NeuroFeedback-NeuroTherapy
"The brain is wider than the sky."
— Emily Dickinson
The involvement of real-time monitoring of brainwave activity to provide individuals with info about their brain functions is referred as Neurofeedback, also known as EEG biofeedback or neuro therapy.
This Subject has been studied for several decades. (1)
In the simplest term neurofeedback can be defined as the method which assists individuals to control their brain waves consciously.
As discussed in the binaural beats paper each frequency has a particular physiological function. So we know that EEG signal observes the delta waves when a person is asleep, theta waves when a person is sleepy, alpha waves when a person’s muscles are loose and is relaxed but they are awake, beta waves appear when a person is alert and gamma waves are observed in problem solving tasks. Positive behavioral outcomes, such as the relief of symptoms associated with psychiatric diseases or the enhancement of particular cognitive abilities in healthy individuals, have been demonstrated to be triggered by neurofeedback. The ability of subjects to learn throughout their lives and brain plasticity mechanisms are necessary for these good behavioral outcomes.(1)(2)
Neurofeedback treatment protocols mainly focus on the alpha,beta,delta,theta and gamma treatment or could be a combination of alpha/theta ratio, beta/theta ratio, etc.
The most commonly used protocols are the alpha/theta ratio, alpha, beta and theta.
EEG, the electrical activity of the brain can be recorded by the placement of electrodes around the scalp.
Neurofeedback is a type of therapy that uses real-time data, usually electrical data in the form of eggs, to supposedly teach one to regulate their brainwave patterns.
The band or electrodes placed on the head monitor different parts of the brain, depending on where they're placed. Then, through audio or visual feedback, patients can see how their brain reacts to different prompts that a therapist or practitioner gives them. (3)
HISTORY
Edward Thorndike developed the law of effect in 1898. He postulated in his writings that consequences, whether pleasant or unpleasant, influence conduct.(8) The basis for operant conditioning was established by this. Using a ballistic galvanometer, German psychiatrist Hans Berger discovered a tiny current in 1924 after attaching many electrodes to a patient's scalp. Berger investigated EEGs qualitatively in his later study, but G. Dietsch became the first researcher to apply quantitative EEG (QEEG) in 1932, when he applied Fourier analysis to seven EEG data. Neal E. Miller of Yale University succeeded in teaching mice to control the frequency of their heartbeats in 1950. He went on to work with humans later on, instructing them via aural feedback.
Joe Kamiya published the first study to show neurofeedback in 1962. Two components made up Kamiya's experiment: In the first section, participants were asked to close their eyes and indicate whether they were feeling alpha waves while a tone was emitted. At first, the subject would estimate the states accurately roughly 50% of the time, but some individuals would ultimately improve their capacity to discriminate between states.
Cats were trained by M. Barry Sterman to alter their EEG patterns in order to show more of the so-called sensorimotor rhythm (SMR). This research was published by him in 1967. (7) .Subsequently, Sterman found that the SMR-trained cats showed significantly greater resistance to epileptic seizures than the non-trained cats did when exposed to the convulsant drug monomethylhydrazine.He documented comparable outcomes with an epileptic patient in 1971 whose seizures were managed with SMR training. Joel Lubar made contributions to the field of EEG biofeedback research, initially focusing on epilepsy and then moving on to hyperactivity and ADHD.Ming-Yang Cheng made significant contributions to the field of EEG neurofeedback research, focusing on improving SMR power in expert golfers. (6)
TYPES
Different types of frequencies represent different types of brain functions or reactions.
For each sort, the cathodes connected to the skin search for specific mind frequencies — which is fundamentally the speed at which brain waves are being produced — that can show how an individual is responding.
Frequency/Power Neurofeedback
This is the most simple and common type of therapy, and it's sometimes even referred to as "surface neurofeedback." It involves attaching two to four electrodes to the head to detect frequencies related to ADHD, anxiety, and insomnia.(16)
Slow Cortical Potential Neurofeedback (SCP-NF)
This type of therapy aims to help people dealing with ADHD, epilepsy, and migraines. It has even been tested in children who have ADHD as a potential alternative to pharmacological solutions. (15)
Low-Energy Neurofeedback System (LENS)
In addition to helping people with hyperactive disorders, neurofeedback can also help those with low energy. This type of therapy aims to change the patient's brain waves while lying motionless with their eyes closed. It's been used to help people with insomnia, fibromyalgia, restless legs syndrome, anxiety, depression, and anger.
