Monthly summary of general news, case histories,
and introductory articles about neurofeedback
for the interested layperson
Vol. 9 No. 10 - October 2006
Past issues are available at start.eegspectrum.com/News/
Copyright (C) 2001 by EEG Spectrum International. All rights reserved.
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All links at news.yahoo.com/fc/Science/Brain_Research
The history of biofeedback began with ear wiggling (Bair, 1901), but the history of SMR biofeedback emerged serendipitously from toxin-induced seizures (Sterman, Fairchild, & McRae, 1972; Sterman & Kovalesky, 1979), along with an incidental investigation of electroencephalographic correlates of behavioral inhibition in cats (Roth et al., 1967; Sterman & Wyrwicka, 1967; Sterman et al., 1969). SMR biofeedback was preceded by alpha biofeedback (Adrian, 1934; Kamiya, 1968); however SMR neurofeedback and associated protocols are the primary form for treating ADHD symptoms.
The treatment of ADHD with neurofeedback began 30 years ago. In a replication and extension of Sterman’s research into motor inhibitory processes (Sterman, 1973), Lubar and Bahler (1976) trained epileptics in order to reduce seizure but also noted that a hyperactive epileptic showed a general decrease in his overactivity after SMR enhancement and theta suppression training. This led to further case studies in which ADHD symptoms were directly addressed with neurofeedback (Lubar & Shouse, 1976;1977; Shouse & Lubar, 1979).
More than 200 patients has since been involved in controlled research for ADHD (cf.Monastra et al., 2005) and nearly 2,000 patients in case studies and clinical trials (e.g. Alhambra et al, 1995; Lubar et al, 1995; Rossiter & LaVaque, 1995; Linden et al., 1996, Rossiter, 1998; Boyd et al. 1998; Thompson & Thompson, 1998; Kaiser & Othmer, 2000; Carmody et al, 2001; Monastra et al., 2002; Fuchs et al., 2003; Rossiter, 2004; Strehl et al., 2006, although some continue to ignore the vast majority of this work.
Loo & Barkley (2005), for instance, attacked neurofeedback research by discounting the accuracy of unknown psychiatrists (i.e., faulty client diagnosis), among other factors, and supported their conclusion with an unpublished conference presentation (Fine, Goldman, & Sandford, 1994), definitely not the stuff of which strong scientific argument is made. Despite fishing in the unpublished world, they failed to find the dozens and dozens of supporting studies including my own at a more prestigious conference than Fine's APA, i.e., AAAS, the most prestigious of all scientific societies and publisher of the journal Science (Kaiser & Othmer, 2000).
Polemics aside, neurofeedback for ADHD diagnosis appears to be as effective as stimulant medication for this condition without notable side effects. Stimulant therapy, on the other hand, is associated with "measurable effects on the rate of growth in school-age children" -- a 20% reduction in height growth rate (Charach et al, 2006; Swanson et al., 2006). And the presidence of training a child to swallow a pill to govern his behavior is not the lesson I care to teach. Teaching a child the value of self-regulation and learning is the foundation of our culture, at least we pretend it is.
EEG training likely impacts long-term potentiation, perhaps either increasing the number of GABAergic receptors in the somatosensory pathway or increasing their efficacy or like mechanism. Neurophysiological changes associated with EEG training were sure to emerge and are likely to flourish as more clinicians gain access to neuroimaging technology. Beauregard & Levesque (2006; Levesque et al., 2006) are the first to report functional neuroimaging differences between neurofeedback and untreated ADHD children using fMRI technology. Other researchers have found rhythm-associated seizure resistance in rats, a creature not well known for placebo effect (Miller et al., 1994). Last year I tried to convince Dennis McGinty, a neuroscientist involved in receptor research, to seek out anatomical substrates of behavioral inhibition in terms of GABA, the brain primary inhibitory neurotransmitter. A near-term goal of our field should be to determine whether SMR training leads to increased GABAergic receptor density or not. A couple studies and a few looks under the microscrope may resolve the issue once and for all.
Selected References
Charach A, Figueroa M, Chen S, Ickowicz A, Schachar R.(2006). Stimulant treatment over 5 years: effects on growth. J Am Acad Child Adolesc Psychiatry, 45, 415-21.
Heinrich H, Gevensleben H, Freisleder FJ, Moll GH, Rothenberger A. (2004). Training of slow cortical potentials in attention-deficit/hyperactivity disorder: evidence for positive behavioral and neurophysiological effects. Biol Psychiatry, 55, 772-5.
Kaiser, D.A., & Othmer, S. (2000). Effects of neurofeedback on variables of attention in a large multi-center trial. American Assoc. Advancement of Science, Feb 17, Wash DC.
Kamiya, J. (1968, November). Conscious control of brain waves. Psychology Today, 1, 56-60.
Loo SK, Barkley RA. (2005).Clinical utility of EEG in attention deficit hyperactivity disorder. Appl Neuropsychol. 12, 64-76.
