A Neural Training Method with Biological Feedback in the Treatment of Cognitive Impairments in Patients with Early Cerebral Small Vessel Disease

Dobrynina L.A., Novikova E.S., Dobrushina O.R., Gnedovskaya E.V., Korepina O.S., and Byrochkina A.A. 
Neuroscience and Behavioral Physiology, Vol. 55, No. 2, February, 2025
Objective. To compare the effectiveness of neural training using biofeedback (BF) at infra-low and α frequencies in the correction of cognitive impairments (CI) in patients with early cerebral microangiopathy (CMA). Materials and methods. The study included 71 patients (mean age 52.8 ± 6.3 years, 15% men, 85% women) with early CMA and 21 healthy volunteers (mean age 53.2 ± 4.8 years, 29% men, 71% women). All participants were assessed for clinical manifestations and cognitive functions and underwent brain MRI and EEG investigations. Patients with CMA were randomized using the envelope method with double-blind placebo control. Three biofeedback neural training groups were formed: 25 patients with infra-low waves, 22 with α waves, and 24 with simulated biofeedback using the EEG (placebo). Fifteen 30-minute sessions were conducted at a rate of 2–5 times a week. Cognitive profi les and EEG recordings were assessed immediately and 6–8 weeks after completion of biofeedback courses. Results. The group of patients with CMA had subjective (65%) and moderate (35%) cognitive impairments with predominant deviations in the components of the executive functions of the brain. Biofeedback neural training using infra-low waves signifi cantly improved cerebral executive functions in the productivity, switching, inhibition, and non-verbal delayed memory components immediately after courses, with the effect persisting for at least 6–8 weeks and accompanied by an increase in the power (μV2 ) of the α rhythm in the occipital regions. Biofeedback training with α waves led to improvements in the Stroop test (interference index) in the longer-term period. Conclusions. Infra-low frequency biofeedback neural training is advisable in patients with early CMA and deterioration of cerebral executive functions, with the aim of correcting CI and creating a cognitive reserve. The increase in α-rhythm power in the occipital regions during biotraining courses can be regarded as a prognostic marker of its effectiveness.