This type of therapy doesn't require any conscious effort from the patient. This type works by attaching the electrodes to the head. This identifies the areas where brain activity is low.
The electrodes then emit really low magnetic field frequencies that, over time, can potentially change how the brain functions. (14)
Hemoencephalography (HEG) Neurofeedback
This type of neurofeedback therapy is for people who have terrible migraines. The electrodes show where the blood flow is in the brain and work to use this information to increase blood flow and reduce the pain or reoccurrence of migraines. (13)
Live Z-score Neurofeedback
This type of neurofeedback is for people who have insomnia. According to one case study, it even improved a group's symptoms after 15 sessions that were 20-minutes each. (10)
Low-Resolution Electromagnetic Tomography (LORE-TA)
This therapy requires 19 electrode attachments, and that's because it's monitoring the brain for particular brain activities pertaining to obsessive-compulsive disorder, addiction, and depression. This type of therapy has revealed lots of intricate details about the inner workings of the brains of people with an addiction. (11)
Functional Magnetic Resonance Imaging (fMRI)
This is still a method of neurofeedback therapy that is the most research-based. It's using electrodes to map out the inner workings of the brain. (https://www.radiologyinfo.org/en/info/fmribrain#:~:text=Functional%20magnetic%20resonance%20imaging%20(fMRI,or%20to%20guide%20brain%20treatment.)
OPERANT CONDITIONING
Operant conditioning, sometimes referred to as instrumental conditioning, is a method of learning that employs rewards and punishments for behavior. Through operant conditioning, an association is made between a behavior and a consequence (whether negative or positive) for that behavior. For example, when lab rats press a lever when a green light is on, they receive a food pellet as a reward. When they press the lever when a red light is on, they receive a mild electric shock. As a result, they learn to press the lever when the green light is on and avoid the red light. But operant conditioning is not just something that takes place in experimental settings while training lab animals. It also plays a powerful role in everyday learning. Reinforcement and punishment take place in natural settings all the time, as well as in more structured settings such as classrooms or therapy sessions. (4)
One of the main challenges of substance use disorders is regulating temptation and cravings for substances in affected individuals. Neurofeedback research studies have shown that neurofeedback can decrease cravings and improve overall well being. Specifically, well-controlled intervention studies using EEG neurofeedback demonstrated positive outcomes such as good adherence, reduced addiction severity, and psychological benefits.(4)
Consequences can strengthen a behavior, which is a bedrock principle of modern psychology. It is known, that rewards are great for changing behavior
NEURAL PLASTICITY
The way that our brain is structured and therefore how it functions is always changing and adapting to what life demands of us.
A 2010 study discovered evidence linking brainwave training to modifications in the structure and function of the brain. The study found that after practicing brain rhythm control for 30 minutes, participants' brain cell interactions and functions changed over time. Following the neurofeedback training, the brain's responsiveness to transcranial magnetic stimulation (TMS) dramatically increased, according to the researchers. This prolonged increased reaction lasted for twenty minutes or more and was associated with EEG patterns suggesting activity-dependent alterations in the brain.
Neuroplasticity, also known as neural plasticity or brain plasticity, is a process that involves adaptive structural and functional changes to the brain. It is defined as the ability of the nervous system to change its activity in response to intrinsic or extrinsic stimuli by reorganizing its structure, functions, or connections after injuries, such as a stroke or traumatic brain injury (TBI). This activity describes neuroplasticity, the evaluation and management of neuroplasticity, and reviews the role of the interprofessional team in improving care for patients (9)
Neurofeedback relies heavily on both of them. The reasoning being that if people are rewarded for the behavior or EEG Pattern (Like calming down from an anxious state or concentrating better), a Lasting change to the neural pathways can be observed that make them easier to achieve. During a Neurofeedback session, readings of electrical brain activity are analyzed as they happen, and feedback is given to the patient on whether or not those patterns look normal.
