Hiya all
Neurofeedback also is helpful for people with seizures. See the book, A
Symphony for the Brain"
mjh

Building Brainpower Neurobiofeedback helps tame the storm for brain injury
patients
FLINT

THE FLINT JOURNAL FIRST EDITION
Monday, January 19, 2004 By Ron Krueger
JOURNAL STAFF WRITER

QUICK FACTS
The cells in an infant brain are like open grassland. As the child learns, is
stimulated and exposed to the world, the grassland begins to sprout thicker
grasses, then small shrubs and trees that are separated from each other. The
trees grow closer larger and closer and branches multiply. Finally, there is a
rich, dense canopy of connected neurons, teeming with life. The richer the
canopy, the more connections there are among the trees, the more fertile the
habitat.-- From A Symphony in the Brain' by Jim Robbins***
Darren sits in a small, darkened room with sensors connected to his scalp.
Before him is a video monitor showing four frequency bars that dance up and
down. The bars reflect the electrical activity on the right and left sides of
the
16-year-old's brain. (Darren is not the youth's real name. The family asked
that his name not be used.) Technician Don Deering instructs the Shiawassee
County teen to relax and focus. "I want him to remain alert but clear his mind,"
Deering says. The goal of the exercise is to help the young man's brain work
better in the aftermath of a brain injury suffered in a September 2002 fall. The
technique is called neurofeedback, neurobiofeedback or EEG biofeedback. By
instantaneously "feeding back" a person's brainwave activity, it is believed she
or he can improve the efficiency of the brain. Darren's mother says it is
working. "I was really scared when they said they wanted to hook his head to
some
computer," she said. "But I can't say enough good about this therapy. It has
given me my son back." When Darren was injured, doctors told his mother he had
suffered a mild brain injury and to watch for symptoms. "He called me from
school one day and told me to come pick him up," she says. "He couldn't remember
his locker combination or where he was supposed to go. He was totally
confused." Over the next months, she says she watched him deteriorate further.
He
suffered headaches, blurred vision, was tense and slept for long periods. "He
slept all the time, then he didn't sleep at all. He was a mess." The scientific
basis of neurofeedback is the electrical activity of the brain. Author Jim
Robbins calls it a "constant electrical storm," but it is little more than a
whisper in terms of voltage and thus hard to measure. The first known
measurements
were made by German psychiatrist Hans Berger in the 1920s. He placed leads on
the head of his teenage son and connected them to a pen trained on a piece of
moving paper. Berger hooked up all kinds of people to his primitive
electroencephalogram - or EEG. He connected his 14-year-old daughter and watched
the pen
jumped when he asked her to divide 196 by 7, says Robbins in "A Symphony in
the Brain" (Atlantic Monthly Press, $24). Further research showed the human
brain operates between 1 and 40 hertz. A hertz is the number of cycles per
second. The higher the hertz, the faster the brain wave. Wave activity was
broken up
into five ranges. A person sleeping normally registers 4 hertz and below. In
a drowsy state, the range is 4 to 8. The expected range for someone who is
relaxed but focused is 8 to 12. For someone who is relaxed but thinking, it is
12-15 and for active thinking, it is 15-18. Nineteen and above indicates
excitement. These ranges have been given Greek letter names: delta and theta for
low
activity, alpha for relaxed focus, beta for active thinking and high beta for
excitement. Later research turned up the 12-15 range ("active thinking") when
sensors were attached to the so-called sensorimotor regions - the parts of the
brain responsible for voluntary movement and processing information from the
skin, muscles, joints and organs. Darren and his family learned about
neurofeedback through Neal Alpiner, an M.D. specializing in rehabilitation. Most
of
his patients have brain injuries. Alpiner last year founded the Neurohealth
Institute with offices in the Hurley Eastside Clinic, 2700 Robert T. Longway
Blvd.
The institute consists of three small rooms for neurofeedback and one each
for innovative vision and auditory therapies. He contracted with Deering to
perform the feedback therapy. Deering, a Ph.D. candidate in psychology, works
with
James White Jr., a Ph.D. psychologist, at the Michigan Institute for
Neurofeedback in Troy. White has been working in neurofeedback for more than a
decade.
Alpiner says neurofeedback is no longer experimental, although some in the
health insurance industry and medical establishment still think that. "Are
physical and occupational therapy experimental? Is speech therapy experimental?"
Alpiner asks. "We use them not because there are lots of expensive studies to
prove they work. We just know they work. It's the same with neurofeedback. Any
program that is serious about brain injury rehabilitation has to offer it."
Darren's headaches and nausea are forms of biofeedback. His brain is telling him
something is wrong. The stethoscope a physician uses to checks a person's
heart and lungs is a biofeedback instrument. Sophisticated neurofeedback
equipment
and software, operated by a trained technician, allows the patient to
