Pilot Study of EEG and Cerebral Blood Flow Biofeedback Training in Remediating Cognitive and Behavioral Deficits in Adults With a Dementing Illness.

Objectives and Significance

1. What is (are) the primary goal(s) of the study The purpose of this study is to evaluate the efficacy of biofeedback training to increase regional cerebral blood flow (CBF) and peak alpha frequency (PAF) on the cognitive and behavioral symptoms of frontotemporal dementia (FTD). We will also measure the effects of EEG driven photostimulation during PAF neurofeedback on learning of higher PAF states and related clinical outcomes.
2. What is (are) the secondary goal(s) of the study A diversity of clinical, neuropsychological, and physiological variables will be collected in this study. For instance, a full 19-channel quantitative EEG (QEEG) assessment will be performed at intake. The relationship between EEG power and coherence and the symptoms of this disorder could potentially provide an important contribution to the literature on the usefulness of QEEG for differential diagnosis.

An additional goal of the study is to contribute to the understanding of how neurofeedback works. For instance, we will take measurements to determine if learning to control the PAF involves awareness of some internal subjective state related to the PAF. Also, the effect of the reward signal on a brainwave called the P300 may show the importance of having the reward tone sounding the majority of the time during neurofeedback sessions. Finally, we will measure whether blood flow changes during EEG biofeedback and whether the EEG is affected by blood flow biofeedback.

We propose several measurements that will contribute to an understanding of the mechanism of action of neurofeedback.

Frontotemporal Dementia and Cerebral Hyperperfusion Single photon emission computed tomography (SPECT) studies have shown cerebral blood flow to be significantly reduced in the frontal and temporal regions in FTD patients (Miller et al., 1997; Read et al., 1995). The anatomical distribution of reduced CBF corresponds to the pattern of neuropsychological deficits (McMurtray et al., 2006).