The Use of Neurofeedback Techniques as a Mechanism for Enhancing Human Performance - Essay Example

Year of study: Topic: Critically evaluate the use of neurofeedback techniques as a mechanism for enhancing human performance. Introduction This report is a critical evaluation of the use of neurofeedback techniques as a mechanism for enhancing human performance. The author presents a working definition of the term Neurofeedback, followed by some background information of the technique as it is used in the medical field. The report then presents a detailed discussion of the technique highlighting its clinical effectiveness as a therapeutic measure in training patients to overcome their problematic conditions and probably improve their performances. The report also differentiates neurofeedback from other therapeutic treatments used in training the human brain to regulate various cortical activities of their bodies (LaVaque, 2003). Finally, the report pinpoints the numerous criticisms that have been levelled against the use of neurofeedback technique and sums it up by a short concluding remark. From the outset, LaVaque (2003) attempted to define Neurofeedback by alluding that it is a form of conditioning technique aimed at bringing gradual change to the human mind. Broadly, the technique has been associated with Biofeedback which on one hand is claimed to be fundamentally concerned with improving the inherent communication between the mind and the body (Linden & Moseley, 2006). This claim is further confirmed by the definition arrived at by three professional Biofeedback organizations sometime in 2008 where they noted: “Biofeedback is a process that enables an individual to learn how to change physiological activity for the purposes of improving health and performance. By use of precise instruments to measure physiological activity such as brainwaves, heart function, breathing, muscle activity, and skin temperature, accurate information is rapidly relayed back to the user for eventual implementation”. But in the views of Andrasik & Moss (2008), Neurofeedback is considered “a form of behavioural training aimed at developing skills for self-regulation of brain activity”. It is therefore applied mainly as a therapeutic tool to treat different types of disorders including autism, incontinences, epilepsy and or insomnia. For the foregoing definitions, it becomes critical to address the pertinent issues associated with Neurofeedback techniques. Background Research has variously identified Neurofeedback as a somewhat complicated form of biofeedback that requires sufferers to learn self-regulating certain aspects of their body activities through conditioning. Such distinct parameters of these body activities have been cited by Bladin (2006) as coherence in their mind processes that can be studied using a painless technique namely electroencephalography (EEG). As noted by Nestoriuc et al (2008), Biofeedback has been used in relieving headaches, asthma and blood pressure as well as optimizing performance in elite athletes for close to forty years. The practice has continued to date where Neurofeedback is actively being applied as a therapeutic tool to treat different types of disorders including but not limited to epilepsy, lack of sleep or reduced alertness in children (Norbert, 2007). Further observations by Mark & Barlow (2009) indicate that the advancement in IT has enabled partially incapacitated patients to converse and even show some signs of mobility. Additionally, application of technological prowess has greatly seen Neurofeedback allowing otherwise incapacitated patients learn to normalize physiological processes such as muscle co-ordination, respiration, and blood pressure. This breakthrough is further evidenced by the development of “Inner Act’s platform for Biofeedback” which is lauded by Cannon et al (2008) as the mostly utilized platform for elite athletes. It is therefore in the interest of this report to mention that most recent researches have focused on the possibility of using healthy individuals as control subjects to prove the efficacy of neurofeedback techniques. At Inner Act platform for example, evidence has been adduced that “subjects who are able to gain control over different EEG parameters might even succeed in increasing performance levels in various cognitive tasks” (Cannon et al, 2008). Research findings by Laine & Glazer (2006); Mark & Barlow (2009) and Peper et al (2008) have demonstrated that there is a growing body of evidence supporting the use of Neurofeedback techniques to activate specific brain functions in subjects with certain afflictions. According to their arguments, it has become quite possible for the medical science to directly overcome common maladaptive brain activities that are associated with various disorders like epilepsy, reduced mental concentration and/or insomnia (Quoted in Norbert, 2007). The combination of Neurofeedback and Biofeedback training has been found to be quite effective in improving training results of study subjects. In more recent times, published works by Laine & Glazer (2006) and Peper et al (2008) have shown fundamental monumental improvements in the methodologies used to apply Neurofeedback. By overcoming the shortcomings manifested by earlier NF methodologies, there is tangible evidence showing that current Neurofeedback techniques are making successful bases for its clinical