NeurofeedbackPresented by:

Holly FooteJeanette Stott

Sue Roh

IntroductionUnderstanding certain functions of the brain and factors that affect its development has major implications on how we approach assessment, treatment and attitudes towards those considered to be psychologically dysfunctional or impaired.

Why is this important?It is only when we have a better understanding of the complex inter-workings of the brain that more effective approaches to treatment and prevention within the mental health service delivery system can best serve the general public, which, in turn, has ripple effects in other public service arenas.

Neuroimaging and advances in computerized neurophysiology (QEEG)

Imaging technology (functional magnetic resonance imaging, in vivo imaging and PET scans) have advanced researchers’ ability to “apprehend brain activity during cognitive tasks” (Masterpasqua & Healy, 2003, p. 652)

Refers to the concept that neural connections or brain synapses are constantly being created or eliminated, all depending on how often they are used and largely depending on individual actions or experiences.Cells in the hippocampus (associated with long and short-term memory and spatial navigation) continue to form neurons throughout one’s lifetime. estimated ten billion cells form in each hemisphere in the cerebral cortex formation is rapid and at its peak and most critical developmental period, is believed to produce 250,000 neurons per minute.

Brain plasticity/“Neuroplasticity”

Brain plasticity/“Neuroplasticity” cont.

The multitudes of synaptic formation within the cerebral cortex (more than 100,000 trillion) leads most researchers to conclude such formations are not the sole product of genetic programming

The influence of the environment on the development and direction of synapses adds to the complexity and differences in cerebral circuitry within all human beings

(Kolb & Gibbs, 2011, n.p.)

“We are constructed from a genetic blueprint and born into a world of circumstances about which we have no choice in our most formative years. The complex interactions of genes and environment means that the citizens of our society possess different perspectives, dissimilar personalities and varied capacities for decision making; these are not free-willed choices of the citizens, these are the hands of cards we’re dealt.”

(Eagleman, 2011, n.p.)

Connectome

Map of connections between neurons inside a nervous

system (Gross, 2012)

Perceptions and behaviors are controlled by inaccessible subroutines

that can be easily perturbed (Eagleman, 2011, n.p.)

In the 1970s and '80s scientists mapped out all 7,000 connections between its 300 neurons.

The one and only organism where entire connectome has been mapped.

Human Brain-estimated 100 billion neurons in human brain (Gross, 2012)

C. Elegance worm (one long) millimeter

Current imaging methods use measurements of highly processed blood flow signals

covers tens of cubic millimeters of brain tissue estimated 100 million synaptic connections between neurons in a single

cubic millimeter of brain tissue lacks resolution for scientists to examine individual connections and

microcircuitry(Eagleman, 2011, n.d.)

Neuroimaging Still Remains “crude” Technology

Alternative, non-evasive techniques should be a major consideration in how mental health treatment services are provided

Individual experiences have significant impacts on brain development. Recent studies- psychoactive

medication alters brain development(Kolb & Gibb, 2011, n.p.)

Like the human body, genetics provide constructive tools in basic

composition. Factors- genetic

predispositions/abnormalities + environmental experiences/exposure +

occurrences of illnesses/injuries = whole self

Can be modified throughout one’s lifetime.

(Eagleman, 2011, n.p.), (Kolb & Gibb, 2011, n.p.)

The human brain is composed of a“team of rivals”(Eagleman, 2011, n.d)

Decisions (major/minor) are made and based on the outcome of

competition for dominance among different neural populations

The strength of each neural population depends on the strength of the individual

“players” within that population

Outcome of the competition can be “tipped” (Eagleman, 2011, n.d.)

Neurofeedback is an electroencephalographic (EEG) operant-conditioning training technique that helps individuals learn to control or change their brain activity.

“exercise for the brain” The brain is conditioned to function more

efficiently and effectively usingneurofeedback.

What is Neurofeedback?

Neurofeedback uses a feedback EEG to show the current electrical patterns in the cortex of the brain.

EEG produced by postsynaptic potentials of thousands of neurons to reflect specific brain sources and functions.

Utilizes a baseline EEG to identify abnormal patterns.

Neurofeedback Defined

Biofeedback is a mind-body therapy. Biofeedback instruments measure muscle activity,

skin temperature, heart rate, blood pressure, brain electrical activity and brain blood flow

Biofeedback therapies guide the individual to facilitate the learning of voluntary control over body and mind.

