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October 4, 2010
NeurofeedbackGains Popularity andLabAttention
Yousit in a chair, facing a computerscr...
works,that peoplecanchangebrain activity,”he said.“The big questions we stillhaven’t answeredare
precisely howit works and...
Dr. NormanDoidge,a psychiatristattheCenterforPsychoanalyticTrainingand Researchat Columbia
and the authorof“TheBrainThat C...
The equipment, which costs $1,800,is advertisedas “asophisticatedadvancement ofneurofeedback.”Mr.
Freersays his clients in...
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October 4, 2010 Neurofeedback Gains Popularity and Lab Attention ...


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October 4, 2010 Neurofeedback Gains Popularity and Lab Attention ...

  1. 1. 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 flora. 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 popularity. 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
  2. 2. 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 and medication. 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 with humans. 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 exploreneurofeedback’s potentialbenefits. 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.
  3. 3. 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 parents. 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 report remarkableimprovements. “Today I’dsay hehas ‘autismlight,’ ” he added. “He stillhas some symptoms,but he is much more manageable.” 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 and more.” 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 behavior.
  4. 4. 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.”