efficacy and effectiveness in neuropsychiatric disorders (Peper et al, 2008). Additionally, Andrasik & Moss (2008) have argued that Neurofeedback has been employed successfully in substance use disorder (SUD) over the last three decades. The SUD has been defined as a complex series of disorders associated with frequent substance abuse resulting in EEG abnormalities of several types (Mark & Barlow, 2009). Neurofeedback while been employed in conjunction with other therapies has thus produced successful results in suppressing common SUDs like alcoholism. Based on published clinical studies, Bladin (2006) identifies this application as related to alpha theta training-either alone for alcoholism or in combination with beta training for stimulant and mixed substance abuse. In combination with residential treatment programs, this application is found probably efficacious as explained by efficacy criteria adapted by Mark & Barlow (2009). Types of Neurofeedback Neurofeedback has always been confused with other forms of brain therapies such as EEG Biofeedback and Brainwave Biofeedback for quite some time. But all in all, the three terms basically describe the form of Biofeedback that is founded directly on the brain’s electrical activity as espoused by Andrasik & Moss (2008). Particularly at Inner Act, the term Neurofeedback is more regularly used than the others. Research has therefore identified two main types of Neurofeedback technology used by the Inner Act as The EEG Spectrum International Platform and the Zengar Platform. The EEG Spectrum Platform (EEGer) is produced by a clinician-owned company and is based on technology driven by research, EEG practitioners and client needs as observed by Mark & Barlow (2009). The platform applies computer software that “has been researched extensively for effectiveness with attention, autism, attachment, learning and performance” (Norbert, 2007). Research has further indicated that EEGer is used for site-specific training and specific placements and for power performance to increase or decrease a specific brain frequency (Andrasik & Moss, 2008). Using sensors placed at specific sites, EEGer provides real-time traces with many advanced options including alpha-theta training. The Zengar Platform on the other hand is an approach that works comprehensively across all available brainwave frequencies rather than a limited subset. Here, the software adapts to the client’s response to Neurofeedback while the training is ongoing as noted by Linden & Moseley (2006). The brain receives information about what it has done and uses the same to re-organize itself. Bladin (2006) argues that the Zengar Platform is unique in itself because it notices when a self-regulatory mechanism has stopped functioning and hence triggers the orienting response to reset the process. It is explained that this temporary break in the continuity of the mechanism triggers the brain’s orienting response (Norbert, 2007) that activates the self-regulatory mechanisms and returns the brain to a state of optimal functioning. According to views held by LaVaque (2003), the most advanced Neurofeedback technologies and treatment approaches available are based on these two platforms. Available documented evidence confirm that the different Neurofeedback products and software platforms that are currently in use are rigorously researched and purchased according to the clients’ needs (Nestoriuc et al, 2008). Constant upgrading of these software platforms is necessary to keep abreast with the most current technological changes occurring in the field of Neurofeedback and Neuroscience in general (Mark & Barlow, 2009). Effectiveness of Neurofeedback A number of cases have been presented to demonstrate the clinical effectiveness of Neurofeedback training to correct certain Neuropsychiatric disorders in humans particularly children. Cannon et al (2008) for instance observe that Neurofeedback training’s efficacy has been proven by over 300 controlled studies throughout the world. Similarly, Andrasik & Moss (2008) quote some cases reported in numerous white papers and books that show Neurofeedback studies bringing positive improvements in patients with reduced attention and memory processes as well as performance in real-life conditions. Additionally, several of these studies demonstrated that children with attention-deficit hyperactivity disorder (ADHD) improved behavioural and cognitive variables after being subjected to Neurofeedback therapy (Linden & Moseley, 2006). According to views proffered by Mark & Barlow (2009), Neurophysiologic effects have also been measured successfully using Neurofeedback. The foregoing arguments clearly demonstrate the effectiveness of Neurofeedback training as a therapeutic measure. In spite of the colourful successes enumerated in the foregoing paragraph, it has been discovered that specific and unspecific training effects could not be separated in these studies. For example, studies on “drug-resistant patients with epilepsy, significant and long-lasting decreases of seizure frequency and intensity through slow cortical potential (SCP) training were clumped together with those dealing with other child psychiatric disorders (Peper et al, 2008). Cannon et al (2008) and Linden & Moseley (2006) further report that the available case study results were obtained in NF training where self-regulation of specific aspects of electrical brain