Therapeutic Efficacy of EEG/qEEG Neurofeedback: The Domain of Remedial Bio-Electrical Self-Regulation

Transcription

1 Therapeutic Efficacy of EEG/qEEG Neurofeedback: The Domain of Remedial Bio-Electrical Self-Regulation BY BRAIN SCIENTIFIC

2 Abstract The theory of neurofeedback is based on a simple concept When you have information on what your brainwaves are doing, your brain can use that information to change how it works. Brain Scientific Neurofeedback is also known as EEG/QEEG Biofeedback. Neurofeedback is guided exercise for the brain. It is actually a learning modality designed to retrain dysregulated brainwave patterns. The goal of any neurofeedback methodology is to transform an unhealthy, dysregulated brainwave pattern into a normal, healthy, organized pattern, a balanced synchrony. By doing this, the brain becomes more stable and is able to operate optimally and efficiently. It is completely noninvasive and is considered by the Food and Drug Administration to be safe. In fact, the FDA recognizes that neurofeedback has NEVER produced a serious side effect since it was first discovered over 40 years ago. Uses and Benefits of Neurofeedback The US military uses neurofeedback to treat soldiers with PTSD and brain injuries and for performance enhancement. Published scientific research has demonstrated neurofeedback s efficacy in managing many neurological conditions including Post-Concussive Disorder. Before training sessions begin, a comprehensive assessment is performed with a baseline EEG/QEEG. This assessment procedure allows the doctor to determine, in a scientifically objective manner whether a client s brainwave patterns are different from normal. The assessment provides the doctor with the neurofeedback training protocols that will be used during the training sessions. These protocols are designed to retrain the brainwave patterns toward normal. In their very inherent powerful ways, Neurofeedback promotes the brainwave patterns to normalize while teaching you to consciously control your brainwaves to achieve the desired brainwave state. Alpha waves occur when you are relaxed. Beta waves are associated with alertness, but when maintained the too long lead to feelings of fear and anxiety. So increasing alpha wave activity while reducing beta wave activity is one common goal of biofeedback (see figure 1 below): 2

3 Figure 1. Normally occurring human brain waveforms in their states of presence Brain Scientific Neurofeedback as a Therapy Tool Once the protocols are determined the individual is wirelessly hooked to a computer; using our EasyCap TM sensors, and the computer records his or her brainwave activity while uploading the results to our cloud infrastructure for data-mining and analysis. These sensors are dry and noninvasive, as no electrical current is put into the brain. The sensors simply record the brainwaves coming from the brain. Information about these brainwaves is displayed on the doctor s monitor. 3

4 Through sophisticated algorithms; industry-leading artifact-filtering, and unmatched noise-cancellation, the Brain Scientific software automatically detects true brainwaves which are properly ordered and it feeds that information back to the patient. This feedback appears in the form of a game, movie, or sound which signals the patient that the brainwaves are becoming more ordered. For example, a patient watches a puzzle of a picture that is being filled in piece by piece. As long as the patient s brain waves are moving in an orderly direction, the puzzle pieces are filled in and the patient hears a tone. If the brainwave patterns move away from an orderly pattern, then the puzzle does not get filled in and no tone is produced. The patient is actually controlling the completion of the puzzle with their brain and by doing so, the brain is learning how to regulate itself. In another design, the patient performs the training while watching a movie. In this case, the patient may watch a DVD movie that is being controlled by their ability to regulate their brainwaves. The movie will get brighter as the brain waves normalize and become darker when they become dysregulated. The brain s natural desire to watch the movie clearly will drive those neurological circuits that normalize the brainwaves and allow the picture to be visualized. The more those circuits are driven and used the more neuroplastic changes take hold. The patient learns how to use those new circuits during the demands of everyday life (see figure 2 below). The same principles apply to multiple medical/neuropsychiatric conditions including post-concussive patients and performance conditioning. 4

