October 4, 2010 Neurofeedback Gains Popularity and Lab Attention ...
October 4, 2010
NeurofeedbackGains Popularity andLabAttention
By KATHERINE ELLISON
Yousit in a chair, facing a computerscreen,while a clinician sticks electrodesto yourscalp witha viscous goop
that takes days to washout ofyourhair. Wires from the sensors connect to a computerprogrammedto
respondto yourbrain’s activity.
Try to relaxand focus.If yourbrain behaves as desired,you’ll be encouragedwith soothingsounds and visual
treats,likeimages ofexplodingstars ora floweringfield.If not,you’llget silence,a darkening screenand wilting
This is neurofeedback,a kind of biofeedbackforthe brain, which practitionerssay canaddress a host of
neurologicalills — amongthem attentiondeficit hyperactivity disorder,autism,depressionandanxiety — by
allowingpatients toaltertheirownbrainwaves through practice andrepetition.
The procedureis controversial,expensiveandtime-consuming.An average course oftreatment,withat least
30 sessions,cancost $3,000 ormore,andfew healthinsurers will pay forit. Still,it appears tobe growingin
Cynthia Kerson,executivedirectorofthe InternationalSocietyforNeurofeedbackandResearch,an
advocacy group forpractitioners,estimates that7,500mentalhealthprofessionalsinthe UnitedStates now
offerneurofeedbackand that morethan100,000 Americans have triedit overthe past decade.
The treatment is also gainingattentionfrommainstreamresearchers,including some formerskeptics.The
NationalInstituteofMentalHealthrecentlysponsoredits first study ofneurofeedbackforA.D.H.D.: a
randomized, controlledtrialof36 subjects.
The results areto beannounced Oct.26 at the annual meetingofthe AmericanAcademy ofChild and
Adolescent Psychiatry.Inaninterviewin the summer, the study’s director,Dr.L. Eugene Arnold,an emeritus
professorofpsychiatryat Ohio State,notedthat there hadbeen“quite a bit of improvement”in many of the
children’s behavior, as reportedby parents andteachers.
Dr. Arnoldsaid that ifthe results boreout that neurofeedbackwas makingthe difference,he would seek
financing fora broaderstudy,with as many as 100 subjects.
John Kounios,a professorofpsychology atDrexelUniversity,publisheda smallstudy in 2007 suggesting
that thetreatment speededcognitiveprocessinginelderly people.“There’s no questionthat neurofeedback
works,that peoplecanchangebrain activity,”he said.“The big questions we stillhaven’t answeredare
precisely howit works and how it can be harnessedto treat disorders.”
RussellA. Barkley,a professorofpsychiatryat the MedicalUniversityofSouthCarolina and a leading
authority onattentionproblems,has longdismissedclaims that neurofeedbackcan help. But Dr.Barkley
says hewas persuadedto takeanotherlookafterDutchscientistspublished an analysis ofrecent
internationalstudies finding significant reductions in impulsiveness and inattention.
Still, Dr.Barkley cautionedthat hehad yet to see credible evidence confirming claims that such benefits can
be longlasting,much less permanent.
And anothermainstreamexpert is much more disapproving.WilliamE.Pelham Jr., directorofthe Centerfor
Children and Families at Florida InternationalUniversity,calledneurofeedback“crackpotcharlatanism.”He
warned that exaggeratedclaims forit might leadparents to favorit overprovenoptions like behavioraltherapy
Neurofeedbackwas developedinthe 1960s and’70s,withAmericanresearchers leadingthe way.In1968,
M. Barry Sterman,a neuroscientist at the University ofCalifornia,Los Angeles,reportedthat thetraining
helpedcats resist epileptic seizures.Dr.Stermanand others laterclaimedto have achievedsimilarbenefits
The findings prompteda boomlet ofinterestinwhich clinicians of varyingdegrees ofrespectabilityjumped
into thefield, making many unsupportedclaims about seemingmiracle cures and taintingthe treatment’s
reputationamongacademicexperts.Meanwhile,researchers inGermany and the Netherlands continuedto
A major attractionofthetechnique is thehope that it canhelp patients avoiddrugs,which oftenhave side
effects.Instead,patients practiceroutines thatseemmore like exercisinga muscle.
