P4‐265: Efficacy Of Neurofeedback For Executive And Memory Function In Dementia

Previous studies have shown that dementia is associated with quantitative EEG (QEEG) and cerebral perfusion abnormalities including focal hypoperfusion, increased cortical slowing and a reduction in the dominant alpha frequency. This study tested whether using EEG biofeedback (neurofeedback) training to normalize abnormal EEG activity could improve measures of memory and executive function. Participants were randomly assigned to immediate treatment or to a waiting-list control group. All participants received neuropsychological and QEEG assessments before and after treatment or control conditions. Each participant's pre-treatment QEEG was compared to a normative database, and neurofeedback protocols were customized to normalize EEG activity at significantly deviant frequencies and specific scalp locations. Treatment consisted of 30-40, thirty-minute neurofeedback training sessions involving operant conditioning of the EEG using simultaneous visual, auditory and tactile reinforcements. Sixteen subjects and 11 waitlist controls have completed treatment. Pre-post-treatment scores displayed significant improvements in verbal memory (mean Mini Mental Status Exam [MMSE] orientation and recall, Memory Assessment Scales’ (MAS) list and prose memory, p< .05); visual memory (mean MAS Visual and Rey Figure recall, p< .01); Behavioral Rating Inventory of Executive Function (mean self and informant General Executive Composite, p< .05); Immediate Visual and Auditory (IVA) continuous performance test response control (p< .05). Trends toward improvement were seen in the MMSE (p= .072) and psychiatric distress measured by the Symptom Checklist 90-Revised (p= .085). A number of executive function measures did not significantly improve, including the IVA Attention, Wisconsin Card Sort and the Delis-Kaplan Executive Function System (with the exception of verbal fluency, p< .05). In the treatment group, the standardized mean treatment effect on variables that improved (at p< .10) correlated significantly with the pretreatment MAS Global Memory index (r= .71, p< .01). In the control group, this correlation was -.06.These results support QEEG-based neurofeedback training as a “probably efficacious” treatment for dementia. The strong correlation of efficacy with pretreatment memory suggests the importance of learning and memory in this treatment's mechanism of action, and suggests that neurofeedback is more strongly indicated as an earlier stage intervention.