The Effectiveness of Neuro-Feedback on the Severity of Gastrointestinal Symptoms, Depression, Anxiety, Stress and Quality of Life in Patients with Irritable Bowel Syndrome (IBS): A Randomized Controlled Clinical Trial

Document Type : Original Article (s)

Authors

1 Associate Professor, Department of Health Psychology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 MSc of Clinical Psychology, Department of Clinical Psychology, Roudehen Branch, Islamic Azad University, Roudehen, Iran

3 Associate Professor, Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

4 PhD of Clinical Psychology, Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, AND Department of Clinical Psychology, Roudehen Branch, Islamic Azad University, Roudehen, Iran

5 MSc of Positive Psychology, Soroush Andisheh Ebn e Sina Clinical Psychology Institute, Isfahan, Iran

Abstract

Background: New technologies in neuroscience like neurofeedback (NFB) is one of the growing and challenging issues. The aim of present study was to determine the effectiveness of NFB on the severity of gastrointestinal (GI) symptoms, depression, anxiety, stress and quality of life in irritable bowel syndrome (IBS) patients.
Methods: This study was a double-blind clinical trial with a control group conducted in 2021 .The Initial screening included 160 patients with IBS who were referred by a gastroenterologist. Thirty patients were randomly assigned to three groups of NFB intervention; placebo (Pseudo-NFD) and control group (GI drugs only). The groups completed the IBS Severity Scale (IBS-SSS), Depression, Anxiety and Stress Scale (DASS-42) and IBS Quality of Life Questionnaire (QOL-IBS) before and after the intervention. Data were analyzed using ANOVA.
Findings: The results showed that NFB and placebo had a greater and significant effect on reducing depressive symptoms and IBS severity compared to the drug alone (P < 0.05). The placebo group with the drug showed an increase in higher quality of life scores than the other groups (P < 0.05). There was no significant difference between the groups in stress and anxiety.
Conclusion: The findings support the use of NFB along with medication for IBS patients, which is associated with appropriate therapeutic relationship, to enhance the effectiveness of interdisciplinary interventions.

