POSITIVE EFFECTS OF NEUROFEEDBACK INTERVENTION ON RADIATION ONCOLOGY PHYSICIANS' WORKLOAD DURING GO/NO-GO PERFORMANCE TEST

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 (flowstate 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.