activity is acquired by means of immediate feedback and positive reinforcement. Training of slow cortical potentials (SCPs) on one hand addresses the regulation of cortical excitability as stressed by Mark & Barlow (2009). More results from various studies have gone further to indicate that both Biofeedback and Neurofeedback seem to be offering the kind of evidence-based practice required by modern day healthcare establishments demanding. As it were in the past, both Biofeedback and Neurofeedback were basically research-based conducted in the laboratory dealing purely with psychophysiology and behaviour therapy. The paradigm is currently changing to include mental processes in addition to the earlier issues. A number of bodies and associations have attempted in validating the treatment protocols followed in Neurofeedback applications as cited in Andrasik & Moss (2008). This observation is further supported by the results of a task force appointed in 2001 to establish standards for the efficacy of Biofeedback and Neurofeedback as reported by Peper et al (2008). According to the findings of the said task force, documented evidence in a series of white papers illustrates that Neurofeedback has shown efficacy in addressing a series of disorders listed by Yucha & Montgomery (2008) as “anorectal, attention deficit, hypertension, urinary incontinence, substance abuse and headache”. Cannon et al (2008) further observe that a broader review was published, applying the same efficacy standards to the entire range of medical and psychological disorders. These efficacy standards were updated sometime in 2008 to include over forty clinical disorders that ranged from alcoholism/substance abuse to vulvar vestibulitis (Mark & Barlow, 2009). The interpretation of the ratings for each disorder is used to indicate the effectiveness of Neurofeedback. Conversely, a lower rating is not a reflection of the ineffectiveness of Neurofeedback for the problem but rather an indication of lack of adequate research on the affliction (Norbert, 2007). Works by Yucha and Montgomery (2008) have identified five levels of efficacy based on the recommendations made by the task force mentioned earlier in this report. On adoption by renowned bodies and associations in the Neuroscience, the levels run from weakest to strongest. The first level was assigned to “eating disorders, immune function, spinal cord injury and syncope as it seemed “not empirically supported” lacking tangible case studies (Yucha and Montgomery, 2008). The second level was assigned a myriad of disorders including asthma, autism, Bell palsy, cerebral palsy, coronary artery disease, cystic fibrosis, depression, erectile dysfunction and urinary incontinence in children among many others. Mark & Barlow (2009) termed this as possibly efficacious as it requires at least one study of sufficient statistical power with well identified outcome measures. Probably efficacious constitutes the third level to which Yucha and Montgomery (2008) assigned alcoholism and substance abuse as well as arthritis, diabetes mellitus and faecal disorders in children. This level requires multiple observational and clinical studies. Level four addresses efficaciousness and requires the satisfaction of correct statistical data manipulation criteria (Andrasik & Moss, 2008). To this level, Yucha and Montgomery (2008) assigned anxiety, chronic pain, epilepsy and constipation in adults as dominant. Finally, efficacious and specific constitutes the fifth level where the investigational treatment must be shown to be statistically superior to credible sham therapy, pill, or alternative bona fide treatment in at least two independent research settings (Yucha and Montgomery, 2008). Urinary incontinence in females was assigned to this category. The working of Neurofeedback technique As earlier indicated, Neurofeedback is a form of Biofeedback which is based directly on the brain’s electrical activity. Arguments abound explain that the normal functioning of the brain normally generates a wave of electrical activity that is used in monitoring. According to views held by Nestoriuc et al (2008), the tiny sensors placed on the scalp of a client picks up the electrical activity of the brain and then allows it to be recorded and analyzed by a therapist’s computer. As the client’s brain continues to function, it is monitored by the therapist on a computer screen for as long as it takes. This basically forms the basis of Neurofeedback. As identified by Mark & Barlow (2009), this procedure is entirely non-invasive as it does not involve the application of any voltage or current to the brain. Norbert (2007) says and I quote: “the electrodes are simply ‘listening’ to the electrical activity of the brain”. The sensors are simply attached to the scalp with a safe, easily removed conductive adhesive gel. The working of Neurofeedback technique requires at least two computers to function effectively. This allows the therapist to monitor the session on one computer as the patient receives visual and audio feedback from the other computer through images and sound that are controlled directly by their brain (Andrasik & Moss, 2008). The brain uses visual and auditory information to re-organize itself and release old patterns of “stored information”. The client gets an opportunity to learn to relax and increase mental alertness and focus as the process gives him/her positive