Askovic Mirjana, Watters Anna J, Coello Mariano, Aroche Jorge, Harris Anthony W F, Kropotov Jury
New South Wales Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS), Carramar, New South Wales, Australia.
Brain Dynamics Centre, The Westmead Institute for Medical Research and Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
Clin EEG Neurosci. 2020 Mar;51(2):79-86. doi: 10.1177/1550059419849170. Epub 2019 May 27.
. Neurofeedback holds promise as an intervention for the psychophysiological dysfunction found in posttraumatic stress disorder (PTSD). Few empirical studies have assessed the efficacy of neurofeedback for PTSD, and none in individuals with refugee trauma. A proposed mechanism for neurofeedback efficacy in PTSD is through remediating deficits in cognitive control. We assessed pre- and postchanges in symptoms and neurocognitive functioning of refugee clients participating in a neurofeedback intervention for PTSD. . Clinical data for 13 adult refugees with chronic PTSD who participated in neurofeedback combined with trauma counseling (NFT) was compared with 13 adult refugees placed on a waitlist to receive neurofeedback. Waitlist clients continued to receive trauma counseling alone (TC). NFT was additionally assessed pre- and posttherapy for changes in event-related potentials (ERPs) and behavioral indices of cognitive control using a visual continuous performance task (VCPT). Comparison VCPT data from healthy controls (HC) was available from the Human Brain Index database. . Posttherapy, NFT had significantly lower symptoms of trauma, anxiety, and depression compared with TC. NFT demonstrated an increased P3 amplitude and improved behavioral performance suggesting a normalization of cognitive control. . These preliminary observations are consistent with a possible benefit of neurofeedback for remediating PTSD. This may be achieved at least partially by an improvement in cognitive control. Further confirmation of the effectiveness of the treatment now requires a randomized controlled trial that considers issues such as placebo response, nonspecific therapist effects, and duration of treatment.
神经反馈有望成为一种干预创伤后应激障碍（PTSD）中心理生理功能障碍的方法。很少有实证研究评估神经反馈对PTSD的疗效，对于有难民创伤经历的个体则尚无此类研究。神经反馈对PTSD有效的一种推测机制是通过纠正认知控制方面的缺陷。我们评估了参与PTSD神经反馈干预的难民客户在症状和神经认知功能方面的治疗前后变化。将13名患有慢性PTSD的成年难民参与神经反馈结合创伤咨询（NFT）的临床数据，与13名被列入等待名单以接受神经反馈的成年难民进行比较。等待名单上的客户继续仅接受创伤咨询（TC）。此外，在治疗前后对NFT进行评估，使用视觉持续操作任务（VCPT）来检测事件相关电位（ERP）的变化以及认知控制的行为指标。来自健康对照（HC）的比较VCPT数据可从人类大脑指数数据库获得。治疗后，与TC相比，NFT的创伤、焦虑和抑郁症状明显减轻。NFT表现出P3波幅增加和行为表现改善，表明认知控制趋于正常。这些初步观察结果与神经反馈对治疗PTSD可能有益的观点一致。这至少部分可能是通过改善认知控制来实现的。现在需要进行一项随机对照试验，考虑安慰剂反应、非特异性治疗师效应和治疗持续时间等问题，以进一步证实该治疗方法的有效性。
