The use of EEG biofeedback in rehabilitation of a patient with amyotrophic lateral sclerosis with cognitive, mood and motivation disorders
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Department of Public Health, Epidemiology and Microbiology, Faculty of Health Sciences, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Poland
Clinical University Hospital in Olsztyn, Poland
Department of Pathophysiology, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Poland
Department of Neurology and Neurosurgery, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Poland
Dorota Mroczkowska   

Uniwersytecki Szpital Kliniczny w Olsztynie, Warszawska 30, 10-082 Olsztyn, Poland. Tel.: +48 531 052 830.
Submission date: 2017-04-12
Acceptance date: 2017-10-19
Online publication date: 2018-02-05
Publication date: 2019-11-16
Pol. Ann. Med. 2018;25(1):68–73
Amyotrophic lateral sclerosis (ALS) is primarily a degenerative disease of the nervous system, progressive, and of unknown aetiology. It leads to the limitation of movement (muscular dystrophy), impaired communication with others (speech disorders, dysarthria), dietary problems (dysphagia) and mental dysfunctions.

Our purpose was to assess the neurorehabilitation effectiveness of patient with ALS.

Case study:
A 71-year-old male patient was diagnosed with ALS. The study of cognitive, mood and motivation disorders was performed using neuropsychological and neurophysiological methods. The authors assessed the impact of the neurofeedback method on EEG neurophysiological parameters: beta, beta2, sensorimotor (SMR) and theta waves. We used 4-channel headbox EEG DigiTrack BF.

Neuropsychological diagnosis showed the presence of executive deficits: the ability to plan and perform complex tasks, and distraction in response to an external stimulus. Test for depression showed moderate mood decline and impulsiveness. Fear of the disease was manifested by excessive concentration on health, depersonalization, diurnal mood swings and intense obsessions. Reinforcement of behaviours responsible for an increase in SMR waves (the so-called high alpha 12–15 Hz) was aimed at reducing impulsive behaviour. Our goal was to diminish the amplitude and percentage share of: theta (4–8 Hz) and beta2 (frequency above 18 Hz) waves whose excess was manifested by emotional states, such as anxiety and psychomotor agitation. After a series of 10 sessions, the amplitude of SMR waves in the right hemisphere was increased. In addition, the desired reduction of beta2 waves was achieved.

The study suggests that neurofeedback can be used as a neurorehabilitation component of the personalized complex rehabilitation protocol for the ALS patients. The improvement of mental health is largely associated with better patient collaboration in the management of somatic disease by: enhancing motivation for rehabilitation, increasing tolerance of the disease and reducing anxiety.

This is supported by the National Centre for Research and Development Grant STRATEGMED1/234261/2NCBR/2014.
None declared.