Neuromarkers of anxiety and depression in a patient after neuro-ophthalmic surgery of the meningioma – effect of individually-tailored tDCS and neurofeedback
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Chair of Neuropsychology, Andrzej Frycz Modrzewski Cracow University, Cracow, Poland
Center for Cognition and Communication, New York, N.Y., U.S.A.
Department of Neurosurgery and Neurotraumatology, CMUJ, Cracow, Poland
Department of Ophtalmology, Ludwik Rydygier Memorial Specialist Hospital, Cracow, Poland
Maxillofacial Surgery Department, Ludwik Rydygier Memorial Specialist Hospital, Cracow, Poland
Laboratory for theNeurobiology of Action Programming, Institute of the Human Brain, Russian Academy of Sciences, St. Petersburg, Russia
Institute of Psychology, Norwegian University for Science and Technology, Trondheim, Norway
Maria Pąchalska   

Chair of Neuropsychology, Andrzej Frycz Modrzewski Cracow University, Cracow, Poland
Ann Agric Environ Med. 2015;22(4):718–723
The aim of the study was to evaluate the effectiveness of individually tailored anodal tDCs/ neurofeedback protocol for the reduction of post-operative depression after a neuroophtalmological operation of the meningioma. The neuromarkers in Quantitative EEG (QEEG) and Event-related potentials (ERPs) were utilized in the construction of protocol and evaluation. Case description. A 45-year-old female after successful neuro-ophthalmic surgery of the meningioma, complained of severe pain and anxiety, difficulties with sleeping, attention and memory problems, as well as inability to continue working in her given profession. Neuropsychological testing showed lack of cognitive disturbances and post-operative depression. Two working hypotheses were tested to find neuromarkers of depression and anxiety. In line with the ‘depression hypothesis’ a frontal alpha asymmetry pattern was found in the patient, and in line with the ‘anxiety’ hypothesis an increased left temporal P1 wave in response to visual stimuli was found in ERPs. A specific alpha asymmetry neurofeedback protocol combined with an anodal tDCS was suggested. Twenty sessions of individually-tailored anodal tDCs/ neurofeedback protocol were performed. The QEEG frontal asymmetry pattern and the excessive temporal P1 wave were normalized after the intervention. Conclusions.The patient recovered from post-operative depression and returned to work after 20 sessions of the combined neurofeedback/tDCS protocol. Specific patterns of QEEG and ERPs serve as neuromarkers for constructing the protocol and for monitoring the results of intervention.
1. World Health Organization. World Cancer Report 2008. International Agency for Research on Cancer, Lyon. 2009.
2. Pachalska M, Kaczmarek BLJ, Kropotov JD. Neuropsychologia kliniczna: od teorii do praktyki. Warszawa: Wydawnictwo Naukowe PWN. 2014 (in Polish).
3. Aldecoa C, Pico S, Rico J, Vazquez B, Gomez L, Garcia-Bernardo C, Gomez-Herreras J. Post-traumatic stress disorder after surgical ICU admission. Crit Care. 2010; 14 (Suppl 1): P441.
4. Luini A, Gatti G, Zurrida S, Talakhadze N, Brenelli F, Gilardi D, et al. The evolution of the conservative approach to breast cancer. Breast. 2007;16:120–9.
5. Meda N, Bognounou V, Seni E, Daboue A, Sanfo O. Cataract in Burkina Faso: Factors of choice between modern and traditional surgical procedures. Med Trop. 2005; 65(5): 473–6.
6. Commins DL, Atkinson RD, Burnett ME. Review of Meningioma Histopathology. Neurosurg Focus. 2007; 23(4):E3.
7. Gold C, Fachner J, Erkkilä J. Validity and reliability of electroencephalographic frontal alpha asymmetry and frontal midline theta as biomarkers for depression. Scand J Psychol. 2013; 54(2): 118–126.
8. Kropotov JD. Quantitative EEG, event related potentials and neurotherapy. San Diego: Academic Press, Elsevier, 2009.
9. Jesulola E, Sharpley CF, Bitsika V, Agnew LL, Wilson P. Frontal alpha asymmetry as a pathway to behavioural withdrawal in depression: Research findings and issues. Behav Brain Res. 2015 Jun 5; 292: 56–67. doi: 10.1016/j.bbr.2015.05.058.
10. Weinberg A, Hajcak G. Electrocortical evidence for vigilance-avoidance in Generalized Anxiety Disorder. Psychophysiology. 2011 Jun;48(6):842–51. doi: 10.1111/j.1469–8986.2010.01149.x.
11. Morel S, George N, Foucher A, Chammat M, Dubal S. ERP evidence for an early emotional bias towards happy faces in trait anxiety. Biol Psychol. 2014 May; 99: 183–92. doi: 10.1016/j.biopsycho.2014.03.011.
12. Arul-Anandam AP, Loo C. Transcranial direct current stimulation: a new tool for the treatment of depression? J Affect Disord. 2009 Oct; 117(3): 137–45. doi: 10.1016/j.jad.2009.01.016.
13. Dias AM, van Deusen A. A new neurofeedback protocol for depression. Span J Psychol. 2011 May; 14(1): 374–84. Review. PubMed PMID: 21568194.
14. Morris PL, Robinson RG, Raphael B, Hopwood MJ. Lesion location and poststroke depression. J Neuropsychiatry Clin Neurosci. 1996; 8: 399–403.
15. Davidson RJ. Anterior electrophysiological asymmetries, emotion, and depression: conceptual and methodological conundrums. Psychophysiology. 1998 Sep; 35(5): 607–14.
16. Sugase Y, Yamane S, Ueno S, Kawano K. Global and fine information coded by single neurons in the temporal visual cortex. Nature 1996; 400(6747): 869–873.
17. Graczyk M, Pąchalska M, Ziółkowski A, Mańko G, Łukaszewska B, Kochanowicz K, Mirski A, Kropotov ID. Neurofeedback training for peak performance. Ann Agric Environ Med. 2014; 21(4): 871–875. doi: 10.5604/12321966.1129950.
18. Chantsoulis M, Mirski A, Rasmus A, Kropotov JuD, Pachalska M. Neuropsychological rehabilitation for traumatic brain injury patients. Ann Agric Environ Med. 2015; 22(2): 368–379. doi: 10.5604/12321966.1152097.
19. Pąchalska M, Kropotov ID, Mańko G, Lipowska M, Rasmus A, Łukaszewska B, Bogdanowicz M, Mirski A. Evaluation of a neurotherapy program for a child with ADHD with Benign Partial Epilepsy with Rolandic Spikes (BPERS) using event-related potentials. Med Sci Monit. 2012; 18(11): CS94–104.
20. Chrapusta A, Pąchalska M, Wach R. Evaluation of the health-related quality of life during the treatment of severe burn complicated by multiple organ dysfunction syndrome (MODS). Acta Neuropsychologica 2014; 12(4): 483–492.