Neurofeedback

1. Neurofeedback Steele Taylor www.uvm.edu/~jstaylor/UVM/PSYC255.ppt jstaylor@uvm.edu

2. Topics: • Nervous System Fundamentals • Introduction to Mind-Body Axes • Biological Principles of Feedback and EEG • History of Neurofeedback • Classic Applications of Neurofeedback • Future Applications of Feedback-Medicine

3. Organization of the Nervous System Input (afferent) Somatic Sensory Special Sensory Visceral Sensory Processing (interneurons) Triune Processing Centers: 1. Spinal Cord and Brainstem 2. Limbic System 3. Cerebrum (cortex) Output (efferent) Somatic Motor Visceral Motor Glandular Secretions

4. Mind-Body Axes • Neuro-Endocrine • Neuro-Muscular • Neuro-Immunological • Autonomic Nervous System • Neurogenic Analgesia/Hyperalgesia

5. Functional Localizations in the CNS http://www.morphonix.com/software/education/science/brain/game /specimens/images/wet_brain.gif http://www.colorado.edu/intphys/Class/IPHY3730/image/figure5-8.jpg http://img.sparknotes.com/figures/8/865bcf35b080d38c5465f4c2dbea8f0d/brainstem.gif http://www.laesieworks.com/spinal/pict/SpinalCord.jpg http://www.ideachampions.com/weblogs/left-brain-right-brain.jpg

6. http://www.simpsonstrivia.com.ar/simpsons-photos/wallpapers/homer-simpson-wallpaper-brain-1024.jpghttp://www.simpsonstrivia.com.ar/simpsons-photos/wallpapers/homer-simpson-wallpaper-brain-1024.jpg http://blogs.technet.com/blogfiles/tarpara/WindowsLiveWriter/CORRECTIONVistaSearchAnnoyance_125D5/homer%27s%20brain_thumb.png

7. http://www.scholarpedia.org/article/Neurovascular_coupling http://www.alzheimer.ca/english/alzheimer_brain_mini_site/images/02a.jpg http://cortivis.umh.es/Images/fmri_blind.jpg http://cercor.oxfordjournals.org/content/vol12/issue3/images/medium/coverfig.gif

8. The Thalamus • Gateway to the cortex • Filter of Sensory Data • Arousal Regulator • Cortical Pacemaker http://mri.kennedykrieger.org/images/projection4_side1@.jpg http://alpha.furman.edu/~einstein/general/neurodemo/105C.gif

9. Neurobiological Principals of Electroencephalography • Excitatory and Inhibitory Post-Synaptic Potentials (EPSP’s and IPSP’s) • Generated by neurotransmitter activation of ion channels on post-synaptic membrane • The movement of ions across the membrane generates minute electrical currents • The sum of Post-Synaptic Potentials on thousands of neurons in the outer layers of cortex is recorded in the electroencephalogram • The frequency is the cycles per second and is measured in hertz (Hz) • Stronger synchrony leads to higher amplitudes

10. http://people.eku.edu/ritchisong/synaptic_knobs.gif http://www.biogetic.com/img/eeg2.gif http://domino.watson.ibm.com/comm/pr.nsf/pages/rscd.neurons_picd.html/$FILE/Three%20Golden%20Columns_s.bmp http://www.nature.com/npp/journal/v27/n1/images/1395884f2.gif

11. EEG Take Home Message • Frequencies differ across different regions of the cortex • Specific frequencies or bandwidths correspond to certain behavioral states • Frequencies fluctuate within a region • ‘flickering’ in and out of different frequencies • As the EEG inclines towards a certain desired frequency, a rewarding stimulus will be applied by neurofeedback equipment to reinforce that frequency • The Thalamus is the pacemaker, however, due to interconnections of neurons, frequencies can spread to encompass broader areas of cortex (not always desirable)

12. Characteristic Brainwave Patterns • Delta • 0-3 Hz • Deep Sleep, Repair, Problem Solving • Predominates during infancy • Theta • 4-7 Hz • Creativity, Insight, Altered States, Sleep-Wake Transition • Slow wave disorders: foggy thinking, epilepsy, ADHD, coma • Alpha • 8-12 Hz • Calm Alertness, Meditation, Daydreaming • (8-10Hz = slow alpha / 10-12 Hz = relaxed alpha) • Beta • 13-21 Hz • Focused Thought, Sustained Attention, Industrious Behavior • High Beta • 20-30 Hz • Hyperalertness, Anxiety…especially if right beta exceeds left beta • Sensory Motor Rhythm (SMR) • 12-15 Hz within sensory-motor strip • Physically Relaxed, Poised for Action, Calm Vigilance • Gamma • 30-80Hz • Tend to be bursts of cognitive activity, often during difficult tasks • Often deficient in learning disorders and mental retardation

13. What is Feedback-Based Therapy? • Three essential components: • Input • Electrodes: EEG / SEMG • Infrared: Regional Cerebral Blood Flow • Functional MRI: Real Time fMRI • Processing Unit • Filter raw data and amplify • Set to desired bandwidths • May be general or very specific • Percentage goals for simultaneously occurring frequencies • Inhibit Threshold is equivalent to a limbo bar • Reward Threshold is equivalent to a hurdle • Output: The reward must occur at the appropriate time! • Auditory Stimuli • Visual Stimuli

