Enhancing Cognitive Function with Neurofeedback

Emerging research supports the use of neurofeedback to improve cognitive functions in conditions such as stroke (Kober et al., 2015; Kober et al., 2017) and multiple sclerosis (Kober et al., 2019; Keune et al., 2019). The focus has also expanded to Alzheimer’s disease (AD), the most common form of dementia, and mild cognitive impairment (MCI), a precursor to dementia (Petersen, 2004; Albert MS et al., 2019). The goal is to delay cognitive decline and the onset of dementia.

Neural Imbalance in Cognitive Decline

Memory impairment is a hallmark of early AD and its precursor, amnestic MCI (aMCI). Other cognitive domains may also be affected. EEG studies typically show that MCI and AD are characterized by an increase in slow frequencies (delta: 2-4 Hz; theta: 4-8 Hz) and a decrease in faster frequencies (alpha: 8-12 Hz; beta: 13-20 Hz) (Vigil J. Tataryn et al., 2017). These EEG features correlate with poor cognitive performance (Klimesch, 1999), atrophy in brain regions such as the thalamus, hippocampus, and basal ganglia (Moretti et al., 2012; Wolf, 2004), and the presence of amyloid-beta plaques (Sharma & Nadkarni, 2020).

The brain produces different types of electrical signals based on your mental state. For instance, beta waves are active when you're focused and alert, alpha waves are linked to relaxation, and theta waves often emerge during deep relaxation or daydreaming. Cognitive decline is often associated with an imbalance in these waves, such as excessive slow-wave (theta) activity or reduced fast-wave (beta) activity.

Cognitive decline happens when communication between brain cells (neurons) weakens due to factors like aging, stress, or neurological conditions. This affects memory, attention, and decision-making. Imbalances in brain waves can reflect underlying issues with brain function.

Neurofeedback therapy helps correct abnormal brainwave patterns by teaching the brain to self-regulate. Sensors track brain activity in real-time, and the therapy encourages the brain to adjust waves like reducing excess theta (linked with inattention) and enhancing beta (for focus and alertness). This can improve mental clarity, focus, and memory, counteracting aspects of cognitive decline by promoting healthier brainwave balance.

Evidence of Effectiveness

Mild Cognitive Impairment (MCI)

Verbal Memory: Lavy et al. (2019) reported improved verbal memory in MCI participants after ten 30-minute sessions focusing on enhancing individual central-parietal upper-alpha waves. These improvements were maintained at a 30-day follow-up.

 Visual Processing and Working Memory:

 Jirayucharoensak et al. (2019) found that alpha- and beta-enhancement neurofeedback (twenty 30-minute sessions) improved rapid visual processing and spatial working memory in healthy or aMCI women, as an add-on to usual care.

Alzheimer’s Disease (AD):

Cognitive Screening and Memory/Executive Function: Studies using individualized neurofeedback protocols reported improved performance on cognitive screeners and enhancements in memory and executive function, compared to wait-list controls (Surmeli et al., 2015; Berman et al., 2015).

Conclusion

Neurofeedback therapy offers a promising approach for managing cognitive decline associated with conditions like MCI and AD. By targeting specific neural imbalances, neurofeedback can enhance cognitive function, improve memory performance, and potentially delay the progression of cognitive impairment.