Keywords

Main Subjects

References

  1. Drossman DA, Hasler WL. Rome-IV functional GI disorders: disorders of gut-brain interaction. Gastroenterology 2016; 150(6): 1257-61.
  2. Midenfjord I, Borg A, Törnblom H, Simrén M. Cumulative effect of psychological alterations on gastrointestinal symptom severity in irritable bowel syndrome. Am J Gastroenterol 2021; 116(4): 769-79.
  3. Palsson OS, Whitehead W, Törnblom H, Sperber AD, Simren M. Prevalence of Rome IV functional bowel disorders among adults in the United States, Canada, and the United Kingdom. Gastroenterology 2020; 158(5): 1262-73.
  4. Mearin F, Lacy BE, Chang L, Chey WD, Lembo AJ, Simren M, et al. Bowel disorders. Gastroenterology 2016; 150(6): 1393-407.
  5. Mayer EA, Tillisch K. The brain-gut axis in abdominal pain syndromes. Annu Rev Med 2011; 62: 381-96.
  6. Deldin PJ, Chiu P. Cognitive restructuring and EEG in major depression. Biol Psychol 2005; 70(3):
    141-51.
  7. Gotlib IH, Hammen CL. Handbook of depression. 2nd New York, NY: The Guilford Press; 2010. p. 3.
  8. Henriques JB, Davidson RJ. Left frontal hypoactivation in depression. J Abnorm Psychol 1991; 100(4): 535.
  9. Davidson RJ. What does the prefrontal cortex “do” in affect: perspectives on frontal EEG asymmetry research? Biol Psychol 2004; 67(1-2): 219-34.
  10. Hayee BH, Forgacs I. Psychological approach to managing irritable bowel syndrome. BMJ 2007; 334(7603): 1105-9.
  11. Khoshsorour S. Investigating the effect of Neurofeedback in decreasing anxiety and symptom severity of patients with Irritable Bowel Syndrome (IBS) [in Persian]. Stud Med Sci 2018; 28(10): 647-58.
  12. Moore NC. A review of EEG biofeedback treatment of anxiety disorders. Clin Electroencephalogr 2000; 31(1): 1-6.
  13. Hou Y, Zhang S, Li N, Huang Z, Wang L, Wang Y. Neurofeedback training improves anxiety trait and depressive symptom in GAD. Brain Behav 2021; 11(3): e02024.
  14. Marzbani H, Marateb HR, Mansourian M. Neurofeedback: a comprehensive review on system design, methodology and clinical applications. Basic Clin Neurosci 2016; 7(2): 143-58.
  15. Hosseini SH, Maleki I, Farnia S, Kazemi-Malekmahmoudi S. Comparing the effectiveness of music therapy and alpha-theta neuro-feedback training on anxiety and depression among patients with chronic irritable bowel syndrome. J Chronic Dis 2018; 6(3): 143-51.
  16. Gunkelman JD, Johnstone J. Neurofeedback and the brain. J Adult Dev 2005; 12(2): 93-8.
  17. Hammond DC. What is neurofeedback? J Neurother 2007; 10(4): 25-36.
  18. Moriyama T, Polanczyk G, Rohde L. National institute of developmental psychiatry for children and adolescents. Neurotherapeutics 2012; 14(2): 12-9.
  19. Arns M, Conners CK, Kraemer HC. A decade of EEG theta/beta ratio research in ADHD: a meta-analysis. J Atten Disord 2013; 17(5): 374-83.
  20. Afshar H, Bagherian R, Foroozandeh N, Khorramian N, Daghaghzadeh H, Maracy MR, et al. The relationship between illness perception and symptom severity in patients with irritable bowel syndrome [in Persian]. J Isfahan Med Sch 2011; 29(137): 526-36.
  21. Patrick DL, Drossman DA, Frederick IO, Dicesare J, Puder Quality of life in persons with irritable bowel syndrome (Development and validation of a new measure). Dig Dis Sci 1998; 43: 400-11.
  22. Lovibond PF, Lovibond SH. The structure of negative emotional states: Comparison of the depression anxiety stress scales (DASS) with the beck depression and anxiety inventories. Behav Res Ther1995; 33: 335-43.
  23. Afzali A, Delavar A, Borjali A, Mirzamani M. Psychometric properties of DASS-42 as assessed in a sample of Kermanshah High School students [in Persian]. J Res Behav Sci 2007; 5(2): 81-92.
  24. Hammond DC. Neurofeedback with anxiety and affective disorders. Child Adolesc Psychiatr Clin N Am 2005; 14(1): 105-23.
  25. Nainian MR, Babapour J, Garoosi Farshi T, Shaeeri MR, Rostami R. Comparing the influence of drug therapy and neurofeedback training on reduction of anxiety symptoms and life quality of generalized anxiety disorder (GAD) patients [in Persian]. CPAP 2013; 10(2): 1-14.
  26. Oraki M, Dortaj A, Mehdizadeh A. Evaluating the effectiveness of neurofeedback treatment on depression, anxiety, stress and abdominal pain in patients with chronic psychosomatic abdominal pains [in Persian]. Neuropsychology 2016; 2(6): 45-60.
  27. Mazi M, Ebrahimi A, Daghaghzadeh H, Aghaee H. The effectiveness of compassion focused therapy (CFT) on perceived stress in patients with irritable bowel syndrome; an experimental study [in Persian]. J Isfahan Med Sch 2020; 38(588): 602-8.
Journal of Isfahan Medical School
Volume 41, Issue 712
4th Week, May
May and June 2023
Pages 172-179

Files

History

  • Receive Date: 22 November 2022
  • Accept Date: 19 April 2023

Share

How to cite

Statistics