Application Bio- and Neurofeedback Clinical use and use in peak …human.kyst.com.tw/upload/Workshop...
Transcript of Application Bio- and Neurofeedback Clinical use and use in peak …human.kyst.com.tw/upload/Workshop...
Application Bio- and Neurofeedback –Clinical use and use in peak performance
Tim Keren
Mind Media BV - Mission
To empower researchers, clinicians and health professional with innovative systems for measuring, training and optimizing human neurophysiology, health and performance
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Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Mind Media BV - Vision3
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Focus on Health, not on Disease.
(mens sana in copere sano)
Biofeedback
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Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Development of Biofeedback
• Instrumental conditioning of the autonomic nervous system (1967-1969 Miller)
• Psychophysiology (Shapira 1965)
• 1969 – Biofeedback Research Society
• 1988 – Association of Applied Psychophysiology and Biofeedback –www.aapb.org
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Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Biofeedback is a technique that enables an individual to learn how to change
physiological activity for the purposes of improving health and performance
(Gilbert & Moss, 2003; Schwartz & Andrasik, 2003)
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Physiological activity7
• Muscle Tension – ElektroMyoGram/EMG
• Heart Rate – EKG/Pulse
• Respiration (rate)
• Sweating – Skin Conductance
• Peripheral Temperature
• Brain Waves – EEG
• And more: Force, HEG, Oxygen, etc.
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Biofeedback8
• Important:
– Motivated Client
– High quality instruments thatreliably measure what you would like to measure (validity)
– Good therapist.
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Active involvement of client = Training!
Biofeedback Instruments
Biofeedback instruments are used to visualize physiological processes, increase awareness of them and to gain voluntary control over
body and mind.
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Biofeedback Instruments
Learning principle:• Operant conditioning: creating new habits by (positive) reinforcement (Skinner)
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Biofeedback Instruments
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Set-up 12
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Therapist Client
General indications for Biofeedback
• Showing psychophysiological interaction and increasing knowledge of biopsychosocial model
• Stressmanagement/relaxation
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Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Specific indications for Biofeedback
• Tension Headache, Migraine• Chronic pain, back pain• Essential hypertension • ADHD• Anxiety• Insomnia • PTSD• Performance enhancement – sports/management • Constipation• Substance abuse – drugs/alcohol• Rehabilitation• Incontinence• …….
“Evidence-Based Practic in Biofeedback and Neurofeedback”. Carolyn Yucha Ph.D; Doil Montgomery, Ph. D. American Association of Apllied Psychophysiology & Biofeedback (AAPB. www.aapb.org)”
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Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Goals of Biofeedback
• Improvement of perception of physiological processes (Interoception)
• Improvement of controlling these processes and improvement of believe of control.
• Identification of factors that influence physiological processes
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Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Steps in Biofeedback
• Awareness of physiological processes
• Control – changing Behaviour
• Generalization - Transfer to daily life.
Generally about 10 sessions in Biofeedback/30-40 in Neurofeedback
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Stress - Biopsychosocial model17
Stress Stress
Stress
WHO 1948: “Health is a state of complete
physical, mental and social well-being and
not merely the absence of disease or infirmity”
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Environment18
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Stress and our brain19
Stress/Thoughts can lead to physical/physiologicaleffects that can be similar to physical excercise
(body/mind interaction)
Psychosomatic Romans about 2000 years ago “Mens sana in corpero sano” – A healthy mind in a healthy body.
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
(Autonomic) Nervous System 20
The nervous system
Central nervous system (CNS)
Brain Spinal cord
Peripheral nervous system (PNS)
Somatic nervous system
Controls voluntary movement
Peripheral nervous system
Controls involuntary responses
Sympathic
Fight or flight
Parasympathic
Rest and digest
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Sympathetic (Gas – Fight/Flight) Parasympathetic (Brake - Relaxation)
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Stress - Survival mechanism22
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Chronic Stress 23
Effect stress fully normal, chronic stress can lead to disbalances which in its turn can lead to different (or have effect on) conditions like chronic tension
headache, anxiety, hypertension, etc.
