What's New in Neurofeedback

• Rehabilitation of auditory memory functioning with EEG biofeedback.

• Functional considerations for the nature of schizophrenia support neurophysiological approaches to treatment such as neurofeedback."

• Our Conscious Mind Could Be An Electromagnetic Field

• Depressed Brain May Heal Itself, But Only Briefly

• The Rewired Brain

We've seen it a hundred times before. A TV show, some movie, a bumbling criminal-type and his henchman are planning to break into a building or fancy house. The know-it-all suggests entry through a death-defyingly high window or a back door encased in electrified fencing. The camera stays with the mastermind as he wriggles through barbed wire and tight-walks over crazed, leaping pit bulls. When he finally succeeds at his elaborate break-in and sets down inside the darkened house, he is surprised by a tap on the shoulder. It is of course the henchman, already comfortably inside.

"How did you get in?!" the sweaty fool demands.

"The front door was unlocked."

So it may be with neurofeedback. While some clinicians try to work neurofeedback into the (health) system through the cracks, others find the front door ajar depending upon the disorder or problem (e.g., delinquency, recidivism) and parties involved.

SMR neurofeedback is a physiological anticonvulsant (as opposed to a chemical anticonvulsant). This was its first application, with more than 30 years of research to confirm it. Anticonvulsant therapy parallels neurofeedback in that it is applied to clinical conditions where EEG abnormalities are anticipated, such as autism, but also where they are not, such as in alcohol detoxification. Anticonvulsants are currently experiencing a prescription heyday across the entire psychiatric spectrum. I found 70 recent papers on anticonvulsants and autism, 700 paper for anticonvulsant therapy in alcoholism treatment, a 1,000 papers for various anxiety disorders, and nearly 3,000 papers for mood disorders. So this is fertile ground for an effective anticonvulsant, especially one that has few (if any) side effects.

I recently came across a door held extremely wide open for neurofeedback. Fetal Anticonvulsant Syndrome. This syndrome results from prenatal exposure to chemical anticonvulsants. About 1 in 10 children born to epileptic mothers undergoing anticonvulsant therapy acquire the syndrome and as many as 3 in 10 exhibit some of the symptoms. From my calculations, 3,000 children a year in America develop Fetal Anticonvulsant Syndrome and another 3,000 to 6,000 develop some of the milder symptoms. Symptoms range from minor anomalies, such as small nails, to major congenital abnormalities such as unusual facial features, spina bifida, developmental delays, even autism. Folic acid metabolism is apparently hindered in the fetus by exposure to commonly used anticonvulsants (carbamazepine, phenytoin, & sodium valproate). The syndrome derives from the medications themselves, not the maternal disorder (epilepsy) as frequency of malformations is two to three-fold above the background rate and is typically dose-related.

Given the dose-dependency, even a moderate reduction of anticonvulsant doses during pregnancy would be a significant contribution to the million of American women with epilepsy. Who knows? Perhaps neurotherapy might entirely replace chemical anticonvulsants in some. A reduction in patient side effects also goes hand in hand with dose reductions. The side effects of chemical anticonvulsants run from sedation and nausea all the way to infrequent toxicities. Common side effects include overgrowth of gum tissue, decreased coordination, abnormal eye movements, confusion, drowsiness, dizziness, headache and fatigue (depending on the medication). Not so common side effects include abnormal body hair growth, softening of bones, impaired consciousness, irregular heart rhythms, and liver toxicity. Compare this to common side effects of neurofeedback: improved attentiveness and impulse control....

Given the proven developmental neurotoxicity of anticonvulsants and the occasional adverse reactions to anticonvulsants (e.g., Anticonvulsant Hypersensitivity Syndrome), why neurofeedback isn't part of the standard epileptic treatment arsenal is beyond me. And from the insurance point of view, wouldn't it be in their interests to pay out for a few dozen sessions during pregnancy then pay for years of care under pediatric specialists.

This open door might seem a bit small, a bit obscure, but it is one possible entrance for mainstream acceptance. Ritalin was originally developed to treat a similarly obscure condition called narcolepsy, a sleeping disorder that affects less than 200,000 people (about the same lifetime prevalence of fetal anticonvulsant syndrome). From such humble beginnings....

For more information:
• National Fetal AntiConvulsant Syndrome Association -www.facsline.org

• New antiepileptic drugs and psychopathology www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?form=6&db=m&dopt=b&uid=9778603

• Antiepileptic drugs: affective use in autism spectrum disorders www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?form=6&db=m&dopt=b&uid=11587873

News & Reviews NEW BOOKS

Philosophy and the Neurosciences : A Reader
by William Bechtel, RS Stufflebeam, J. Mundale, Pete Mandik

Includes classic and contemporary selections to cover areas of interest to neuroscientists and philosophers alike. -www.amazon.com/exec/obidos/ASIN/063121044X/top100

The Adhd-Autism Connection: A Step Toward More Accurate Diagnoses and Effective Treatments
by Diane Kennedy, Rebecca Banks

History and current research into bipolar disorders, the creativity disease. -www.amazon.com/exec/obidos/ASIN/0792365887/top100

Brain Mapping: The Disorders
by John C. Mazziotta, AW Toga, RJS Frackowiak

Specialists describe the use of brain mapping technologies in evaluating neurological, neurosurgical, and psychiatric disorders. -www.amazon.com/exec/obidos/ASIN/0124814603/top100

Bright Splinters of the Mind: A Personal Story of Research with Autistics Savant
by Beate Hermelin