometric properties of fatigue severity scale in patients with multiple sclerosis. Journal of Kerman University of Medical Sciences, 20(3), 263–278.Google Scholar
- Stenager, E. N., & Stenager, E. (2000). Physical illness and suicidal behavior. In K. Hawton & K. van Heeringen (Eds.), The international handbook of suicide and attempted suicide. New York: Wiley.Google Scholar
- Sterman, M. B. (1999). Atlas of topometric clinical displays: Functional interpretations and neurofeedback strategies. Los Angeles: Sterman-Kaiser Imaging Laboratory.Google Scholar
- Vanathy, S., Sharma, P. S. V. N., & Kumar, K. B. (1998). The efficacy of alpha and theta neurofeedback training in treatment of generalized anxiety disorder. Indian Journal of Clinical Psychology, 25(2), 136–143.Google Scholar
- Wilson, V. E., Peper, E., & Moss, D. (2006). Professional issue “The mind room’’ in Italian soccer training: the use of biofeedback and neurofeedback for optimum performance. Biofeedback, 34, 79–810.Google Scholar
- Yucha, C., & Gilbert, C. (2004). Evidence-based practice in biofeedback and neurofeedback. Wheat Ridge CO: Association for Applied Psychophysiology and Biofeedback.Google Scholar
- Yucha, C., & Montgomery, D. (2008). Evidence-based practice in biofeedback and neurofeedback. Wheat Ridge: Association for Applied Psychophysiology and Biofeedback.Google Scholar