Transtorno de estresse pós-traumático e interações psicofisiológicas de padrões cerebrais, exercício e tratamento não medicamentoso: uma revisão integrativa
Por Lilian Martins (Autor).
Em Revista de Educação Física - Centro de Capacitação Física do Exército v. 92, n 2, 2023.
Resumo
O transtorno de estresse pós-traumático (TEPT) é um problema de saúde mental proeminente em militares veteranos e, também, na população em geral. Podendo durar desde apenas alguns meses a muitos anos, causa diversas incapacidades aos indivíduos que sofrem com o transtorno. Existem opções não medicamentosas que podem, não apenas contribuir, como até mesmo serem necessárias para a recuperação integral de pacientes com TEPT.
Objetivo: Examinar as interações entre aspectos fisiológicos-psicofisiológicos e eletrofisiológicos (padrões corticais) com exercício físico, buscando possíveis alternativas não-medicamentosas para o tratamento de pacientes com transtorno de estresse pós-traumático (TEPT).
Resultados e Discussão: A disfunção do hipocampo é causa de TEPT e problemas no funcionamento cerebral (ansiedade, depressão e comprometimento cognitivo), além de prejuízos na função mitocôndria e na neuroplasticidade. O exercício físico e a neuromodulação autorregulatória podem contribuir, e até serem indispensáveis, para a recuperação desses pacientes.
Conclusão: Exercícios físicos, por meio da melhora induzida do nível do fator neurotrófico derivado do cérebro, do aprimoramento da função mitocondrial e da indução à neuroplasticidade e a taxa de apoptose no hipocampo contribui para a recuperação de pacientes com TEPT. Além disso, indica-se a neuromodulação autorregulatória.
Referências
American Psychiatric Association. Manual Diagnóstico e Estatístico de Transtornos Mentais - DSM-5-TR: Texto Revisado.. 5a edição. Porto Alegre, RS: Artmed; 2023.
Mello Filho J, Burd M. Psicossomática Hoje.. 2a edição. Porto Alegre-RS: Artmed; 2010.
Kumar A, Chanana P. Role of Nitric Oxide in Stress-Induced Anxiety: From Pathophysiology to Therapeutic Target. Vitamins and Hormones. 2017;103: 147–167. https://doi.org/10.1016/bs.vh.2016.09.004.
U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans, 2nd edition.. 2nd ed. Washington-DC: U.S. Department of Health and Human Services; 2018.
Peluso MAM, Guerra de Andrade LHS. Physical activity and mental health: the association between exercise and mood. Clinics (Sao Paulo, Brazil). 2005;60(1): 61–70. https://doi.org/10.1590/s1807-59322005000100012.
Warburton DER, Bredin SSD. Health benefits of physical activity: a systematic review of current systematic reviews. Current Opinion in Cardiology. 2017;32(5): 541–556. https://doi.org/10.1097/HCO.0000000000000437.
Kandola A, Stubbs B. Exercise and Anxiety. Advances in Experimental Medicine and Biology. 2020;1228: 345–352. https://doi.org/10.1007/978-981-15-1792-1_23.
Hamer M, Stamatakis E, Steptoe A. Dose-response relationship between physical activity and mental health: the Scottish Health Survey. British Journal of Sports Medicine. 2009;43(14): 1111–1114. https://doi.org/10.1136/bjsm.2008.046243.
Carek PJ, Laibstain SE, Carek SM. Exercise for the treatment of depression and anxiety. International Journal of Psychiatry in Medicine. 2011;41(1): 15–28. https://doi.org/10.2190/PM.41.1.c.
Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Reports. 1985;100(2): 126–131.
Daniela M, Catalina L, Ilie O, Paula M, Daniel-Andrei I, Ioana B. Effects of Exercise Training on the Autonomic Nervous System with a Focus on Anti-Inflammatory and Antioxidants Effects. Antioxidants. 2022;11(2): 350. https://doi.org/10.3390/antiox11020350.
