History and Applications Neurotherapy History and Applications

What is neurofeedback/neurotherapy? Neurofeedback uses EEG to provide feedback in the form of games/other stimuli Neurotherapy is the use of the EEG to resolve symptoms

History of neurotherapy Pavlov: 1880’s classical conditioning Early 1940’s: Jasper and Shagass 1962: Sterman, et. al: classical conditioning of the EEG using auditory signal 1968: Sterman initiation of what we now call neruotherapy reinforcing SMR in cats

Who benefits from neurotherapy Can’t everyone benefit from an improved brain? Peak performance training Assessment guided neurotherapy

Assessment for effective neurotherapy Biology Psychological Social QEEG On-going assessment: session to session and in session

Assessing the EEG The wave states are not independent Dynamic and interactive

Delta 1-4 hz Commonly associated with sleep Predominant frequency in infants Can indicate TBI Inattention

Theta 4-7 hz Present sinusoidal, rhythmic/arrhythmic Creativity and spontaneity Inattention

Alpha 8-12 or 8-13 hz. Inner calm High anterior amplitudes associated with daydreaming and depression in children Depression commonly correlated with increased left frontal alpha

Sensorimotor rhythm 12-15 or 12-16hz. May reflect being internally oriented One paper indicates 56% of kids with ADHD have excessive SMR (Gurner)

Beta “any rhythmic activity >13hz”. People with excessive beta: on edge Out of session self awareness strategies

High Beta 20-32hz. A marker for many disorders

Gamma 40hz. Found during problem solving Lacking in learning disorders

Treatment considerations Sleep Diagnostic signatures; fired and wired

Treatment Barriers Effect is not immediate Treatment requires consistent attendance

Treatment Positives/Benefits Low side effect profile Usually long lasting effects

Selecting protocols Evidence based practice Trauma: ACES study Sebern Fisher: calming protocols

Attention Assessing arousal Under arousal and inattention Over arousal: over focus, distractibility, impulsivity Executive function Arns meta analysis ADHD a sleep disorder?

Anxiety Obsessive rumination Panic Fear The importance of check ins throughout the day

Depression Unmanaged stress/anxiety Frontal lobe asymmetry

Treatment Sessions and Beyond Identifying target symptoms and triggers Out of session support

Related techniques Trans cranial direct stimulation Heart Rate Variability Commercial products

Recommended readings The Body Keeps Score, Bessel Van Der Kolk Neurofeedback in the Treatment of Developmental Trauma, Sebern Fisher Healing Young Brains: The Neurofeedback Solution, Robert Hill and Eduardo Castro