Pakistani scholar lectures on treatment protocols of neurofeedback
Assistant Professor from DOW University of Health Sciences (DUHS) gave a presentation on treatment protocols of neurofeedback during the EEG and Neurofeedback Research and Clinical Applications webinar held on Thursday.
MSTF Media reports:
In the first webinar of the series of Innovation Lab webinars on neuroscience and electrophysiology, organized by the Mustafa
Science and Technology Foundation, ScienceBeam Institute, and Dow University of Health Sciences (DUHS), Meha Fatima Aftab, Assistant Professor at Institute of Medical Technology at DUHS, Pakistan, delivered a lecture on “Clinical Applications and Treatment Protocols of Neurofeedback.”
Commencing her speech by pointing to the distinctions between the right and the left hemispheres of the brain, and how the excellent coordination between the hemispheres, and between different parts of the brain, synchronizes us with both the internal and external environments, she said “This is the concept underlying the application of Nuerofeedback which is called the Neurofeedback equation.”
Talking about the dominant brain waves in each hemisphere, she said “there is more alpha wave on the right hemisphere compared to the left, while on the left side we have more beta wave. Theta wave is almost always in the frontal lobe.”
Comparing the front of the brain to the back of the brain, Aftab said “there is more alpha wave in the back regions while more beta and theta waves are observed in the frontal region.”
According to Aftab, the disturbance of balance in those equations leads to some conditions. For instance, depression, low motivation, and apathy occur as a result of low beta wave on the right hemisphere of the brain. In case of high theta wave on the right hemisphere, one experiences emotional volatility. Moreover, emotional shutdown and decreased motivation occur as a consequence of high alpha wave on the left hemisphere.
Aftab then explained how the brain waves can be regulated and disorders treated through neurofeedback.
General neurofeedback protocols
Presenting the “general neurofeeback protocols,” she said what she is presenting in this section is not specific to any particular disease. For example, some usages of alpha waves, she said, are pain relief, anxiety and stress reduction, memory improvement, breathing rate regulation, and heart rate decrease. The beta waves are utilized in improving focus, attention, and the computational performance, reducing overthinking, treating obsessive compulsive disorder (OCD), and insomnia.
Delta waves, Aftab remarked, help alleviate headaches, treat traumatic brain injuries, learning disorder, and hard sharp contraction of muscles. Theta waves are utilized for reducing anxiety, depression, daydreaming, and distractibility, in addition to treating emotional disorders and ADHD.
Aftab emphasized that “the most popular Neurofeedback training for reducing stress is Alpha/ Theta protocol,” adding, it is also utilized in case of “severe depression and addiction, and enormously helps healing from trauma reactions.” This treatment is done “under eyes-closed condition that increases the ratio of theta to alpha waves using auditory feedback,” she added.
Explaining how and where the gamma wave works, she said “it was less known earlier,” adding that this wave is “responsible for the brain’s neural connections and data transfer to the outside world.”
Gamma wave is mainly observed in hippocampus. It is used for promoting cognition, and increases brain sharpness, the brain’s overall activity, and helps in problem-solving tasks. Moreover, it improves calculation, organizes the brain, and improves the speed of information processing.
Eureka moment—defined as ‘a moment of sudden, triumphant discovery, inspiration, or insight’—occurs especially when there is high gamma wave power “in the temporal regions of the brain,” she clarified.
Neurofeedback in specific disorders
Speaking about neurofeedback in treating ADHD, she said EEG findings show that in ADHD condition, there is elevated relative theta power in the brain, and reduced relative alpha and beta powers.
Moreover, theta/alpha and theta/beta ratio is elevated in ADHD, and “that is the reason people with Attention Deficit somehow get drifted away from their focus of attention,” she highlighted.
The two options of Neurofeedback treatment protocol for ADHD are monopolar training and bipolar training, each used in certain conditions based on special calculations.
“We obtain a mean of theta/beta ratio in conditions such as baseline-eyes fixed, silent reading, listening, and reading,” she said, adding “we increase beta and decrease theta.”
Among the crucial points to be considered here, she stressed, is that “theta wave on frontal lobe must not be increased, even if its amplitude is low.”