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Stress related parameters
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Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
What happens in stress?25
• Muscle Tension
• Skin Conductance
• Heart Rate
• Temperature
• Respiration rate
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What happens in stress?26
• Muscle Tension
• Skin Conductance
• Heart Rate
• Temperature
• Respiration rate
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
A core principle that Biofeedback uses is physiological activation versus relaxation
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Activation versus relaxation
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(Ab-)normal stress responses28
Normal stress response
Abnormal stress response
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Stress profiling
• Set-up
– Baseline (reading in silence)
– Stressors
• Alphabet backwards
• Think of as much animals with an “R”
• Deduct 7 from 1081, etc..
– Relaxation
• Offers valuable information for client and therapist (or athlete!)
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Performance enhancement - Sports
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Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Performance enhancement - Sports
Peak performance does not depend on physical ability alone.
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Where physiology meet psychology
• Difference can be made by mental focus of an athlete, especially under high pressure.
• Athletes have to be able to relax and control their mental state.
Psychology Physiology
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Performance and Bio- Neurofeedback
Biofeedback and Neurofeedback can be helpful for athletes to
detect shift in mental state while resting, practicing, or participating in high stress
and competitive environment.
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Performance and Bio- Neurofeedback
• Getting insight in psychophysiology (biofeedback) in order to:
– Improve emotional self-regulation (biofeedback). More contol over energy levels.
– Improve focus (bio- and neurofeedback)
• Can help facilitate in recovery from injury.
Use and training techniques
• Examples
– Complementary to existing (relaxaton) techniques
– Visualization: reduce stress, sustain focus by directing attention of the athlete to a specific aspect of the performance.
– Simulators: replicate physiological sensations and control them, learning to better anticipate
– Insights in physiology before, during and after performance
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Use and training techniques36
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Training Mind-Body functions
Demo measurement
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Cases
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Case Headache40
• Intake
– Headaches since 1 year, originated from stressfull period.
– Less stress is less complaints, symptoms never completely gone.
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Skin Conductance
Temperature
Breathing
Heart rate
Left shoulder
Right shoulder
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
42 Left Trapezius1,9 uV
Frontalis –forehead 2,1 uV
Right Trapezius2.2 uV
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Case Headache43
• Results– EMG and hand temperature go well– Skin Conductance high and reactive– Breathing rate high (18 times a minute)– Too little interaction between heart rate and
breathing rate
• Client– Also thinks muscle tension is not a problem and
recognizes warm (sweaty) hands– Skin conductance: always busy, sees and hears
everything– Didn’t know about interaction breathing/heart rate
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Case Headache44
• Protocol– Headache probably not related to muscle tension.
High skin conductance remarkable. Client continuously reacting which can lead to overload, which results in headache
– Idea to try biofeedback to lower skin conductance and normalize breathing
• Home work– Slower breathing
– Meditation – bodyscan
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Case Headache45
• Session 2
– Home work done in car and at home, could not do it a work
– Bodyscan very hard
• New measurement
– With breathing based on feeling
– SC little less and little less reactive
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Skin Conductance
Temperature
Breathing
Heart rate
Left shoulder
Right shoulder
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Case Headache47
• Training
– Puzzle: stops when skin
conductance rises
– Bargraph: moves too much
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Case Headache48
• Training
– Bargraph removed:
Lowering SC, still quite reactive
– Slow breathing at same time
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Case Headache49
• Results
– Learned to control and lower skin conductance within 4 session
– Takes more rest, especially when too many thing are going on
– Strong reduction headache to almost none
– Last appointment cancelled due to absence of complaints
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Case Fatigue 50
• Intake
– Mrs B, 46 years old
– Fatigued, agitated and emotionally unstable
– Feeling gest worse at situations she does not feel at ease, feeling of unwelcomeness and no being accepted
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Skin Conductance
Temperature
Breathing
Heart rate
Left shoulder
Right shoulder
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Case Fatigue52
• Results
– Fast and shallow breathing
– Cold hands with temperature decreasing during the test.
– Unconcious tensing shoulder.