Hamer M, Endrighi R, Poole L. Physical Activity, Stress Reduction, and Mood: Insight into Immunological Mechanisms. Methods in molecular biology (Clifton, N.J.). 2012;934: 89–102. https://doi.org/10.1007/978-1-62703-071-7_5.
Stults-Kolehmainen MA, Sinha R. The Effects of Stress on Physical Activity and Exercise. Sports medicine (Auckland, N.Z.). 2014;44(1): 81–121. https://doi.org/10.1007/s40279-013-0090-5.
Buchan MC, Romano I, Butler A, Laxer RE, Patte KA, Leatherdale ST. Bi-directional relationships between physical activity and mental health among a large sample of Canadian youth: a sex-stratified analysis of students in the COMPASS study. International Journal of Behavioral Nutrition and Physical Activity. 2021;18(1): 132. https://doi.org/10.1186/s12966-021-01201-z.
Steinmo S, Hagger-Johnson G, Shahab L. Bidirectional association between mental health and physical activity in older adults: Whitehall II prospective cohort study. Preventive Medicine. 2014;66: 74–79. https://doi.org/10.1016/j.ypmed.2014.06.005.
Souza MT de, Silva MD da, Carvalho R de. Integrative review: what is it? How to do it? Einstein (Sao Paulo, Brazil). 2010;8(1): 102–106. https://doi.org/10.1590/S1679-45082010RW1134.
Bower JE, Kuhlman KR. Psychoneuroimmunology: An Introduction to Immune-to-Brain Communication and Its Implications for Clinical Psychology. Annual Review of Clinical Psychology. 2023;19: 331–359. https://doi.org/10.1146/annurev-clinpsy-080621-045153.
Chang HH, Chen PS. Inflammatory Biomarkers for Mood Disorders - A Brief Narrative Review. Current Pharmaceutical Design. 2020;26(2): 236–243. https://doi.org/10.2174/1381612826666200115100726.
Miller M, Fry WF. The Effect of Mirthful Laughter on the Human Cardiovascular System. Medical hypotheses. 2009;73(5): 636. https://doi.org/10.1016/j.mehy.2009.02.044.
Panagi L, Poole L, Hackett RA, Steptoe A. Happiness and Inflammatory Responses to Acute Stress in People With Type 2 Diabetes. Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine. 2018;53(4): 309–320. https://doi.org/10.1093/abm/kay039.
Sallam N, Laher I. Exercise Modulates Oxidative Stress and Inflammation in Aging and Cardiovascular Diseases. Oxidative Medicine and Cellular Longevity. 2015;2016: e7239639. https://doi.org/10.1155/2016/7239639.
Somani A, Singh AK, Gupta B, Nagarkoti S, Dalal PK, Dikshit M. Oxidative and Nitrosative Stress in Major Depressive Disorder: A Case Control Study. Brain Sciences. 2022;12(2): 144. https://doi.org/10.3390/brainsci12020144.
Adami P, König P, Vetter Z, Hausmann A, Conca A. Post-traumatic stress disorder and amygdala-hippocampectomy. Acta Psychiatrica Scandinavica. 2006;113(4): 360–363. https://doi.org/10.1111/j.1600-0447.2005.00737.x.
Hegberg NJ, Hayes JP, Hayes SM. Exercise Intervention in PTSD: A Narrative Review and Rationale for Implementation. Frontiers in Psychiatry. 2019;10: 133. https://doi.org/10.3389/fpsyt.2019.00133.
Coêlho BM, Santana GL, de Souza Dantas H, Viana MC, Andrade LH, Wang YP. Correlates and prevalence of post-traumatic stress disorders in the São Paulo metropolitan area, Brazil. Journal of Psychiatric Research. 2022;156: 168–176. https://doi.org/10.1016/j.jpsychires.2022.09.047.
Porges SW. Vagal tone: a physiologic marker of stress vulnerability. Pediatrics. 1992;90(3 Pt 2): 498–504.
Porges SW. The polyvagal perspective. Biological Psychology. 2007;74(2): 116–143. https://doi.org/10.1016/j.biopsycho.2006.06.009.