14. Feedback Must Operate Through Mind-Body Axes • Biofeedback operates upon the autonomic and peripheral nervous systems • Skeletal Muscle • Smooth Muscle • Cardiac Muscle • Glands • Neurofeedback is biofeedback for the central nervous system • Brainwave Patterning • Cerebral Blood Flow

15. Applications of Biofeedback • Fecal and Urinary Incontinence • Headache • Bruxism / Temporo-Mandibular Pain • Muscle Spasm • Hypertension • Fibromyalgia • Raynaud’s Syndrome • Tinnitus • Gait Training / Neuromuscular Reeducation • Diabetes Mellitus • Premature Ejaculation

16. History of Neurofeedback • Shamanic Journeying • Drumming at around 4 Hz to propel shaman into a psychedelic trance • Hans Berger • 1929: first EEG recordings • Observed differences between sleep/wake • Barry Sterman • Trained cats to achieve SMR voluntarily • Observed sounder sleep in these cats • 1967: Contracted by US army to research seizures induced by rocket fuel • SMR trained cats were resistant to grand-mal seizures • Later trained humans to achieve SMR 4. Joe Kamiya • Trained his grad students to access alpha at will

17. Why Neurofeedback? • Neurofeedback vs. Pharmacological Agents • Accurate and non-invasive diagnostic measures • Eliminate adverse effects and toxicities • Sustained therapeutic benefit because the healing is self generated and penetrates core dysfunctions • Series sessions followed by ‘booster’ sessions • Neurofeedback vs. ESB Pacemakers • Neurofeedback vs. Psychotherapy • The results are quantifiable • Specific targeting of correlated neurological deficits

18. Classic Applications of Neurofeedback • Alpha / theta training • Basics: • Trauma as well as long-standing anxiety can lead to limbic ‘locking’ with accompanying reductions in specific types of activity and input to the frontal lobes • Reinforce alpha and theta at a ratio appropriate to the therapeutic purpose of the session and the needs of the client • Crossover occurs when theta>alpha • Normally it is difficult to dwell in theta without falling asleep • Alpha/theta programs inhibit delta to avoid this • Hypnogogic: imagery while falling asleep • Hypnopompic: imagery while waking

19. Classic Applications of Neurofeedback • Alpha / theta training • Clinical Applications: • Therapeutic benefit rests in the vivid imagery as well as the self-corrective and intuitive thinking that tends to emerge • PTSD, Anxiety, Depression, Rage, Addiction • ‘Unlock’ the dominant limbic circuits to restore normal information flow and processing between limbic + cortex • Enables resolution of long standing trauma as traumatic memories essentially bubble to the surface for resolution • Described as witnessing the events versus experiencing them vividly and emotionally • Non-Clinical Applications: • Creativity, Insight, Performance

20. Classic Applications of Neurofeedback 2. Beta Training: ADD and ADHD • Biochemical Etiology: • Reduced dopaminergic and noradrenergic innervation of cognitive, attentive and reward centers • To compensate, stimulus seeking behavior is sought out • Benefits of medication are typically medication dependant, typically do not generate actually physiological alterations • Likely underlying deficiencies in cholinergic signalling • Electroencephalic Correlates: • Inappropriate cortical slow wave (theta = alpha) dominance during cognitive activities • Poor SMR • Neurofeedback Protocol: • Reward beta, particularly left hemispheric and SMR

21. Classic Applications of Neurofeedback 2. Beta Training: Epilepsy • Epilepsy represents the invasion of slow (3Hz) and strongly synchronous activity throughout the cortex • Can be partial (absence), or widespread • Strengthen cortical low beta • Strengthen SMR • Net effect is to enhance the seizure threshold

22. Classic Applications of Neurofeedback 2. Beta Training: Performance • Athletes • Musicians • Speakers/Politicians • Medical Professionals

23. The Future of Feedback Medicine • Real-Time Functional MRI (fMRI) • Christopher DeCharms project • Participant can observe functional MRI in real time to alter their neurological activity • Based on known structure-function relationships in the brain • Immediate applications are for chronic pain management, but the possibilities are endless http://futurefeeder.com/wp-content/IImages/fMRI.jpg

24. The Future of Feedback Medicine 2. Virtual Reality • Real-time monitoring of biochemical markers as patient engages in a game or task

25. Further Reading • Demos, John. Getting Started With Neurofeedback. 2005 • Robbins, Jim. A Symphony in the Brain. 2000 • Schwartz MS and Andrasik F (editors). Biofeedback: A Practitioner’s Guide. 2003 • Castaneda, Carlos. The Art of Dreaming.

26. Your New Heroes • Hans Berger • Barry Sterman • Joe Kamiya • Margaret Ayers • Michael Tansey • Joel Lubar • Eugene Peniston • Christopher DeCharms

27. Websites • www.neurocybernetics.com • www.heartmath.com • www.omneuron.com • www.lumosity.com • http://www.ted.com/index.php/talks/christopher_decharms_scans_the_brain_in_real_time.html