– Cold hands may indicate that client approaches the world with suspision, which is indeed the case. (insecurity, anxious). Shallow breathing may be explained by this as well (pattern associated with anxiety)
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Case Fatigue53
• Protocol– Breathing training with pacer
– Home excercises.
• Results– Noticed that other accepted her, being herself.
– Comfortable in groups
– Another job, which suited better
– After a while fatigue diminished
– Last stress stress warm hand and normal responses
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Case Sleeping disorder #254
• Intake
– Woman, 38 years, mother of 3, volunteer at school
– Sleeping problems, wakes up regularly, since 15th
– Other problems: tense, especially in the evening. Feels unsafe at times. Legs and arms painful during sleep.
– Since 15th year medication; feels like this helps, but very tired in the morning, more and more concentration problems which could be side effect
– Stopped with medication since a week, tried to stop several times
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Skin Conductance
Temperature
Breathing
Heart rate
Left shoulder
Right shoulder
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Case Sleeping disorder #256
• Results
– Fast breathing with sighing
– Reactive skin conductance without relaxation
– Temperature drops
– Shoulders helping during breathing excercise
– Client want to learn to be less alert, doesn’t know how. Wants to be there any time for her children
– Temperature drops: fits feeling unsafe
–
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Case Sleeping disorder #257
• Protocol
– Doesn’t like slow breathing
– Advice:
• Sleep diary
• Temperature training, create feeling of being safe
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Case Sleeping disorder #258
• Training
– Lowering SkinConductance and raising temperature by visualizing lying on a warm beach
• Homework
– Hand thermometer
– Visualisation
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Skin Conductance
Temperature
Breathing
Heart rate
Left shoulder
Right shoulder
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Case Sleeping disorder #260
• Results
– Learned to lower skin Conductance and warm hand, muscles relax as well.
– Sleeping improved, deeper sleep, less waking up and felt more rested
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Case High Blood Pressure61
• Intake
– 47 old woman, high blood pressure since first pregnancy 13 years ago.
– Medicine: beta blocker.
– Self reported BP 85-95 systolic and 135-150 systolic
– Busy job (coach) but able to relax through Meditation.
– Personality: activ, enthusiastic! Motivated to work on her health and to try to lower blood pressure!
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• Assesment
– Biofeedback measurement in rest (reading magazin), 3 stressors and 3 relaxations.
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Case High Blood Pressure
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Skin Conductance
Temperature
Breathing
Heart rate
Left shoulder
Right shoulder
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Baseline Stressor Relaxation
• Assesment first session
– No slower breathing during relaxation, HRV drops.
Case High Blood Pressure
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• Second session - training
– Paced breathing 7; 6,5 and 6 times for 3 minutes
Case High Blood Pressure
Skin Conductance
Temperature
Breathing
Heart rate
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• Second session
Case High Blood Pressure
Pulse
Breathing
Heart rate
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• Second session
– Heart skips beat: client doesn’t feel or know this. Has been extensively tested, skipping beat harmless but taken in to consideration.
– Temperature drops
– Conclusion: pacer not best way, better to breath based on feeling. Client comes with the idea to practice this while walking her dog.
Case High Blood Pressure
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• Third session
– Breathing on feeling, 6 times a minute.
Case High Blood Pressure
Skin Conductance
Temperature
Breathing
Heart rate
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• Results
– Perfect stress profile
– Now practices 3 times a day during walk with dog
– Reduction in medication, discussing with physician to lower even more.
– Lower blood plessure
– Feels more vital and can sleep better
Case High Blood Pressure
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Case Hyperventilation70
• Intake
– 37 year old woman
– Hyerventilation
• Assesment stress test
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Skin Conductance
Temperature
Breathing
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• Results stress test
– Breathing rate baseline 16 when not paying attention to breathing
– Breath rate relax: 6, during awareness of breathing
– Pacer breathing: drop in temperature, increase in skin conductance.