Porges S. The polyvagal theory: New insights into adaptive reactions of the autonomic nervous system. Cleveland Clinic journal of medicine. 2009;76(Suppl 2): S86–S90. https://doi.org/10.3949/ccjm.76.s2.17.
Porges SW. Polyvagal Theory: A Science of Safety. Frontiers in Integrative Neuroscience. 2022;16. https://www.frontiersin.org/articles/10.3389/fnint.2022.871227
Sistema nervoso autônomo. Kenhub. https://www.kenhub.com/pt/library/anatomia/sistema-nervoso-autonomo [Accessed 13th February 2024].
Sistema nervoso parassimpático. Kenhub. https://www.kenhub.com/pt/library/anatomia/sistema-nervoso-parassimpatico [Accessed 13th February 2024].
Nervo vago (NC X). Kenhub. https://www.kenhub.com/pt/study/nervo-vago [Accessed 14th February 2024].
Nervo vago (X). Kenhub. https://www.kenhub.com/pt/library/anatomia/nervo-vago [Accessed 13th February 2024].
Fitchett A, Mastitskaya S, Aristovich K. Selective Neuromodulation of the Vagus Nerve. Frontiers in Neuroscience. 2021;15. https://www.frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2021.685872
Giunta S, Xia S, Pelliccioni G, Olivieri F. Autonomic nervous system imbalance during aging contributes to impair endogenous anti-inflammaging strategies. GeroScience. 2024;46(1): 113–127. https://doi.org/10.1007/s11357-023-00947-7.
Kaplan GB, Lakis GA, Zhoba H. Sleep-wake and arousal dysfunctions in post-traumatic stress disorder: Role of orexin systems. Brain Research Bulletin. 2022;186: 106–122. https://doi.org/10.1016/j.brainresbull.2022.05.006.
Sutcliffe JG, de Lecea L. The hypocretins: excitatory neuromodulatory peptides for multiple homeostatic systems, including sleep and feeding. Journal of Neuroscience Research. 2000;62(2): 161–168. https://doi.org/10.1002/1097-4547(20001015)62:2<161::AID-JNR1>3.0.CO;2-1.
Mavanji V, Pomonis B, Kotz CM. Orexin, serotonin, and energy balance. WIREs mechanisms of disease. 2022;14(1): e1536. https://doi.org/10.1002/wsbm.1536.
Chen Y, Guo Y, Yan X, Zeng M, Chen H, Qiu D, et al. Orexin-A Excites Airway Vagal Preganglionic Neurons via Activation of Orexin Receptor Type 1 and Type 2 in Rats. Frontiers in Cellular Neuroscience. 2019;13. https://www.frontiersin.org/articles/10.3389/fncel.2019.00478
Dong XY, Feng Z. Wake-promoting effects of vagus nerve stimulation after traumatic brain injury: upregulation of orexin-A and orexin receptor type 1 expression in the prefrontal cortex. Neural Regeneration Research. 2018;13(2): 244–251. https://doi.org/10.4103/1673-5374.226395.
Wohlfahrt P, Jenča D, Melenovský V, Jarolím P, Dlouhá D, Šramko M, et al. Attenuation of Hypocretin/Orexin Signaling Is Associated With Increased Mortality After Myocardial Infarction. Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease. 2023;12(6): e028987. https://doi.org/10.1161/JAHA.122.028987.
Couvineau A, Voisin T, Nicole P, Gratio V, Abad C, Tan YV. Orexins as Novel Therapeutic Targets in Inflammatory and Neurodegenerative Diseases. Frontiers in Endocrinology. 2019;10: 709. https://doi.org/10.3389/fendo.2019.00709.
World Health Organization. Physical activity. https://www.who.int/news-room/fact-sheets/detail/physical-activity [Accessed 14th February 2024].