Braincells communicate with oneanother,in part,througha constant stormofelectricalimpulses.Their
patterns showup onan electroencephalogram,orEEG,as brain waves withdifferent frequencies.
Neurofeedbackpractitioners saypeople have problems whentheirbrain wave frequencies aren’t suitedfor
thetaskat hand, or when parts ofthebrain aren’t communicating adequately withotherparts.Theseissues,
they say,canbe representedona “brainmap,” the initial EEGreadings that serve as a guide fortreatment.
Subsequently, a clinician will help a patient learnto slowdownorspeedup those brainwaves,through a
process knownas operant conditioning.The brain begins by generatingfairly randompatterns,whilethe
computersoftware responds withencouragement wheneverthe activity meetsthe target.
Dr. NormanDoidge,a psychiatristattheCenterforPsychoanalyticTrainingand Researchat Columbia
and the authorof“TheBrainThat Changes Itself”(Viking,2007),saidhe consideredneurofeedback“a
powerfulstabilizerofthebrain.” Practitionersmake evenmore enthusiasticclaims.Robert Coben,a
neuropsychologistinMassapequa Park,N.Y.,saidhe had treatedmore than1,000 autisticchildrenoverthe
past sevenyears andhad conducteda clinical study,finding strikingreductions in symptoms,as reportedby
Maureen and TerrenceMagagnos ofLynbrook,N.Y.,tooktheir7-year-oldson,Peter,to Dr.Cobenafter
he was given a diagnosis ofpervasivedevelopmentaldisorderinfirst grade.“He hadclassicsymptoms of
autism,” saidMr. Magagnos.“His speechwas terrible,he made very little eye contact andhe screamedfor
attention— literally screamed.”
Their exceptionally generous insurancecoveredneurofeedback,so they decidedto give it a try,with sessions
twicea week forthenext five years.
At thestart ofthetreatment,Dr.Cobensaid,he discoveredthat Peterhadbeensuffering tiny,
asymptomaticseizures.Hesays neurofeedbackhelpedstabilize the child’s brain activity,eliminatingthe
seizures.And within threemonths,saidMr. Magagnos,a retiredpolice officer,Peter’s teachers werecallingto
“Today I’dsay hehas ‘autismlight,’ ” he added. “He stillhas some symptoms,but he is much more
Whethersuch results canbe achievedwith otherchildren is a matterofdebate.Still,as practitioners lobby for
broaderacceptance,includinginsurance recognition,a sure sign of neurofeedback’s increasingpopularity is
thenumber ofcompanies sellingsupposedly mind-alteringsystems touse at home.
Withnames like SmartBrainTechnologies andthe Learning Curve Inc.,they offerequipment purported,
respectively,to “pump theneurons”and “make lastingchanges inattention, memory,mood,control,pain,sleep
The Foodand DrugAdministrationregulates allbiofeedbackequipment as medicaldevices.The only
approveduse,however,is for “relaxation.”
PeterFreer,a formergrade-schoolteacherwho is chief executive ofa NorthCarolina firmcalledUnique
Logicand Technology,says that sincehebeganhis business in 1994,he has soldseveralthousandof his
“Play Attention”systems,advertisedto improve a child’s focus,behavior, academicperformance and social
The equipment, which costs $1,800,is advertisedas “asophisticatedadvancement ofneurofeedback.”Mr.
Freersays his clients include more than600 schooldistricts.(He adds that his system,as distinct from
“clinical”neurofeedback,aims not to change brain waves but ratherto put the user in an “attentive state”that
makes it easierto learnskills.)Neurofeedbackingeneralis a largely unregulated,with practitioners often
devising theirown protocols about whereonthe scalp to place electrodes.Results vary widely,and
researchers cautionthat it is extremely important tochoose one’s practitionerwithcare.
When it comes to to theactualdevices,Dr.Kerson,at the InternationalSociety forNeurofeedbackand
Research,cautionedthat they shouldneverbe used without experiencedsupervision.
“Oftentimes what peopledo is find a way to get one ofthese machines on eBay anduse it at home,” she said,
adding that unskilled use could interferewith medications orprompt ananxiety attackora seizure.
“Neurofeedbackis a powerfultherapy,”she said, “andshould be treatedthat way.”