– Breathing pacer not the way
Case Hyperventilation
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Case Hyperventilation73
• Training protocol
– Relaxed breathing while being measured
– Homework
– Awareness of breathing by using Resperate
– Tone says when to breath in and breath out
• Results– Within 5 session less anxious, less frequent and
intense hyperventilation episodes
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Case Sleeping disorder74
• Intake
– Male, 31 years, teacher
– Since 4 month sleeping issues, sleeping in after 1,5hours and wakes up during the night
– Low energy, headache, feeling exhausted. Sleeps during weekend to recover.
– Cause is combination work and study less free time. Feel like being active all the time. Tries not to check mails in the evening and not work when at home
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Skin Conductance
Temperature
Breathing
Heart rate
Left shoulder
Right shoulder
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Case Sleeping disorder76
• Results
– Fast breathing
– No recovery after stressor (skin conductance)
– High rise in heart rate with stressor
– Tense shoulders, especially during stressors
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Case Sleeping disorder77
• Protocol
– Lower Skin Conductance
– Practice slow breathing
– Awareness muscle tension
– Home work
• Mini breaks during the day
• Apps slow breathing/Resperate
• PIP skin conductance
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Case Sleeping disorder78
• Results
– After about 8 session increase sleep efficiency to 75-80% . Client already satisfied with this
– Less tense, will keep on using homework to improve even more.
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Neurofeedback
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Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Neurofeedback is a speciality field within Biofeedback where the goal is to training
people to gain control over electro-physiological activity in the human brain (EEG
– ElectroEncephalogram)
(Gilbert & Moss, 2003; Schwartz & Andrasik, 2003)
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Development of EEG/Neurofeedback81
- First EEG – Hans Berger 1929
-Digital EEG 1960
-QEEG 1960-1970 ULCA Brain Research Institute (Ross Adey).
-Neurofeedback 1960’s (Joe Kamiya, Barry Sterman)
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Neurofeedback applications
• #1: ADHD, very well investigated
• Well investigated
– Epilepsy
– Sleep disorder/insomnia
• Experimental
– Traumatic brain injury
– Autism
• Peak Performance (John Gruzelier)
• Improvement attention and memory
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EEG - Neurofeedback83
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EEG – physiological basis84
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EEG Physiological basis85
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EEG Physiological basis86
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EEG Physiological basis87
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Addition of electrical activity of billions of pyramid cells
Locations – Ten20 system88
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Neurofeedback training approaches
- Frequency band training
* Standard protocol (Cz, C3, C4)
* QEEG guided Neurofeedback
- Z-score training
- Slow Cortical Potentials neurofeedback
- HEG neurofeedback
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Neurofeedback sessions
• 30/40 session 1-2 times a week
– Often combined with BFB to reduce # sessions
– Different phases:
• Learning/Automisation;– 1-10 sessions; client feels tired in beginning, after around 10
sessions getting feeling of control and keeping the desired state
• Stabilising: – 11-20: learned condition is stabilised and can be controlled for
longer periods. Often more feeling of focus. Often feeling ofbteer sleeps, faster recovery.
• Performance enhacement phase– 21-30: Increasing learned control even more.
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Therapist screen91
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Client screen92
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Client screen93
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Client screen94
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Client screen95
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Client screen96
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Neurofeedback session
Duration video: 3 minutes
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Spontaneous EEG98
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Beta: 13 – 30 Hz
Alpha: 8-12 Hz
Theta: 4-8 Hz
Delta: 1-4 Hz
Mental awareness
Cerebral activity
Neurofeedback –Frequency bands99
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Neurofeedback –Frequency amplitudes100
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Theta (4-8 Hz)101
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
• Theta: distractability/inattention/daydreaming
• ADHD/Learning disabilities: reduction of Theta
• Used in Theta/Beta ratio reduction theta and increase beta reduction of Theta/Beta ratio.
SMR (12-15 Hz) 102
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
• SMR: Sensomothoric Rhytm, mental alertness, physical relaxation.
• ADHD: increase
• Sensomotoric cortex (Cz, C3, C4)
(Low) Beta (13-21 Hz) 103
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
• Low Beta: attentive wakefullness
• ADHD: increase. Used in Theta/Beta ratio reduction theta and increase beta reduction of Theta/Beta ratio.
