Using neurofeedback to restore normal functioning in the brains of cancer patients could potentially alleviate the mental fogginess that many report after treatment, according to a new pilot study published in the Journal of Complementary and Integrative Medicine.
The UCLA study is one of the first to indicate that neurofeedback, or electroencephalogram (EEG) biofeedback, could help address cognitive deficits of cancer patients experiencing ‘chemo brain’, a constellation of symptoms that could include problems with memory, concentration and organisation, as well as other symptoms like trouble sleeping and emotional difficulties. In previous studies, neurofeedback, in which brain waves are trained to operate in optimal frequency patterns, has been shown to help improve cognitive function in patients with cognitive impairments like attention-deficit/hyperactivity disorder, stroke and seizures, as well as helped regulate brain activity in patients with substance use and post-traumatic stress disorders.
“The history of neurofeedback shows that it’s helpful for a whole range of disorders and symptoms. This study was an opportunity for seeing whether neurofeedback is something that could be helpful with chemo brain,” said study leader Stephen Sideroff, a UCLA professor who has used neurofeedback training with patients for over 20 years.
The study by Sideroff and UCLA colleagues David Wellisch and Valerie Yarema included nine female breast cancer patients between the ages of 21 and 65 who had completed chemotherapy at least one year earlier and complained of debilitating symptoms of chemo brain, which brought significant disruptions to their work and personal lives. A clinical nurse practitioner conducted a brief mental status interview with each patient to confirm that they had persistent difficulties with concentration, memory, organization and confusion. The patients selected for the study did not have a current breast cancer diagnosis, a present or recent diagnosis of a major depressive disorder or other mental illness, or used cognitive-altering medications that might confound study results.
Before the neurofeedback training sessions began, the study participants received neurocognitive and psychological tests, as well as a quantitative EEG to measure brain wave frequencies that could be compared to normative data. The pre-training quantitative EEGs shows that each study participant had abnormal brain waive activity compared to healthy adult brains.
The study participants received a series of 18 neurofeedback sessions, scheduled for 30 minutes each over a six-week period. During these sessions, sensors were placed on the scalp and earlobe to monitor brain wave frequencies. Patients were shown a monitor displaying these frequencies in bar graphs, and they were told their goal was to increase or decrease the amplitude of specific frequency ranges to turn each bar green. They received audio and visual feedback when they successfully shifted these amplitudes.
Quantitative EEGs taken after completion of the 18 neurofeedback sessions found that brain wave frequencies had significantly normalised in seven of the nine study participants, and significantly improved in the other two.
Neurocognitive tests also showed substantial improvements in the study participants’ information processing, executive set shifting and sustained visual attention. There was improvement for all in everyday functioning and overall psychological.
Study limitations include a small sample size and lack of a control group, and some were unable to complete the study in the allotted period.
“Our results are more impressive given we were not able to have subjects stick to the schedule,” Prof Sideroff said.
Prof Sideroff said the study results were strong enough to support further research into whether neurofeedback is an effective approach for addressing chemo brain and determining the ideal protocols for conducting neurofeedback training sessions.
