Neurofeedback (neurotherapy)

Neurofeedback, also known as neurotherapy, is a form of treatment in which the patient is taught to regulate brain activity to achieve a desired result. Brain activity is mapped through electroencephalography, and areas of high and low function are noted by trained medical professionals. This information is used to identify areas that need to function in a different manner to control the patient's condition. Over the course of a number of sessions, the patient is taught how to make these changes. Experts differ over the effectiveness of neurofeedback. However, some see great potential for treating a variety of conditions, including depression, anxiety, post-traumatic stress disorder (PTSD), attention deficit hyperactivity disorder (ADHD), autism, concussions, tinnitus, drug addiction, learning disabilities, and epilepsy.

Background

The cells in the brain communicate with the rest of the body through a series of electrical impulses. Detecting and mapping these impulses can give physicians a picture of how the brain is functioning. The test that is used to do this is called an electroencephalogram, or EEG.

An EEG is a noninvasive test with no known side effects. The patient wears a special cap that fits close to the head, and the head is usually coated with a special gel that helps make it easier to collect the electrical impulses. Sometimes small adhesive pads connected to wires are attached directly to the patient's scalp instead.

The patient then rests in a comfortable position while the EEG device collects the electrical impulses. An attendant may ask the patient questions or provide other stimuli to help trigger activity in certain areas of the brain that are affected by the patient's condition. The resulting brain impulses are mapped as a series of wavy lines that go up and down like the peaks and valleys of a mountain range. In some cases, physicians may also use other brain imaging techniques, such as magnetic resonance imaging (MRI), to supplement the EEG readings. This also helps the physician see what areas of a patient's brain are reacting or not reacting as they should.

EEGs have been used as a diagnostic tool since the 1920s. On July 6, 1924, German psychiatrist Hans Berger conducted the first EEG on the brain of a seventeen-year-old boy who was undergoing brain surgery. His findings were published five years later, but were not widely accepted until the 1940s. During the 1950s, it was discovered that both animals and people could be trained to alter their brain waves to minimize the incidence of epileptic seizures. These seizures, which occur when electrical impulses in the brain misfire, can be controlled by altering the types of brain waves most associated with the seizures.

The idea of using an EEG as a tool in biofeedback arose several decades later. Biofeedback is a technique in which a person is trained to control bodily functions that are not normally consciously controlled. This is done by monitoring certain physical responses, such as breathing, muscle contractions, sweat, or skin temperature, and teaching the person skills that will help alter these responses. For instance, a person can be taught to recognize the signs that the heart rate is rising along with breathing and relaxation techniques that will help slow the heart rate.

Overview

Neurofeedback, or neurotherapy, is a form of biofeedback; the technique is sometimes called neurobiofeedback. All varieties of biofeedback use some form of technology to monitor a person's condition. The readings gathered through this monitoring are then used to help the person adjust or change the condition. Neurofeedback is the form of biofeedback that uses the brain waves from an EEG to direct the course of therapy.

During the 1960s and 1970s, there was a great deal of interest in using neurofeedback to monitor and deepen meditative trances by increasing the amount of brain waves known as alpha waves. It was widely believed that the techniques could help intensify the trance state and bring about greater enlightenment, which was seen as highly desirable. In the 1980s and 1990s, experts in human psychology began debunking these claims. They noted that the presence of alpha waves did not necessarily mean they were responsible for the intensity of a meditative state.

In the decades since, the idea of using neurofeedback to help with a number of physical and mental health conditions has grown. The technique continued to be used to control seizures in epileptic individuals, but it also gained increased attention as a way to help control the behaviors associated with attention deficit hyperactivity disorder (ADHD). This condition, which affects about 11 percent of all children from ages four to seventeen and can affect adults as well, often causes patients to act impulsively and have difficulty paying attention and focusing. It is treated with medications, which often have undesirable side effects.

Some physicians and parents have opted to treat the condition with neurofeedback. First, the patient's brain is mapped using the cap and electrodes to identify the areas of the brain that are either over or under normal levels of activity. The patient is then trained to change these levels. This is usually done by having the patient play a video game or watch a movie that only advances when the patient activates the appropriate areas of the brain. With practice, this grows easier. Some patients can reduce or eliminate medication use. Experts are divided on whether the results last; some believe it is only a placebo effect that results from the patient having the attention of the people administering the treatments. However, for families who have seen improvement in the patient, the treatment is viewed as a great benefit regardless of why it worked.

Neurofeedback treatment is relatively expensive, costing more than $100 per session and with two to three dozen sessions necessary to achieve results. Some doubt the ability of neurofeedback to have long-lasting effects once treatment is stopped. Others see promise in the technique for treating not only epilepsy and ADHD but also any condition that involves the activity of brain cells.

Bibliography

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"Neurofeedback Shows Promise in Treating Tinnitus." Science Daily, 27 Nov. 2017, www.sciencedaily.com/releases/2017/11/171127091127.htm. Accessed 8 Feb. 2018.

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