Singh B, Olds T, Curtis R, Dumuid D, Virgara R, Watson A, et al. Effectiveness of physical activity interventions for improving depression, anxiety and distress: an overview of systematic reviews. British Journal of Sports Medicine. 2023;57(18): 1203–1209. https://doi.org/10.1136/bjsports-2022-106195.
Zhang Q, Miao L, He L, Wang H. The Relationship between Self-Concept and Negative Emotion: A Moderated Mediation Model. International Journal of Environmental Research and Public Health. 2022;19(16): 10377. https://doi.org/10.3390/ijerph191610377.
Rimmele U, Seiler R, Marti B, Wirtz PH, Ehlert U, Heinrichs M. The level of physical activity affects adrenal and cardiovascular reactivity to psychosocial stress. Psychoneuroendocrinology. 2009;34(2): 190–198. https://doi.org/10.1016/j.psyneuen.2008.08.023.
Huang CJ, McAllister MJ, Slusher AL. The Roles of Psychological Stress, Physical Activity, and Dietary Modifications on Cardiovascular Health Implications. In: Oxford Research Encyclopedia of Psychology. 2017. https://doi.org/10.1093/acrefore/9780190236557.013.208. [Accessed 5th February 2024].
El Assar M, Álvarez-Bustos A, Sosa P, Angulo J, Rodríguez-Mañas L. Effect of Physical Activity/Exercise on Oxidative Stress and Inflammation in Muscle and Vascular Aging. International Journal of Molecular Sciences. 2022;23(15): 8713. https://doi.org/10.3390/ijms23158713.
Hassan W. The Endothelium and Endothelin: Beyond Vascular Reactivity. Annals of Saudi Medicine. 2006;26(5): 343–345. https://doi.org/10.5144/0256-4947.2006.343.
Pertrini CM, Miyakawa AA, Laurindo FRM, Krieger JE. Nitric oxide regulates angiotensin-I converting enzyme under static conditions but not under shear stress. Brazilian Journal of Medical and Biological Research. 2003;36: 1175–1178. https://doi.org/10.1590/S0100-879X2003000900005.
Quan N, Banks WA. Brain-immune communication pathways. Brain, Behavior, and Immunity. 2007;21(6): 727–735. https://doi.org/10.1016/j.bbi.2007.05.005.
Childs E, de Wit H. Regular exercise is associated with emotional resilience to acute stress in healthy adults. Frontiers in Physiology. 2014;5: 161. https://doi.org/10.3389/fphys.2014.00161.
Patel PN, Zwibel H. Physiology, Exercise. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024. http://www.ncbi.nlm.nih.gov/books/NBK482280/ [Accessed 6th February 2024].
Meng Q, Lin MS, Tzeng IS. Relationship Between Exercise and Alzheimer’s Disease: A Narrative Literature Review. Frontiers in Neuroscience. 2020;14: 131. https://doi.org/10.3389/fnins.2020.00131.
Schneider S, Askew CD, Diehl J, Mierau A, Kleinert J, Abel T, et al. EEG activity and mood in health orientated runners after different exercise intensities. Physiology & Behavior. 2009;96(4–5): 709–716. https://doi.org/10.1016/j.physbeh.2009.01.007.
Buch AN, Coote JH, Townend JN. Mortality, cardiac vagal control and physical training--what’s the link? Experimental Physiology. 2002;87(4): 423–435. https://doi.org/10.1111/j.1469-445x.2002.tb00055.x.
Chapleau MW, Sabharwal R. Methods of assessing vagus nerve activity and reflexes. Heart Failure Reviews. 2011;16(2): 109–127. https://doi.org/10.1007/s10741-010-9174-6.
Coote JH, Bothams VF. Cardiac vagal control before, during and after exercise. Experimental Physiology. 2001;86(6): 811–815. https://doi.org/10.1111/j.1469-445x.2001.tb00049.x.
Pathan FKM, Pandian JS, Shaikh AI, Ahsan M, Nuhmani S, Iqbal A, et al. Effect of slow breathing exercise and progressive muscle relaxation technique in the individual with essential hypertension: A randomized controlled trial. Medicine. 2023;102(47): e35792. https://doi.org/10.1097/MD.0000000000035792.
