You sit in a chair, facing a computer
screen, while a clinician sticks
electrodes to your scalp with a
viscous goop that takes days to
wash out of your hair. Wires from
the sensors connect to a computer
programmed to respond to your
brain ’s activity.
Try to relax and focus. If your brain
behaves as desired, you ’ll be
encouraged with soothing sounds
and visual treats, like images of
exploding stars or a flowering field.
If not, you ’ll get silence, a
darkening screen and wilting flora.
This is neurofeedback, a kind of
biofeedback for the brain, which
practitioners say can address a host
of neurological ills — among them
attention deficit hyperactivity
disorder , autism, depression and
anxiety — by allowing patients to
alter their own brain waves
through practice and repetition.
The procedure is controversial,
expensive and time-consuming. An
average course of treatment, with
at least 30 sessions, can cost $3,000
or more, and few health insurers
will pay for it. Still, it appears to be
growing in popularity.
Cynthia Kerson, executive director
of the International Society for
Neurofeedback and Research, an
advocacy group for practitioners,
estimates that 7,500 mental health
professionals in the United States
now offer neurofeedback and that
more than 100,000 Americans
have tried it over the past decade.
The treatment is also gaining
attention from mainstream
researchers, including some former
skeptics. The National Institute of
Mental Health recently sponsored
its first study of neurofeedback for
A.D.H.D.: a randomized, controlled
trial of 36 subjects.
The results are to be announced
Oct. 26 at the annual meeting of
the American Academy of Child and
Adolescent Psychiatry. In an
interview in the summer, the
study ’s director, Dr. L. Eugene
Arnold, an emeritus professor of
psychiatry at Ohio State, noted that
there had been “quite a bit of
improvement” in many of the
children’s behavior, as reported by
parents and teachers.
Dr. Arnold said that if the results
bore out that neurofeedback was
making the difference, he would
seek financing for a broader study,
with as many as 100 subjects.
John Kounios, a professor of
psychology at Drexel University,
published a small study in 2007
suggesting that the treatment
speeded cognitive processing in
elderly people. “There’s no question
that neurofeedback works, that
people can change brain activity,”
he said. “The big questions we still
haven’t answered are precisely
how it works and how it can be
harnessed to treat disorders. ”
Russell A. Barkley, a professor of
psychiatry at the Medical
University of South Carolina and a
leading authority on attention
problems, has long dismissed claims
that neurofeedback can help. But
Dr. Barkley says he was persuaded
to take another look after Dutch
scientists published an analysis of
recent international studies finding
significant reductions in
impulsiveness and inattention.
Still, Dr. Barkley cautioned that he
had yet to see credible evidence
confirming claims that such benefits
can be long lasting, much less
permanent.
And another mainstream expert is
much more disapproving. William E.
Pelham Jr., director of the Center
for Children and Families at Florida
International University, called
neurofeedback “crackpot
charlatanism.” He warned that
exaggerated claims for it might
lead parents to favor it over
proven options like behavioral
therapy and medication.
Neurofeedback was developed in
the 1960s and ’70s, with American
researchers leading the way. In
1968, M. Barry Sterman, a
neuroscientist at the University of
California, Los Angeles, reported
that the training helped cats resist
epileptic seizures. Dr. Sterman and
others later claimed to have
achieved similar benefits with
humans .
The findings prompted a boomlet
of interest in which clinicians of
varying degrees of respectability
jumped into the field, making
many unsupported claims about
seeming miracle cures and tainting
the treatment’s reputation among
academic experts. Meanwhile,
researchers in Germany and the
Netherlands continued to explore
neurofeedback ’s potential benefits.
A major attraction of the technique
is the hope that it can help patients
avoid drugs, which often have side
effects. Instead, patients practice
routines that seem more like
exercising a muscle.
Brain cells communicate with one
another, in part, through a constant
storm of electrical impulses. Their
patterns show up on an
electroencephalogram, or EEG, as
brain waves with different
frequencies.
Neurofeedback practitioners say
people have problems when their
brain wave frequencies aren ’t
suited for the task at hand, or when
parts of the brain aren ’t
communicating adequately with
other parts. These issues, they say,
can be represented on a “brain
map,” the initial EEG readings that
serve as a guide for treatment.
Subsequently, a clinician will help a
patient learn to slow down or speed
up those brain waves, through a
process known as operant
conditioning. The brain begins by
generating fairly random patterns,
while the computer software
responds with encouragement
whenever the activity meets the
target.
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