RESUMEN
Schizophrenia is a neuropsychiatric disorder affecting approximately 1 in 300 people worldwide. It is characterized by a range of symptoms, including positive symptoms (delusions, hallucinations, and formal thought disorganization), negative symptoms (anhedonia, alogia, avolition, asociality, and blunted affect), and cognitive impairments (impaired memory, attention, executive function, and processing speed). Current treatments, such as psychopharmacology and psychotherapy, often do not fully address these symptoms, leading to impaired everyday functionality. In recent years, there has been a growing interest in neuromodulation due to computer and engineering science making extraordinary computational advances. Those put together have reinitiated the spark in the field of neurofeedback (NF) as a means for self-regulation and neuromodulation with the potential to alleviate the daily burden of schizophrenia. We review, in a systematic way, the primary reports of electroencephalogram (EEG)-based NF as a therapeutical tool for schizophrenia. The main body of research consists mostly of case studies and case reports. The results of a few randomized controlled studies, combined with case studies/series, underscore the potential use of NF as an add-on treatment option for improving the lives of suffering individuals, being sustained by the changes in brain function and symptomatology improvement. We aim to provide important evidence of neuromodulation using NF in patients with schizophrenia, summarizing the effects and conclusions found in several clinical trials.
RESUMEN
BACKGROUND: Alcoholism is a serious social, economic and public health problem. Alcoholism can affect the gastrointestinal, neurological, cardiovascular and respiratory systems, and it can be fatal, costing the healthcare system huge amounts of money. Despite the availability of cognitive-behavioural and psychosocial therapies, alcoholism has a high recurrence rate and a dismal prognosis, with a wide inter-individual variation. As a result, better or adjuvant therapies that improve or facilitate alcoholism therapy are required. We conducted a systematic review to look into the published studies that reported the effectiveness of non-pharmacological neurofeedback (NF) interventions in patients with alcohol use disorders (AUDs). METHODS: PubMed, Google Scholar, The Cochrane Library, Science Direct and Clinicaltrial.gov were searched until 4 April 2022. Original articles of any design reporting on the use of NF approaches in the treatment of AUDs were included. Information related to study design, participants, control group, neuromodulation therapy, number of sessions and key findings of the study were extracted. The Joanna Briggs Institute's (JBI) Critical Appraisal Checklist for Studies was used to assess the quality of studies. RESULTS: A total of 20 research articles (including 618 participants) were retrieved and included for qualitative analysis. The sample size ranged from 1 (case report) to 80, with years of publication ranging from 1977 to 2022. Nine of the 20 articles included in the study were conducted in the United States, followed by Germany, the United Kingdom, India, the Netherlands and South Korea. Out of the 20 studies included, 8 (40%) had a moderate risk of bias, while the other, i.e. 60% had a low risk of bias. The effectiveness of various neurological treatments in the treatment of AUDs was established in these 20 studies. There have been 11 studies on EEG NF training, three studies on real-time FMRI NF, two studies each on transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS), and one study each on deep brain stimulation (DBS) and theta burst stimulation (TBS). These alternative neurological therapies have been demonstrated to lower alcohol cravings and consumption temporarily, reduce anxiety and depression scores, reduce relapse rates and increase control of brain activity. CONCLUSIONS: The use of various neuromodulation approaches to the treatment of AUD shows promise. However, more research with larger sample size is required.