Ropelle ER, da Silva ASR, Cintra DE, de Moura LP, Teixeira AM, Pauli JR. Physical Exercise: A Versatile Anti-Inflammatory Tool Involved in the Control of Hypothalamic Satiety Signaling. Exercise Immunology Review. 2021;27: 7–23.
Garg P, Mendiratta A, Banga A, Bucharles A, Victoria P, Kamaraj B, et al. Effect of breathing exercises on blood pressure and heart rate: A systematic review and meta-analysis. International Journal of Cardiology. Cardiovascular Risk and Prevention. 2024;20: 200232. https://doi.org/10.1016/j.ijcrp.2023.200232.
Browning KN, Verheijden S, Boeckxstaens GE. The vagus nerve in appetite regulation, mood and intestinal inflammation. Gastroenterology. 2017;152(4): 730–744. https://doi.org/10.1053/j.gastro.2016.10.046.
Dinan TG, Cryan JF. Brain-Gut-Microbiota Axis and Mental Health. Psychosomatic Medicine. 2017;79(8): 920–926. https://doi.org/10.1097/PSY.0000000000000519.
Misra S, Mohanty D. Psychobiotics: A new approach for treating mental illness? Critical Reviews in Food Science and Nutrition. 2019;59(8): 1230–1236. https://doi.org/10.1080/10408398.2017.1399860.
Motiani KK, Collado MC, Eskelinen JJ, Virtanen KA, Löyttyniemi E, SALMINEN S, et al. Exercise Training Modulates Gut Microbiota Profile and Improves Endotoxemia. Medicine and Science in Sports and Exercise. 2020;52(1): 94–104. https://doi.org/10.1249/MSS.0000000000002112.
Phelps EA, Ling S, Carrasco M. Emotion facilitates perception and potentiates the perceptual benefits of attention. Psychological Science. 2006;17(4): 292–299. https://doi.org/10.1111/j.1467-9280.2006.01701.x.
Storbeck J, Clore GL. Affective Arousal as Information: How Affective Arousal Influences Judgments, Learning, and Memory. Social and personality psychology compass. 2008;2(5): 1824–1843. https://doi.org/10.1111/j.1751-9004.2008.00138.x.
Hortobágyi T, Vetrovsky T, Balbim GM, Sorte Silva NCB, Manca A, Deriu F, et al. The impact of aerobic and resistance training intensity on markers of neuroplasticity in health and disease. Ageing Research Reviews. 2022;80: 101698. https://doi.org/10.1016/j.arr.2022.101698.
Lin TW, Tsai SF, Kuo YM. Physical Exercise Enhances Neuroplasticity and Delays Alzheimer’s Disease. Brain Plasticity. 2018;4(1): 95–110. https://doi.org/10.3233/BPL-180073.
Rosenbaum S, Sherrington C, Tiedemann A. Exercise augmentation compared with usual care for post-traumatic stress disorder: a randomized controlled trial. Acta Psychiatrica Scandinavica. 2015;131(5): 350–359. https://doi.org/10.1111/acps.12371.
Sabri S, Rashid N, Mao ZX. Physical Activity and Exercise as a Tool to Cure Anxiety and Posttraumatic Stress Disorder. Mental Illness. 2023;2023: e4294753. https://doi.org/10.1155/2023/4294753.
Budzynski TH, Budzynski HK, Evans JR, Abarbanel A, [eds.]. Introduction to Quantitative EEG and Neurofeedback: Advanced Theory and Applications.. 3nd edition. Amsterdam: Academic Press; 2009.
Gonçalves ÓF, Boggio PS. Neuromodulação Autorregulatória. Princípios e Prática. São PAulo: Pearson; 2016.
Mascaro L. Para que Medicação?. Rio de Janeiro, RJ: Elsevier; 2011.