Aftab then talked about Neurofeedback treatment protocol for anxiety, first explaining the brain activity that causes this disorder. In anxiety, she said, decreased occipital alpha, decreased occipital theta, and increased frontal alpha—which reflects anxiety and irritability—are observed.
For treatment, “we increase alpha and theta on posterior sides of brain like parafacial zone (PZ), and reduce theta/beta ratio in left prefrontal cortex (PFC). Moreover, we down regulate high beta rhythms,” she said.
Before delving into Neurofeedback treatment protocol for depression, she drew attention to a fascinating point: “Right brain reflects negative emotions and avoidant behaviors, while left brain is responsible for positive emotions and approach behaviors,” Aftab said.
“More alpha power on the left side reflects the dominance of negative emotions,” she remarked.
The EEG findings in depression, she said, show elevated slow alpha wave, elevated beta in left hemisphere, and frontal alpha asymmetry. Moreover, some studies have shown reduced gamma in anterior cingulate cortex.
According to the established protocols, we correct the asymmetry problem by decreasing alpha on F3 region and decreasing beta, in addition to decreasing high beta at parietal cortex.
She then focused on Neurofeedback treatment protocol for post-traumatic stress disorder (PTSD). The general findings, she said, suggest that in PTSD there is suppressed alpha power on posterior sides. Besides, there is excessive 21-30 Hz frequency at parietal sites, in addition to greater alpha suppression which indicates “hyper responsiveness to deviant stimuli.”
Furthermore, increased synchronization in theta band power over right fronto-central channels, enhanced automatic pre-attentive auditory processing and hypersensitive auditory discrimination, and increased gamma power across frontal sides were among the other findings of EEG in PTSD according to Aftab.
Noting that “treating PTSD through neurofeedback is still under consideration and investigation,” Aftab said “as we are understanding this disorder further, we are coming up with even better protocols.”
The established neurofeedback treatment protocol for PTSD recommend alpha-theta training, decreasing 21-30 Hz frequency at P3 and P4 regions, and increasing 10 Hz frequency at P3 and P4 regions.
As Aftab explained, the EEG findings regarding obsessive-compulsive disorder (OCD) show decreased alpha and beta power at fronto-temporal regions of the brain, increased theta power at fronto-temporal regions, and increased 21-30 Hz at C3 and C4 regions.
The treatment protocol for OCD, she pointed out, recommends decreasing 21-30 Hz and 2-7 Hz frequencies in addition to increasing 10 Hz at C3 and C4 regions of the brain.
The neurofeedback treatment of the last disorder she gave a detailed description of was Autism, to which Aftab pointed as her favorite.
The EEG findings regarding the brain activity in autistics, she reported, reveal that there is hyper-connectivity between the fronto-temporal regions of the brain, which is associated with problems with attention, self-regulatory functions, social behavior, communication skills, and social cognition.
“They also have mu rhythm (SMR) complexity, which occurs over the sensorimotor strip,” she stated. It is associated with reduced integrity of the mirror neuron system that is essential in observing others as a basis for proper responding.
Moreover, there is hypoconnectivity between cortical regions of their brain which leads to language problems; “they have problems articulating words and speeches and communicating their needs,” Aftab said.
The overall suggested protocols for treating autism via neurofeedback include increasing 3-7 Hz power over fronto-temporal regions, and increasing high beta activity. The goal of this treatment, she said, is “inhibiting theta-alpha ratio while enhancing beta wave.”
“The treatment of autistic children in terms of better improving their language, communication, and social skills is still under consideration and investigation,” Aftab noted.
She then gave a summary of research avenues available in the area of neurofeedback, highlighting that “they mostly arise from methodological limitations in previous studies.”
One of the research avenues is studying obesity and weight control patterns, “because hunger is the result of signals sent from the brain,” she said, adding that another area is gamma wave and its association with spiritual behaviors.
Other research avenues in neurofeedback include experimental methods, brain connectivity using qEEG, spiritual health, and exploring therapeutic techniques like games, music, and animations—which is, in Aftab’s words, “kind of merging Information Technology, games and animations with biological feedback.”
The Innovation Lab aims to develop neuroscience and electrophysiology research in the Islamic world by holding a series of webinars, spring school, and offering grants. The second webinar revolving around Emerging Trends and Advances in Neuroscience will be held on April 8, 2021, in collaboration with Khazar University, Azerbaijan.
