It was not many years ago that the term “neuromodulation” would have been considered a contradictory term by many at least in regard to modification of a damaged or dysfunctional central nervous system. Although it generally had been assumed that learning and memory somehow resulted in relatively permanent modifications of brain structure and/or function, the notion persisted that neural function and structure basically were set by genetics and were relatively immune to change. However, within the past couple of decades developments in neuroimaging have enabled scientific research providing evidence of neural plasticity far greater than previously had been imagined. Research on neural plasticity is burgeoning, along with a plethora of scientifically unsubstantiated claims by practitioners from many different professions for “brain based” methods for remediation of various medical, psychological, and educational problems.
Despite the fact that, until recently, brain plasticity was not a generally accepted concept, for many years there have been remedial approaches where advocates make either explicit or implied claims that their use results in modulation of brain function. Some involve intensive, graduated practice of functions that had been impaired by brain damage, e.g., cognitive rehabilitation. Some involve exposure of clients to various types of stimuli, which usually are rhythmic or of specified frequency (e.g., auditory/visual stimulation with light/sound machines, music therapy). Often this is done with the assumption that rhythms of the brain are entrained or otherwise modified by such exogenous stimuli. Some consider electro shock therapy and transcranial magnetic stimulation to fall into this category. Still others emphasize self directed activity, such as making precise movements in synchrony with a metronome, or learning self control of one’s brain rhythms (EEG) with the aid of electronic equipment that provides feedback concerning specific aspects of those endogenous rhythms, i.e., EEG biofeedback or neurofeedback. Practitioners of such remedial approaches generally have been marginalized by mainstream medicine, psychology, and education, partially due to the aforementioned belief in immutability of brain structure/function, but also due to perceived, or real, lack of scientific support for efficacy of the methods involved.
It is the editors’ opinion that two procedures for neuromodulation hold special promise due to emerging scientific evidence of their enduring effectiveness with a variety of conditions that are known, or believed, to be due to brain damage and/or dysfunction. These are neurofeedback (NF) and transcranial magnetic stimulation (TMS) in their various forms. Research and clinical practice in NF began in earnest in the 1960s and 1970s, decreased considerably for a while thereafter, but, since the early 1990s, have grown rapidly. There are NF practitioners in many countries around the world, professional NF associations have been formed on three continents, at least ten books have been published dealing primarily with NF, and a professional journal devoted almost exclusively to NF ( Journal of Neurotherapy) has been published regularly since 1995. Unlike many other groups with claims of facilitation of neuromodulation, the field of NF actively promotes scientific research; and in Australia, Belgium, Canada, England, Germany, the Netherlands, Russia and the United States (as well as some other countries) rigorous scientific research on the mechanisms and efficacy of NF is being actively pursued. The field has evolved far from its beginnings when research participants or patients could be provided feedback concerning only degree of power or percent age of power in a specific EEG frequency band at a single scalp electrode site. Today, feedback can be adjusted to reflect not only EEG power at all frequency/site combinations (now including even ultra low frequencies such as 0.001 Hertz), but also degree of connectivity (e.g., coherence) between all site combinations. Using low resolution electromagnetic tomography (LORETA) procedures, feedback concerning EEG activity in various subcortical areas and cortical networks or “hubs” presently is possible. And, feedback of information concerning activity in cortical and subcortical regions using functional MRI (fMRI) is receiving considerable research attention as an alternative or supplement to EEG biofeedback.
TMS, as usually defined today, is a relative newcomer to the field of neuromodulation. In this approach weak electrical currents are produced in brain tissues by applying rapidly changing magnetic fields to specific scalp locations. In some contrast to NF, which historically has been associated mainly with the field of psychology, TMS primarily is associated with medical research and practice. Also in some contrast to NF, where laboratory discoveries quickly were applied to clinical practice, the field of TMS appears to be moving more cautiously, building upon solid research findings prior to making claims for clinical efficacy. As with NF, scientific research on TMS and its potential clinical uses is occurring in many parts of the world.
