2nd Asian Neurofeedback Conference 2016

During the 2nd Asia Neurofeedback Conference this year, I speak about Tic disorder and Tourette syndrome management by using Neuro-hypnotherapy and EEG biofeedback. I am really glad to be here today. 

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Abstract

This paper discussed EEG biofeedback as a standalone tool or used together with neuro-hypnotherapy approach for Tics and Tourette Syndrome. In this paper, the advantages of EEG biofeedback alone or integrating EEG biofeedback in neuro-hypnotherapy were explained. Four cases of patients with presenting problems related to tics and Tourette syndrome were presented. The protocol and improvement were mentioned and highlighted. 

Speakers of the day

*Special thanks to Miss Tan Wan Yen. Thank you for giving me a hand in doing research.

Education and the Brain: What Happens When Children Learn?

Have you lost your house keys recently? If so, you probably applied a spot of logical thinking. You looked first in the most obvious places – bags and pockets – and then mentally retraced your steps to the point when you last used them.

Researchers looking at child development often use search-and-find tasks to look at the ways in which children apply what they are learning about the physical world. Tests carried out on toddlers reveal that something quite remarkable happens in child development between the ages of two and five – a stage identified by both educationalists and neuroscientists as critical to the capacity for learning.

Dr Sara Baker is a researcher into early childhood at the Faculty of Education. She is interested in the role of the brain’s prefrontal lobe in how young children learn to adapt their understanding to an ever-shifting environment. Many of her studies chart changes in children’s ways of thinking about the world. She uses longitudinal designs to examine the shape of individual children’s learning curves month by month.

Research by Baker and colleagues is contributing to an understanding of the acquisition of skills essential to learning. She explains: “The brain’s frontal lobe is one of the four major divisions of the cerebral cortex. It regulates decision-making, problem-solving and behaviour. We call these functions executive skills – they are at the root of the cognitive differences between humans and other animals. My executive functions enable me to resist a slice of cake when I know I’m soon having dinner.”

In an experiment designed to identify the age at which executive skills develop, Baker and colleagues used a row of four interconnected boxes to test children’s ability to apply their knowledge of basic physics. A ball rolled down an incline entered the first box and disappeared. A barrier (its top visible) was slotted in between two of the boxes to stop the ball rolling any further. The children were asked to open the door of the box in which the ball was hidden.

Aged 29–31 months, only 32% of the children correctly identified the location of the ball by working out that the barrier would have stopped it. Aged 32–36 months, 66% of children were successful. Toddlers under the age of three appear to understand the principles of solidity and continuity, but have trouble acting on this knowledge. A single month in a child’s age affected their ability to carry out the task correctly.

Baker’s interest in children’s development of executive skills dates from the moment a decade ago when she picked up a picture book while sitting in the foyer of a nursery school; the narrative focused on opposites: big/small, light/dark, hot/cold. How would children respond if they were asked to point to the opposite picture to the one depicting the word they heard spoken? This question became the topic for her PhD. Her findings confirmed that the huge variability of children’s executive skills could explain the range of social and cognitive behaviours we see emerging in the early years. What we learn at this stage, and what we learn to apply, sets us on course for life.

Most three-year-olds find the ‘opposites’ task hard. Given two pictures of bears, one big, one small, they automatically point to the big bear when they hear the word ‘big’ spoken aloud. They point to the big bear even when they have been asked (and appear to have understood) to point to the image that is the opposite of the word they hear.

Five-year-olds are much more successful in carrying out the task explained to them. “By age five, most children have acquired the ability to override their impulses, and put them on hold, in order to follow a request,” says Baker. “The ability to control impulses is vital to children’s socialisation, their ability to share and work in groups – and ultimately to be adaptable and well adjusted.”

What happens in children’s brains and minds to enable them to make these important leaps in understanding? The answer involves an understanding of neuroscience as well as child development. Baker and colleagues are engaged in multidisciplinary projects including examining how individuals with autism may perceive and learn about the physical world differently from those without a diagnosis. Her team is also developing a pedagogical, play-based approach in collaboration with teachers.

“Executive function is a hot topic in education. When we talk to teachers about the psychology behind frontal lobe development, they immediately recognise how important self-regulation is, and will tell you about the child who can’t concentrate. It might be the case that this child is struggling with their executive functions: their working memory or inhibitory control might be flagging,” says Baker.

