What's New in Neurofeedback

A Monthly Summary of News and Events

Vol. 6 No. 5 - May 2003

This newsletter is sponsored by EEG Spectrum International Intl, Inc.,
a leader in providing clinical service and training professionals.

Past issues are available at start.eegspectrum.com/Newsletter/
Information on how to subscribe or cancel a subscription appear at the end.
The opinions related in this newsletter reflect those of the author only.
Copyright (C) 2002 by EEG Spectrum International Intl, Inc. All rights reserved.



  • Announcements  - News
  • In the Spotlight     - Neurotherapy since 2000
  • News & Reviews - Books & journal papers
  • Events & Locations - Conferences, Courses
  • Last Word               - Exterminating Spam

  •  

    Announcements


     

    In the Spotlight

    Neurotherapy since 2000

    In the September 2002 issue of this newsletter, I listed the recent publications in the field of neurofeedback or EEG biofeedback. Since then, I realize we need to reserve the term "neurotherapy" for this field. Operant conditioning of EEG or other neuroimaging techniques like HEG, fMRI, for therapeutic ends should be called "neurotherapy." We need to eliminate "neurobiofeedback", which is not even in Medline's keyword database, and perhaps use the term "neurofeedback" whenever we perform operational conditioning but stray away from therapy (e.g., peak performance, lie detection). "EEG biofeedback" has been taken up by the nascent field of Brain-Computer Interfaces (BCI). Not a big problem, but possibly a confusing one. BCIs are about communication, not symptom remediation. Animals communicate entirely through motor acts, and humans are no exception. When humans suffer severe motor impairment from disease (ALS or Lou Gehrig's disease) or injury, the resulting locked-in syndrome is in some ways more debilitating than the demyelinating condition, because they are now unable to communicate with loved ones. BCIs provide the promise of reconnection.

    Our field of neurotherapy is publishing about 25 papers a year, with two-thirds appearing in Journal of Neurotherapy and Applied Psychophysiology & Biofeedback, and the remaining third in scattered journals and books.


            YEAR   # Publications
            1998       16
            1999       27
            2000       27
            2001       30
            2002       23
    

    Here is an up-to-date list of recent publications (since 2001).

    1. Quantitative Electroencephalographic Comodulation: An Investigation of Patterns in Chronic Fatigue Syndrome
      By Lorensen TD, Gow KM, Journal of Neurotherapy, Vol 7(1), 2003.

    2. Neurofeedback Training: Integration with Diet and Detoxification Programs
      By Ibric VL, McCourt JE, Journal of Neurotherapy, Vol 6(4), 2003.

    3. Efficacy of Neurofeedback for Children in the Autistic Spectrum: A Pilot Study.
      By Jarusiewicz B, Journal of Neurotherapy, Vol 6(4), 2003.

    4. Neurofeedback treatment for ADHD in children: a comparison with methylphenidate.
      By Fuchs T, Appl Psychophysiol Biofeedback, 2003 Mar; Vol. 28 (1), pp. 1-12     [abstract online]

    5. Clinical application of an EEG-based brain-computer interface: a case study in a patient with severe motor impairment.
      By Neuper C Clin Neurophysiol, 2003 Mar; Vol. 114 (3), pp. 399-409     [abstract online]

    6. The effect of training distinct neurofeedback protocols on aspects of cognitive performance.
      By Vernon D, Int J Psychophysiol, 2003 Jan; Vol. 47 (1), pp. 75-85     [abstract online]

    7. The effects of stimulant therapy, EEG biofeedback, and parenting style on the primary symptoms of ADHD.
      By Monastra VJ, Appl Psychophysiol Biofeedback, 2002 Dec; Vol. 27 (4), pp. 231-49     [abstract online]

    8. EEG signature and phenomenology of alpha/theta neurofeedback training versus mock feedback.
      By Egner T, Appl Psychophysiol Biofeedback, 2002 Dec; Vol. 27 (4), pp. 261-70     [abstract online]

    9. Task Force Report on methodology and empirically supported treatments: introduction.
      By Moss D, Appl Psychophysiol Biofeedback, 2002 Dec; Vol. 27 (4), pp. 271-2     [abstract online]