Martins LCX, Russo MT, Ribeiro P. Neural Correlates of Shooting Sports Performance: A Systematic Review on Neural Efficiency Hypothesis. Revista de Educação Física / Journal of Physical Education. 2022;91(4): 350–374. https://doi.org/10.37310/ref.v91i4.2915.
Williams LM. Precision psychiatry: a neural circuit taxonomy for depression and anxiety. The Lancet Psychiatry. 2016;3(5): 472–480. https://doi.org/10.1016/S2215-0366(15)00579-9.
Hosseinifard B, Moradi MH, Rostami R. Classifying depression patients and normal subjects using machine learning techniques and nonlinear features from EEG signal. Computer Methods and Programs in Biomedicine. 2013;109(3): 339–345. https://doi.org/10.1016/j.cmpb.2012.10.008.
Robertson CV, Skein M, Wingfield G, Hunter JR, Miller TD, Hartmann TE. Acute electroencephalography responses during incremental exercise in those with mental illness. Frontiers in Psychiatry. 2022;13: 1049700. https://doi.org/10.3389/fpsyt.2022.1049700.
Dayan J, Rauchs G, Guillery-Girard B. Rhythms dysregulation: A new perspective for understanding PTSD? Journal of Physiology, Paris. 2016;110(4 Pt B): 453–460. https://doi.org/10.1016/j.jphysparis.2017.01.004.
Luck SJ. An Introduction to the Event-Related Potential Technique.. 2nd ed. edição. Cambridge, Massachusetts: Bradford Book; 2014.
Miller LN, Simmons JG, Whittle S, Forbes D, Felmingham K. The impact of posttraumatic stress disorder on event-related potentials in affective and non-affective paradigms: A systematic review with meta-analysis. Neuroscience and Biobehavioral Reviews. 2021;122: 120–142. https://doi.org/10.1016/j.neubiorev.2020.12.027.
Veltmeyer MD, Clark CR, McFarlane AC, Felmingham KL, Bryant RA, Gordon E. Integrative assessment of brain and cognitive function in post-traumatic stress disorder. Journal of Integrative Neuroscience. 2005;4(1): 145–159. https://doi.org/10.1142/s0219635205000719.
Veltmeyer MD, McFarlane AC, Bryant RA, Mayo T, Gordon E, Clark CR. Integrative assessment of brain function in PTSD: brain stability and working memory. Journal of Integrative Neuroscience. 2006;5(1): 123–138. https://doi.org/10.1142/s0219635206001057.
Joseph JJ, Golden SH. Cortisol dysregulation: the bidirectional link between stress, depression, and type 2 diabetes mellitus. Annals of the New York Academy of Sciences. 2017;1391(1): 20–34. https://doi.org/10.1111/nyas.13217.
Hong J, Park JH. Efficacy of Neuro-Feedback Training for PTSD Symptoms: A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health. 2022;19(20): 13096. https://doi.org/10.3390/ijerph192013096.
Evancho A, Tyler WJ, McGregor K. A review of combined neuromodulation and physical therapy interventions for enhanced neurorehabilitation. Frontiers in Human Neuroscience. 2023;17: 1151218. https://doi.org/10.3389/fnhum.2023.1151218.
LaMarca K, Gevirtz R, Lincoln AJ, Pineda JA. Brain-Computer Interface Training of mu EEG Rhythms in Intellectually Impaired Children with Autism: A Feasibility Case Series. Applied Psychophysiology and Biofeedback. 2023;48(2): 229–245. https://doi.org/10.1007/s10484-022-09576-w.
Dupee M, Werthner P. Managing the Stress Response: The Use of Biofeedback and Neurofeedback with Olympic Athletes. Biofeedback. 2011;39: 92–94. https://doi.org/10.5298/1081-5937-39.3.02.
Pinel JP, Schultz TD. Effect of antecedent muscle tension levels on motor behavior. Medicine and Science in Sports. 1978;10(3): 177–182.
Rydzik Ł, Wąsacz W, Ambroży T, Javdaneh N, Brydak K, Kopańska M. The Use of Neurofeedback in Sports Training: Systematic Review. Brain Sciences. 2023;13(4): 660. https://doi.org/10.3390/brainsci13040660.