Biofeedback vs. Neurofeedback

Neurofeedback is a specialty field within biofeedback.

Neurofeedback devotes itself to training control over electro-chemical processes in the human brain.

Biofeedback vs. Neurofeedback

Neurofeedback is used to treat various neurological and psychological conditions.

Increases Cognitive Performance. Most common conditions treated with

Neurofeedback: Attention Deficit Hyperactivity Disorder (ADHD) Anxiety Epilepsy Addictive Disorders

Neurofeedback as Treatment

Hans Berger/physician, neurologist 1920’s- invented electroencephalogram (EEG), first to record human

brain waves discovered alpha rhythm (associated with relaxed/awake frequency) first

identified signature of the EEGJoe Kamiya/psychologist 1960’s- first to study EEG’s in relation to “felt states” to measure human

awareness regarding their own alpha activity 1950’s- tested effects of active reinforcement on active alpha rhythm

activity, first form of neurofeedback Presented findings in Psychology Today (1968, Nov.), “Conscious

control of brain waves” Research findings not credible by general psychology community due to

reliance on subjective states of awareness/feeling

Significant Researchers

Maurice Barry Sterman, PhD/psychologist and neurologist Used animals in research- removed subjectivity of felt states Focused on sensorimotor rhythm (SMR) and spindle-burst (high frequency) EEG

activity in animal subjects’ sensorimotor cortex- observable in waking, but physically still, state.

Form of beta (associated with alertness/vigilenge) training First to strengthen inhibit functions on behavioral stillness using conditioning methods,

rewards based on SMR spindles levels rising above background activity Even though human waking EEG activity, in regards to SMR spindle levels, not

replicated as with animal subjects, training philosophy carried over

Joel Lubar, PhD/biopsychologist First to strengthen inhibit functions with the objective of training toward more normal

frequency activities. Differed from reward-based training, more non-conditional appeal to the brain Presented findings in Brain Research (1967) Promoted EEG normalcy as guiding principle to the use of EEG reinforcement, had

major implications for development of NF.(Brain and Body Solutions, n.d.), (Othmer, 2008, pp.4,5), (Scarpa & Raine, 2003, pp.217,

218)

Significant Researchers, cont.

Relevant ResearchersAdrian Raine, PhD/psychologist & Angela Scarpa, PhD/psychologist

One of the first to research biosocial interactions and consider the cumulative effects of biological and social risk factors and how they can result in adverse psychosocial functioning

Propose that well functioning nervous system is protective factor that allows for reception towards social conditioning. Even subtle non-detectable impairments in frontal lobe functioning can cause deficits in ability to regulate emotions and executive cognitive functioning (planning, decision making, future-oriented decision making)

Called for both biological and psychosocial variables to “form more complete models of antisocial behavior”

Raine & colleagues: “Social push” hypothesis- if no concrete psychosocial factors found to contribute to antisocial behavior, causes most likely biologically rather than socially based. “Are relatively resistant to socializing influence”

(Eagleman, 2011), (Scarpa & Raine, 2003, pp.209, 213)

Relevant Researchers, cont.

Sebastian Seung, PhD/neuroscientist Brain wiring pattern/”connectome”

constantly changes as influenced by new memories and emotional experiences.

Wiring individualistic, theoretically possible to diagram

“Even doing small parts of the brain now is going to tell us a lot about brain function. So one kind of study we would like to do is to search for these connectopathies, these abnormal patterns of connection that are hypothesized to underlie mental disorders like autism and schizophrenia…My goal is simply to see what's wrong. That's not, in itself, a cure, but obviously it's a step towards finding better treatments.”