    10. The circle of the soul: the role of spirituality in health care.
      By Moss D, Appl Psychophysiol Biofeedback, 2002 Dec; Vol. 27 (4), pp. 283-97     [abstract online]

    11. On the pathophysiology of migraine--links for 'empirically based treatment' with neurofeedback.
      By Kropp P, Appl Psychophysiol Biofeedback, 2002 Sep; Vol. 27 (3), pp. 203-13     [abstract online]

    12. Functional MRI for neurofeedback: feasibility study on a hand motor task.
      By Yoo SS, Neuroreport, 2002 Aug 7; Vol. 13 (11), pp. 1377-81     [abstract online]

    13. EEG biofeedback on cognitive function of children with ADHD.
      Jiang, Ronghuan; Wang, Yufeng; Gu, Bomei; Chinese Mental Health Journal, Vol 16(6), Jun 2002. pp. 407-410.

    14. Alpha-theta therapy in the treatment of a dually diagnosed patient: A case study.
      Loytsker, Julia V.; Dissertation Abstracts International: Section B: The Sciences & Engineering, Vol 62(11-B), Jun 2002. pp. 5381. [Dissertation]

    15. Neurofeedback and epilepsy.
      Monderer, Renee S.; Harrison, Daniel M.; Haut, Sheryl R.; Epilepsy & Behavior, Vol 3(3,Pt1), Jun 2002. pp. 214-218.

    16. An assessment of eeg biofeedback for the remediation of ADHD.
      Heywood, Charles Edward; Dissertation Abstracts International: Section B: The Sciences & Engineering, Vol 62(10-B), May 2002. pp. 4829. [Dissertation]

    17. A Janusian perspective on the nature, development and structure of schizophrenia and schizotypy.
      By Gruzelier J, Schizophr Res, 2002 Mar 1; Vol. 54 (1-2), pp. 95-103     [abstract online]

    18. ADD/ADHD EEG beta enhancement: A test of Barabasz's instant alert hypnosis with neurotherapy
      Anderson, Kathryn Dawn; Dissertation Abstracts International Section A: Humanities & Social Sciences, Vol 62(12-A), 2002. pp. 4053. [Dissertation]

    19. Mechanism(s) of the placebo response and the future of neurofeedback research.
      La Vaque, T. J.; Journal of Neurotherapy, Vol 6(1), 2002. pp. 1-4.

    20. EEG-NeuroBioFeedback treatment of patients with brain injury Part 3: Cardiac parameters and finger temperature changes associated with rehabilitation.
      Laibow, Rima E.; Stubblebine, Albert N.; Sandground, Henry; Journal of Neurotherapy, Vol 6(1), 2002. pp. 5-21.

    21. Neurofeedback for AD/HD: A ratio feedback case study and tutorial.
      Rossiter, Thomas; Journal of Neurotherapy, Vol 6(3), 2002. pp. 9-35.

    22. EEG-NeuroBioFeedback treatment of patients with brain injury Part 4: Duration of treatments as a function of both the initial load of clinical symptoms and the rate of rehabilitation.
      Bounais, Michel; Laibow, Rima E.; Stubblebine, Albert N.; Journal of Neurotherapy, Vol 6(1), 2002. pp. 23-38.

    23. Impact of qEEG-guided coherence training for patients with a mild closed head injury.
      Walker, Jonathan E.; Norman, Charles A.; Weber, Ronald K.; Journal of Neurotherapy, Vol 6(2), 2002. pp. 31-43.

    24. Application of repetitive visual stimulation to EEG neurofeedback protocols.
      Collura, Thomas F.; Journal of Neurotherapy, Vol 6(2), 2002. pp. 47-70.

    25. Behaviorism and neurofeedback: Still married.
      Fultz, Dwight E.; Journal of Neurotherapy, Vol 6(3), 2002. pp. 67-74.

