Effects of a theta/Sensorimotor rhythm neurofeedback training protocol on measures of impulsivity, drug craving, and substance abuse in forensic psychiatric patients with substance abuse

Randomized controlled trial

Sandra Fielenbach, Franc Cl Donkers, Marinus Spreen, Stefan Bogaerts

Research output: Contribution to journalArticleScientificpeer-review

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Abstract

Background: 
Forensic psychiatric patients are often diagnosed with psychiatric disorders characterized by high levels of impulsivity as well as comorbid substance use disorders (SUD). The combination of psychiatric disorders and SUD increases the risk of future violence. Chronic substance abuse can lead to a structural state of disinhibition, resulting in more drug taking and eventually loss of control over drug intake. When treating SUD, it is crucial to address high levels of impulsivity and lack of inhibitory control.

Objective: 
This study set out to investigate the effects of a theta/sensorimotor rhythm (SMR) neurofeedback training protocol on levels of impulsivity, levels of drug craving, and actual drug intake in a population of forensic psychiatric patients with a diagnosis of SUD.

Methods: 
A total of 21 participants received 20 sessions of theta/SMR neurofeedback training in combination with treatment-as-usual (TAU). Results of the intervention were compared with results from 21 participants who received TAU only.Results: SMR magnitude showed a significant (P=.02) increase post training for patients in the neurofeedback training group, whereas theta magnitude did not change (P=.71). Levels of drug craving as well as scores on the motor subscale of the Barratt Impulsivity Scale-11 decreased equally for patients in the neurofeedback training group and the TAU group. Other measures of impulsivity as well as drug intake did not change posttreatment (P>.05). Therefore, neurofeedback+TAU was not more effective than TAU only.

Conclusions: 
This study demonstrated evidence that forensic psychiatric patients are able to increase SMR magnitude over the course of neurofeedback training. However, at the group level, the increase in SMR activity was not related to any of the included impulsivity or drug craving measures. Further research should focus on which patients will be able to benefit from neurofeedback training at an early stage of the employed training sessions.
Original languageEnglish
Article numbere10845
Number of pages13
JournalJMIR Mental Health
Volume5
Issue number4
DOIs
Publication statusPublished - 2018

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Neurofeedback
Impulsive Behavior
Pharmaceutical Preparations
Drug and Narcotic Control

Keywords

  • ADULTS
  • ALCOHOL
  • ATTENTION-DEFICIT/HYPERACTIVITY DISORDER
  • BEHAVIOR
  • BIOFEEDBACK
  • BLIND
  • CHILDREN
  • EEG
  • RISK
  • VIOLENCE
  • drug craving
  • impulsivity
  • neurofeedback
  • offenders
  • substance use disorder

Cite this

@article{d625c4f2f524409dbbbf6fe11d1d24b3,
title = "Effects of a theta/Sensorimotor rhythm neurofeedback training protocol on measures of impulsivity, drug craving, and substance abuse in forensic psychiatric patients with substance abuse: Randomized controlled trial",
abstract = "Background: Forensic psychiatric patients are often diagnosed with psychiatric disorders characterized by high levels of impulsivity as well as comorbid substance use disorders (SUD). The combination of psychiatric disorders and SUD increases the risk of future violence. Chronic substance abuse can lead to a structural state of disinhibition, resulting in more drug taking and eventually loss of control over drug intake. When treating SUD, it is crucial to address high levels of impulsivity and lack of inhibitory control.Objective: This study set out to investigate the effects of a theta/sensorimotor rhythm (SMR) neurofeedback training protocol on levels of impulsivity, levels of drug craving, and actual drug intake in a population of forensic psychiatric patients with a diagnosis of SUD.Methods: A total of 21 participants received 20 sessions of theta/SMR neurofeedback training in combination with treatment-as-usual (TAU). Results of the intervention were compared with results from 21 participants who received TAU only.Results: SMR magnitude showed a significant (P=.02) increase post training for patients in the neurofeedback training group, whereas theta magnitude did not change (P=.71). Levels of drug craving as well as scores on the motor subscale of the Barratt Impulsivity Scale-11 decreased equally for patients in the neurofeedback training group and the TAU group. Other measures of impulsivity as well as drug intake did not change posttreatment (P>.05). Therefore, neurofeedback+TAU was not more effective than TAU only.Conclusions: This study demonstrated evidence that forensic psychiatric patients are able to increase SMR magnitude over the course of neurofeedback training. However, at the group level, the increase in SMR activity was not related to any of the included impulsivity or drug craving measures. Further research should focus on which patients will be able to benefit from neurofeedback training at an early stage of the employed training sessions.",
keywords = "ADULTS, ALCOHOL, ATTENTION-DEFICIT/HYPERACTIVITY DISORDER, BEHAVIOR, BIOFEEDBACK, BLIND, CHILDREN, EEG, RISK, VIOLENCE, drug craving, impulsivity, neurofeedback, offenders, substance use disorder",
author = "Sandra Fielenbach and Donkers, {Franc Cl} and Marinus Spreen and Stefan Bogaerts",
year = "2018",
doi = "10.2196/10845",
language = "English",
volume = "5",
journal = "JMIR Mental Health",
issn = "2368-7959",
number = "4",