High Beta (21-35 Hz) 104
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
• High Beta: very active, busy head, impulsiveness
• ADHD: decrease
Z-score training105
• Training to normalize (0 standard deviations)
– EEG data is compared while measuring with database
– Neuroguide database
0Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Z-score training106
• Screenshot nieuwe software
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Slow cortical potentials (SCP)107
SCP Frequency bandsBiofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Slow cortical potentials (SCP)108
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
• Phenomenons in the EEG that last for a couple of hundred milliseconds up to several seconds. In other words slower than regular EEG
• Show the cortical activation
• Distinction between positive and negative potentials
• Close relationship SCP to attention, memory, reaction time Negative SCP Positive SCP
Slow cortical potentials (SCP)109
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
• Phenomenons in the EEG that last for a couple of hundred milliseconds up to several seconds. In other words slower than regular EEG
• Show the cortical activation
• Distinction between positive and negative potentials
• Close relationship SCP to attention, memory, reaction time Negative SCP Positive SCP
SCP training110
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
• Set-up:
– SCP Sensor (TP connection)
– Ground TP sensor
– Sintered Electrodes + Accesories
– Red on Cz, 2x Black on A1/A2, ground anywhere
SCP training111
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
• Protocol
– Baseline (1-2 sec)
– Negativity/Positivity at random (8 second)
– Reward/No reward (2 sec)
– +- 50 times/trials (1 run)
– Several runs possible
SCP training112
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
• Goal: Voluntary Negativity and Positivity
Therapist screen SCP113
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Client screens114
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• Regional Cerebral Blood Flow (rCBF):
– Measurement of relative cortical blood flow
– Experimental
HEG Neurofeedback
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HEG Neurofeedback
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QEEG117
QEEG is Quantified EEG. Nuwer, 1997: The mathematical processing of digitally recorded EEG in order to highlight specific waveform components, transform the EEG into a format or domain that provides relevant information, or associate numerical results with the EEG data for subsequent review or comparison.” (Nuwer, 1997)
One of the simplest forms is spectral analysis 1 channel quantified EEG
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
QEEG118
- Often linked to 21 channel full cap EEG.
- Clinically: comparing (standard deviations) to a QEEG database like:
• Neuroguide• Loreta
-Prognostic tool.
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Demo measurement
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Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Cases ADHD
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Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Case ADHD #1
• Intake
– 56 years, male
– Recently diagnosed with ADHD
– Problem with concentration, busy head, problem with planning, forgetfullness.
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• QEEG screening (21 channels)
– High beta relatively high associated with busy head
– Protocol Cz downtraining 20-24 Hz
– Start with HRV training
Case ADHD #1
Case ADHD #1
• After 8 sessions– Self-reported increased focus
– Better organized, less chaotic
• EEG data shows reduction Beta amplitude (20-24)
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Case ADHD #2
• Intake
– Male 58
– Presenting diagnosis ADD
– Planning and execution issues
– Distractible
– Task completion issue
– Also:
• Episodic migraine
• Eleveated blood pressure 140-160/80-100
• Generalized anxiety disorder
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Case ADHD #2
• Assesment
– Excess 9-10 Hz in
central, temporal, parietal
• Protocol
– 2 channel z-score training
• Fz and Pz (13 sessions)
• F3 and F4 (4 sessions)
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Case ADHD #2
• Improvements– Better focus
– Able to complete tasks
– Faster responses to cognitive challeng
– Less volatile emotional responses
– Fewer migraine episoded and reduced intensitiy.
• Unchanged– Blood Pressure
– Anxiety
– Continued migraine episodes
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Case ADHD #2
• Extra training (5 sessions)
– HRV training office
– Home (Resperate for Blood pressure control)
• Improvements
– Reduced blood pressure 10-15 points systolic and diastolic
– Reduced migraine
– Mess anxiety, less need for control
– Memory and cognitive improvement
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Case ADHD #2
• Assesment
– Reduction 9-10 Hz
– Also elimination of 18-19 Hz in parietal
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Case: Elle – 10 year old girl
• Diagnosed with (DSM-IV):
– ADHD
• Main symptoms:
– Easily distracted
– Hard to keep her attention for some time
– Moves around
– Stares
– Dreamy
– School problems: mainly inability to automate:
math, reading, days of week, tell time
• Main impression:
– Sweet, cheerful and energetic child
– Passionate about animals, can be completely wrapped up into this subject
– Appears to be dreamy, in her own world, but makes adequate contact
– Seems to need some time to process information coming from her environment
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Intake: QEEG130
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– QEEG:
• Over aroused: excess of high beta activity (20-30 Hz), mainly in the parietal cortex area.
