Neurofeedback Steele Taylor jstaylor/UVM/PSYC255.ppt [email protected].

Neurofeedback

Steele Taylorwww.uvm.edu/~jstaylor/UVM/PSYC255.ppt

[email protected]

Topics:

1. Nervous System Fundamentals

2. Introduction to Mind-Body Axes

3. Biological Principles of Feedback and EEG

4. History of Neurofeedback

5. Classic Applications of Neurofeedback

6. Future Applications of Feedback-Medicine

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

Mind-Body Axes

1. Neuro-Endocrine

2. Neuro-Muscular

3. Neuro-Immunological

4. Autonomic Nervous System

5. Neurogenic Analgesia/Hyperalgesia

Functional Localizations in the CNS

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The Thalamus

• Gateway to the cortex

• Filter of Sensory Data

• Arousal Regulator

• Cortical Pacemaker

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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

http://people.eku.edu/ritchisong/synaptic_knobs.gif

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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)

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

What is Feedback-Based Therapy?• Three essential components:

1. Input 1. Electrodes: EEG / SEMG2. Infrared: Regional Cerebral Blood Flow3. Functional MRI: Real Time fMRI

2. Processing Unit1. Filter raw data and amplify2. Set to desired bandwidths

1. May be general or very specific 1. Percentage goals for simultaneously occurring frequencies

3. Inhibit Threshold is equivalent to a limbo bar4. Reward Threshold is equivalent to a hurdle

3. Output: The reward must occur at the appropriate time!1. Auditory Stimuli2. Visual Stimuli

Feedback Must Operate Through Mind-Body Axes

1. Biofeedback operates upon the autonomic and peripheral nervous systems

1. Skeletal Muscle2. Smooth Muscle3. Cardiac Muscle4. Glands

2. Neurofeedback is biofeedback for the central nervous system

1. Brainwave Patterning2. Cerebral Blood Flow

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

History of Neurofeedback

1. Shamanic Journeying• Drumming at around 4 Hz to propel shaman into a psychedelic

trance

2. Hans Berger– 1929: first EEG recordings– Observed differences between sleep/wake

3. 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

Why Neurofeedback?1. Neurofeedback vs. Pharmacological Agents

1. Accurate and non-invasive diagnostic measures

2. Eliminate adverse effects and toxicities

3. Sustained therapeutic benefit because the healing is self generated and penetrates core dysfunctions

1. Series sessions followed by ‘booster’ sessions

2. Neurofeedback vs. ESB Pacemakers

3. Neurofeedback vs. Psychotherapy1. The results are quantifiable

2. Specific targeting of correlated neurological deficits

Classic Applications of Neurofeedback1. 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

Classic Applications of Neurofeedback1. 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

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

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

Classic Applications of Neurofeedback

2. Beta Training: Performance

• Athletes

• Musicians

• Speakers/Politicians

• Medical Professionals

The Future of Feedback Medicine

1. 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

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The Future of Feedback Medicine

2. Virtual Reality1. Real-time monitoring of biochemical markers

as patient engages in a game or task

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.

Your New Heroes

• Hans Berger• Barry Sterman• Joe Kamiya• Margaret Ayers• Michael Tansey• Joel Lubar• Eugene Peniston• Christopher DeCharms

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