Neurofeedback works like this: you are hooked up to instruments that measure your brain activity (usually via electroencephalography or functional magnetic resonance imaging) and feed it back to you via auditory or visual feedback. The feedback represents the brain activity, and gives you a chance to modulate it, much as you might modulate the movements of your hand given visual or haptic feedback about its activity. What is interesting about the use of neurofeedback is it appears to train people to exercise some control over brain activity related to cognitive and mood-related processes. In other words, neurofeedback might potentially allow agents to modify the activity in their brains such that mood, attentional capacity, and other mental functions improve.
The connection between the relevant brain activity – e.g., the training of ‘slow cortical potentials’ or the voluntary increase of beta band activity and the decrease of ‘theta band activity’ (see Gevensleben et al. 2009) – and the improvement of cognitive functions like attention is not extremely well understood. But the connection is promising. A recent randomized controlled trial amongst school children found that neurofeedback training was associated with improvements in the symptoms of ADHD, and that the improvements remained 6 months after training ended (Steiner et al. 2014). (for an accessible summary of the relevant results, by Boston Globe health reporter Deborah Kotz, see here).
It looks like neurofeedback is a potentially useful and non-intrusive tool for human enhancement. The usual caveats about side-effects and cost of implementation apply, of course: we need a better understanding of the specific effects of neurofeedback training, as well as possible side-effects. But given that neurofeedback training depends in part on our understanding of human cognition, and on the quality of brain measurement tools, it is plausible that we will in the future (perhaps quite soon) have low-cost and more effective neurofeedback techniques than we currently have. It is also plausible – although not guaranteed – that this kind of technique will be useful for more than ADHD treatment. It might be that such techniques promote self-control and well-being quite generally.
Should we view the application of such techniques as a luxury, available to those willing to pay? Or are we as a society obligated to provide such techniques for our children? Assuming it is effective enough to justify whatever costs are associated, should brain training be a normal part of public schooling?
I think so. If readers disagree, I’d like to hear why.
Gevensleben, Holger, et al. “Is neurofeedback an efficacious treatment for ADHD? A randomised controlled clinical trial.” Journal of Child Psychology and Psychiatry 50.7 (2009): 780-789.
Steiner, Naomi J., et al. “In-School Neurofeedback Training for ADHD: Sustained Improvements From a Randomized Control Trial.” Pediatrics 133.3 (2014): 483-492.
I am generally positive to neurofeedback, although I wonder about the non-intrusive aspect. The fact that neural change occurs because of training does not mean that it occurs like normal learning through experience. I don’t think this has any ethical importance (unless the readings are misleading and promote learning the ‘wrong’ state), but it does involve making the user part of an extended cybernetic system. Much of the therapy is rather ad hoc rather than based on any understanding of the underlying condition or neural system.
Also, there have been adverse effects reported: http://www.isnr.org/neurofeedback-info/adverse-loreta.cfm Most appear fairly benign, but the call for better practice standards in the top paper in the bibliography suggests a problem in rolling out the technology widely in schools.
Anders,
I am the inventor of the neurofeedback technology used in the Tufts studies. You can see in reference #32, the technology was Play Attention. It’s been used in school systems globally since 1996.
Although it was not described as being quite different than clinical EEG, it is. Clinical EEG is rather facile; it is theorized that changing one’s brainwaves changes performance. This is true in a limited sense as it is widely known (40+ years of research) that attention can be improved by self-monitoring. However, ADHD is not simply an attentional issue; it involves co-morbidity in many cognitive areas. Thus, I integrated cognitive skills with neurofeedback — we place the student in an attentive state and then teach him skills that are necessary for peak performance. These include discriminatory processing, visual tracking, social skills, motor skills, math skills, academic generalization, working memory, short-term memory, spatial memory, attention stamina, and auditory processing. I hold a graduate degree in education which is the primary reason for integrating these skills sets with neurofeedback. I based this work on work performed at NASA that trained astronauts to pay attention in states of hypo and hyper arousal. I lectured at the National Space Society conference at NASA’s request. Traditional clinical EEG doesn’t come close to this in scope or method.
Students can activate the learning exercises by mind alone. When they reach a peak attention state, they are actively engaged in games that teach them the aforementioned skill sets. There is nothing passive about this type of learning/training. It is used by NASA, Olympic teams, nuclear power industry, NASCAR, the US Military, corporations, and universities.
We are also quite aware of how this process works. I noted that some people were alarmed by the technology, but there is no magic. It’s simply teaching and learning. That’s all. One’s ultimate teacher is one’s brain if one can see what is happening to it in real-time. Here’s how this occurs: Our brains are comprised of billions of cells called neurons. A typical neuron communicates with 1,000-10,000 other neurons at any time, and some neurons in the cerebellum have has many as 200,000 connections on one cell. A single neuron has to work together with neighboring neurons to accomplish even the simplest tasks. For example, when your alarm clock goes off, you sleepily respond by pressing the snooze button. A single neuron cannot process that information by itself and then assist with your response. Neurons collaborate. Here’s how: The branching dendrites receive incoming signals while the axon transmits electro-chemical signals from terminals. Dendrites don’t actually fuse to axons. Instead, they communicate across a small valley between them called the synaptic cleft. Electrical impulses pass from the soma along the axon. However, most neurons don’t actually pass the electrical signal to and from each other. Instead when the electrical signal passes into the axon terminal, it triggers the release of fluid chemicals or neurotransmitters from the bouton into the synaptic cleft. The release of the neurotransmitter can either have an excitatory or inhibitory effect on the next neuron in line. If the reaction is excitatory, it will cause the adjoining neuron to fire or to increase its rate of firing to the next neuron in line. If the reaction is inhibitory, then the next neuron in line will be prevented from firing. The cells then work together in a network to perform a function allowing you to move from deep sleep to a drowsy state, to view the alarm clock, hear the beeping, lift your arm, touch the snooze button, and go back to sleep.