Lubar JF, Bahler WW. (1976). Behavioral management of epileptic seizures following EEG biofeedback training of the sensorimotor rhythm. Biofeedback Self Regul. 1976 Mar;1(1):77-104.
Levesque J, Beauregard M, Mensour B. (2006). Effect of neurofeedback training on the neural substrates of selective attention in children with attention-deficit/hyperactivity disorder: a functional magnetic resonance imaging study. Neuroscience Letters, 394, 216-21.
Miller JW, Turner GM, Gray BC. (1994). Anticonvulsant effects of the experimental induction of hippocampal theta activity. Epilepsy Research, 18, 195-204.
Sterman MB. (1973). Neurophysiologic and clinical studies of sensorimotor EEG biofeedback training: some effects on epilepsy. Semin Psychiatry. 1973 Nov;5(4):507-25.
Sterman MB, Fairchild MD, & McRae GL (1972). Effects of hydrazine on electrophysiology, behavior and runway performance in the cat. DTIC technical report AD0746014.
Sterman, M.B. & Kovalesky, R.A. (1979). Anticonvulsant effects of restraint and pyridoxine on hydrazine seizures in the monkey. Experimental Neurology, 65, 78-86.
Strehl U, Leins U, Goth G, Klinger C, Hinterberger T, Birbaumer N. Self-regulation of slow cortical potentials: a new treatment for children with attention-deficit/hyperactivity disorder. Pediatrics. 2006 Nov;118(5):e1530-40.
Swanson J, Greenhill L, Wigal T, Kollins S, Stehli A, Davies M, Chuang S, Vitiello B, Skrobala A, Posner K, Abikoff H, Oatis M, McCracken J, McGough J, Riddle M, Ghuman J, Cunningham C, Wigal S. (2006). Stimulant-related reductions of growth rates in the PATS. J Am Acad Child Adolesc Psychiatry, 45, 1304-13.
-DK
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ARTICLES
Fragmented Visuospatial Processing in Pervasive Developmental Disorder.
:
Children with one form of PDD were deficient in visual global processing.
Bispectral Index With Glasgow Coma Score In Mild/Moderate Head Injuries.
:
GCS scores were associated with BIS (anesthesia-type) scores but not tightly enough to be used in the place of the GCS.
Psychobiology of the suicidal mind.
:
Neuroimaging advances may illuminate where and how decisions about the self are made.
Dissociation of the component processes of attention in healthy adults.
:
Attention is not unitary but comprised of four distinct components: Sensory Selective Attention, Response Selection, Focus/Capacity, and Sustainability.
MEG and TMS combined with EEG for mapping alcohol effects.
:
Alcohol changes the functional connectivity between motor and prefrontal cortices and alcohol is associated with decreased prefrontal cortical excitability.
Long-Term Treatment of Children with ADHD
:
A fraction of ADHD children are treated for this condition and few persist for any length of time.
Suicidal behaviour and depression in epilepsy
:
Suicidal ideation and other features were present in depressed patients and these were not associated with any neurological variable.
Evaluating brain activity in obsessive-compulsive disorder
:
Abnormal corticostriatal activity in OCD patients was observed using a network-analysis approach.
Initial fMRI data modeling on connectivity reported between brain areas.
:
Initial attempts to correlate blood flow between regions.
Brain neuroimaging in cannabis use: a review.
:
Structural and functional neuroimaging studies of cannabis use.
Cortical Thinning of Attention and Executive Function Networks in ADHD
:
Adults with ADHD show thinning of cerebral cortex in attentional and executive networks, especially in the right hemisphere.
Post-traumatic neural depression and neurobehavioral recovery after brain injury.
:
Reviews basic and applied TBI research.
Intra-personal EEG variability of multiple personality disorder.
:
EEG variability between alters was mostly observed in frontal and temporal beta activity.
EEG correlates of WAIS
:
Temporal theta correlated with working memory ability.
Cocaine treatment and adult ADHD
:
Improvement in ADHD symptoms was associated with a reduction in cocaine use.
Fragmented Visuospatial Processing in Pervasive Developmental Disorder.
:
Children with one form of PDD were deficient in visual global processing.
Bispectral Index With Glasgow Coma Score In Mild/Moderate Head Injuries.
:
GCS scores were associated with BIS (anesthesia-type) scores but not tightly enough to be used in the place of the GCS.
Psychobiology of the suicidal mind.
:
Neuroimaging advances may illuminate where and how decisions about the self are made.
Dissociation of the component processes of attention in healthy adults.
:
Attention is not unitary but comprised of four distinct components: Sensory Selective Attention, Response Selection, Focus/Capacity, and Sustainability.
MEG and TMS combined with EEG for mapping alcohol effects.
:
Alcohol changes the functional connectivity between motor and prefrontal cortices and alcohol is associated with decreased prefrontal cortical excitability.