    26. The alpha rhythm EEG.
      Hammond, D. Corydon; Journal of Neurotherapy, Vol 6(3), 2002. pp. 89-100.

    27. Alternative treatments for ADHD: does evidence support their use?
      By Brue AW, Altern Ther Health Med, 2002 Jan-Feb; Vol. 8 (1), pp. 68-70, 72-4     [abstract online]

    28. Physical mechanisms in neuroelectromagnetic therapies.
      By Liboff AR, NeuroRehabilitation, 2002; Vol. 17 (1), pp. 9-22     [abstract online]

    29. The improvement/rehabilitation of auditory memory functioning with EEG biofeedback.
      By Thornton KE, NeuroRehabilitation, 2002; Vol. 17 (1), pp. 69-80     [abstract online]

    30. Learned self-regulation of EEG frequency components affects attention and event-related brain potentials in humans.
      By Egner T, Neuroreport, 2001 Dec 21; Vol. 12 (18), pp. 4155-9     [abstract online]

    31. EEG NeuroBioFeedback Treatment of Patients with Brain Injury. Part 1: Typological Classification of Clinical Symptoms
      By M Bounias, RE Laibow, A Bonaly, AN Stubblebine Journal of Neurotherapy, Vol 5(4), 2001.

    32. EEG NeuroBioFeedback Treatment of Patients with Brain Injury Part 2.
      By RE Laibow, AN Stubblebine, H Sandground, M Bounias Journal of Neurotherapy, Vol 5(4), 2001.

    33. Neurofeedback Therapy of Attention Deficits In Patients with Traumatic Brain Injury
      By Ingo Keller Journal of Neurotherapy, Vol 5(1), 2001.

    34. Attention and Neurofeedback Synchrony Training: Clinical Results and Their Significance
      By J. T. McKnight, L. G. Fehmi, Journal of Neurotherapy, Vol 5(1), 2001.

    35. Changes in Lateralized Memory Performance in Subjects With Epilepsy Following Neurofeedback Training
      By M. B. Sterman, DeLee Lantz Journal of Neurotherapy, Vol 5(1), 2001.

    36. A comparison of EEG activity in adults with ADHD and normal controls while performing tasks that require attention.
      De Jong, Michael David; Dissertation Abstracts International: Section B: The Sciences & Engineering, Vol 62(2-B), Aug 2001. pp. 1072. [Dissertation]

    37. The effects of neurofeedback on intelligence and behavior of children with attention deficit disorders.
      O'Dell, Brenda Dawn; Dissertation Abstracts International: Section B: The Sciences & Engineering, Vol 62(2-B), Aug 2001. pp. 1093. [Dissertation]

    38. The efficacy of neurofeedback on migrainous neuralgia.
      Walcutt, Diana L.; Dissertation Abstracts International: Section B: The Sciences & Engineering, Vol 62(1-B), Jul 2001. pp. 568. [Dissertation]

    39. Treatment of fibromyalgia incorporating EEG-driven stimulation: A clinical outcomes study.
      Mueller, Horst H.; Donaldson, C. C. Stuart; Nelson, David V.; Journal of Clinical Psychology, Vol 57(7), Jul 2001. pp. 933-952.

    40. Alternative treatments for adults with ADHD.
      By Arnold LE, Ann N Y Acad Sci, 2001 Jun; Vol. 931, pp. 310-41     [abstract online]

    41. EEG biofeedback treatment of ADD. A viable alternative to traditional medical intervention?
      By Ramirez PM, Ann N Y Acad Sci, 2001 Jun; Vol. 931, pp. 342-58     [abstract online]

    42. Flexyx Neurotherapy System in the treatment of traumatic brain injury: an initial evaluation.
      By Schoenberger NE, J Head Trauma Rehabil, 2001 Jun; Vol. 16 (3), pp. 260-74     [abstract online]

    43. Neurotherapy does not qualify as an empirically supported behavioral treatment for psychological disorders.
      Lohr, Jeffrey M.; Meunier, Suzanne A.; Parker, Lisa M.; Behavior Therapist, Vol 24(5), May 2001. pp. 97-104. [30 years of research studies in humans, cats, and monkeys notwithstanding :-)]

    44. Effect of biofeedback training of sensorimotor and beta-sub-1EEG rhythms on attention parameters.
      Grin'-Yatsenko, V. A.; Kropotov, Yu. D.; Ponomarev, V. A.; Human Physiology, Vol 27(3), May 2001. pp. 259-266.

