Positive effects of neurofeedback intervention on radiation oncology physicians’ workload during go/no-go performance test

By Lukasz M. Mazur, Alana Campbell, Elizabeth Comitz, David Planting, Steven B. Lowen, Prithima Reddy Mosaly, A. Belger, Bhisham Chera, L. B. Marks

The purpose of this pilot study was to subjectively and objectively measure workload and performance levels among radiation oncologists performing a computerized performance test before and after introducing neurofeedback as a measurable intervention. The intervention consisted of eight neurofeedback sessions, each 28 minutes in length divided into four separate seven-minute training periods, targeting cortical alpha/theta/beta activity in both temporal lobes (C5 alpha/theta, C5 beta, C6 beta, and C6 alpha/theta). The inhibit frequencies for C5 and C6 alpha/theta were 2-4 Hz and 15-30 Hz while the reward frequencies were 5-7 Hz and 8-11 Hz. The inhibit frequencies for beta C5 and beta C6 were 1-12 Hz and 22-30 Hz while the reward frequency was 15-18 Hz. All sensors were referenced to linked ears. Eight subjects were recruited for this pilot study. Workload was assessed subjectively using the NASA Task Load Index (NASA-TLX) instrument, and objectively using electroencephalography (EEG) data analysis. Performance was subjectively assessed using flow-state survey, and objectively assessed based on time-to-test completion and performance-based errors. Statistical differences in pre- vs. post-intervention scores of i) NASA-TLX, time-to-test completion, and performance-based errors were tested using matched pairs t-test; ii) perceived performance as quantified by the flow-state survey using Wilcoxon signed-rank test; and iii) and pre vs. post temporal lobes EEG changes that were acquired during a continuous performance test using analysis of variance (ANOVA). Analysis indicated significant reductions in NASA-TLX (p = .01); significant increases in theta power (training reword; 4-7Hz; p < .01), and reduction in high-alpha/low-beta power (training reword; 13Hz, p < .01) suggesting improved information processing performance; and significant improvements in subjective performance (flow-state survey: p < .01). No significant differences were found in objective continuous performance test measures (time-to-test completion, and performance-based errors; p > .05). Future research is needed to further quantify the impact of neurofeedback on radiation oncology providers’ workload and performance.


  • Neurofeedback
  • Workload
  • Performance
  • Patient Safety
  • Physicians
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