Methodology and feasibility of neurofeedback to improve visual attention to letters in mild Alzheimer's disease

Brain computer interfaces systems are controlled by users through neurophysiological input for a variety of applications including communication, environmental control, motor rehabilitation, and cognitive training. Although individuals with severe speech and physical impairment are the primary users of this technology, BCIs have emerged as a potential tool for broader populations, especially with regards to delivering cognitive training or interventions with neurofeedback. The goal of this study was to investigate the feasibility of using a BCI system with neurofeedback as an intervention for people with mild Alzheimer's disease. The study focused on visual attention and language since ad is often associated with functional impairments in language and reading. The study enrolled five adults with mild ad in a nine to thirteen week BCI EEG based neurofeedback intervention to improve attention and reading skills. Two participants completed intervention entirely. The remaining three participants could not complete the intervention phase because of restrictions related to covid. Pre and post assessment measures were used to assess reliability of outcome measures and generalization of treatment to functional reading, processing speed, attention, and working memory skills. Participants demonstrated steady improvement in most cognitive measures across experimental phases, although there was not a significant effect of NFB on most measures of attention. One subject demonstrated significantly significant improvement in letter cancellation during NFB. All participants with mild AD learned to operate a BCI system with training. Results have broad implications for the design and use of bci systems for participants with cognitive impairment. Preliminary evidence justifies implementing NFB-based cognitive measures in AD.