Brain Topography

, Volume 29, Issue 2, pp 308–321 | Cite as

Towards Using Microstate-Neurofeedback for the Treatment of Psychotic Symptoms in Schizophrenia. A Feasibility Study in Healthy Participants

  • Laura Diaz HernandezEmail author
  • Kathryn Rieger
  • Anja Baenninger
  • Daniel Brandeis
  • Thomas Koenig
Original Paper


Spontaneous EEG signal can be parsed into sub-second periods of stable functional states (microstates) that assumingly correspond to brief large scale synchronization events. In schizophrenia, a specific class of microstate (class “D”) has been found to be shorter than in healthy controls and to be correlated with positive symptoms. To explore potential new treatment options in schizophrenia, we tested in healthy controls if neurofeedback training to self-regulate microstate D presence is feasible and what learning patterns are observed. Twenty subjects underwent EEG-neurofeedback training to up-regulate microstate D presence. The protocol included 20 training sessions, consisting of baseline trials (resting state), regulation trials with auditory feedback contingent on microstate D presence, and a transfer trial. Response to neurofeedback was assessed with mixed effects modelling. All participants increased the percentage of time spent producing microstate D in at least one of the three conditions (p < 0.05). Significant between-subjects across-sessions results showed an increase of 0.42 % of time spent producing microstate D in baseline (reflecting a sustained change in the resting state), 1.93 % of increase during regulation and 1.83 % during transfer. Within-session analysis (performed in baseline and regulation trials only) showed a significant 1.65 % increase in baseline and 0.53 % increase in regulation. These values are in a range that is expected to have an impact upon psychotic experiences. Additionally, we found a negative correlation between alpha power and microstate D contribution during neurofeedback training. Given that microstate D has been related to attentional processes, this result provides further evidence that the training was to some degree specific for the attentional network. We conclude that microstate-neurofeedback training proved feasible in healthy subjects. The implementation of the same protocol in schizophrenia patients may promote skills useful to reduce positive symptoms by means of EEG-neurofeedback.


EEG Neurofeedback Resting state Microstates Modelling Schizophrenia 



This study was supported by the Swiss National Science Foundation (Sinergia Grant #136249) and by the Center for Cognition, Learning and Memory, University of Bern, Bern, Switzerland. We want to give special thanks to Béatrice Zumkehr, Christine Krebs and Leandra Schmid for helping with the data acquisition as well as to all the participants in the study.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Laura Diaz Hernandez
    • 1
    Email author
  • Kathryn Rieger
    • 1
    • 2
  • Anja Baenninger
    • 1
  • Daniel Brandeis
    • 3
    • 4
    • 5
    • 6
  • Thomas Koenig
    • 1
    • 2
  1. 1.Translational Research Center, University Hospital of PsychiatryUniversity of BernBern 60Switzerland
  2. 2.Center for Cognition, Learning and MemoryUniversity of BernBernSwitzerland
  3. 3.Department of Child and Adolescent PsychiatryUniversity of ZürichZurichSwitzerland
  4. 4.Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty MannheimHeidelberg UniversityMannheimGermany
  5. 5.Zurich Center for Integrative Human PhysiologyUniversity of ZürichZurichSwitzerland
  6. 6.Neuroscience Center ZurichUniversity and ETH ZürichZurichSwitzerland

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