5 Applications of Brain Scientific Neurofeedback Only the external neurocognitive methodology is different allowing for more customized, rapid, efficient, and result-oriented patient outcomes. There are many alternative forms that are customized to each patient s needs and experience, for example: AVS (Audio/Visual Stimulation) BAUD (Bio-Acoustical Utilization Device) CES (Cranial Electrotherapy Stimulation) HEG (Hemoencephalography) HRV (Heart Rate Variability) LENS (Low Energy Neurofeedback System) NeuroField proshi (Personal Roshi) QEEG (Quantitive EEG) Figure 2. Showing Brain Scientific s quantitative electroencephalographic (QEEG-brain mapping) changes in bio-electrical brain activity before and after neurofeedback where red areas indicate abnormal dysregulated brain activity 5

6 The applications of Neurofeedback of brain self-regulation that underlie EEG Feedback (Neurofeedback) include but not limited to: Anxiety-Depression spectrum Traumatic Brain Injury and Post-Concussion Syndrome Seizures Addictions Autism Spectrum and Asperger s Bipolar Disorders Specific Learning Disabilities Sleep Disorders Strokes Post-Traumatic Stress Disorder (PTSD) Attention Deficit Hyperactivity Disorder (ADHD) Obsessive-Compulsive Disorder (OCD) Women s issues such as PMS and menopause Issues of aging such as Parkinsonism and Alzheimer s Dementia Age-Related Cognitive Decline Pain Syndromes/Chronic Pain Neuro-Regulation in the Bio-Electrical Domain Other references deal with the brain mechanisms that underlie EEG Feedback. This refers essentially to the mechanisms of neuro-regulation in the bio-electrical domain, a relatively new field of study in the neurosciences. The brain must be understood as an interacting network whose function is dependent on precise timing. The means by which the brain organizes and shapes its own timing must, therefore, be thoroughly understood. This involves first of all the small-world model of networks; which supports the high level of functional integration that we observe, as well as the hierarchical structure of regulation. It also involves the time-binding model of sensory integration; the ensemble character of information in the brain; and the frequency-basis of the organization of cortical activation and de-activation. Cortical and sub-cortical architecture must be re-evaluated in terms of its role in the maintenance of brain timing at the microscopic level; of ensembles at the intermediate level, and of networks at the global level. Psychopathologies are then understood, in their physiological aspect, as failures of brain internal communication. Such failures may arise from inappropriate activation at certain sites; or from the inadequacies in communication within the networks, or from inappropriate coupling between different EEG frequencies. 6

7 The latter has recently come to the fore through a general model of thalamocortical dysrhythmias. This model complements but does not contradict, neurochemical models of brain dysfunction. Understanding Neurofeedback Neurochemical models are completely incapable on their own of yielding an understanding of the temporal dynamics of brain function, for which we must rely on bioelectrical models that can describe the time course of brain events. We must bring frequency-based analysis to bear. Neurofeedback is then understood as an appeal to the mechanisms by which the brain maintains its own timing and frequency relationships. The brain must obey the laws that apply to any regulatory system. Moreover, it must assure its own stability entirely through self-regulatory means. By either operant conditioning or overt visual or electromagnetic stimulation, the brain is arbitrarily moved out of its instantaneous state, thus invoking the brain s own resources of control in the task of re-establishing regulation. Neurofeedback is, therefore, a gradual learning process in which the brain enhances its native skills of self-regulation. This holds true for all of those functions that are subject to regulation by timing, which includes all discrete events that involve synaptic information transport. The above is referred to as the Regulatory Challenge model of Neurofeedback. We are able to deploy the technique of Neurofeedback successfully even before the underlying mechanisms of brain self-regulation are fully understood. This is because the brain can be viewed as a self-organizing nonlinear dynamical system. Through numerous internal feedback loops, the brain is strongly constrained against large excursions in state space. When these do occur in the compromised brain, such deviations can be readily detected in the EEG and employed in negative feedback to the brain in order to further constrain its behavior. Behavior Mod for the Brain Over time, learning occurs and brain-behavior improves. Neurofeedback can, therefore, be considered behavior mod for the brain. Through thousands of cues per minute, based on Brain Scientific s increasingly sophisticated analysis of the EEG, the brain is shaped toward improved self-regulation. When remediation occurs systematically, we have our evidence for the validity of the initial assumption that the condition at issue was in fact mediated by frequency-based or timing-based dysregulation. 7