“The tricky part is to grasp the processes developing in the child’s brain and come up with ways to encourage that development. In early years’ education, playful learning and giving children freedom to explore could help to encourage independence as well as the ability to know when to ask for help, both of which depend on self-regulatory skills. If we want to encourage adaptability and self-reliance, we have to look beyond the formal curriculum.”

Baker’s research into children’s ability to apply knowledge to successfully predict the location of an object hidden from view revealed much more than simply which age group was successful. She says: “In looking at the data from tasks, it’s not enough to focus only on children’s failures. We need to look at why they search for an object in a particular place. Often they’re applying something else that they’ve learnt.”

When younger children opened the same door twice in the boxes experiment, despite the barrier having been moved, they were applying logic: an object may be precisely where it was found before. After all, it’s always worth looking for the house keys first where they should be.

In another experiment (involving dropping balls into opaque tubes that crossed each other), the younger children applied their knowledge of gravity (the ball would fall down the tube) but failed to take into account that the tubes were not straight. Baker says: “When children repeat a mistake, they reveal something about their view of the world and, as researchers, we learn how their brain is developing. As teachers and parents, our role is to help children to overcome that strong, but wrong, impulse.”

During the course of a day, your frontal lobe will have enabled you to do far more than find your keys. The synaptic firing of millions of cells in your brain may have guided you through a tricky situation with colleagues or prompted you to make a split-second decision as you crossed a busy road. “The development of this vital area of your brain happened well before you started formal education and will continue throughout your lifetime,” says Baker.

Source:

http://www.cam.ac.uk

Natural Health Magazine (March 2016 Issue) "Snoring and Sleep Apnea, symptoms too loud to ignore" by Hiro Koo

Natural Health Magazine (March 2016 Issue)  

"Snoring and Sleep Apnea, symptoms too loud to ignore" by Hiro Koo

Tourette Syndrome Treatment in Malaysia - EEG biofeedback/Neurofeedback

Gilles de la Tourette syndrome (TS) is characterized by motor and vocal tic manifestations, often accompanied by behavioral, cognitive and affective dysfunctions. 

Electroencephalography of patients with TS has revealed reduced Sensorimotor Rhythm (SMR) and excessive fronto-central Theta activity, that presumably underlie motor and cognitive disturbances in TS. 

Some evidence exists that EEG biofeedback or neurofeedback (NFB) training aimed at enhancing SMR amplitude is effective for reducing tics. The present report is an uncontrolled single case study where a NFB training protocol, involving combined SMR uptraining/Theta downtraining was delivered to a 17-year-old male with TS. 

After sixteen SMR-Theta sessions, six additional sessions were administered with SMR uptraining alone. SMR increase was better obtained when SMR uptraining was administered alone, whereas Theta decrease was observed after both trainings.

The patient showed a reduction of tics and affective symptoms, and improvement of cognitive performance after both trainings. 

Overall, these findings suggest that Theta decrease might account for some clinical effects seen in conjunction with SMR uptraining. Future studies should clarify the feasibility of NFB protocols for patients with TS beyond SMR uptraining alone.



Source:
https://www.researchgate.net/publication/51641932_Neurofeedback_Training_for_Tourette_Syndrome_An_Uncontrolled_Single_Case_Study

First neural evidence for the unconscious thought process

Hemingway (1964/2010) describes a process that people who engage in creative pursuits from time to time recognize. While you are engaged in one thing—say a conversation with friends—consciously, something that you had been working on beforehand is still simmering unconsciously. At times the simmering is quite vigorous, and the repeating conscious intrusions can make it difficult to fully concentrate on your current activity—talking to your friends.

The idea of that incubation or unconscious thought can aid creativity or problem solving is old (Schopenhauer, 1851), and 10 years ago, we started to link the process of unconsious thought to decision making in a series of experiments (Dijksterhuis, 2004; Dijksterhuis and Nordgren, 2006;Dijksterhuis et al., 2006). The idea was based on two considerations. The first was that it is quite a small step from problem solving to decision making and the second was that the process of unconscious thought as described in the first paragraph can often be sensed, introspectively, when one is in the process of making an important decision such as buying a house or choosing between one’s job and a job offer for a new one.

In our initial experiments, we gave participants the task to choose between four alternatives (houses, cars, roommates, etc.) on the basis of a number of aspects (often 12 per alternative). Participants either decided immediately after reading the decision information, or after a period of conscious thought, or after a period of distraction during which unconscious thought was assumed to take place. In our early experiments, unconscious thinkers made better decisions than participants in the other two conditions. We initially called this the deliberation without attention effect; however, now we prefer the term unconscious thought effect (UTE).

