Intensive Neurofeedback-based Training to Improve Impaired Attention and Executive Functions Secondary to Resection of Tuberculum Sellae Meningioma: A Case Study

Abstract

Introduction. The present study aimed to evaluate the effectiveness of neurofeedback (NFB) for the treatment of acquired cognitive impairment after brain tumor surgery. Methods. The patient was a 49-year-old bilingual African woman who underwent surgical craniotomy after a tuberculum sellae meningioma was diagnosed. Cognitive deficits were evident following post-surgical recovery, and therefore intensive NFB training consisting of 15 sessions was carried out over a period of three weeks. Full neuropsychological testing and quantitative EEG analysis were performed before and after the training for outcome measurements. Results. The treatment resulted in improved attention and executive functions; specifically sustained, focused, and divided attentional abilities; cognitive flexibility, access to the lexical vocabulary, and a better processing speed. Analysis of the qEEG revealed an increased alpha peak frequency value and reduced delta/alpha ratio in frontal areas. The EEG examination revealed interhemispheric asymmetry after treatment. Conclusion. These findings suggest that a delta/alpha decrease might account for some clinical effects on cognitive abilities seen in a brain tumor resection survivor, reducing cognitive symptoms that can have a significant impact on daily life functions. Future studies on larger patients’ samples should clarify the feasibility of NFB protocols for patients with brain tumors. have associated with positive cognitive outcomes (e.g., control and shifting, attention, executive functions, abstract reasoning, nonverbal intelligence). Alpha activity is linked to