The incredibly minute size of the electrical potentials measured by neurofeedback most likely come from pyramidal cells in the cortex because they are close to the surface, are aligned, and fire synchronously. This produces a field of energy produced by dendritic activity and post synaptic activity. Attention is a signature that can easily be derived by this field.
When we learn, all the various stimuli – sound wave striking the ear drum (teacher talking, listening to a motor, hearing an alarm clock, etc.), photons striking the retina (teacher’s presentation, viewing a control panel, etc.), pressure on the skin, heat, cold, etc. are converted to variable rates of neuron firings in the brain. So, no matter what material we are learning, the brain converts this material to a common medium: the firing of neurons at variable rates. Quite remarkably, all the training we get over a life-time, all of our memories, all of our stored experiences are reproduced for us over networks that are composed of neurons firing at various rates.
There is no side effect to using this. I suppose someone could try to cause harm in the way one could turn the volume to the maximum on one’s iPod and lose their hearing. You can’t do that with Play Attention. It’s preset and unmodifiable.
Alas, if it were only as simple as using a musical instrument and fixing one’s problems! My brother is assistant principal timpanist for the Cleveland Orchestra, one of the finest orchestras in the world. He chuckled at that comment.
Can you please identify yourself?
So your brother thinks it’s easy to play a musical instrument ? And he does it with no self-control, without concentrating or staying in one place for a considerable time ?
By the way, I haven’t claimed that music playing solves all problems, but anyone googling the effects of learning a musical instrument for children with attention disorders can decide for themselves….
Agreed. Rolling out the technology widely in schools should be considered only after we get a more sophisticated understanding of how NF works (if it indeed has positive and long-term benefits).
So we take children with a hugely over-diagnosed condition and sit them down for 40 * 45-minute sessions in concentrating on something, at a cost of $3000 and more, and we see a slight improvement… Isn’t neuro-science wonderful ?
And if they learnt to play a musical instrument during this time, it seems that they would have very similar positive effects on concentration, self-control and well-being – and on top of that they would develop a talent that could last a lifetime (I doubt that learning to keep a dolphin at the bottom of a virtual fishtank is something that brings life-long satisfaction).
Agreed. Whenever I see people arguing for using more industry-made enhancers that interact with the brain of the user without her actually engaging in an activity each stages of which she has direct access and control over, I cannot help but think that there is an enormous amount of naivety going on.
Sorry, should have written “neuro-feedback”, not “neuro-science”. Apologies to neuro-scientists everywhere….
I agree and disagree to different extents. I think that having the neuro-technology that’s able to help people with certain functions and problems they have, like ADHD is positive and worth exploring. Students these days do have a harder time with self-control and discipline and having neuro0feedback, which is able to improve those qualities would impact the future of children. There would be better grades and smarter people and in the future we’d have a generation that’s further advanced then we are.
However, i also think that because we don’t know all there is to know about neuro-feedback and the cognitive side effects and long term deffects it could result in, we’d have to proceed carefully with this in the future. Children should not be subjected to this sort of brain changing technology without scientist knowing 100% what it will do, the risks involved and the ecaxt results that will come from its use. I don’t think improved self-control or the ‘reversal’ of ADHD is worth the potential harm to children and others until we know without a doubt what it means long term.
I use neurofeedback and biofeedback as a therapeutically procedure for quite some time, partly due to my training in psychology which is psychophysiology. The first article states that the connection between brain activity and the “improvement of cognitive functions” is not well understood which is not right. We are learning that the white matter, below the surface of the brain, is the key to the whole process, because it is the speed with which the connections in this area interact with each other which determines the amount of information one pays attention to information, behaviours or any other cognitive process and neurofeedback trains or corrects this speed. That is why “voluntary increase of beta band activity and the decrease of ‘theta band activity’” enhances attention as the speed of the brain to collect information from our senses becomes dominated at beta level rather than below alpha activity. This lower activity just makes the person to stay and look more internally (his/her moods and feelings) rather than looking at and analysing external information around the person which is a beta activity. Therefore, by increasing beta power the time one pays attention to things gets longer and the person/child becomes calmer and attend more to everything.
I am a proponent that there is adequate evidence neurofeedback can be beneficial to a large cohort of children a should be piloted within schools. That said, a sophisticated assessment process is needed to match the appropriate type of neurofeedback to each learner. We should train to the individual brain and not offer a standard protocol to all brains.
I also believe almost all children would benefit from mindfulness training, exposure to cognitive games at certain key development al stages that build executive function and/or neurofeedback if their self-regulatory capacity is particularly low. For these reasons, I hope to sponsor pilots in Baltimore city schools to determine what combination of these modalities is most beneficial to a large cohort of students. These pilots would be coupled with rigorous outcomes measures.
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