These initial findings led a number of colleagues to also investigate the relation between unconscious thought and decision making and, looking back now at 10 years of unconscious thought research, the research seems to have revolved around two questions. The first is whether unconscious thought indeed leads to better decisions that conscious thought or no thought, the second is whether unconscious thought really exists in the first place (and if so, what exactly is it)? The contribution by Creswell et al. (2013) constitutes a major step towards answering the second question, so I focus briefly on the first before devoting the remainder of this introduction to the second and to the work by Creswellet al.

Does unconscious thought lead to better decisions? As such things tend to go, 10 years of research has led to a rather predictable answer: Probably, but only under some circumstances. The paradigm we developed turned out to be much more fragile than we had hoped, and although the UTE has been replicated independently in well over dozen laboratories, at least equally often people did not obtain any evidence for improved decision making after unconscious thought. Some individual papers, as well as a recent meta-analysis (Strick et al., 2011), identified a number of moderators. It seems that unconsious thought is beneficial when decisions are based on a lot rather than on little information, when the decision information is presented blocked by decision alternative rather than completely randomized, when the distraction task is not too cognitively taxing, and when the decision information contains visual stimuli in addition to verbal stimuli. It is encouranging for proponents of the work on unconscious thought that unconscious thoughts seem to be more fruitful when the experimental set-up becomes more ecologically valid.

That being said, some people have argued that unconscious thought does not really exist in the first place. People may make better decisions after being distracted, but that does not yet mean that any decision related mental activity took place while they were distracted. Some have proposed, for instance, that participants in unconscious thought conditions form an impression of the decision alternatives online—that is, while they read the decision information—and later simply retrieve this information. These participants may perform better than conscious thinkers, because under some circumstances, conscious thought can actually hamper decision making. Although it is indeed very likely that a reasonable proportion of participants in some unconscious thought experiments indeed merely retrieved online impression (which, by the way, can be prevented by presenting the stimulus materials rapidly), this cannot explain why unconscious thinkers also often outperform immediate decision makers (Strick et al., 2010), something that has been curiously overlooked when this alternative explanation was first published. However, there is also evidence that people who are not given the goal to make a decision before they are distracted make worse decisions than people who do have the goal (Bos et al., 2008), and this rules out this alternative explanation even more effectively. Unconscious thought is a goal-directed unconscious process, and merely distracting people does not do anything.

The experiment by Creswell et al.—in which they provide the first neural evidence for the UTE—also provides strong evidence for the unconscious thought process. They indeed found that unconscious thinkers made better decisions than conscious thinkers and than immediate decision makers. More importantly, they compared neural activity among people who were thinking unconsciously while they were engaged in a distraction task with the neural activity of people doing this same distraction task without engaging in unconscious thought. They found evidence forreactivation. The same regions that were active while people encoded the decision information—the right dorsolateral prefrontal cortex and left intermediate visual cortex—were active during unconscious thought. Moreover, the degree of neural reactivation differed between participants and was predictive of the quality of the decision after unconscious thought.

This is a breakthrough in unconscious thought research, and, quite appropriately in a celebratory sort of way, published almost exactly 10 years after the first experiments with the unconscious thought paradigm. Again, Creswell et al. provide the first neural evidence, and thereby—in my view at least—unambiguous evidence for the unconscious thought process. Finally, they also provide insight into the characteristics of the unconscious thought process.

Althought some aspects of the unconscious thought process can be carefully deduced from moderators, direct process-oriented evidence is scarce. Unconscious thought leads the representations of the decision alternatives in memory to become better organized and more polarized (Dijksterhuis, 2004; Bos et al., 2011) and interestingly, a recent paper shows that unconscious thinkers rely more on gist memory than on verbatim memory (Abadie et al., in press) thereby also integrating fuzzy-trace theory (e.g. Reyna and Brainerd, 1995) and unconscious thought theory. The reactivation account by Creswell et al. is fully in line with these earier findings, as earlier work on reactivation has repeatedly found (for references see the article by Creswell et al.) that reactivation improves memory and learning processes.

The work by Creswell and colleagues constitues a vital step forwards. The combined evidence now suggests that unconscious thought is a goal-directed process of neural reactivation during which memory representations of—in this case decision alternatives—change.

