What's New in Neurofeedback

A Monthly Summary of News and Events

Vol. 9 No. 9 - September 2006

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) 2005 by David Kaiser or ESII. All rights reserved.



  • Announcements  - News
  • In the Spotlight     - Technology-assisted self-regulation
  • News & Reviews - Books & journal papers
  • Events & Locations - Conferences, Courses
  • Last Word    - Somewhere over New York

  •  

    Announcements


     

    In the Spotlight

    Technology-Assisted Self-Regulation (TASR)

    I planned to discuss ADHD this month, but Monastra et al's paper on ADHD is due this week so I'll review it and other ADHD papers next month. Many people have requested a layperson description of neurofeedback training and QEEG assessment. My first attempt at writing one for the journal of neurotherapy was clocked in at MD/PhD reading level, despite my attempt to assessibility. I hope this try is closer...

    In the 1950s neuroscientists developed equipment that allowed rats to stimulate the pleasure centers of the brain. A lever was connected to a weak electrical generator which itself was connected by a wire to the deepest part of the rat’s brain. Whenever a rat tapped the lever, a miniscule amount of electricity flowed from the generator into the rat’s brain, into the pleasure center of the brain. Rats wired in this fashion quickly caught on to the nature of the task and after little training would tap the lever thousands of times an hour to receive the impulse. The rodent wireheads would pass up sleep, comfort, food, and even a receptive mate to work the bar. It was found to be the strongest form of learning ever to occur on the planet, and extremely resistant to extinction, to use the terminology of the day. Most rats would indulge in day-long binges of self-stimulation without a moment’s rest and even when an electrified grid was placed between them and the lever, the rats would risk a gauntlet of shocks to gain access to their beloved.

    The implications for studying addiction were obvious; the implications for learning and brain normalization training less so. But rats are rats. Would humans fare any better if allowed to reward themselves similarly, that is, intra-cranially without restraint?

    What do you think? A few epileptic patients stimulated themselves into convulsions before the experiments were called off.

    EEG operant conditioning does not stimulate the brain directly -- rewards come in through the eyes and ears and mind of the individual -- but by rewarding EEG changes with visual and auditory rewards a therapist is able to help shape an individual’s brainwave activity toward normal patterns of activity. The advent of powerful personal computers and advances in miniaturization and amplification has allowed anyone who doesn’t mind getting gel in their hair the ability to visualize the electrical activity of their own brain and once you can visualize your behavior, you can change it.

    Brainwaves are minute electrical voltages generated by the top layer of the brain (cortex) which can be detected by modern electrical equipment. Sensors placed on the scalp record these tiny voltage changes across the scalp and analyze the signals looking for specific rhythms. When brain rhythms are normal, an individual is rewarded, usually by means of a sound (bell or chime) or light or video event. But when his or her brainwave activity deviates from normal, this positive feedback stops and a negative response may be provided such as a red flashing light or even a buzzer. In this fashion good brain-behaviors are exercised and undesirable brain-behaviors are not reinforced, with a goal being the accumulation of good brain-behaviors. A reasonably large repertoire of healthy behaviors is the basis for cognitive flexibility and self-regulation. An important point to realize is that no electrical current is put into the brain. The brain’s electrical activity are merely registered passively at the scalp and these brain energies are relayed to a computer.

    Human EEG consists of random events and rhythms. By means of operant conditioning -- rewarding the presence of certain brain activity patterns and not others -- healthy brain behaviors can be learned and unhealthy brain behaviors unlearned. Therapists typically focus on brain rhythms which have been studied for decades, which are called alpha (8-12 Hertz or cycles per second), beta (15-40 Hz), gamma (40+ Hz), delta (0.1-4 Hz) -- the first four letters of the Greek alphabet -- plus theta (4-8 Hz), the 8th letter, and the more English-sounding SMR (12-15 Hz) which stands for sensorimotor rhythm. Because these rhythms encompass a variety of physiological processes, however, each rhythm is often also dissected into smaller frequency ranges and such "narrow bands" are identified by their numerical range (8-10 Hz, 10-11 Hz).

    When someone closes their eyes, alpha activity occurs across most or all of the brain. When he or she opens his eyes in a well-lighted room, alpha rhythms are replaced by beta rhythms, which are fast and low-amplitude waves. The amount of replacement and brain locations where these replacements occur varies depending upon the complexity, novelty, and meaningfulness of the environment, among other factors. Alpha rhythm replacement may involve all of the electrode positions or be selective and only occur at a few sites. Drugs, drowsiness, drive, and time of day generally influence every part of the brain whereas sensory and cognitive demands activate only a selected few brain areas.