Kavianipoor H, Farsi A, Bahrami A. The Effect of Neurofeedback Training on Executive Control Network of Attention and Dart-Throwing Performance in Individuals with Trait Anxiety. Applied Psychophysiology and Biofeedback. 2023;48(3): 379–391. https://doi.org/10.1007/s10484-023-09587-1.
Prończuk M, Trybek G, Terbalyan A, Markowski J, Pilch J, Krzysztofik M, et al. The Effects of EEG Biofeedback Training on Visual Reaction Time in Judo Athletes. Journal of Human Kinetics. 2023;89: 247–258. https://doi.org/10.5114/jhk/174272.
Wu JH, Chueh TY, Yu CL, Wang KP, Kao SC, Gentili RJ, et al. Effect of a single session of sensorimotor rhythm neurofeedback training on the putting performance of professional golfers. Scandinavian Journal of Medicine & Science in Sports. 2024;34(1): e14540. https://doi.org/10.1111/sms.14540.
Graczyk M, Pąchalska M, Ziółkowski A, Mańko G, Łukaszewska B, Kochanowicz K, et al. Neurofeedback training for peak performance. Annals of agricultural and environmental medicine: AAEM. 2014;21(4): 871–875. https://doi.org/10.5604/12321966.1129950.
Yalfani A, Azizian M, Gholami-Borujeni B. Adding Neurofeedback Training to Neuromuscular Training for Rehabilitation of Chronic Ankle Instability: A 3-Arm Randomized Controlled Trial. Sports Health. 2023; 19417381231219198. https://doi.org/10.1177/19417381231219198.
Angelakis E, Lubar JF, Stathopoulou S, Kounios J. Peak alpha frequency: an electroencephalographic measure of cognitive preparedness. Clinical Neurophysiology. 2004;115(4): 887–897. https://doi.org/10.1016/j.clinph.2003.11.034.
Cabaleiro P, Cueli M, Cañamero LM, González-Castro P. A Case Study in Attention-Deficit/Hyperactivity Disorder: An Innovative Neurofeedback-Based Approach. International Journal of Environmental Research and Public Health. 2021;19(1): 191. https://doi.org/10.3390/ijerph19010191.
Egner T, Zech TF, Gruzelier JH. The effects of neurofeedback training on the spectral topography of the electroencephalogram. Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology. 2004;115(11): 2452–2460. https://doi.org/10.1016/j.clinph.2004.05.033.
Dornowski M, Wilczyńska D, Lachowicz M, Sokolowska I, Szot T, Urbański R, et al. The effect of EEG neurofeedback on lowering the stress reaction level depending on various stressors on the biochemical, muscular and psychomotor sphere: A preliminary randomized study. Medicine. 2024;103(5): e37042. https://doi.org/10.1097/MD.0000000000037042.
Chiasson P, Boylan MR, Elhamiasl M, Pruitt JM, Ranjan S, Riels K, et al. Effects of neurofeedback training on performance in laboratory tasks: A systematic review. International Journal of Psychophysiology. 2023;189: 42–56. https://doi.org/10.1016/j.ijpsycho.2023.04.005.
van Son D, van der Does W, Band GPH, Putman P. EEG Theta/Beta Ratio Neurofeedback Training in Healthy Females. Applied Psychophysiology and Biofeedback. 2020;45(3): 195–210. https://doi.org/10.1007/s10484-020-09472-1.
Gong A, Nan W, Yin E, Jiang C, Fu Y. Efficacy, trainability, and neuroplasticity of SMR vs. alpha rhythm shooting performance neurofeedback training. Frontiers in Human Neuroscience. 2020;14. https://doi.org/10.3389/fnhum.2020.00094.
Matsuzaki Y, Nouchi R, Sakaki K, Dinet J, Kawashima R. The Effect of Cognitive Training with Neurofeedback on Cognitive Function in Healthy Adults: A Systematic Review and Meta-Analysis. Healthcare. 2023;11(6): 843. https://doi.org/10.3390/healthcare11060843.
