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Brain and behavior alterations due to synergistic effect of biofeedback and neurofeedback intervention for smoking
EANS Academy. Athanasiou A. 09/25/19; 275821; EP12029
Dr. Alkinoos Athanasiou
Dr. Alkinoos Athanasiou

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Abstract
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Introduction and aim: Smoking is one of the leading causes of preventable disease and death. It is associated with multiple morbidities including cerebral stroke resulting to long-lasting disability, while stroke induced fatality is twice as possible for smokers. Smoking cessation attempts are currently based on a combination of pharmacological and behavioral treatment but drug adverse effects or unsuitability generates the need for alternative non-pharmacological approaches. The primary aim of the current study is to investigate the synergistic effects of biofeedback and neurofeedback on the clinical condition and behavioral parameters of smokers. Moreover, we investigated neural plasticity effects on resting state brain networks, focusing on default mode network (DMN).
Methods: We analyzed clinical, behavioral and electrophysiological data from 15 smokers before and after 25 sessions of synergistic training in biofeedback and neurofeedback. Data were also further analyzed according to gender. Analysis was performed using IBM SPSS (v23) and electroencephalography (EEG) recordings were analyzed using a home-developed pipeline based on BESA research, Matlab and Network Based Statistic (NBS) toolbox.
Results: Although the clinical condition of smokers was not markedly improved, significant improvements were observed in the degree of nicotine dependence, in anxiety traits, in self-esteem and in quality of sleep of participants. Synergistic training also had significant impact on visual scanning speed and on inhibition. From the EEG analysis, although we did not observe a full reorganization of resting state networks, we did observe localized alterations such as an increased inflow of information to left pre-frontal lobe after the training.
Conclusion: Synergistic training in biofeedback and neurofeedback appears to positively impact various behavioral parameters. Moreover, documented brain network plasticity, such as localized alterations to information exchange in important DMN nodes, was interpreted as both neuroprotective mechanisms and as physiological basis of behavioral trait improvements.
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