Abstract: As a discipline at the forefront of mind-body medicine, applied psychophysiology must address itself to the arbitrary split between feedback on peripheral physiology and on the EEG. It is most likely that changes adopted in the practitioner community to combine the strengths of both approaches will lead toward a theoretical reconceptualization of feedback by any modality as an aspect of a more unitary approach toward improved self-regulation.

EEG Foundations Course #200): Brain Models Underlying Neurofeedback

Abstract:
The objective of this talk is to give an overview in several areas. The first task is to present some basic models of brain function that support the case for neurofeedback. Secondly, the basic approaches to neurofeedback will be classified, yielding further implications for brain models. Thirdly, the attempt will be made to connect the principal neurofeedback approaches with the standard formulations of psychopathology in terms of classical disorders and of neurophysiological failure modes. Finally, the case will be made for a systems perspective on disorders of disregulation, with neurofeedback and biofeedback constituting a comprehensive self-regulation remedy.

Plenary #80): Simplicity and Complexity in Neurofeedback

Considerable proliferation has occurred in recent years in basic approaches to neurofeedback. Yet there is considerable overlap in terms of efficacy. The attempt is made in this talk to extract the essential elements of commonality among these approaches, and the essential elements that differentiate them. In the manner, it may be possible to discern a minimal set of attributes that neurofeedback strategies should feature in order to yield full coverage of the clinical terrain.

Workshop #81): Theoretical Models Underlying Neurofeedback

One of the most striking aspects of neurofeedback is that it addresses such a broad variety of clinical conditions with a very simple set of techniques. What can explain such generality of effects? It is helpful to adopt a network model in which neurofeedback addresses the “hub” of a regulatory network that is hierarchical in nature, and to which yet other regulatory networks are intimately coupled. A second key aspect is that it addresses the problems of regulation where the most stringent constraints apply.

Plenary #193): "The Self-Regulation Regime: Conceptual and Practical Reunification of Biofeedback and Neurofeedback"

The division of the field of applied psychophysiology into biofeedback and neurofeedback was originally necessary to allow neurofeedback to put down roots. However, the division has become counter-productive for the field of applied psychophysiology. A rapprochement of the two disciplines now needs to be actively sought and promoted.
Neurofeedback has shown itself to be a versatile tool for the recovery of brain function and acquisition or restoration of good self-regulation. On the other hand, the EEG often does not change dramatically throughout the training process, and therefore does not offer a good index of progress in the general case. Peripheral measures of physiology tend to reflect physiological change with great sensitivity and immediacy. On the other hand, in the context of neurofeedback they offer more limited training opportunities. An approach that combines the relative strengths would employ neurofeedback for training purposes and peripheral measures for progress monitoring. Better clinical guidance of the neurofeedback process would be in prospect. For some purposes, matters might well be reversed: peripheral biofeedback modalities should be employed, and the EEG might well be used as an independent index of state change or of improved regulation. An alternative approach combines all of the relevant measures, central and peripheral, in a combined “Figure of Merit” on which the client trains.
Paradoxical findings from feedback research indicate the need for a more unified and generalized theory of self-regulation. A network model is proposed as a formulism for such a generalized theory.
As a result of impending changes in the conduct of feedback, along with a more supportive theoretical framework, a more integrated understanding of feedback will emerge. The independent lines of evidence for each particular kind of feedback can then be combined in support of the more inclusive model. Such an inclusive view does greater justice to the organization of our regulatory systems, and it will also command greater credence from the allied health professions.

Course Precis:
Following on Rob Kall’s historical introduction it is appropriate to give another kind of overview or synthesis relevant to the present moment. First we will discuss relevant models of brain function that give us a vantage point for understanding neurofeedback. This will include top-down or integrated models as well as bottom-up models that constrain brain models at the basic building-block level of neuronal function. Then there are also the phenomenological models in which both normal function and dysfunction are revealed in various EEG phenomenology.

We will then review the current proliferation of neurofeedback techniques as an evolutionary process of speciation, to help us determine the critical factors that account for such divergences. We can walk backwards from these data back to brain models. A classification of the principal approaches to neurofeedback will be presented.

Our next task will be to connect the phenomenology of neurofeedback with more classical understandings of psychopathology, i.e. in terms of diagnostic categories and in terms of failure modes of specific cognitive, affective, and other functions.

The discussion will lead us to consider a more integrated, systems perspective on disorders of disregulation, for which neurofeedback and biofeedback are offered as the essential remedies. In this model, disregulation is the core issue being addressed, and neurofeedback constitutes the remedy that most closely targets the defined problem. When biofeedback and neurofeedback are combined with biochemical remedies that target the biochemical/endocrinological/immunological dimension of disorders of disregulation, a comprehensive remedy for a variety of intractable psychopathologies may be at hand.

Neurofeedback has in fact undergone considerable metamorphosis over its 30-year life: from an initial focus on reinforcement of specific events (alpha and SMR spindle bursts) and amplitude training at the outset to the latest emergence of coherence, comodulation and phase-based training. There has also been a growing divergence of methodologies, with the growth of stimulation-based approaches to complement standard neurofeedback; with the maturation of EEG-driven stimulation; with the emergence of pulsed along with steady-state stimulation; and with the continuing maturation of both targeted and protocol-based training strategies. It is useful to ask what the commonalities are in these approaches that might constitute a “minimum set” of brain challenges that should be provided in neurofeedback for complete coverage of the clinical categories. Such a minimum set would be matched to the principal failure modes that have been identified thus far in the EEG. What remains are conditions which are responsive to neurofeedback, on the one hand, but unconnected with any observable EEG signature or deviation, on the other. To explain efficacy in such cases, a more inclusive network model is needed that accords primacy to the role of sub-cortical nuclei, for which disregulation involves no obvious cortical signature.

The world of science moves us to be as specific as possible in demonstrating efficacy of neurofeedback, but increasingly the breadth of clinical efficacy motivates us in the opposite direction to try to explain the generality of effects. Critical neurophysiology experiments in the past decade are drawn upon to define the key elements of such a generalized model. The first approach will be to arrive at a “top-down” model, for which we appeal to the emerging understanding of networks. This will be followed up with a “bottom-up” model that inquires into the most general observations that can be made from the neuronal level that constrains the global architecture.

From network theory we find that despite the apparent morphological homogeneity of cortical neurons the brain is not organized as a random network, but rather as a “scale-free” network, or as a “small-world model,” in the new idiom. The resulting organization is highly hierarchical. If that is indeed the case, then the most efficient techniques of remediation should be those that appeal to the highest levels of the organizational hierarchy. Conversely, given the broad efficacy of neurofeedback techniques, the explanation most likely lies in the fact that the predominant appeal is to the higher levels of the regulatory hierarchy. This may be true quite irrespective of the particular techniques employed.

Given the proposed model, a classification of neurofeedback techniques is attempted with respect to the key identified “failure modes” of regulation in the bio-electrical domain. The resulting categorization of techniques may give us insights into how best to move forward in their refinement and further exploitation.

Siegfried Othmer Ph.D.
22020 Clarendon St
#305
Woodland Hills,, California 91367

phone: (818) 373-1334
cell: (818) 631-9209
fax: (818) 373-1331

siegfried@eeginfo.com

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Siegfried Othmer	Siegfried Othmer Siegfried Othmer has been active in neurofeedback for more than twenty years, through instrumentation development, clinical research, and the conduct of professional training courses. The EEG Institute 22020 Clarendon #305 Woodland Hills, CA 91367 (818) 373-1334