    45. Evaluation of the effectiveness of an attention enhancement program for children diagnosed with ADHD administered in the school setting.
      Grisanzio, William Richard; Dissertation Abstracts International: Section B: The Sciences & Engineering, Vol 61(9-B), Apr 2001. pp. 5043. [Dissertation]

    46. Ethical research issues: Going beyond the Declaration of Helsinki.
      Striefel, Sebastian; Applied Psychophysiology & Biofeedback, Vol 26(1), Mar 2001. pp. 39-59.

    47. "The ethical use of placebo controls in clinical research: The Declaration of Helsinki": Reply.
      La Vaque, Theodore J.; Rossiter, Thomas R.; Applied Psychophysiology & Biofeedback, Vol 26(1), Mar 2001. pp. 67-71.

    48. Upper-limb discoordination in hemiparetic stroke: Implications for neurorehabilitation.
      Dewald, Julius P. A.; Sheshadri, Vikram; Dawson, Michelle L.; Topics in Stroke Rehabilitation, Vol 8(1), Spr 2001. pp. 1-12.

    49. The ethical use of placebo controls in clinical research: the Declaration of Helsinki.
      By La Vaque TJ, Appl Psychophysiol Biofeedback, 2001 Mar; Vol. 26 (1), pp. 23-37; discussion 61-5     [abstract online]

    50. The efficacy of EEG neurofeedback in the treatment of ADHD children: A case study analysis.
      Padolsky, Ilean Phyllis; Dissertation Abstracts International: Section B: The Sciences & Engineering, Vol 61(12-B), 2001. pp. 6716. [Dissertation]

    51. The value of observational studies in neurotherapy.
      Trudeau, David L.; Journal of Neurotherapy, Vol 4(3), 2001. pp. 1-4.

    52. EEG biofeedback training and ADHD in an elementary school setting.
      Carmody, Dennis P.; Radvanski, Diane C.; Wadhwani, Sonia; Journal of Neurotherapy, Vol 4(3), 2001. pp. 5-27.

    53. Clinical use of an alpha asymmetry neurofeedback protocol in the treatment of mood disorders: Follow-up study one to five years post therapy.
      Baehr, Elsa; Rosenfeld, J. Peter; Baehr, Rufus; Journal of Neurotherapy, Vol 4(4), 2001. pp. 11-18.

    54. The effects of Performance Enhancement Training on hypertension, human attention, stress, and brain wave patterns: A case study.
      Norris, S. Louise; Lee, Ching-Tse; Burshteyn, Dmitry; Journal of Neurotherapy, Vol 4(3), 2001. pp. 29-44.

    55. Electrophysiology of auditory memory of paragraphs towards a projection/activation theory of the mind.
      Thornton, Kirtley E.; Journal of Neurotherapy, Vol 4(3), 2001. pp. 45-72.

    56. EEG biofeedback treatment of ADD: A viable alternative to traditional medical intervention?
      Ramirez, Paul Michael; DeSantis, Deborah; Opler, Lewis A.; In Adult attention deficit disorder: Brain mechanisms and life outcomes. New York, NY, US: New York Academy of Sciences. pp. 342-358.

    57. Adult attention deficit disorder: Brain mechanisms and life outcomes.
      Wasserstein, Jeanette; Wolf, Lorraine E.; LeFever, F. Frank; 2001. New York, NY, US: New York Academy of Sciences. x, 409 pp.

    58. Agitation therapy for antisocial and psychopathic personalities: an outline.
      By Martens WH, Am J Psychother, 2001; Vol. 55 (2), pp. 234-50     [abstract online]

    59. [Neurofeedback in therapy of tinnitus]
      (German) By Gosepath K, HNO, 2001 Jan; Vol. 49 (1), pp. 29-35     [abstract online]

    60. Treatment of chronic fatigue with neurofeedback and self-hypnosis.
      By Hammond DC, NeuroRehabilitation, 2001; Vol. 16 (4), pp. 295-300     [abstract online]

    -DK

     


    News & Reviews NEW BOOKS

    Brain Injury and Mental Retardation: Psychopharmacology and Neuropsychiatry
    by C. Thomas Gualtieri
    Clarifies key issues in the psychopharmacologic treatment of brain injury and mental retardation --www.amazon.com/exec/obidos/ASIN/0781734738/top100