• © The Author (2013). Published by Oxford University Press. For Permissions, please email: [email protected]

Source: http://scan.oxfordjournals.org/content/8/8/845.full

马来西亚妥瑞症治疗Non-drug therapy for Tics/Tourette syndrome

妥瑞氏症 （Tourette Syndrome）
妥瑞氏症也稱妥瑞氏綜合症，患者會有不自主重複性動作的癥狀，表現在臉部、手部或腳部可觀察的小肌肉規律性抽動，以及額頭、眼尾、鼻子、嘴部肌肉群的區塊抽動。重症者會出現頭部、頸部、肩膀、身體、腳部的上下前後扭動，以至二個手臂連接整個上半身的大擺動，再結合從小聲至大聲的囈語或穢語。抽動的範圍愈大，時間愈久、次數愈頻繁，顯示癥狀愈為嚴重，反之則癥狀愈為緩解。

妥瑞氏症簡介 妥瑞氏症也稱妥瑞氏綜合症、吐雷氏症、吐雷氏綜合症。此症是法國妥瑞（last nameJean-Nartub Charcot ，first name Gillies de la Tourette）醫生於1885年提出的8個病例報告。此種患童會不自主動作，包括抽搐、眨眼睛、噘嘴巴、裝鬼臉、臉部扭曲、聳肩膀、搖頭晃腦；及不自主出聲，包括清喉嚨、大叫或發類似「干」的怪聲。約有百分之五十的患者會伴有注意力缺陷過動症。

症状 聲語上的抽搐（Vocal Tics） 聲語型抽筋可說是妥瑞氏症最為人所知的癥狀。聲語型抽筋包含廣泛，從單純的清喉嚨，擤鼻涕，發出象豬的咕嚕聲，狗叫聲，到突然說一些詞語或發出無意義的聲音。絕大多數的人以為妥瑞氏症患者會突然口出穢言。事實上，大約只有15%的妥瑞氏症病例會出現這種情形。如同運作型抽筋，聲語型抽筋的嚴重程度是變動的，且形式經常改變（譬如說，從發出象豬的呼嚕聲到說一些話語），癥狀隨著狀況不同時好時壞。 聲語型抽筋可分為簡單型以及複雜型。簡單型聲語抽筋包括發出一些簡單的聲響象是清喉嚨或是擤鼻涕。複雜型的聲語抽筋則包括任何言語，連猥褻的言詞也囊括其中；重複別人的話；或是反覆喃喃自語。

動作上的抽搐（Motor Tics） 動作型抽筋是一些不自主的運動，通常發生於臉和脖子的肌肉。這些不自主的運動包括聳肩，眨眼，以及擤鼻子。當手臂伸展，踢腿或跳躍時，身體其他部位也參與其中。動作型抽筋通常發生於身體的同一部位，但是隨著時間的過去，抽筋的現象可能從一部份消逝而在另一個部位又冒出來。

動作型抽筋可以分為簡單型以及複雜型。 簡單型抽筋是突發的、短暫動作，它通常的發作模式是一次只有單一一個位置的肌肉抽筋。象是眨眼、聳肩或是搖頭晃腦都是簡單型動作抽筋的例子。 複雜型抽筋則是一連串的動作。看起來好象是有目的，象是那個人刻意有那些舉動，但實際上他們是不自主的做了那些動作。 舉例來說，複雜型抽筋可能是聞東西（它包含了把東西拿起來，將物體靠近鼻子，聞一聞，然後放下）或是模仿別人的動作（稱為仿作"echopraxia"）。 這些舉動很可能被解釋成是患者刻意作出來的。但有一些複雜型抽筋看起來並非刻意而為，象是反覆的踢腿或是搖頭聳肩。 感覺上或心理上的抽搐 大部分的妥瑞氏症兒童都有出現癥狀的前兆，譬如：眼皮酸而眨眼睛，脖子酸而搖頭聳肩，通常是抽搐前兆。也有單獨的燒灼感、緊繃感、肌肉緊張、疼痛。甚至於覺得別人搔癢而去抓人，也有在心理說粗話或重複說一樣的話妥瑞氏兒童在專心於某一行為時（例如：談鋼琴、看錄像帶、玩電動遊樂器、看漫畫書等）抽搐常會消失，熟睡或酒後多半癥狀也會消失；相反地，壓力疲憊無聊及興奮時，會明顯加重抽搐的頻率與強度。 伴隨癥狀過動、注意力不集中（ADHD）及強迫症。根據葉啟斌醫師的說法約有40%的妥瑞氏症兒童有強迫症。Deputy（ 2002）表示：至少有五分之一的妥瑞氏症兒童伴隨有注意力缺陷過動症（ADHD）。 

