Increasing the effectiveness of neurofeedback and tDCS trough

Increasing the effectiveness of neurofeedback and tDCS trough right positioning in the complex therapies

Velikova S. 1,2, Karyakin N.N.2

1European commission, Brussels, Belgium,
2Privolzhskiy Research Medical University Nizhny Novgorod, Russia

    The neuromodulation techniques (Neurofeedback, tDCS, TMS) are considered promising tools for neuro-rehabilitation, but the data reporting their effectiveness is largely heterogeneous. The analysis of published studies shows that the bias in the reported level of effectiveness of these methods may be due to their different positioning in the complex of therapeutic interventions. Most studies test the application of certain technical protocol for a given pathology, comparing it with placebo or medication treatments, but only a few of them involve an initial subtyping of brain functional state using quantitative
electroencephalography (qEEG), which can be used as a navigator to optimize the protocol choice. In addition, the accumulation of data indicates, that a given disturbance in brain functional circuits can be caused by various exogenous and endogenous factors, suggesting that, an integrative approach, including a comprehensive biochemical and immunological status of the patient is strongly recommended. For example, the initial treatment of ‘leaky gut’ problems, observed often with ADHD and autism spectrum disorder, may be a key factor in the success of Neurofeedback or tDCS therapy in these pathologies. Another important pathophysiological factor to consider is the possible presence of a subclinical chronic inflammatory process in the brain, in which the use of agents that reduce inflammation and microglial activation (eg. Minocyclin), can increase the effectiveness of neuromodulation therapy. Complication with mild traumatic brain injury (mTBI), which often remains undiagnosed, can also affect the effectiveness of neuromodulation therapy; therefore screening (eg. TBI-index based on qEEG, Neuroguide, Applied Neuroscience) can be useful.
    Conclusions: The effectiveness of nueromodulation methods of therapy can be optimized using an individual therapeutic approach, taking into account the patients’ biochemical and immunological status, as well as the presence of neuroinflamation and TBI. Correction of eventual disturbances in the domains above should precede the application of Nueromodulation methods of treatment. The qEEG can be used for individual planning the therapeutic procedures and for an objective evaluation of the results.