PDF(Pubmed)
Abstract：
UNASSIGNED: Among the brain-machine interfaces, neurofeedback is a non-invasive technique that uses sensorimotor rhythm (SMR) as a clinical intervention protocol. This study aimed to investigate the clinical applications of SMR neurofeedback to understand its clinical effectiveness in different pathologies or symptoms.
UNASSIGNED: A systematic review study with meta-analysis of the clinical applications of EEG-based SMR neurofeedback performed using pre-selected publication databases. A qualitative analysis of these studies was performed using the Consensus tool on the Reporting and Experimental Design of Neurofeedback studies (CRED-nf). The Meta-analysis of clinical efficacy was carried out using Review Manager software, version 5.4.1 (RevMan 5; Cochrane Collaboration, Oxford, UK).
UNASSIGNED: The qualitative analysis includes 44 studies, of which only 27 studies had some kind of control condition, five studies were double-blinded, and only three reported a blind follow-up throughout the intervention. The meta-analysis included a total sample of 203 individuals between stroke and fibromyalgia. Studies on multiple sclerosis, insomnia, quadriplegia, paraplegia, and mild cognitive impairment were excluded due to the absence of a control group or results based only on post-intervention scales. Statistical analysis indicated that stroke patients did not benefit from neurofeedback interventions when compared to other therapies (Std. mean. dif. 0.31, 95% CI 0.03-0.60, p = 0.03), and there was no significant heterogeneity among stroke studies, classified as moderate I2 = 46% p-value = 0.06. Patients diagnosed with fibromyalgia showed, by means of quantitative analysis, a better benefit for the group that used neurofeedback (Std. mean. dif. -0.73, 95% CI -1.22 to -0.24, p = 0.001). Thus, on performing the pooled analysis between conditions, no significant differences were observed between the neurofeedback intervention and standard therapy (0.05, CI 95%, -0.20 to -0.30, p = 0.69), with the presence of substantial heterogeneity I2 = 92.2%, p-value < 0.001.
UNASSIGNED: We conclude that although neurofeedback based on electrophysiological patterns of SMR contemplates the interest of numerous researchers and the existence of research that presents promising results, it is currently not possible to point out the clinical benefits of the technique as a form of clinical intervention. Therefore, it is necessary to develop more robust studies with a greater sample of a more rigorous methodology to understand the benefits that the technique can provide to the population.
UNASSIGNED: A systematic review study with meta-analysis of the clinical applications of EEG-based SMR neurofeedback performed using pre-selected publication databases. A qualitative analysis of these studies was performed using the Consensus tool on the Reporting and Experimental Design of Neurofeedback studies (CRED-nf). The Meta-analysis of clinical efficacy was carried out using Review Manager software, version 5.4.1 (RevMan 5; Cochrane Collaboration, Oxford, UK).
UNASSIGNED: The qualitative analysis includes 44 studies, of which only 27 studies had some kind of control condition, five studies were double-blinded, and only three reported a blind follow-up throughout the intervention. The meta-analysis included a total sample of 203 individuals between stroke and fibromyalgia. Studies on multiple sclerosis, insomnia, quadriplegia, paraplegia, and mild cognitive impairment were excluded due to the absence of a control group or results based only on post-intervention scales. Statistical analysis indicated that stroke patients did not benefit from neurofeedback interventions when compared to other therapies (Std. mean. dif. 0.31, 95% CI 0.03-0.60, p = 0.03), and there was no significant heterogeneity among stroke studies, classified as moderate I2 = 46% p-value = 0.06. Patients diagnosed with fibromyalgia showed, by means of quantitative analysis, a better benefit for the group that used neurofeedback (Std. mean. dif. -0.73, 95% CI -1.22 to -0.24, p = 0.001). Thus, on performing the pooled analysis between conditions, no significant differences were observed between the neurofeedback intervention and standard therapy (0.05, CI 95%, -0.20 to -0.30, p = 0.69), with the presence of substantial heterogeneity I2 = 92.2%, p-value < 0.001.
