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MEDICINE | IN THE LAB

Physical therapy for the brain

Treating certain ailments without drugs is possible with neurofeedback. It lets patients view and modify their mind's activity.

November 27, 2006|Eric Jaffe | Special to The Times

EVERY week for two years, Michael Hammett stared at a computer screen, trying to open a flower with his mind.

Hammett had developed a case of carpal tunnel syndrome so severe he needed surgery. But being a former opiate abuser, he refused to use the medications that would be needed to control the resulting pain. Having already tried physical therapy, he set his mind on another alternative: neurofeedback.

In neurofeedback, people with mental or psychological conditions learn to regulate and reduce their symptoms -- in Hammett's case, pain -- by monitoring their brain waves on a computer. The treatment is an increasingly popular cousin to biofeedback, in which people control physical stress by monitoring their heart rate or muscle tension.

Hammett learned to do both. Electrodes attached to his scalp transmitted electrical signals from his brain to a computer displaying a closed white flower. Other sensors were attached to muscles in both his hands and arms. As Hammett learned what it felt like to relax these muscles, and therefore reduce his pain, the flower began to open. Over time, he trained his brain to calm his central nervous system whenever the pain recurred.

"That image of the flower opening is so burned into my psyche, in conjunction with the moment of relaxation," the 48-year-old Santa Monica resident says, three years after finishing his therapy.

Neurofeedback has been used for decades in private clinics, but few well-controlled research studies have been done -- giving it an unscientific reputation. That's beginning to change.

Researchers are now studying and refining the therapy -- with promising results. Neurofeedback is being used to treat a growing number of conditions, including chronic pain, attention-deficit hyperactivity disorder, asthma, migraines, post-traumatic stress disorder, substance abuse, autism and a variant of autism called Asperger's syndrome.

"We've done some definitive studies finally that show it works in important ways," says Eran Zaidel, a professor of behavioral neuroscience and cognition at UCLA's Brain Research Institute.

"It's still considered an alternative approach to medicine, but some people won't do conventional medicine at all," he says. "Many, many people are very eager to use this method."

Studies show the advantages

Neurofeedback therapy emerged from work done in the 1960s by psychologist Barry Sterman, now professor emeritus at the UCLA School of Medicine. He wired electrodes to the heads of cats, then rewarded them whenever their brain waves reached a frequency that indicated a relaxed state. In subsequent experiments, Sterman found, cats that had learned to relax themselves this way had a higher resistance to the onset of seizures.

The medical applications seemed obvious: If people learned to relax in such a way, they too might be able to stave off seizures or anxiety attacks.

Such a method has advantages over simply taking a pill, says Rob Kall, a neurofeedback practitioner in Newtown, Penn. "When you're done with medication, it goes out of your system," Kall says. But when you're done with neurofeedback training, the benefits remain.

Perhaps the most researched and accepted application of neurofeedback is with patients who suffer from ADHD.

In 2002, a clinical team led by psychology professor Vincent J. Monastra, director of the FPI Attention Disorders Clinic in Endicott, N.Y., studied 100 children diagnosed with the condition. All the patients received Ritalin and counseling, but about half also received neurofeedback. Every week, Monastra hooked electrodes to the frontal cortex of these patients and taught them to increase arousal in that area. Heightened frontal cortex activity reflects a reduction in hyperactivity and improvements in attention.

After a year, all the patients showed some improvement. But when the researchers discontinued treatment for a week and reevaluated the patients, only those who received neurofeedback retained those improvements.

The neurofeedback appeared to actually change the patients' brain patterns, the research found, and neurological tests showed greater activity in the parts of the brain responsible for attention and behavioral control. The study was published in the December 2002 issue of the journal Applied Psychophysiology and Biofeedback.

Between drugs and neurofeedback, only the latter can potentially offer long-lasting change, says clinical psychologist Roger deBeus of Eastern Virginia Medical School in Norfolk, Va. "As the brain becomes more normal, patients don't need as much or any medication," he says.

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