Note that there is a lot of natural variation in what a ‘normal’ brain wave is. So neurofeedback practitioners have a subjective standard here. In theory this can help the patient pinpoint the ‘abnormal’ brain waves in check.
For example, if a patient is going through treatment for anxiety they can actively try to alter their brainwaves through focusing,relaxation or whatever helps them look more ‘typical’ if they manage it they get a ‘reward’ like treating themselves with their favorite food.
Using this system of feedback and rewards, practitioners say they can train people’s brain activity to be in line with supposedly ‘normal’ brain waves.
This is supposed to resolve symptoms of disorders such as ADHD, schizophrenia, depression and more.
Some Meta-Analyses which look at Data from across several studies to spot trends, say its effective, But others Don’t
One review from 2016 can help us understand the situation. 30 studies were identified with a total of 1171 participants that met their criteria of being scientifically sound. Participants were randomized into experimental or control groups, and that both participants and experimenters were blind to which experimental condition they were in.
Overall, the review of these 30 studies found mixed results. Many of the studies showed that neurofeedback had some effect, but the researchers found serious limitations throughout the entire body of the research. The method used in a lot of the studies were not as rigorous as they needed to be to suggest neurofeedback had any feedback.
While some patients seem to find relief via neurofeedback, that does not necessarily mean that neurofeedback affects people in the way we think it might. Some scientists raise issues with the fact that neurofeedback practitioners might be targeting certain eeg variations that do not have much to do with the conditions they aim to treat. After all, EEG patterns differ from person to person. Two people’s patterns may not match each other, but that doesn't make one of them abnormal. Critics argue that when there is a shift in a patient's condition or eeg after neurofeedback, it might just be the result of the patient being conditioned to relax or refocus their attention. There is no reason to think that some supposed problem with their brainwaves has actually been fixed. If the patient feels better about their condition, that is positive but that still does not constitute that neurofeedback is doing what its backers say it is doing. Even if it helps people somehow we need to know whether it works the way they claim. For neuro feedback to really come on its own as an evidence based therapy its practitioners will need to address all these concerts, with an improvement in the study designs, showcasing the atypical eeg and then show that training those patterns improves the conditions they’re supposedly associated with.
Meditation and NeuroFeedback
CASE STUDIES
In a district of Suzhou City, China, a creative undertaking headed by Granny Han has the potential to teach us the immense benefits of neurofeedback on special education students. The idea of providing more personalized education that can meet the unique needs of her own grandson who had suffered a very severe brain injury (that led to his low IQ) was the source of inspiration that motivated Granny Han to set up the school with the aim of enabling other children with similar challenges. The school, which started with 5 students, has developed, attracting the attention from the local government and the International Red Cross, as well as the Amity Foundation. In the same year, UNESCO financed the building of a modern facility, which is going to be one of the first special education schools modeled after UNESCO standards. Nowadays, this school addresses 135 students and has got reputations on upcoming national levels for its higher educational standards.
Multiple Cases Studies with the Neurofeedback Application as the Main Focus.
Many pupils in Granny Han’s school have demonstrated the power of neurofeedback through how much they have grown this school year. Through the neurofeedback sessions usually carried out since 2010, Little Moon was an autistic child. Within this short, three month period, she demonstrated a set of new skills. These included the improved focus, social interaction, and academic performance; the change was from being a formerly withdrawn student to now being an active one. When he started having neurofeedback in December 2010, his math skills improved immensely and he joined the 3-kilometer run club within just one year. Mr. Lee Chung Shau who was afflicted with concentration failures considers that the solution to his problems was the neurofeedback treatment which increased his logical thinking, personal independence, and academic achievements after six months of the therapy.
Methodological Aspects and Practical Use of Neurofeedback
Neurofeedback uses sensors placed on the scalp and ear to measure brainwave activity through which it optimizes the feedback given to the user. This technique is called EEG, it is non-invasive, and is based on brain activity monitoring giving the necessary feedback, which enhances desirable brainwave patterns. As an instance, in autistic children, neurofeedback works on the mains function which is an excessive brainwave activity at particular areas and leads to behavioral and cognitive improvements. Through displaying qEEG (quantitative EEG) mapping information, we get more accurate targeting and better assess areas where brainwave activity is atypical.