病因 
過度敏感反應 目前所知的病因是腦基底核的多巴胺過度敏感反應，及腦基底核與腦皮質之間的聯繫出現問題，導致出現慢性、反覆、半不自主的動作及聲語上的抽搐（tic）。約50-70%的妥瑞兒與遺傳有關。 與鏈球菌感染有關 根據國外的研究約有四成的妥瑞氏症兒童與鏈球菌感染有關。妥瑞氏症可能與紅斑性狼瘡一樣，是一種自體免疫疾病，鏈球菌感染是危險因子。有妥瑞氏症家族史及體內B型淋巴結免疫缺損的孩童應盡量避免感染鏈球菌。 　 感冒對神經傳導物質多巴胺也會有所破壞，造成多巴胺不足而導致妥瑞氏症及帕金森症。

其它環境因素 環境因素如有毒物質、心理興奮劑、過敏原、食品等。


發病人群 妥瑞氏症在所有人種皆可見。 妥瑞氏症的病徵通常在18歲之前出現，在7 歲半左右發作。 男性妥瑞氏症的發生率比女性高三到四倍。

诊断 雖然說並無法使用單一一個測驗即可檢測出一個人是否罹患妥瑞氏症，但是某些檢驗，例如：MRI，CT，EEG 以及血液測試皆可幫助醫師將癥狀與妥瑞氏症類似的疾病排除。假如受檢對象在其他的檢查的結果都是陰性的，而此人長期以來一直有多重的動作型或聲語型抽筋，癥狀持續超過一年以上，則可以做出此人為妥瑞氏症患者之臨床診斷。

治療 妥瑞氏症的心理治療分成二個階段，分別處理癥狀與癥狀造成的影響。
第一階段是抽動動作、行為的矯治，以及腦部異常放電之腦電波心身回饋治療。
第二階段是偏差行為矯治、人格重建以及深度心理治療。 父母親的協助以及當事人意志力的激發，是治療妥瑞氏症最重要的助力。若無家屬和患者的全力配合，通常心理治療作業都會中斷無法建構療程與療效。

对于妥瑞症的治疗，Newmindcentre.com的治疗师和医师们提供以下服务：


1) 了解病因：检测环境因素
Nutritional therapy合格的营养咨询师将教导您使用食物保養神經的作用穩定 大腦中有許多神經細胞，靠神經傳導物質當「傳令兵」，幫忙傳達指令，身體各部位一收到訊息，就會有所反應。 神經傳導物質有上百種，其中和情緒、壓力有關的包括多巴胺、正腎上腺素、血清素等。好消息是，一些食物可以增加神經傳導物質的濃度，維持神經的作用穩定，不妨適量攝取。营养咨询师可透过头发重金属检测Hair Tissue Mineral Analysis (HTMA)的方法了解环境因素，对症下药了解身体里超标的有毒物质并改变您的饮食，从而帮助您改善身心状态。重金屬藉由飲食、呼吸或是直接接觸方式進入人體，但重金屬不似其他毒素能在肝臟進行分解代謝後排出體外。相對的，它非常容易囤積在大腦、腎臟等器官，漸進式破壞身體的正常功能。簡單、精確、無侵入性的重金屬檢測幫助您提早發現不正常警訊和預防疾病發生。近代學術研究發現，近頭皮的頭髮所含之元素與體內之元素有密切的相關性，並且有強大的學術支持，這些由頭髮檢測之元素即代表體內的元素含量，其中包括了有毒金屬及營養性元素。因頭髮之分析檢測比血液檢測更加的靈敏，可發揮提早發現不正常警訊及與防疾病之優點。

2) 第一階段治疗：抽動動作、行為的矯治(Habit Reversal Therapy)与腦電波心身回饋治療(EEG biofeedback/Neurofeedback)
我们拥有在马来西亚极少数受过合格脑电波心身回馈治疗与拥有丰富临床经验的治疗师。治疗师除了提供科学，安全无痛又无副作用的脑电波心身回馈治疗，也会教导客户如何使用Habit Reversal Therapy等对抽動動作、行為的矯治疗法。