Despite growing clinical use of TMS, and especially of NF, and despite emerging research results supporting their efficacy, both remain on the fringes of medical, psychological, and education practice. Charges of “show me the data” often are made by critics who claim there is no solid scientific support for these approaches. Such evidence exists, but here to fore has been scattered among many different professional journals and other sources. The editors perceived a need for the latest and best theorizing and research findings concerning these neuromodulation techniques to be brought together in a single source to which professionals and other interested persons would have ready access. We believe that this book accomplishes that goal. Although there certainly are others, it could be argued that the chapter authors of this text constitute the majority of the leading NF and TMS theoreticians and scientists of today’s world. Several books have been published on the general topic of neuromodulation or specifically on neurofeedback. While a few have chapters detailing supportive research, most were oriented primarily toward theories of efficacy, descriptions of various approaches to NF, and/or details of clinical practice. This book is unique in its emphasis on solid scientific support as it brings together for the first time the neuromodulation fields of NF and TMS.
Contents
Chapter 1 Use of Quantitative EEG to Predict Therapeutic Outcome in Neuropsychiatric Disorders
Chapter 2 EEG Source Analysis: Methods and Clinical Implications
Chapter 3 ERP-Based Endophenotypes: Application in Diagnosis and Neurotherapy
Chapter 4 EEG Vigilance and Phenotypes in Neuropsychiatry: Implications for Intervention
Chapter 5 Neurofeedback with Children with Attention Deficit Hyperactivity Disorder: A Randomized Double-Blind Placebo-Controlled Study
Chapter 6 Emerging Empirical Evidence Supporting Connectivity-Guided Neurofeedback for Autistic Disorders
Chapter 7 Neurofeedback and Epilepsy
Chapter 8 Feedback of Slow Cortical Potentials: Basics, Application, and Evidence
Chapter 9 Real-Time Regulation and Detection of Brain States from fMRI Signals
Chapter 10 Repetitive Transcranial Magnetic Stimulation in Depression: Protocols, Mechanisms, and New Developments
Chapter 11 Transcranial Magnetic Stimulation for Tinnitus
Chapter 12 Neurophysiological Effects of Transcranial Direct Current Stimulation
Chapter 13 Functional Neuroimaging Evidence Supporting Neurofeedback in ADHD
Chapter 14 The Immediate Effects of EEG Neurofeedback on Cortical Excitability and Synchronization
Chapter 15 Enduring Effects of Neurofeedback in Children
INDEX
Despite the fact that, until recently, brain plasticity was not a generally accepted concept, for many years there have been remedial approaches where advocates make either explicit or implied claims that their use results in modulation of brain function. Some involve intensive, graduated practice of functions that had been impaired by brain damage, e.g., cognitive rehabilitation. Some involve exposure of clients to various types of stimuli, which usually are rhythmic or of specified frequency (e.g., auditory/visual stimulation with light/sound machines, music therapy). Often this is done with the assumption that rhythms of the brain are entrained or otherwise modified by such exogenous stimuli. Some consider electro shock therapy and transcranial magnetic stimulation to fall into this category. Still others emphasize self directed activity, such as making precise movements in synchrony with a metronome, or learning self control of one’s brain rhythms (EEG) with the aid of electronic equipment that provides feedback concerning specific aspects of those endogenous rhythms, i.e., EEG biofeedback or neurofeedback. Practitioners of such remedial approaches generally have been marginalized by mainstream medicine, psychology, and education, partially due to the aforementioned belief in immutability of brain structure/function, but also due to perceived, or real, lack of scientific support for efficacy of the methods involved.
