Randomized controlled trial of adjunctive EEG-biofeedback treatment of obsessive-compulsive disorder

Shanghai Arch Psychiatry. 2014 Oct;26(5):272-9. doi: 10.11919/j.issn.1002-0829.214067.

Abstract

Background: Current interventions for obsessive-compulsive disorder (OCD) are often of limited benefit.

Aim: To evaluate the effect of adjunctive treatment with EEG biofeedback training on the symptoms and cognitive functioning of individuals with OCD.

Aim: To evaluate the effect of adjunctive treatment with EEG biofeedback training on the symptoms and cognitive functioning of individuals with OCD.

Methods: A total of 79 individuals with OCD were randomly assigned to the study group (n=40) or the control group (n=39). The control group was treated using a combination of sertraline (50 to 200 mg/d) and weekly cognitive behavioral therapy sessions by trained therapists for 8 weeks; the study group was treated using the same regimen plus EEG biofeedback sessions 5 times per week. The Yale Brown Obsessive Compulsive Scale (YBOCS) was administered by a psychiatrist who was blind to patients' treatment status before treatment and at the end of the 2(nd), 4(th), 6(th) and 8(th) week for treatment; the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was administered before and after the 8-week trial.

Results: Three individuals dropped out of the study group and four dropped out of the control group (χ (2)=0.186, p=0.712). At the end of the study, treatment was considered effective in 32 of the 37 (86.5%) participants in the study group and in 22 of the 35 (62.9%) participants in the control group (χ (2)=5.36, p=0.021). Repeated measures analysis of variance showed that the improvement in OCD symptoms was greater in the study group than the control group by the 6(th) week of treatment. At the end of the trial all 5 cognitive dimensions assessed by the RBANS were significantly better in study groups subjects than in control group subjects and the changes in the YBOCS score were significantly correlated with changes in the RBANS overall score in the study group (r=0.43, p=0.007), but not in the control group (r=0.171, p=0.327).

Conclusions: This methodologically rigorous study demonstrates that 8 weeks of adjunctive treatment with EEG biofeedback training can significantly improve the clinical symptoms and cognitive functioning of OCD patients being treated with medication and psychotherapy. Further work is needed to assess the long-term effects of biofeedback training and the need for booster sessions after an initial period of training.

背景: 目前对强迫症(OCD)的干预措施往往疗效有限。

目的: 评价脑电生物反馈训练作为强迫症患者症状和 认知功能辅助治疗的效果。

方法: 共79名强迫症患者随机分为研究组(n=40)和 对照组(n=39)。对照组服用舍曲林(50~200mg/d) 合并每周一次、连续8周的认知行为治疗;研究组采 用相同的方案再加上脑电生物反馈训练,每周5次。 由一位单盲于患者治疗状态的精神科医师分别在治疗 前和治疗第2周末、第4周末、第6周末和第8周末 采用耶鲁-布朗强迫量表(YBOCS)对患者进行评估; 采用重复性神经心理状态成套测验(RBANS)在试验 前和8周后对患者进行评估。

结果: 研究组有3例脱落,对照组有4例脱落(χ2=0.186, p=0.712)。在研究结束时,研究组37例中32例治 疗有效(86.5%),对照组35例中22例治疗有效 (62.9%)(χ2=5.36, p=0.021)。重复测量方差分析 表明治疗6周时研究组强迫症症状的改善显著大于 对照组。试验结束时,研究组患者的RBANS量表所 有5个维度的认知评估均显著好于对照组,并且研究 组YBOCS评分的变化与RBANS总分的变化显著相关 (r=0.43, p=0.007),但在对照组中不相关(r=0.171, p=0.327)

结论: 该项方法严谨的研究表明,强迫症患者在接受 药物和心理治疗的同时辅以8周的脑电生物反馈训练 可显著改善临床症状和认知功能。今后需要进一步开 展工作以评估生物反馈训练的长期效果和初始阶段训 练后强化训练的必要性。

Keywords: China; EEG biofeedback; Obsessive compulsive disorder; cognitive function.

Grant support

This study was supported by the Jingzhou Science and Technology Development Plan (Grant No. 2013AE39).