3）第二階段治疗：偏差行為矯治、人格重建以及深度心理治療(Psychotherapy and Neuro-hypnotherapy)。
我们拥有执业临床催眠师，可以透过临床催眠疗法除了可以减轻妥瑞症的症状，也能帮助客户进行偏差行为矫正，情绪与心理治疗以帮助客户进行完善的人格重建。我们所使用的脑电波心身回馈治疗也专门设计了针对客户的智力与情绪进行正面的调整功能。

4) 提供客户的亲属适当的心理建设Psychoeducation 
我们提供父母或亲属适当的心理建设与应对措施，让他们了解如何与病患相处。同时也可以和家属亲人一起探讨对策，帮助病患一起面对来自学校，工作以及社会所给予的压力与不平等对待。

总结，我们治疗的5大特点是：

科学验证疗法，

非侵入性并完全无痛，

安全并无副作用，

完全不使用任何药物，
许多成功减轻病情临床案例。

 资料来源： http://www.twwiki.com/wiki/%E5%A6%A5%E7%91%9E%E6%B0%8F%E7%97%87

Keeping Emotions in Check With Neurofeedback

Difficulty handling emotions and keeping them under control can cause various psychological issues, and may even lead to full-blown psychiatric problems. This is especially true in childhood. Trauma experienced in youth can contribute to later problems such as depression and anxiety. There are various techniques for helping people control their emotions. One of these is neurofeedback; a training method in which information about changes in an individual’s neural activity is provided to the individual in real-time. This enables the individual to self-regulate thier neural activity and produces changes in behaviour. While already in use as a treatment tool for adults, this method has not been used on young people until now. Researchers believe neurofeedback could help younger people by providing more efficient control of their emotions.

The new study used real time fMRI-based neurofeedback on a sample of kids. “We worked with subjects between the ages of 7 and 16,” explains SISSA researcher and one of the authors of the study, Moses Sokunbi. “They observed emotionally- charged images while we monitored their brain activity, before ‘returning’ it back to them.” The region of the brain studied was the insula, which is in the cerebral cortex.

The young participants could see the level of activation in the insula on a “thermometer” presented on the MRI projector screen. They were instructed to reduce or increase activation with cognitive strategies while verifying the effects on the thermometer. All of them learned how to increase insula activity, although decreasing was more difficult. Specific analysis techniques made it possible to reconstruct the complete network of the areas involved in regulating emotions (besides the insula) and the internal flow of activation. The researchers observed that the direction of flow when activity was increased reversed when decreased.

“These results show that the effect of neurofeedback went beyond the superficial- simple activation of the insula- by influencing the entire network that regulates emotions,” explains Kathrine Cohen Kadosh, Oxford University researcher and first author of the study. “They demonstrate that neurofeedback is a methodology that can be used successfully with young people.”

“Childhood and adolescence is an extremely important time for young people’s emotional development,” says Jennifer Lau, from the Institute of Psychiatry, Psychology & Neuroscience at King’s College London, who has taken part in the study. “Therefore, the ability to shape brain networks associated with the regulation of emotions could be crucial for preventing future mental health problems, which are known to arise during this vital period when the brain’s emotional capacity is still developing.”

Source:

http://neurosciencenews.com/emotion-psychology-neurofeedback-3201/

Brain Training for Anxiety, Depression and Other Mental Conditions

A new treatment for psychiatric disorders like depression and anxiety uses real-time scans to show patients how their brains go awry—and how to fix the dysfunction.

The treatment is called neurofeedback.

There is an urgent need for new approaches for psychiatric disorders, particularly depression. Almost 17% of Americans will suffer from major depression during their lifetime, according to a 2012 study published in the International Journal of Methods in Psychiatric Research.

Not everyone responds to current treatments like antidepressant medication and talk therapy. In one study of almost 3,000 patients, only about 1/3 of them achieved remission from their depression after up to 14 weeks on the drug citalopram (brand name Celexa).

An fMRI scan from a participant in a study using neurofeedback for spider phobia. The study targeted activity in part of the insula, a brain region implicated in sustained anxiety. It is at the center of the white cross. PHOTO:ANNA ZILVERSTAND, ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI

Neurofeedback aims to be more precise than current therapies. It directly targets the brain dysfunctions and emotional and cognitive processes that are understood to underlie psychiatric disorders. Doctors hope that treatments could also be personalized to address the issues in each individual’s brain.

Besides depression, neurofeedback is being studied in phobias, obsessive-compulsive disorder, addiction, traumatic brain injury and chronic pain, among other illnesses.