reinforcement (Norbert, 2007). Moreover, Linden & Moseley (2006) maintain that the client soon realizes that fidgeting, daydreaming, planning events, worrying and other brain activity interrupts the feedback and as such should remain calm. As the brain recovers from instability, it is further trained to regulate and synchronize itself toward a state of optimal functioning (Norbert, 2007). With the use of Neurofeedback, LaVaque (2003) notes that the brain learns to operate with increasing efficiency, flexibility and resiliency, thereby permitting the concerned subjects experience numerous improvements in their lives. Criticisms Although Neurofeedback is indicated as having been utilized in training epileptics to manage seizures for over twenty-five years, critics have not failed to fault it in one way or the other. For instance, Mark & Barlow (2009) argue that Biofeedback and Neurofeedback professionals continue showing a lot of reservations about the cost-effectiveness and efficacy of their treatments especially in today’s healthcare environment that emphasizes cost containment and evidence-based practice. In fact, critics are perverse with questions about how these treatments compare with conventional behavioural and medical interventions on efficacy and cost. But whether or not these techniques are economical, it remains an issue of further investigations. Conclusion The foregoing paragraphs have re-emphasised the necessity of Neurofeedback as a valuable treatment kit for neuropsychiatric disorders. It has also been established that the use of controlled studies are indispensable in ensuring clinical efficacy and effectiveness of common therapeutic measures. The field of Neurofeedback training has largely proceeded without clear validation even though successful results have been attained. Recent researches have largely concentrated on reviewing studies directed at validating other protocols used for improving ‘attention, memory, and mood, music and dance performance in healthy participants (Norbert, 2007). The much needed scientific basis to Neurofeedback research has proved to be elusive, but concerted efforts are in the pipeline for a real-time investigation. Researchers have further proposed a real-time setup comprising of a pre-surgical mapping tool, the investigation of functional brain dynamics, and possibly for Neurofeedback training and brain computer interfaces to be used in the improvement of human performance. This set-up is projected to go a long way in closing the knowledge gap that has been left by the lack of validated Neurofeedback technique. According to parents’ and teachers’ ratings in earlier studies, children of the Neurofeedback training group, particularly in attention and cognition related domains seemed to have improved more than children who had participated in a group therapy program (Mark & Barlow, 2009). However, children of both groups showed similar improvements when tested on neuropsychological measures. Accessed study findings tend to illustrate Neurofeedback techniques to be very fundamental in helping improve performance in human beings. Where Neurofeedback is applied to study subjects, research findings reveal that majority of them learned to regulate their cortical activities (Norbert, 2007). Additionally, behavioural improvements of these subjects were moderately related to Neurofeedback training performance rather than any other intervening variables like effective parental support or otherwise. References Andrasik, F & Moss, D. (2008). Foreword: Evidence-based practice in biofeedback and neurofeedback. Wheat Ridge, CO: Association for Applied Psychophysiology and Biofeedback. Bladin, P. F. (2006). W. Grey Walter, pioneer in the electroencephalogram, robotics, cybernetics, artificial intelligence. Journal of Clinical Neuroscience, 13(2), 170-177. Cannon, R. L., Sokkhadze, E. M & Trudeau, D. (2008). EEG Biofeedback as a treatment for substance use disorders: Review, rating of efficacy and recommendations for further research. Applied Psychophysiology and Biofeedback, 33(1), 1-28. Laine, C. D & Glazer, H. I. (2006). Pelvic floor muscle biofeedback in the treatment of urinary incontinence: A literature review. Applied Psychophysiology and Biofeedback, 31(3), 187-201. LaVaque, T. J. (2003). Neurofeedback, Neurotherapy, and quantitative EEG. Handbook of mind-body medicine for primary care (pp. 123-136). Thousand Oaks, CA: Sage. Linden, W & Moseley, J. V. (2006). The efficacy of behavioural treatments for hypertension. Applied Psychophysiology and Biofeedback, 31(1), 51-63. Mark, D. V & Barlow, D. (2009). Abnormal psychology: an integrative approach. Belmont, CA: Wadsworth Cengage Learning. pp. 331. Nestoriuc, Y., Martin, A., Rief, W., & Andrasik, F. (2008). Biofeedback treatment for headache disorders: A comprehensive efficacy review. Applied Psychophysiology and Biofeedback, 33(3), 125-40. Norbert, W. (2007). Cybernetics or Control and Communication in the Animal and the Machine. Kessinger Publishing, LLC. Peper, E., Tylova, H., Gibney, K. H., Harvey, R & Combatalade, D. (2008). Biofeedback mastery: An experiential teaching and self-training manual. Wheat Ridge, CO: Association for Applied Psychophysiology and Biofeedback. Yucha, C & Montgomery, D. (2008). Evidence-based practice in biofeedback and neurofeedback (2nd ed.). Wheat Ridge, CO: Association for Applied Psychophysiology and Biofeedback. Read More