    Electrodes are positioned on the scalp according to a 50-year standard known as the International 10-20 system which divides the head into proportional distances --10% or 20 % of the way between the dent of the nose (nasion), protrusion in the back of the head (inion), and preauricular points directly in front of each ear. Labels reflect underlying brain areas: FP for frontal pole, F for frontal, P for parietal, C for central, T for temporal, and O for occipital. Sites are numbered with zero or "z" in the middle of the head (midline), followed by larger numbers as electrodes are positioned farther out to either side, with odd numbers alternating with even numbers between the left and right hemispheres (i.e., odd on the left, even on the right). Electrodes are spaced 6 or 7 cm apart on most heads. If more coverage is needed, additional electrodes may be placed halfway between any pair of electrodes. This system owes its endurance to its simplicity and fortuitous division of the scalp into brain regions that remain useful for cognitive and psychiatric research. Finally an EEG signal is always the difference in electrical potential between two electrodes on the scalp. Each electrode may be compared to its neighbor (e.g., C3 to Cz, P3 to Pz), or every electrode can be compared to the same electrode (C3 to Cz, P3 to Cz, O1 to Cz, etc).


    See figures at http://start.eegspectrum.com/Newsletter/sep2006.htm

    EEG training allows an individual to monitor his or her own brain behavior, making visible and discrete what is normally hidden and continuous. This transformation of the invisible to the visible allows anyone to alter the behavior of his or her own brain. Without technological assistance, brain behaviors would be simply too subtle or ambiguous for proper detection and training (i.e., operational conditioning). This is the strength of neurofeedback -- operant conditioning of psychophysiological responses beyond the level of normal (unassisted) observation. EEG biofeedback acts like a telescope to the mental sky. But with this strength comes some ambiguity as brain behaviors (neurophysiological responses) are not so readily classified as good or bad as motor actions can be. That is why children are often trained towards a database norm. The rationale is that if most children on average show a specific brain behavior, a certain incidence of this or that brain rhythm, this behavior ought to be generally healthy and positive. Many neurotherapists guide training by performing a quantitative EEG assessment of an individual before training and even at regular intervals during training.

    Behavioral and mental states such as mathematical processing, reading, or relaxation are believed to consist of unique and distinct perceptual and cognitive operations and every mental operation has its own unique EEG profile -- that is, a unique pattern of rhythmic activity in various parts of the brain. This concept is the foundation of functional neuroimaging including functional magnetic resonance imaging (fMRI), a popular method of investigating cerebral blood flow. This concept also provides the rationale for EEG normalization training: One’s brain activity is trained toward a population norm because any deficit or excess of rhythmic activities is likely a result of abnormal neurophysiology and mental irregularity.

    Running on a treadmill helps a physician determine how well a patient's heart handles work or stress. Running through a test battery of reading, math, and problem-solving during the acquisition of EEG signals helps determine how well an individual's brain handles work or stress. Eyes closed relaxation or simply opening the eyes may reveal mental shortcomings for some individuals while others require challenges such a general test battery to reveal suspected or known deficits. Continuous attention tasks are often used to reveal processing deficits in attention deficit hyperactivity disorder (ADHD) children and executive control and inhibition tasks for identifying disturbances in the frontal lobe.

    A minute of EEG contains a vast amount of information. Frequency analysis reduces EEG to a manageable handful of numbers. Spectral information, as it is called because we examine the entire frequency spectrum for rhythmic patterns, can be presented in tables, histograms, line graphs or the popular brain maps. Brain maps convert numbers into colors, which allows the human eye to quickly detect important patterns. In addition to unusual amounts of energy in various parts of the brain, we can also depict abnormal network activity. Too little or too much reciprocity between brain areas is quantified by means of comodulation and coherence analysis. Comodulation captures the reciprocity of energies between brain areas and coherence captures the timing relationships.

    The figure below is an example of a brain-network map of a healthy adult compared to a brain-injured adult of similar age. We are looking down on the head of each person, with their nose on top and ears to either side. Each circle is positioned at one of the 19 electrode sites sitting atop the head and depicts within itself all of the connections between electrodes relative to its position. The color yellow indicates normal function (i.e., database average), green and orange mostly normal, with blue and red indicating too little and too much connectivity, respectively.