Conclusion and Future Potential
It is this success that comes out of Granny Han’s kindergarten, the proof of NF as an effective tool turning the life of special-needs children drastically better. Since the brain is now forced to control itself, neurofeedback is now a major contributor to the changes that students make in terms of their advancement in cognitive and behavior development. This approach appears not only transformative for special education; it does also make the lives of those who suffer from neurological problems better in the global context.
Certain EEG-derived features have been linked to symptoms of cognitive decline, such as poor cognitive performance, as well as to brain structural alterations that are associated with dementia, including atrophy of the thalamus, hippocampus, and basal ganglia, as well as the formation of amyloid-beta plaques. According to research studies, there's increasing evidence of neurofeedback improving cognitive function and reducing cognitive decline in Alzheimer's disease (AD), the most common form of dementia, mild cognitive impairment (MCI), a pre-dementia condition, as well as in conditions such as stroke and multiple sclerosis
When there is an imbalance in brain wave activity, such as increased left frontal alpha (8-12 Hz), suggesting less activation and an inability to regulate the subcortical regions that play a role in emotion processing, a physiological predisposition for depression occurs. According to research, two neurofeedback protocols (alpha asymmetry protocol and enhancing beta/inhibiting theta or alpha at C3) can modify this suboptimal brain state. (17)
SIDE EFFECTS
In general, neurofeedback treatment is regarded as a low-risk and safe procedure. According to one study, fatigue and headset discomfort were the most frequent adverse effects. However, veterans with traumatic brain injury, chronic pain, and post-traumatic stress disorder (PTSD) said that the drowsiness was a good side effect because it improved their ability to sleep. Adverse effects of the therapy may include agitation, cognitive interference, anxiety, impatience, and hostility, according to studies that tried it on individuals with depression and central nervous system impairment. Aside from Side effects, there is a chance that neurofeedback therapy won't work for you or that its benefits won't last, which could result in a waste of time and money. Its usefulness is also debatable.
There is also the risk of receiving therapy from an unqualified individual. Dr. Carney warns that someone who is not well versed in behavioral health conditions “could miss important diagnostic or risk concerns such as triggering suicidal ideation or behaviors.” (18)
REFERENCES
[1]Neurofeedback: A Comprehensive Review on System Design, Methodology and Clinical Applications
[2]Alpha Waves and Sleep
[3]Neurofeedback Therapy: Definition, Techniques, and Efficacy
[6][Neurofeedback History and Development - Brainworks](https://brainworksneurotherapy.com/neurofeedback-history-and-development/#:~:text=Neurofeedback%20began%20in%20the%20late,to%20alter%20their%20brain%20activity.)
[7][Spotlight on Dr. Barry Sterman: The Beginnings of Neurofeedback](https://www.advancedneurotherapy.com/blog/2015/01/15/neurofeedback-sterman-neuroscience)
[8][The Law of Effect in Psychology](https://www.verywellmind.com/what-is-the-law-of-effect-2795331#:~:text=Thorndike%20termed%20this%20the%20%E2%80%9CLaw,less%20likely%20to%20be%20repeated.)
[11][Low Resolution Brain Electromagnetic Tomography - an overview | ScienceDirect Topics](https://www.sciencedirect.com/topics/medicine-and-dentistry/low-resolution-brain-electromagnetic-tomography)
[12][Functional MRI (fMRI) of the brain](https://www.radiologyinfo.org/en/info/fmribrain#:~:text=Functional%20magnetic%20resonance%20imaging%20(fMRI,or%20to%20guide%20brain%20treatment.)
[17][Neurofeedback And Beyond: Exploring The Future Of Brain Training](https://www.familytimecenters.com/blog-post/neurofeedback-and-beyond-exploring-the-future-of-brain-training#:~:text=The%20future%20of%20neurofeedback%20and,to%20optimize%20their%20cognitive%20performance.)
[18][Neurofeedback Therapy | Renewal Behavioral Health](https://montarebehavioralhealth.com/blog/neurofeedback/#:~:text=Just%20like%20any%20other%20type,fatigue%20is%20felt%20is%20different.)