8 It is in light of the above that claims of the efficacy of Neurofeedback for a variety of conditions are to be understood. In some instances, such as Attention Deficit Hyperactivity Disorder (ADHD), Post Traumatic Stress Disorder (PTSD) and Post- Concussion Disorder, we believe dysregulation to be at the heart of the matter. The operative word here is DISORDER. It follows that a self-regulation strategy should constitute a comprehensive remedy. Moreover, once re-regulation has been achieved, by whatever means, the defining aspects of the condition will no longer meet criteria to sustain a diagnosis. In other conditions, however, dysregulation merely accompanies a more structural deficit. This is the case for autism, for example, or traumatic brain injury, or Fetal Alcohol Syndrome. In these instances, the possible progress is constrained by organicity. The attempt at remediation seems, nevertheless, to be quite generally worthwhile. Finally, there are the degenerative conditions such as Parkinsonism and the dementias, where the EEG training may succeed in restoring and then maintaining function even in the face of continuing organic deterioration. In such cases, the training has to be kept up over time in order to maintain levels of function. Benefits of Neurofeedback The benefit of Neurofeedback, whereas it has many explicit applications to psychopathologies and to neurological deficits, is deemed to be diagnostically non-specific. It addresses the broad functional dysregulations that are part and parcel of all clinical syndromes in mental health and accompany organic brain disorders as well. Neurofeedback can be seen as a generalization of what biofeedback has been traditionally concerned with. In the vernacular this has simply been called relaxation, but in the scientific frame, we are really concerned with self-regulation. By working with the EEG directly, the scope of our impact enlarges to all functions under the active management by the central nervous system. This larger conception of EEG Neurofeedback addresses the entire activation-relaxation continuum of brain regulatory networks. It, therefore, impinges upon central and autonomic arousal, on attentional networks, on specific cognitive function, on working memory, and on other memory functions. It addresses the regulation of our moods and emotions; it covers motor control and it modulates our sensitivity and reactivity to the sensory world. The training can moderate our fears as well as regulate our drives such as appetite, thrill-seeking, and drug-seeking. 8

9 Most importantly, the training can confer essential stability on brain function, which heightens the threshold to such conditions as seizures, migraines, panic attacks, and bipolar excursions. Neurofeedback as Mind-Body Medicine Neurofeedback may shortly be more generally recognized as being at the heart of Mind-Body Medicine, in that it utilizes volitional control in the training of sub-conscious brain processes that in turn regulate a variety of bodily functions. Whereas Neurofeedback has important medical implications, strictly speaking, it is not intrinsically a medical procedure (although it becomes one when performed at the direction of an MD). It is simply a structured learning opportunity for the brain, one that can be supported by a variety of health or educational professionals. The technique is accessible to human beings of every age, provided there is sufficient sensory awareness at the brain level to respond to reinforcement. As a non-medical procedure, Neurofeedback is likely to remain classified for some time as part of Complementary or Alternative Medicine. This will remain true despite the fact that the concepts alluded to here will over time take a central place in our understanding of brain function. The understanding of the Operating System of the Brain will be one of the major preoccupations of the current century of neuroscience. How could that understanding not have therapeutic implications? In fact, those implications are already being realized in practice. Even though our understanding may be limited, the reduction to practice is relatively straightforward. We simply have to know enough to cue the brain at any moment as to the direction in which improved performance lies, and that turns out not to be difficult at all in most instances. We simply monitor the brain s trajectory through state-space in the immediate past, and we reward the brain for moving to the more populated parts of state space and discourage its migration toward the wings of the distribution. We reward the brain for moving to a state of higher complexity, or what is known as higher dimensionality. These regions of state space are intrinsically more stable. Remarkably, the brain learns from these cues and slowly changes its own habits. Life then reinforces the learned behavior so that the acquired skills of self-regulation are retained. 9

10 Conclusion We invite the reader to reach out to the Brain Scientific team for updates and education on this exciting research and clinical frontier. The frontier consists of functional remedies for disorders of dysregulation and the domain of bio-electrical selfregulation. Those who are already well acquainted with this field are convinced that the budding professional community of Neurofeedback practitioners is defining the frontier of mental health and of optimum mental performance. 10