    As you can see, the healthy adult (left) shows relatively normal amounts of shared energy between electrodes for the rhythm under investigation while the brain-injured individual (right) shows too little communication or reciprocity between areas, notably between the frontal areas of the brain.

    The theta rhythm dominates a child’s spectral energy while an adult brain contains most of its spectral energy in a faster rhythm, the alpha rhythm.

    When we evaluate children we have to take into account a degree of neurological immaturity. Most of the energy of an infant’s brain resides in the slow-wave delta rhythm and more than a decade of development may pass before an adult brainwave pattern emerges. Theta rhythms are prominent in many children diagnosed with attention deficit hyperactivity disorder (ADHD) because this reflects the immaturity of the ADHD brain. Theta rhythms in an adult or non-ADHD teenager often indicate brain-injury or neurological disease. The brainwave activity of any child may be compared to a database of many normal children in order to identify what parts of the brain, if any, differ in activity and what frequency rhythms are present at these locations.

    Many psychiatric and neurological conditions manifest themselves more as disturbances in brain connections than as local damage or disorder. Therapy can focus on restoring activity to isolated brain areas or focus on re-establishing brain networks. Through trial and error any individual gradually develops mental strategies that modify his or her brain rhythms so as to maximize reward and in so doing alter these rhythms for the better. Neurofeedback works at the level of one’s will, as in will power. An individual explores what is and what is not healthy willful behaviors, however indirectly, through the impact one’s will has on one’s brain rhythms. The brain is enormously plastic in terms of function as well as structure and is capable of altering neural pathways in response to reward. Much like our body, our brain also responds to exercise. Neurofeedback provides one of the best forms of exercise -- regulatory practice, the brain practicing at regulating itself.

    -DK

     


    News & Reviews NEW BOOKS

    Helping Your Child Overcome Separation Anxiety or School Refusal
    by Andrew R. Eisen, et al
    Parenting book for separation anxiety disorder. --www.amazon.com/exec/obidos/ASIN/1572244313/eegspectrum

    Melancholia: Diagnosis, Pathophysiology and Treatment of Depressive Illness
    by MA Taylor, Max Fink
    Reviews melancholia. --www.amazon.com/exec/obidos/ASIN/0521841518/eegspectrum

    Methods in Mind (Cognitive Neuroscience)
    by Carl Senior, et al
    Focuses on methods of cognitive neuroscience. --www.amazon.com/exec/obidos/ASIN/0262195410/eegspectrum

    Effort: A Behavioral Neuroscience Perspective on the Will
    by Jay Schulkin
    Argus for diverse cognitive systems, many embodied in motor systems relevant to self-regulation. --www.amazon.com/exec/obidos/ASIN/0805860096/eegspectrum

    Clinical Neuroembryology: Development and Developmental Disorders
    by Hans J. ten Donkelaar, et al
    Overviews development of CNS in the context of developmental disorders. --www.amazon.com/exec/obidos/ASIN/3540291407/eegspectrum

    Understanding And Treating Anxiety Disorders:
    by Barry E. Wolfe
    Integrative theory for treating anxiety disorders. --www.amazon.com/exec/obidos/ASIN/1591471966/eegspectrum

     


    JOURNAL PAPERS

    Sex differences white matter microstructure and impulsivity in adolescents. : Relates sex-related differences in white-matter development with impulsivity. www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16916700

    Growth and sexual maturation in children and adolescents with ADHD : Confirms that children with ADHD treated with stimulants grow more slowly than untreated individuals. www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16914999

    Juvenile Administration of Methylphenidate Attenuates Adult Hippocampal Neurogenesis. : Early-life exposure to methylphenidate inhibits survival of adult-generated neurons in the hippocampus and may also impact proliferation. www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16893528

    Functional neuroimaging of primary headache disorders. : Reviews functional imaging studies in migraine and other headaches. www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16893344

    QEEG prefrontal cordance as a predictor of response to antidepressants : Decrease in prefrontal cordance indicates early changes of prefrontal activity in responders to antidepressants. www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16889798

    EEG alpha oscillations: Inhibition-timing hypothesis. : Event-related desynchronization reflects release of inhibition associated with complex spreading activation. www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16887192

    Brain oscillations in opioid dependent patients. : EEG of patients with opioid dependence show increased relative beta activity and right-sided dominance among other effects. www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16890339