• Connection with neuropsychology: parietal cortex is involved with automate processes.
– Questionnaire:
• Mother reports a lot of ADD related distractibility and attention problems. Also learning problems.
Intake: QEEG131
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Training
– Protocol:
• Inhibit fast brain waves: 20-30 Hz
• Locations: P3 and P4
– Feedback:
• Watching movie (Planet Earth)
• Each time the high beta amplitude stays below threshold, the video continues playing
– Total amount of sessions:
• 40 session (twice a week)
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Results
– Subjective results: • Parents and Elle are very enthusiastic about the results
of the training
• Elle’s concentration is improved, better able to keep her attention
• Less daydreaming
• Better school results, especially math
• Elle is in a better mood
• Elle makes better social contact, seems to got out of her ‘own world’ and makes a better connection with the world around her
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Result - QEEG134
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Before: After:
The EEG is more normalized. Reduction of high beta around the parietal cortex.
Case: Elle – 10 year old girl135
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Results - Questionairre
– Questionnaire: Strong reduction of reported problems
ADD Distractibility Inattention
Learning problem: linguisticsLearning problem: Reading
Memory problems: visual/reading Notion of social information
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Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Case ADHD #3
• Intake
– Gregoire, 8 years old
– Happy, spontaneous. Parents: inattentive, forgetfullness, losing things.
• Protocol/Results
– Theta/Beta Ratio training Cz, which was elevated.
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Case ADHD #3138
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• Protocol/Results
– First 4 sessions Videos/Animation/Games
– Next sessions more boring animations which was a challenge for Gregory
– 8 Session very hard, motivation talk with Gregory and parents. Rewards after session when doing well.
– After 10th session drop in Theta/Beta ratio
Case ADHD #3139
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
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10
15
5
10
15
Session 1
Session 10
Case ADHD #3140
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
• Protocol/Results
– After 27 sessions 40% drop in Theta/Beta ratio
– Parents/Teacher: better concentration, less impulsive, better social behavior, less chaotic, more independent at home.
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Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Brain waves142
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Frequency Hz Function (positive and negativ)
Delta 1 – 4 Deep sleepUnconciousnes, TBI, Coma
Theta 4 – 8 Drowsiness; deep relaxation, creativitivity, spontanityDistractible, Inattention, Daydreaming, ADHS, Depression, Anxiety
Alpha 8 – 12 Relax awake, internal restDaydreams, Depression, ADHD
SMR 12– 15 Supressed by motoric activity, increase better sensoric input and cognitive integration (metally awake and physically relax)
Beta
High Beta
13– 21
21 – 38
Attentive wakefullnes; ADHD, Sleep and learning disorders
Cognitive workingTense, Hypervigilant, Anxiety
Gamma 38 – 42 „Binding“ – Integration of Neuronen connection with sensoric and cognitive processes, problem solving. Too little: learning deficit, mental deficits
Case ADHD #2
• Intake
– Concentration issues
– Busy head
• Protocol
– Theta and High Beta down (Fz and Pz)
• Sample session
– Theta en High beta reduction
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Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Case ADHD #3144
Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Other applications NFB
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Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Epilepsy
• Review articles Sterman (2000)
– 1972 – 1996
– 18 peer reviewed studies
– 82% experienced >30% reduction
– EEG changes after neurofeedback
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Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring
Sleep
• First publication 1970 Sterman
– Longer periods undisturbed sleep (cats)
– Increased number of sleep spindles
– First “side-effect” most often reported by people submitted to SMR neurofeedback
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Biofeedback, Neurofeedback, Stress and Psychophysiological monitoring