    Clinicians' Guide to Adult ADHD: Assessment and Intervention
    by Sam Goldstein, Anne Teeter Ellison
    Mental health and education scholars discuss how the controversial attention-deficit syndrome affects adults as well as children. --www.amazon.com/exec/obidos/ASIN/0122870492/top100

    The Treatment of Anxiety Disorders: Clinician Guides and Patient Manuals
    by Gavin Andrews and others
    Reviews new developments in research and treatment of anxiety disorders and provides up-to-date treatment materials. --www.amazon.com/exec/obidos/ASIN/0521788773/top100

    Do Seizures Damage The Brain
    by Thomas Sutula, Asla Pitkanen
    What are the consequences of repeated brief seizures? Some patients appear to tolerate seizures with relatively limited long-term consequences. --www.amazon.com/exec/obidos/ASIN/0444508147/top100

    Dual Diagnosis: Mood Disorders and Developmental Disabilities
    by KM Olson, JA Hellings, PA Black, JM O'Toole
    Recent research of treating mood disturbances in developmental delay populations. --www.amazon.com/exec/obidos/ASIN/1557666482/top100

    Neurobehavioural Disability and Social Handicap: After TBI
    by Tom McMillan, Rodger LL Wood
    The nature of neurobehavioral disability, its impact on social functioning and what can be done to address the problems generated by such a handicap. --www.amazon.com/exec/obidos/ASIN/0863778909/top100

    The Parallel Brain: The Cognitive Neuroscience of the Corpus Callosum
    by Eran Zaidel, Marco Iacoboni
    Summarizes current research on the human corpus callosum, including animal models, normal human studies, and clinical evidence. --www.amazon.com/exec/obidos/ASIN/0262240440/top100

     


    JOURNAL PAPERS

    Cingulate lesions on social behaviour and emotion. : Cingulate lesions are associated with decreases in social interactions, time spent in proximity with others, & vocalizations but increased manipulation of inanimate objects, all consistent with a cingulate role in social behavior and emotion. www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?form=6&db=m&uid=12667528

    Acute mania is accompanied by elevated levels within the left dorsolateral prefrontal cortex. : The prefrontal cortical glutamatergic system (left side) is involved in the pathophysiology of acute mania. www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?form=6&db=m&uid=12684737

    Current concepts on the neurobiology of ADHD : Twin studies attribute about 80 percent of the etiology of ADHD to genetic factors, and other research implicate catecholamine-rich fronto-subcortical systems. www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?form=6&db=m&uid=12685515

    Event-related slow-wave activity in two subtypes of ADHD : Early frontal negative and late posterior positive slow-wave components were reduced in ADHD combined type, but not ADHD inattentive type, relative to controls. www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?form=6&db=m&uid=12705431

    Quality of EEG in simultaneous EEG-fMRI for epilepsy. : Recording the EEG simultaneously with fMRI remains an extremely delicate operation due to the fluctuating magnetic fields inside an active MRI machine. www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?form=6&db=m&uid=12705438

    Is treatment-resistant depression a unique subtype of depression? : Treatment-resistant depression may be a specific subtype of depression based on clinical characteristics and course, neurobiological profile, and environment in which it develops. www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?form=6&db=m&uid=12706950

    Neurobiological effects of childhood abuse : Traumatic events during early life, when neuronal connections are most plasticity, may permanently render neuroendocrine stress response systems supersensitive. www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?form=6&db=m&uid=12715261

    Theta power in the EEG of alcoholics. : Increased absolute theta power was seen in alcohol-dependent subjects at central and parietal regions, which may reflect an imbalance in the excitation-inhibition homeostasis in the cortex. www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?form=6&db=m&uid=12711923

    PET Study Of Methylphenidate in Adults with ADHD : Methylphenidate modulates brain regions associated with motor function to achieve a reduction in ADHD symptoms. www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?form=6&db=m&uid=12700698

    Epileptic seizures are preceded by a decrease in synchronization. : Spatial distribution of decrease synchronization minutes to hours before seizures indicates that seizure generation in focal epilepsy is not confined to focus itself but may involve distant, even contralateral brain areas. www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?form=6&db=m&uid=12694925