Orndorff-Plunkett F, Singh F, Aragón OR, Pineda JA. Assessing the Effectiveness of Neurofeedback Training in the Context of Clinical and Social Neuroscience. Brain Sciences. 2017;7(8): 95. https://doi.org/10.3390/brainsci7080095.
Burdack J, Schöllhorn WI. Cognitive Enhancement through Differential Rope Skipping after Math Lesson. International Journal of Environmental Research and Public Health. 2022;20(1): 205. https://doi.org/10.3390/ijerph20010205.
Byun K, Hyodo K, Suwabe K, Ochi G, Sakairi Y, Kato M, et al. Positive effect of acute mild exercise on executive function via arousal-related prefrontal activations: An fNIRS study. NeuroImage. 2014;98: 336–345. https://doi.org/10.1016/j.neuroimage.2014.04.067.
Zhang W, Zhou C, Chen A. A systematic review and meta-analysis of the effects of physical exercise on white matter integrity and cognitive function in older adults. GeroScience. 2023; https://doi.org/10.1007/s11357-023-01033-8.
Ropelle ER, da Silva ASR, Cintra DE, de Moura LP, Teixeira AM, Pauli JR. Physical Exercise: A Versatile Anti-Inflammatory Tool Involved in the Control of Hypothalamic Satiety Signaling. Exercise Immunology Review. 2021;27: 7–23.
Bailey BW, Muir AM, Bartholomew CL, Christensen WF, Carbine KA, Marsh H, et al. The impact of exercise intensity on neurophysiological indices of food-related inhibitory control and cognitive control: A randomized crossover event-related potential (ERP) study. NeuroImage. 2021;237: 118162. https://doi.org/10.1016/j.neuroimage.2021.118162.
Fernández-Rodríguez R, Álvarez-Bueno C, Martínez-Ortega IA, Martínez-Vizcaíno V, Mesas AE, Notario-Pacheco B. Immediate effect of high-intensity exercise on brain-derived neurotrophic factor in healthy young adults: A systematic review and meta-analysis. Journal of Sport and Health Science. 2022;11(3): 367–375. https://doi.org/10.1016/j.jshs.2021.08.004.
Sleiman SF, Henry J, Al-Haddad R, El Hayek L, Abou Haidar E, Stringer T, et al. Exercise promotes the expression of brain derived neurotrophic factor (BDNF) through the action of the ketone body β-hydroxybutyrate. eLife. 2016;5: e15092. https://doi.org/10.7554/eLife.15092.
Moriarty T, Bourbeau K, Bellovary B, Zuhl MN. Exercise Intensity Influences Prefrontal Cortex Oxygenation during Cognitive Testing. Behavioral Sciences. 2019;9(8): 83. https://doi.org/10.3390/bs9080083.
Seo JH, Park HS, Park SS, Kim CJ, Kim DH, Kim TW. Physical exercise ameliorates psychiatric disorders and cognitive dysfunctions by hippocampal mitochondrial function and neuroplasticity in post-traumatic stress disorder. Experimental Neurology. 2019;322: 113043. https://doi.org/10.1016/j.expneurol.2019.113043.
National Cancer Institute. Definition of apoptosis - NCI Dictionary of Cancer Terms - NCI. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/apoptosis [Accessed 15th February 2024].
Baranowski BJ, Marko DM, Fenech RK, Yang AJT, MacPherson REK. Healthy brain, healthy life: a review of diet and exercise interventions to promote brain health and reduce Alzheimer’s disease risk. Applied Physiology, Nutrition, and Metabolism. 2020;45(10): 1055–1065. https://doi.org/10.1139/apnm-2019-0910.
Assouline A, Mendelsohn A, Reshef A. Memory-directed acupuncture as a neuromodulatory treatment for PTSD: Theory, clinical model and case studies. Translational Psychiatry. 2022;12(1): 110. https://doi.org/10.1038/s41398-022-01876-3.