Author of "Connectome: How the Brain's Wiring Makes Us Who We Are"

(Gross, 2012)

William E. Pelham Jr., director of the Center for Children and Families at Florida International University, called neurofeedback “crackpot charlatanism.” He warned that embellished claims for neurofeedback may mislead parents to favor it over other proven options like behavioral therapy and medication

Russell A. Barkley, a professor of psychiatry at the Medical University of South Carolina and an expert on attention problems, has long denied claims that neurofeedback can help

Opponents believe that the task itself can become boring, repetitious and lead to resistance. They do not believe that the results are permanent; can be costly

Require a well-trained clinician/coach Is not as well accepted as most pharmaceutical solutions Is still not very widespread Some researchers think that there are better ways to control brain waves

other than forcing the waves into new patterns Not covered by insurance

Differences in Perspectives/Controversy

National Institute of Mental Health recently sponsored its first study of neurofeedback for ADHD

Better visuals, improved feedback readings now being offered at various chemical dependency treatment facilities as an

evidence based treatment method; also offered as treatment for co-occurring addiction and eating disorders

used by athletes to train their brains to function better during competition The New Mind Brain Mapping System

integrated Bio-Psycho-Social Assessment system Within the last 5–10 years, neurofeedback has taken a new approach, in taking a

second look at deep states. • Alpha-theta training has been used in the treatment of alcoholism and anxiety• Most recent development is the Coordinated Allocation of Resource Model

(CAR) of brain functioning This approach showed improved auditory memory, reading memory in

individuals with learning disabilities and traumatic brain injury

Recent Findings

In 2010, a study provided the first evidence of neuroplastic changes occurring directly after natural brainwave training. Half an hour of voluntary control of brain rhythms was shown to be sufficient to induce a lasting shift in cortical excitability and intracortical function

Ros et al. observed that the cortical response to transcranial magnetic stimulation (TMS) was significantly enhanced after neurofeedback and persisted for at least 20 minutes

Recent Findings

Most of the research on Neurofeedback is centralized around the treatment of ADHD.

Neurofeedback is viewed at times as lacking efficacy or not being empirically supported.

More research is needed on issues such as response rates, predictors of positive response, the role of specific and nonspecific treatment effects in outcome, and side effects of Neurofeedback treatment.

Gaps/future directions for research

Expense, time and labor intensive nature of Neurofeedback makes the treatment unappealing (typical course of TX is 20-40 visits or sessions).

Neurofeedback treatment would benefit from more targeted treatment and measurements, as well as better overall brain mapping.

Improve Data Collection and Analysis.

Gaps/Future Research

Brain and Body Solutions. (n.d.). The history of neurofeedback - Sterman/Lubar studies. Retrieved August 8, 2012, from http://www.brainandbodysolutions.com/the-history---stermanlubar-studies.html

Digital Journal. (2012). The new mind brain mapping system revolutionizes the way clinicians and neurofeedback practicioners work with clients [Press release]. Retrieved from http://www.digitaljournal.com/pr/797607

Eagleman, D. (2011). Blameworthiness- wrong question. In Eagleman, D. (Ed.), Incognito: The Secret Lives of the Brain. [Electronic version]. United States: Pantheon Books

Ellison, K. (2010). Neurofeedback gains popularity and lab attention. The New York Times. Retrieved from http://www.nytimes.com/2010/10/05/health/05neurofeedback.html?pagewanted=all

Gevensleben, H., Holl, B., Albrecht, B., Vogel, C., Schlamp, D., Kratz, O., et al. (2009). Is neurofeedback an efficacious treatment for ADHD? A randomized controlled clinical trial. Journal of Child Psychology and Psychiatry, 50(7): 780–789.

Gross, T. (Host, Co-Executive Producer). (2012, February 29). Fresh Air: The man working to reverse-engineer your brain. [Radio Broadcast]. Philadelphia, Pa: WHYY-FM/National Public Radio

Kolb, B. & Gibb, R. (2011, November). Brain plasticity and behaviour in the developing brain. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 20(4): 265–276

References

Masterpasqua, F. & Healey, K. N. (2003). Neurofeedback in psychological practice. Professional Psychology: Research and Practice, 34(6): 652-656.

Othmer, S. (2008). Introduction to QEEG and neurofeedback: Advanced theory and applications. In Budzynski, T., Evans, J. R., & Abarbanel, A. (Eds.), Neuromodulation Technologies: An Attempt at Classification (4th, pp. 3-26). Amsterdam: Elsevier.

Ros T., Moniek, M., Ruge, D., Gruzelier, J., & Rothwell, J. C. (2010). Endogenous control of waking brain rhythms induces neuroplasticity in humans. European Journal of Neuroscience, 31 (4).

Thornton, K. E., & Carroll, C. (2010). The coordinated allocation of resource (CAR) model intervention for reading problems. Neuroconnections, 8-16.

References (cont)