With neurofeedback, “there’s no need to take medication and no need to talk about your mother to a stranger,” says Kymberly Young, a postdoctoral associate at the Laureate Institute for Brain Research in Tulsa, Okla.

In neurofeedback, patients lie in a functional magnetic resonance imaging scanner. In general, they are told to conjure memories or look at pictures while their brains are scanned. The activity of certain brain regions related to subjects’ illnesses is analyzed via computer. Patients see visual representations of their brain activity almost in real time—often presented in the form of a thermometer or colored bar.

Based on what their brains are doing, subjects are told to enhance or suppress that activity. Patients “need to train their brain like they train their muscles when they want to be fit,” says Anna Zilverstand, a postdoctoral researcher at the Icahn School of Medicine at Mount Sinai in New York and lead author of a 2015 study using neurofeedback to treat women with a phobia of spiders

The science on neurofeedback for psychiatric disorders is in its early days. So far, studies are very small and researchers are still figuring out which brain areas to target and how many sessions to try. Results are modest and it is unclear how long the effects of the treatment last. Also, fMRI scans are expensive, costing hundreds of dollars. Some researchers believe that neurofeedback will most likely be used in addition to current medications and talk therapies.

Dr. Young led a study of 23 depressed patients published in 2014 in the journal Plos One. In it, those who received one session of active neurofeedback for their illness saw their scores on a measure of happiness increase significantly more than those in a control group.

The happiness scores in the active group jumped 20%; the control group went up just 2%. Depression scores and an anxiety measure also dropped after treatment. But depression also dropped among those in the control group, and the difference in the drop between the groups wasn’t statistically significant.

In results from a more recent study, Dr. Young says that after two sessions of neurofeedback, depression scores dropped 50%. In the control group, they dropped 10%. These results are not yet published, but were presented at the Society of Biological Psychiatry annual meeting in 2015.

Neurofeedback didn’t work for everyone: About 10% of depressed participants had normal amygdala activity at the beginning of the studies. Another 10% of participants couldn’t learn how to regulate the amygdala.

While in the scanner, study subjects were told to recall positive autobiographical memories. At the same time, they were shown an image of a red bar, which coordinated with their own brain activity. Subjects in the active group received feedback from their left amygdala, a part of the brain that processes emotional memories.

The amygdala generally isn’t as active in depressed patients when they think of positive autobiographical events. The level of blunting correlates with the severity of symptoms. The control group also received feedback, but from a part of the brain involved in processing numbers and unrelated to depression. Subjects were then told to make the red bar rise.

Beyond recalling happy memories, subjects weren’t given specific strategies on what to do to boost activity. But Dr. Young says that for women, thinking about childbirth or playing with pets boosted amygdala activity the most. For men, pondering thrilling pursuits like sky diving and sex led to the biggest rises.

Zac Williams recently participated in two of the Tulsa neurofeedback studies for depression. “I was going through a tough time. My father had just died and my girlfriend broke up with me,” says the 26-year-old phone repair technician from Tulsa.

While he was in the scanner and trying to get the red bar to rise, researchers told him to pick several happy memories. He said he thought of getting his first car, a camping trip with friends and his first time riding a motorcycle. But those memories, he said, “weren’t necessarily making the bar go up.” So he tried thinking about funny movies. When he recalled scenes of “Dumb and Dumber,” he says the bar spiked. “It was kind of crazy to see something react based on your thoughts.”

Since the treatment, Mr. Williams says his mood has improved. He says he’s also using the skills he learned in the scanner when he feels down. “If there is something that bogs me down, I try to find a way to make myself laugh,” he says.

While fMRI neurofeedback is only a few years old, its principles have been around for decades. Doctors and researchers have long used electroencephalograms (EEG), tests that record electrical activity, to perform a version of neurofeedback. The approach is particularly popular as a treatment for ADHD in children.

But there are drawbacks with EEG. It is much less precise in targeting brain areas than fMRI, says David Linden, a psychiatrist and professor of translational neuroscience at Cardiff University in Wales who has studied the use of fMRI neurofeedback in depression. In a 2012 study of his, depressed patients saw their symptoms drop by 30% after four sessions of neurofeedback.

Researchers at the University of Texas at Austin are trying a novel approach. Instead of displaying feedback as a chart or temperature gauge, they are using pictures that change based on subjects’ brain activity. Depressed patients tend to have what is known as a negative attention bias: They pay more attention to negative stimuli and have a harder time disengaging from it. The goal of the neurofeedback training is to get depressed patients to disengage from the negative.