}

TY - JOUR

T1 - Effects of a theta/Sensorimotor rhythm neurofeedback training protocol on measures of impulsivity, drug craving, and substance abuse in forensic psychiatric patients with substance abuse

T2 - Randomized controlled trial

AU - Fielenbach, Sandra

AU - Donkers, Franc Cl

AU - Spreen, Marinus

AU - Bogaerts, Stefan

PY - 2018

Y1 - 2018

N2 - Background: Forensic psychiatric patients are often diagnosed with psychiatric disorders characterized by high levels of impulsivity as well as comorbid substance use disorders (SUD). The combination of psychiatric disorders and SUD increases the risk of future violence. Chronic substance abuse can lead to a structural state of disinhibition, resulting in more drug taking and eventually loss of control over drug intake. When treating SUD, it is crucial to address high levels of impulsivity and lack of inhibitory control.Objective: This study set out to investigate the effects of a theta/sensorimotor rhythm (SMR) neurofeedback training protocol on levels of impulsivity, levels of drug craving, and actual drug intake in a population of forensic psychiatric patients with a diagnosis of SUD.Methods: A total of 21 participants received 20 sessions of theta/SMR neurofeedback training in combination with treatment-as-usual (TAU). Results of the intervention were compared with results from 21 participants who received TAU only.Results: SMR magnitude showed a significant (P=.02) increase post training for patients in the neurofeedback training group, whereas theta magnitude did not change (P=.71). Levels of drug craving as well as scores on the motor subscale of the Barratt Impulsivity Scale-11 decreased equally for patients in the neurofeedback training group and the TAU group. Other measures of impulsivity as well as drug intake did not change posttreatment (P>.05). Therefore, neurofeedback+TAU was not more effective than TAU only.Conclusions: This study demonstrated evidence that forensic psychiatric patients are able to increase SMR magnitude over the course of neurofeedback training. However, at the group level, the increase in SMR activity was not related to any of the included impulsivity or drug craving measures. Further research should focus on which patients will be able to benefit from neurofeedback training at an early stage of the employed training sessions.

AB - Background: Forensic psychiatric patients are often diagnosed with psychiatric disorders characterized by high levels of impulsivity as well as comorbid substance use disorders (SUD). The combination of psychiatric disorders and SUD increases the risk of future violence. Chronic substance abuse can lead to a structural state of disinhibition, resulting in more drug taking and eventually loss of control over drug intake. When treating SUD, it is crucial to address high levels of impulsivity and lack of inhibitory control.Objective: This study set out to investigate the effects of a theta/sensorimotor rhythm (SMR) neurofeedback training protocol on levels of impulsivity, levels of drug craving, and actual drug intake in a population of forensic psychiatric patients with a diagnosis of SUD.Methods: A total of 21 participants received 20 sessions of theta/SMR neurofeedback training in combination with treatment-as-usual (TAU). Results of the intervention were compared with results from 21 participants who received TAU only.Results: SMR magnitude showed a significant (P=.02) increase post training for patients in the neurofeedback training group, whereas theta magnitude did not change (P=.71). Levels of drug craving as well as scores on the motor subscale of the Barratt Impulsivity Scale-11 decreased equally for patients in the neurofeedback training group and the TAU group. Other measures of impulsivity as well as drug intake did not change posttreatment (P>.05). Therefore, neurofeedback+TAU was not more effective than TAU only.Conclusions: This study demonstrated evidence that forensic psychiatric patients are able to increase SMR magnitude over the course of neurofeedback training. However, at the group level, the increase in SMR activity was not related to any of the included impulsivity or drug craving measures. Further research should focus on which patients will be able to benefit from neurofeedback training at an early stage of the employed training sessions.

KW - ADULTS

KW - ALCOHOL

KW - ATTENTION-DEFICIT/HYPERACTIVITY DISORDER

KW - BEHAVIOR

KW - BIOFEEDBACK

KW - BLIND

KW - CHILDREN

KW - EEG

KW - RISK

KW - VIOLENCE

KW - drug craving

KW - impulsivity

KW - neurofeedback

KW - offenders

KW - substance use disorder

U2 - 10.2196/10845

DO - 10.2196/10845

M3 - Article

VL - 5

JO - JMIR Mental Health

JF - JMIR Mental Health

SN - 2368-7959

IS - 4

M1 - e10845

ER -