How is brain imaging and cognitive neuroscience impacting neurofeedback?
The field of neurofeedback has changed a great deal over the last ten years. By learning from advances in both cognitive neuroscience and brain imaging, neurofeedback has learned to better target different areas of the brain. Recent promising research from imaging studies suggests advances in applying neurofeedback for learning disabilities and chronic pain, for example.
Note that simply identifying areas of the brain does not directly correlate to putting an electrode over the cortex of a particular area. Many of these structures or mechanisms are deep in the brain, and may not have direct connections to the cortex above the structure. Also, since the brain is a richly-integrated network that is a complex system, simply targeting one specific area may not have a specific effect. Much more work must be done to identify the best way to use neurofeedback for training, even if a new area is identified.
Many imaging studies have linked depression to lack of perfusion or activation in the left frontal lobe. These patterns may correlate to other symptoms, not just depression.
As a result of research, many clinicians over the last few years have targeted the left frontal lobe for depression more directly. Others have trained the differential between left and right frontal hemispheres. Psychologists, psychiatrists, and other therapists have reported that training the left frontal lobe often helps depression faster than previous neurofeedback methods. It also helps deal with more resistant types of depression. Several different training approaches have been reported.
More outcome studies are certainly needed. Practicing clinicians see results clinically with the most difficult, depressed clients. They may or may not be managed well with medication. Although clinical and anecdotal evidence abounds, more actual research studies are needed to help improve protocols and efficacy rates.
Obsessive Compulsive Dirsorder, and in particular rumination, has been shown as occurring around the anterior cingulate area of the brain with many imaging studies. As a result, several training strategies targeting sites with the richest pathways and proximity to the anterior cingulate have been created with neurofeedback. This strategy has significantly improved clinical outcomes.
An example: James LeDeoux is a well known researcher who wrote a book called “The Emotional Brain.” It made the amygdala somewhat popular. The amygdala is the part of the brain that plays a major role in trauma or extreme fear.
Since therapists often help clients with PTSD, there’s been great interest in using neurofeedback to influence or quiet the amygdala. Since it’s sub-cortical, well underneath the cortex, there’s no direct way to train it. But there are pathways in the cortex that have loops influencing structures all the way down to the brainstem. Was their a pathway to the amygdala?
Sebern Fisher, a psychotherapist in Massachusetts has a practice that works with a lot of traumatized patients and PTSD. She identified a spot now called FPo2. It’s just under the right eyebrow in the corner of the eye, close to the bridge of the nose. There was some reason to think it may be closer to the amygdala, or there may be pathways between that area of the brain, the prefrontal orbital cortex, and the amygdala. Additional brain research has supported this hypothesis. By training at that spot, she started reporting seeing a profound change in her traumatized clients starting in 2001. She started teaching her specific training model to other therapists, and many reported similar improvements to what Sebern described.