suppress inappropriate low-frequency waves and increase the desirable beta
action.
How one does this isn't simple to explain. "It's an unconscious process that
adults usually try to make conscious," Deering said. "It all has to do with
getting that feedback and reacting to it." It is no mystery why brainwave
activity
in a traumatized brain will be disrupted. The effects will show themselves in
an EEG, just as the physical damage will show up in a CT scan or MRI. But why
do abnormal brainwaves occur where there is no visible damage? This is not
precisely known, but neurofeedback experts readily share theories based on their
observations. Robbins says it has to do with the "disregulated" brain.
Genetics, birth trauma and a long list of environmental factors - poor diet,
toxic
metals in the body, overwork, an unhealthy home environment - can stress the
brain into hyper- or underactivity or just plain instability, he writes. He
reports that two neurotherapists, Susan and Siegfried Othmar, insist that the
myriad of brain-related diagnoses - from bipolar disorder, addictions and immune
dysfuction to panic attacks, epilepsy and migraines - can be traced to these
three kinds of brainwave dysfunction. Robbins says research backs the
effectiveness of neurofeedback in treating ADD/ADHD, epilepsy, depression and
mild brain
injuries. It is being used to treat many other conditions with anecdotal
evidence of benefits, he adds. Research into Alzheimer's and dementia supports
the
thesis that maintaining an active, healthy lifestyle and using one's head -
taking classes, learning new skills, even doing crossword puzzles - keeps a
brain healthy. Darren, in his sessions, gets feedback two ways. The dancing bars
on the screen will glow red when his brainwaves are in the desirable range and
gray when they hang in the slow delta-theta range. As long as his waves remain
in the active area, a tone is heard. When they slip, the tone stops. With
their lower boredom threshhold, younger children need more stimulation.
Ten-year-old Nicole Gay of Davison knows her active waves are in charge when a
little
man pushing a wheelbarrow full of gold keeps moving up the mountain. Rob Smith
of Clio, 26, an automotive engineer with a severe brain injury, listens to
soothing music while watching the screen. When he starts to lose focus, the
music
stops. Patients in time become more adept at maintaining appropriate levels,
so Deering adjusts the parameters to challenge them. He also will move the
sensors around on the scalp to reach different areas of the brain. "With
neurofeedback, the brain eventually takes over and maintains the proper levels.
If a
patient slips, we always can do a tune-up, so to speak, to get them back where
they belong." Those patients whom Alpiner thinks might be candidates for
neurofeedback first go to Deering's Troy office for a quantitative EEG. This is
an
in-depth brain "mapping" procedure that tells the therapist which areas of the
brain show the greatest wave abnormalities. This test is far more
sophisticated than the rudimentary EEG used to determine whether individuals are
susceptible to seizures, Deering said. A "QEEG" is not cheap. Deering's clinic
charges
$980 for one. A neurotherapy session is billed at $125 per half-hour. There
is no treatment to repair damaged parts of the brain. But neurofeedback can
make the healthy areas function more efficiently, Deering said. Neurofeedback
has
strengthened the 70 percent of Darren's brain that is undamaged enough after
six months that most symptoms have subsided. "His memory has improved, he
sleeps, his mood is much better and he has very few headaches," said Darren's
mother. "This has done wonders." For Rob Smith, whose injury is much more
severe,
the changes are more subtle, but no less encouraging to his mother, Sharon.
"The neurofeedback has brought him back from someone who was pretty much
unresponsive. He smiles at jokes and has his way of teasing. This means a lot to
us."
It is a treatment once dismissed as the domain of New Age charlatans. Much of
the criticism has fallen away as the technology has improved. But there is a
reservoir of resistance stemming from the fact that most brain research has
been based on brain chemistry, writes Robbins in his book. "Modern neuroscience
is concerned almost entirely with the cellular level, with an emphasis on
drugs to alter chemical flows in the brain," Robbins writes. Neurofeedback also
has suffered because it was nurtured by psychologists rather than traditional
medicine, he adds. James White, Deering's partner, says experience and research
will determine more precisely which ailments can be most effectively be
treated with neurofeedback. "The tradition of prescribing drugs and things like
physical therapy and psychotherapy are limited," he said. "Drugs have side
effects, some disorders aren't helped by drugs and drugs wear off. "Traditional
therapies are like chipping away around the edges of a problem. Neurofeedback
goes
directly to the source of the problem and of opportunity to fix it.
"Neurofeedback empowers the patient to rehabilitate himself. That's the really
exciting
thing.

" *** Contact Ron Krueger at (810) 766-6117 or rkrueger@....


© 2004 Flint Journal. Used with permission
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MJH
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