    Emotion and its disorders. : Reviews application of neuroimaging techniques to understanding neural mechanisms of emotional experience. www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?form=6&db=m&uid=12697615

    Repetitive TMS: Potential in the Treatment of Depression? : Effect sizes of rTMS varied from modest to substantial, with patient selection focused on therapy-resistant cases. www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?form=6&db=m&uid=12696999

     


     

    Events & Locations

    Upcoming Courses

      4-Day Comprehensive
    • Raleigh/Durham NC - Jul 17-20
    • St Paul, MN - Aug 14-17
    • New York City, NY -Sep 11-14
    • Woodland Hills, CA - Oct 23-26
    • Atlanta, GA -Nov 13-16
    • Woodland Hills, CA Dec 11-14

    Prerequisites: All Adv. classes require successful completion of the 4 Day Comprehensive Beta/SMR.
    * Advanced Practicum requires 150 hours direct NF clinical experience.
    More info at www.eegspectrum.com/course

    Conferences for Neurofeedback Clinicians & Researchers

    CONFERENCELOCATIONDATES
    SNR - http://www.snr-jnt.orgHouston, TXSep 18-21


     

    Last Word

    Exterminating Spam

    In the modern age, the most limited resource we have is not energy, but attention. And it's getting more limited every day thanks in a large part to spam.

    Two of my three email accounts are rapidly becoming useless. Each day I receive more than 100 spams (i.e., junkmail messages) in each. In fact my Eudora crashes from all the messages if I haven't cleared an account recently.

    How many women from Russia can one guy marry? Or how many times can I earn a 6-figure commission from imaginary African princes by merely letting them access my bank account? How many bosses can I fire so I can work from home? Can I really grow more hair, or enlarge other body parts? They won't let up. Fax laws make it illegal to send unsolicited electronic communications but somehow these laws are not being enforced.

    What can be done?

    Yahoo and other mail servers are trying to block spammer email addresses, but that's like trying to exterminate rats in a major city: it cannot be done. You can eliminate the rats from your building temporarily, but you didn't kill them; they simply packed their bags and moved to the adjoining building. And when things quiet down, and all the poisons have been flushed out, they'll sneak back in. AOL allows users to block all emails except from pre-selected individuals, but this doesn't work for people using email for business or educational purposes, where many of the senders will be unknown until they contact you.

    It's guerilla warface. Spammers are quick and numerous, but so are we. The reason they exist is because they can send millions of unsolicited emails for pennies. But we have one thing in our favor they can never have: knowledge. We know the people we are sending our messages to; they do not. All they have is an email address. So let's see if we can use that knowledge to our advantage.

    Public Key Encryption allows anyone to send an encrypted message to anyone else in the world. People publish a public key so anyone can find it and use it. Perhaps we can use other public information about ourselves to re-secure our email accounts.

    Public Keywords: We post half a dozen questions in our signature file and/or in a public depository, easily accessible to all, that anyone emailing us must answer for their message to get through our filters. The emailer need answer only one to escape the filter. And by filter, you don't need fancy ones -- a simple SORT subject line will do. Questions could be about the schools you attended, the city or state you live in, the company or industry you work in or for, even your first name. So someone's questions might be:

    First name? City? State? Company? Industry?

    John Doe's answers might be: John, Seattle, Washington, Boeing, Aviation

    People would start subject lines with one of the answers in parentheses. For example, "(John) Question about last week's meeting" or "(Boeing) We met at the March Conference"

    We could substitute new questions as spammers became wise to the old ones like first name and states. And people could add their own questions and keywords, in case they didn't know your current ones. For instance, "(High school=Waltham High) Upcoming 20th Reunion" or "(Fan=Red Sox) Box seats next to yours" or "(Conference=SNR) A question about your talk"

    Public Keywords might be an interesting anthropological study in its own right. Who knows what about you.

    I doubt this approach will be taken up, but the idea behind it -- using the knowledge we have about the person we are emailing -- can never be overcome by spammers. Spam depends upon cheap communication, email blasts that scale to ever-increasing numbers. Spammers have quantity on their side. But we will always have quality.