    Effect of gender on outcomes following traumatic brain injury : Females are nearly twice as likely as males to die of brain injury. www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16906701

    Transcranial magnetic stimulation in treatment of depressive relapse. : Repetitive transcranial magnetic stimulation is effective in remediating depressive relapse. www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16911751

    Methylphenidate and cocaine : Methylphenidate was well tolerated by those undergoing cocaine recovery and decreased some of positive subjective effects of cocaine usage. www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16916538

     


     

    Events & Locations

    Upcoming Courses

    A Pathway to Brain Regulation - Neurofeedback helps improve neuroregulation. It's used by health care professionals for ADHD, depression, anxiety disorders, LD, mood disorders, and behavioral problems. This 4-day course, Neurofeedback in a Clinical Practice, provides the basis for using Neurofeedback clinically. - *28 CEs

      4-Day Comprehensive Course Dates (subject to change)
    • Chicago IL Oct 19-22
    • Portland OR Nov 16-19
    • Los Angeles CA Dec 7-10

    Our course is a hands-on experience right from the start. Attendees consistently say this format is a very good way to learn Neurofeedback.

    "Neurofeedback should be viewed as one of the three essential or primary forms of intervention - psychotherapy, psychopharmacology, and Neurofeedback. In my experience, neurofeedback is every bit as important and powerful as the other two forms of treatment." - Dr. Laurence Hirshberg, Brown University Medical School, psychologist specializing in Developmental Disorders and Autism.

    Contact Karie Kramer, our training coordinator, for more information 818-789-3456 ext 847 or see www.eegspectrum.com/Training

    * EEG Spectrum International, Inc. is approved by the APA to offer continuing education to psychologists. ESII maintains responsibility for the program.

    Conferences for Neurofeedback Clinicians & Researchers

    CONFERENCELOCATIONDATES
    ISNR - www.isnr.orgAtlanta GASep 7-10


     

    Last Word

    Somewhere over New York

    Most years the ISNR conference takes place on the 2nd weekend of September which means that we are often scurrying through airports on the day of September 11th, Patriot Day. I was in the air on the first anniversary of the World Trade Center and Pentagon attacks and I was in the air this anniversary and it gave me time to pause and reflect on the type of mind that could convince itself that an act of homicidal suicide could somehow benefit him and his family.

    Suicidal terrorism is like taking your sister to the prom -- anyone can do it but what have you accomplished? Longer lines at airports while reducing financial and social opportunities for your children? Terrorism requires almost no investment by the organizing body; just a few older men convincing younger less invested men to act on beliefs which they themselves have never fully acted upon. I’ve heard it said that all fanatics are converts, and perhaps disposing of one’s life on an unverifiable promise takes a special narrowness of thought only acquired during conversion. But where in the brain do such thoughts of suicide lie? Where do they hide? During the ISNR conference a few of us discussed the idea of spiritual neuroscience, a field of investigation into matters of connection to the One and the Infinite, and I asked one of my friends whether spirituality could ever be bad, ever be negative, as emotions possess positive and negative valence. We did not come up with a definitive answer, but considering the spiritual justification of homicide throughout humankind’s history, we should not traipse into this field of investigation naively or with a presumed positive outcome. Spirituality may be as dark as humankind. Even if its origins are outside of the brain, and that is the primary question for this field, the brain is where its impetus are interpreted and acted upon and where all its imperfections will come to light.

    The issue of suicide is where clinical neuroscience, neurotherapy and its like, and any spiritual neuroscience must meet. Four centuries ago the Earl of Oxford, in his most autobiographical of plays, thoroughly summed up the issues surrounding why the vast majority of people do not turn off the present light for a pledge of future brilliance.

    "To grunt and sweat under a weary life, But that the dread of something after death, The undiscover'd country from whose bourn No traveller returns, puzzles the will And makes us rather bear those ills we have Than fly to others that we know not of?"

    To fly to others that we know not of? To fly into a building.

    I use to tell my students that if they wished to save the world, figure out how to control nuclear fusion, provide humanity with endless power. But I was young and naïve then and realize now how endless power would only lead to our annihilation until we can figure out the meaning of life, or better put, why some find meaning in life and some do not.

    Clinical neuroscience may not reveal the undiscovered country, but it should reduce the ills we bear and illuminate the mysteries of mental health.

    David A. Kaiser,
    September 11, 2006
    Somewhere over New York ---