In a small pilot study without a control group, depressed patients were shown a series of images while in the scanner. In each one, a sad face was superimposed on a neutral scene, of a living room, for example. Patients were told to focus on the scenes and ignore the faces.

Because emotional stimuli like faces activate certain parts of the brain, the fMRI scan could distinguish what the subjects paid attention to. The image was then changed based on the subjects’ brain activity: The more they paid attention to the scenes, the fainter the faces appeared. Seven depressed adults had three sessions of neurofeedback in a five-day period. Depression symptoms continued to improve during the following month.

Source: The wall street journal

http://www.wsj.com/articles/brain-training-for-anxiety-depression-and-other-mental-conditions-1453144315?mod=trending_now_2

The brain-computer duel: Do we have free will?

The background to this new set of experiments lies in the debate regarding conscious will and determinism in human decision-making, which has attracted researchers, psychologists, philosophers and the general public, and which has been ongoing since at least the 1980s. At that time, the American researcher Benjamin Libet studied the nature of cerebral processes of study participants during conscious decision-making. He demonstrated that conscious decisions were initiated by unconscious brain processes, and that a wave of brain activity referred to as a 'readiness potential' could be recorded even before the subject had made a conscious decision.

How can the unconscious brain processes possibly know in advance what decision a person is going to make at a time when they are not yet sure themselves? Until now, the existence of such preparatory brain processes has been regarded as evidence of 'determinism', according to which free will is nothing but an illusion, meaning our decisions are initiated by unconscious brain processes, and not by our 'conscious self'. In conjunction with Prof. Dr. Benjamin Blankertz and Matthias Schultze-Kraft from Technische Universität Berlin, a team of researchers from Charité's Bernstein Center for Computational Neuroscience, led by Prof. Dr. John-Dylan Haynes, has now taken a fresh look at this issue. Using state-of-the-art measurement techniques, the researchers tested whether people are able to stop planned movements once the readiness potential for a movement has been triggered.

"The aim of our research was to find out whether the presence of early brain waves means that further decision-making is automatic and not under conscious control, or whether the person can still cancel the decision, i.e. use a 'veto'," explains Prof. Haynes. As part of this study, researchers asked study participants to enter into a 'duel' with a computer, and then monitored their brain waves throughout the duration of the game using electroencephalography (EEG). A specially-trained computer was then tasked with using these EEG data to predict when a subject would move, the aim being to out-maneuver the player. This was achieved by manipulating the game in favor of the computer as soon as brain wave measurements indicated that the player was about to move.

If subjects are able to evade being predicted based on their own brain processes this would be evidence that control over their actions can be retained for much longer than previously thought, which is exactly what the researchers were able to demonstrate. "A person's decisions are not at the mercy of unconscious and early brain waves. They are able to actively intervene in the decision-making process and interrupt a movement," says Prof. Haynes. "Previously people have used the preparatory brain signals to argue against free will. Our study now shows that the freedom is much less limited than previously thought. However, there is a 'point of no return' in the decision-making process, after which cancellation of movement is no longer possible." Further studies are planned in which the researchers will investigate more complex decision-making processes.

Source:

http://www.neuroscientistnews.com/research-news/brain-computer-duel-do-we-have-free-will

[Health talk and assessment] Rin Enzyme Annual Thanks Giving Event

Health talk for Rin Enzyme Annual Thanks Giving event. 

We hope you all enjoyed the health talk and the assessments.

Unreserved Magazine | Cover Story - Think Healthy For the Mind, Body and Soul

Currently I am attached to the SOL Integrative Wellness Centre as a clinical hypnotherapist at KL Malaysia, Malaysia. I work closely with psychiatrist, child psychologist, neurotherapist, chinese physician, nutritional therapist, naturopath and physiotherapist to offer non-pharmacological therapies for ommon health issues.

What is Neuro-hypnotherapy?

Neuro-hypnotherapy is first of its kind in Malaysia developed by Hiro Koo. It is a technique by combining technology and art of science. It is a safe, non-invasive, drug-free and painless procedure whereby one is able to determine the brainwave state while conducting the neuro-hypnotherapy. To analyse the brainwaves, your clinical hypnotherapist will use the neurotherapytechnology, whereby one can observe the brainwave going into different state such as delta, theta, alpha and beta brainwave while the suggestion is being given by the clinical hypnotherapist during the therapy session, personalized self-hypnosis method will be developed based on the brainwave observation.