NeMoRe · NeuroModulation Rehabilitation. A neurofeedback and transcranial alternating-current stimulation approach for the neurorehabilitation of patients with attentional deficits after acquired brain injury

Acquired brain injury (ABI) represents non-progressive cerebral damage occurring after birth (eg., trauma, hypoxia, stroke). ABIs affect several domains, including cognitive functions. Specifically, up to 80% of ABI patients show attentional deficits that highly impact their quality of life and independence by hampering the execution of daily tasks. Since cognitive rehabilitation seems to be only mildly effective in treating these deficits, it is crucial to explore more effective tools for neurorehabilitation. Among emerging techniques, neurofeedback (NF) can effectively improve attentional abilities in patients with ADHD. NF is a training where a subject receives online feedback on their brainwaves, with the goal to normalize brain oscillations through operant conditioning. It is a promising tool for attention rehabilitation of ABI patients, however, currently only 30% of subjects are able to master NF techniques. Transcranial alternating current stimulation (tACS) is a non-invasive electrical stimulation technique that, by delivering a weak current to the brain, can entrain specific frequencies in the brain. Thus, tACS (by increasing the target frequency of NF) could facilitate NF and increase its effectiveness. Our study has 2 aims: 1) to validate NF as an attentional rehabilitation tool for ABI patients; 2) to show that tACS can increase NF effectiveness. We will perform a randomized double-blind placebo-controlled trial with 75 subjects with ABI (with mixed etiologies, matched by cognitive profile) with 3 arms: a) NF alone, b) NF+tACS , c) Control group. Both tACS and NF will target β power. We will have measures for efficacy, transfer to daily life and motivation of the intervention. This innovative protocol will validate a new tool for ABI patients’ neurorehabilitation and open new doors for the combined use of NF+tACS in other rehabilitation fields.