Neurocampus Days 2018

1. BORDEAUX
NEUROCAMPUS
DAY
Jeudi 17 mai 2018 Domaine du Haut-Carré
Jean-Arthur MICOULAUD-FRANCHI
SANPSY, USR 3413
Neurophysiological Issues of Neurofeedback
Applied to Mental and Brain Disorders

2. Jeudi 17 mai 2018 Domaine du Haut-Carré
Neurofeedback is a
neuromodulation therapeutic
inspired from the first
psychophysiological research in 1935
from Durup and Fessard
They first showed that :
1 – EEG activity is related to a specific
mental state
2 – EEG activity can be conditioned
What is neurofeedback ?
Neurofeedback is a French electrophysiological technique

3. Jeudi 17 mai 2018 Domaine du Haut-Carré
1 – EEG activity is
related to a specific
mental state
« les résultats obtenus en
variant les consignes et en
confrontant les auto-
observations du sujet
avec les graphiques montrent
d'ailleurs qu'à côté des
conditions extérieures,
l'attitude mentale du
sujet intervient dans
le déterminisme de la
réaction d'arrêt »
What is neurofeedback ?
Neurofeedback is based on the relation
between mental states and EEG activities
Alpha EEG rhythms arrest
Alpha rhythms is blocked by eyes opening
But also … :

4. Jeudi 17 mai 2018 Domaine du Haut-Carré
2 – EEG activity can be
conditioned
« La réaction d'arrêt de l’alpha
est conditionnable »
What is neurofeedback ?
Neurofeedback is based on the fact
that the cognitive regulation of EEG activities can be learned
Alpha EEG rhythms arrest can be learned
Eyes closed, the subject can learn to block Alpha rhythms
by attentional cognitive activity

5. Jeudi 17 mai 2018 Domaine du Haut-Carré
The five steps of neurofeedback
training
1 – EEG recording (or other brain activity
recording : MEG, fMRI, NIRS)
2 – Real time data analysis
3 – Extraction of a parameter of interest
(related to a cognitive process)
4 – Presentation in real time of the evolution
of the parameter to the subject
5 – Cognitive training to modify the
parameter of interest
What is neurofeedback in practice ?
EEG based cognitive training and learning
1
32
45

6. Jeudi 17 mai 2018 Domaine du Haut-Carré
From a neurophysiological point of
view :
• A neuromodulation procedure not
based on external stimulation but based on
internal cognitive training
• A cognitive training that has the most effect
on a neurophysiological target
In the classical SMR training on cats
(Sterman et al. 1960) :
Each cat exhibits his own behavior to
enhance SMR rhythms
What is the originality of neurofeedback ?
Cognitive training based on neurophysiological target

7. Jeudi 17 mai 2018 Domaine du Haut-Carré
From a neuroscience based clinical
point of view :
A neuromodulation therapeutic that can
target specific biomarker related to the
pathophysiology of mental or brain
disorders
If the biomarker related to the
pathophysiology is corrected by
neurofeedback, the clinical expression
of the disorder is supposed to decrease
For example in ADHD 
What is the originality of neurofeedback ?
Cognitive training based on neurophysiological target
ADHD is supposed to be associated with
abnormal EEG activity
Theta / Beta ratio is higher in ADHD
Related to arousal dysfunction
(Bioulac et al. 2016, 2017)

8. Jeudi 17 mai 2018 Domaine du Haut-Carré
What is the issues of neurofeedback ?
Is neurofeedback efficient for ADHD treatment ?
Inclusion of :
• Randomized controlled trials
(RCT)
• Neurofeedabck based on
Theta/Beta Ratio training
• Control group: semi-active
(i.e., cognitive remediation
and EMG-biofeedback) and
sham-NF.
 Inattention score was
significantly improved in
patients receiving
neurofeedback compared to
controls (SMD = −0.30
[−0.58, −0.03]).

9. Jeudi 17 mai 2018 Domaine du Haut-Carré
Is neurofeedback efficacy related to the
real time presentation of the evolution
of the parameter related to the
neurophysiological target ?
What is the issues of neurofeedback ?
Is neurofeedback efficacy related to the closed loop ?
Schabusetal.2017
Thibault et al. 2017

10. Jeudi 17 mai 2018 Domaine du Haut-Carré
Why neurofeedback is a hot topic ?
A hot topic on Brain journal !

11. Jeudi 17 mai 2018 Domaine du Haut-Carré
Randomized controlled
trials (RCT) control the
control group but not the
neurofeedback group!
Does a training occur in
the neurofeedback group?
We need a model to
control the variable that
drives the training
Which road map for the issues of neurofeedback ?
To better identify variable related to learning
A minimal hypothesis : the more the training, the more the clinical benefit!
But we have to test it!

12. Jeudi 17 mai 2018 Domaine du Haut-Carré
Randomized controlled trials (RCT)
maybe do not target the right target!
The neuroscientific challenge in the field
of neurofeedback is a general
challenge in the field of
neuromodulation for mental and
brain disorders
To develop a specific “EEGcopia” linking
neurophysiological biomarkers and
cognitive processes / clinical dimensions
with sufficient accuracy and evidence of
a causal relationship
Micoulaud Franchi et al., In Press
Which road map for the issues of neurofeedback ?
To better identify valid and reliable biomarker target
RDoC project and Neurofeedback
The Research Domain Criteria -RDoC- project
rather than the Diagnostic and Statistical
Manual of Mental Disorders -DSM- classification
Categorical approach
1 biomarker =
1 disorder
Dimensional approach
1 biomarker =
1 brain / cognitive
altered processes

13. Jeudi 17 mai 2018 Domaine du Haut-Carré
Neuroperf Project
Granted by Labex Brain in 2017
To target drowsiness and related
neurophysiological mechanism in subject
with sleep restriction
Which project in the Sanpsy lab ?
A project on level or arousal, drowsiness and neurofeedback
ISSSUE 1
Better
identification
of a EEG target
related to
drowsiness
ISSUE 2
Better control of
the training and
the learing
during
neurofeedback

14. Jeudi 17 mai 2018 Domaine du Haut-Carré