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The mechanisms of the organization of goal-directed movements in the human arm have received insufficient study. The processes of cortical reorganization on the background of learning new skills and rehabilitation after central nervous system disease are of particular interest. Studies of the motor system and recording of neurophysiological parameters determining the kinematic characteristics of movements at the cortical level use navigated transcranial magnetic stimulation. The present study of 20 healthy volunteers randomized to study and control groups assessed resting motor thresholds, cortical motor representation zones of the extensor digitorum communis muscle in terms of areas and weighted areas, and the displacement of the centers of gravity on the background of training to motor imagery using a brain–computer interface. No significant differences were found between these parameters in the study group and the control group.

IntroductionSham-controlled studies of neurofeedback are aimed to provide evidence-based data regarding its efficacy. However, a sophisticated sham procedure may turn out to be an intervention rather that a neutral control.MethodsData from a single-case cross-over sham-controlled study of NF in migraine were analyzed to access the effects of sham-NF. The study included 5 females with chronic migraine and was divided into 4 phases: pre-evaluation (≥ 2 weeks), treatment 1 (5 weeks), treatment 2 (5 weeks), post-evaluation (≥ 2 weeks), where treatment 1 and 2 included 10 infra-low frequency NF and 10 sham-NF sessions at T3T4 site in randomized order. Participants filled out a computerized diary about headache and emotions.ResultsSham-NF resulted in some reduction of the level of tension (0.8 ± 0.7 vs. 1.1 ± 0.5, P = 0.1) and anxiety (0.56 ± 0.5 vs. 0.95 ± 0.4, P = 0.07) as measured by the mean value in the diary (rating from 0 - no emotion, to 3 - very intense). While the total frequency of headache was not influenced by sham-NF (40 ± 11% vs. 40 ± 7% days, P = 1), a tendency towards an increase in quantity of severe headaches (42 ± 18% vs. 20 ± 18% days, P = 0.07) and in the need for drug intake (74 ± 27% vs. 44 ± 30% days, P = 0.07) was observed. We supposed that expectation of feedback and failure to receive it during sham sessions may have possible negative effects, while frequent visits to the clinic and contact with the therapist may explain reduction in anxiety.ConclusionSham-NF seems to have both placebo and nocebo effects, which should be considered during interpretation of results of the studies.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionPresent article introduces the case of a patient who had traumatic brain injury (TBI) in 2010. During examination V. demonstrated mild sensory aphasia, frontal lobes deficit, memory disorder, limiting beliefs, lack of adequate coping strategies, emotional reactions and disability to describe his feelings and body awareness.Objectives and aimNeuropsychological, correction and psychological counseling performance, considering neuropsychological deficit profile.Methodscounseling was carried out over six weeks in the form of 2 hour sessions once a week. Speech perception impairment was taken into consideration. The process was started with frontal lobe deficit correction. Goal management training was used in conjunction with external control of distractions. Training in structured organization of information has highly improved memorization. Techniques of CBT were used to work with cognitive distortions, dysfunctional beliefs, and self-restricting behavior. Body-oriented therapy was offered to cope with stress factors and vegetative reactions.ResultsV. compensated memory disorder using external sources and motivation. Some adaptive strategies of interaction with people and the outer world were formed. He improved time management skills and learned to follow the priority of current task without distractions. Moreover, he actively started to use body-oriented techniques to regulate his emotional condition. A considerable progress was achieved in understanding his limits and difficulties in everyday life.ConclusionImplementation of psychological consulting according to neuropsychological deficit profile may be effective in interdisciplinary holistic rehabilitation of patients after TBI.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionNeurofeedback in migraine aims to improve neurophysiological state, which is linked to psychosomatic, emotional and cognitive regulation. Objective and complex evaluation of neurofeedback effects is feasible.MethodsA single case design cross-over placebo-controlled study with blinded evaluator included 3 females with frequent migraine (N., E., T.), 1 of whom (T.) also had TTH. Study had 4 phases: evaluation (≥ 2 weeks), treatment 1 (5 weeks), treatment 2 (5 weeks), evaluation (≥ 2 weeks). Treatment 1 and 2 included 10 infra-low frequency neurofeedback and 10 sham-neurofeedback sessions at T3T4 site in randomized order. Detailed psychological assessment was performed a baseline, at phase switch and in the end. Every day participants filler a computerized diary about pain, aura, mood, stress, copings. Before each session they received questionnaires “well-being, activity, mood” (rating of the current state between antonym adjectives, in Russian).ResultsThe main finding was reduction of migraine (but not TTH) frequency during real, but not sham neurofeedback phase: 11% vs. 31% days in N. (P = 0.1), 15% vs. 30% days in E. (P = 0.046), T. After the start of neurofeedback had only TTH. Another detected phenomena was reduction of day-to-day shifts in cognitive function domains of “well-being, activity, mood” (easy/difficult to think, attentive/distracted). In N. and E these domains had co-dynamic with mood (good/bad mood, happy/sad), while in T. – with anxiety (tensed/relaxed, nervous/calm).ConclusionInfra-low frequency neurofeedback from interhemispheric site resulted in decrease in migraine frequency and in reduction of shifts in psychological state. Thus, the treatment had multimodal stabilizing effect.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionIn Russia there was a misconception about employment of people with physical or cognitive disability that served as a psychological barrier for both employers and applicants. The situation has recently changed and special vacancies for invalids are open in some companies. A patient in residual period of traumatic brain injury (2010) attended our rehabilitation center with the request for employment. He grew up in orphanage and he had no experience of searching for vacancies by himself, also he had reduced communication skills. Moreover, TBI resulted in strong executive functions impairment.Objectives and aimHelp V with employment.MethodsHolistic rehabilitation program was developed for V. so he had a training in computer skills, CV writing and communication with employer. Cognitive-behavioral therapy methods were used while working on understanding of his limits and acceptance of his disability, and goal management training was applied to reduce frontal lobes dysfunction.ResultsAfter 1.5 months of counseling V. demonstrated significant improvement. He started to use e-mail and the Internet to find job openings. He was able to keep independent control of his activities. V. managed to accept his disability, so he declared it in his CV – it finally became crucial in his successful employment as clerk in a bank.ConclusionHolistic approach, which includes social work, neuropsychological rehabilitation and psychological support, is promising to overcome psychological barrier in employment of disabled people.Disclosure of interestThe authors have not supplied their declaration of competing interest.