UNASSIGNED: We conclude that although neurofeedback based on electrophysiological patterns of SMR contemplates the interest of numerous researchers and the existence of research that presents promising results, it is currently not possible to point out the clinical benefits of the technique as a form of clinical intervention. Therefore, it is necessary to develop more robust studies with a greater sample of a more rigorous methodology to understand the benefits that the technique can provide to the population.
摘要：
■在脑机接口中，神经反馈是一种使用感觉运动节律(SMR)作为临床干预方案的非侵入性技术.本研究旨在研究SMR神经反馈的临床应用，以了解其在不同病理或症状中的临床有效性。
■使用预先选择的出版物数据库对基于EEG的SMR神经反馈的临床应用进行荟萃分析的系统综述研究。使用神经反馈研究报告和实验设计共识工具（CRED-nf）对这些研究进行定性分析。采用ReviewManager软件对临床疗效进行Meta分析。版本5.4.1(RevMan5；Cochrane协作，牛津,英国）。
■定性分析包括44项研究，其中只有27项研究具有某种控制条件，五项研究是双盲的，只有3人报告在整个干预过程中进行了盲目随访。荟萃分析包括总共203名中风和纤维肌痛患者的样本。多发性硬化症的研究，失眠,四肢瘫痪,截瘫,由于没有对照组或仅基于干预后量表的结果，因此排除了轻度认知障碍。统计分析表明，与其他疗法相比，中风患者无法从神经反馈干预中受益（Std。意思是。dif.0.31，95%CI0.03-0.60，p=0.03），卒中研究之间没有显著的异质性,分类为中等I2=46%p值=0.06。被诊断为纤维肌痛的患者显示，通过定量分析，对于使用神经反馈的组来说，这是一个更好的好处(Std.意思是。dif.-0.73，95%CI-1.22至-0.24，p=0.001）。因此，在执行条件之间的汇集分析时，神经反馈干预和标准治疗之间无显著差异(0.05，CI95%，-0.20至-0.30，p=0.69)，在存在大量异质性的情况下，I2=92.2%，p值<0.001。
■我们得出的结论是，尽管基于SMR的电生理模式的神经反馈考虑了众多研究人员的兴趣和存在提出有希望的结果的研究，目前尚无法指出该技术作为临床干预形式的临床益处.因此,有必要用更严格的方法的更大样本开发更可靠的研究，以了解该技术可以为人群提供的益处。
■使用预先选择的出版物数据库对基于EEG的SMR神经反馈的临床应用进行荟萃分析的系统综述研究。使用神经反馈研究报告和实验设计共识工具（CRED-nf）对这些研究进行定性分析。采用ReviewManager软件对临床疗效进行Meta分析。版本5.4.1(RevMan5；Cochrane协作，牛津,英国）。
■定性分析包括44项研究，其中只有27项研究具有某种控制条件，五项研究是双盲的，只有3人报告在整个干预过程中进行了盲目随访。荟萃分析包括总共203名中风和纤维肌痛患者的样本。多发性硬化症的研究，失眠,四肢瘫痪,截瘫,由于没有对照组或仅基于干预后量表的结果，因此排除了轻度认知障碍。统计分析表明，与其他疗法相比，中风患者无法从神经反馈干预中受益（Std。意思是。dif.0.31，95%CI0.03-0.60，p=0.03），卒中研究之间没有显著的异质性,分类为中等I2=46%p值=0.06。被诊断为纤维肌痛的患者显示，通过定量分析，对于使用神经反馈的组来说，这是一个更好的好处(Std.意思是。dif.-0.73，95%CI-1.22至-0.24，p=0.001）。因此，在执行条件之间的汇集分析时，神经反馈干预和标准治疗之间无显著差异(0.05，CI95%，-0.20至-0.30，p=0.69)，在存在大量异质性的情况下，I2=92.2%，p值<0.001。
■我们得出的结论是，尽管基于SMR的电生理模式的神经反馈考虑了众多研究人员的兴趣和存在提出有希望的结果的研究，目前尚无法指出该技术作为临床干预形式的临床益处.因此,有必要用更严格的方法的更大样本开发更可靠的研究，以了解该技术可以为人群提供的益处。