It is the editors’ opinion that two procedures for neuromodulation hold special promise due to emerging scientific evidence of their enduring effectiveness with a variety of conditions that are known, or believed, to be due to brain damage and/or dysfunction. These are neurofeedback (NF) and transcranial magnetic stimulation (TMS) in their various forms. Research and clinical practice in NF began in earnest in the 1960s and 1970s, decreased considerably for a while thereafter, but, since the early 1990s, have grown rapidly. There are NF practitioners in many countries around the world, professional NF associations have been formed on three continents, at least ten books have been published dealing primarily with NF, and a professional journal devoted almost exclusively to NF ( Journal of Neurotherapy) has been published regularly since 1995. Unlike many other groups with claims of facilitation of neuromodulation, the field of NF actively promotes scientific research; and in Australia, Belgium, Canada, England, Germany, the Netherlands, Russia and the United States (as well as some other countries) rigorous scientific research on the mechanisms and efficacy of NF is being actively pursued. The field has evolved far from its beginnings when research participants or patients could be provided feedback concerning only degree of power or percent age of power in a specific EEG frequency band at a single scalp electrode site. Today, feedback can be adjusted to reflect not only EEG power at all frequency/site combinations (now including even ultra low frequencies such as 0.001 Hertz), but also degree of connectivity (e.g., coherence) between all site combinations. Using low resolution electromagnetic tomography (LORETA) procedures, feedback concerning EEG activity in various subcortical areas and cortical networks or “hubs” presently is possible. And, feedback of information concerning activity in cortical and subcortical regions using functional MRI (fMRI) is receiving considerable research attention as an alternative or supplement to EEG biofeedback.
TMS, as usually defined today, is a relative newcomer to the field of neuromodulation. In this approach weak electrical currents are produced in brain tissues by applying rapidly changing magnetic fields to specific scalp locations. In some contrast to NF, which historically has been associated mainly with the field of psychology, TMS primarily is associated with medical research and practice. Also in some contrast to NF, where laboratory discoveries quickly were applied to clinical practice, the field of TMS appears to be moving more cautiously, building upon solid research findings prior to making claims for clinical efficacy. As with NF, scientific research on TMS and its potential clinical uses is occurring in many parts of the world.
Despite growing clinical use of TMS, and especially of NF, and despite emerging research results supporting their efficacy, both remain on the fringes of medical, psychological, and education practice. Charges of “show me the data” often are made by critics who claim there is no solid scientific support for these approaches. Such evidence exists, but here to fore has been scattered among many different professional journals and other sources. The editors perceived a need for the latest and best theorizing and research findings concerning these neuromodulation techniques to be brought together in a single source to which professionals and other interested persons would have ready access. We believe that this book accomplishes that goal. Although there certainly are others, it could be argued that the chapter authors of this text constitute the majority of the leading NF and TMS theoreticians and scientists of today’s world. Several books have been published on the general topic of neuromodulation or specifically on neurofeedback. While a few have chapters detailing supportive research, most were oriented primarily toward theories of efficacy, descriptions of various approaches to NF, and/or details of clinical practice. This book is unique in its emphasis on solid scientific support as it brings together for the first time the neuromodulation fields of NF and TMS.
Contents
Chapter 1 Use of Quantitative EEG to Predict Therapeutic Outcome in Neuropsychiatric Disorders
Chapter 2 EEG Source Analysis: Methods and Clinical Implications
Chapter 3 ERP-Based Endophenotypes: Application in Diagnosis and Neurotherapy
Chapter 4 EEG Vigilance and Phenotypes in Neuropsychiatry: Implications for Intervention
Chapter 5 Neurofeedback with Children with Attention Deficit Hyperactivity Disorder: A Randomized Double-Blind Placebo-Controlled Study
Chapter 6 Emerging Empirical Evidence Supporting Connectivity-Guided Neurofeedback for Autistic Disorders
Chapter 7 Neurofeedback and Epilepsy
Chapter 8 Feedback of Slow Cortical Potentials: Basics, Application, and Evidence
Chapter 9 Real-Time Regulation and Detection of Brain States from fMRI Signals
Chapter 10 Repetitive Transcranial Magnetic Stimulation in Depression: Protocols, Mechanisms, and New Developments
Chapter 11 Transcranial Magnetic Stimulation for Tinnitus
Chapter 12 Neurophysiological Effects of Transcranial Direct Current Stimulation
Chapter 13 Functional Neuroimaging Evidence Supporting Neurofeedback in ADHD
Chapter 14 The Immediate Effects of EEG Neurofeedback on Cortical Excitability and Synchronization
Chapter 15 Enduring Effects of Neurofeedback in Children
INDEX