Neurofeeedback for Brain Injury 06 2015

A PowerPoint Presentation by Linda Guzman Ellenberger

Proprietor & ClinicianElevate Brain Training

Fresno, CaliforniaEmail: [email protected]

© 2015

A LOOK AT TODAY’S TALK

1. Brain Injury Conquerors

2. The Injured Brain3. Brain Regulation 4. Brain Dysregulation5. Neurofeedback is…6. Neurofeedback is Not…7. Neurofeedback

Sessions8. Neurofeedback’s

Efficacy

Germany, Jan. 2001 World Cup Race: 48-yr-old Anne Abernathy crashed at 70mph

Lost 3 yrs of memory Didn't recognize her

medical coach Black outs, seizures,

impaired balance

Before Neurofeedback

BRAIN INJURY SUFFERER: GRANDMA LUGE

http://anneabernathy.com/crash.htm;Hill, PhD, Robert & Eduardo Castro, PhD. Healing Young Brains: The Neurofeedback Solution. Charlottesville, VA: Hampton Roads, 2009.

2001-02: Qualified for Olympics in SLC

2002 Olympics: 26th overall in Women’s Luge Singles

2003-04: Ranked top 20 in the world

2006: Competed in Torino, Italy Olympics

Training for her 7th Olympics: Rio 2016

After Neurofeedback

BRAIN INJURY CONQUEROR: GMA LUGE

http://anneabernathy.com/crash.htm;Hill, PhD, Robert & Eduardo Castro, PhD. Healing Young Brains: The Neurofeedback Solution. Charlottesville, VA: Hampton Roads, 2009, p. 159.

Suffered head injury 6 years prior to starting BrainPaint neurotherapy

Couldn’t swallow Was tube fed Couldn’t walk or

talk

After only 3 sessions, Brad’s ability to swallow came back

Stomach tube was removed

After only 12 sessions: able to walk

unassisted could talk again

Before After

BRAIN INJURY CONQUEROR: BRAD

William Scott of BrainPaint: http://neurofeedbackdefined.com/neurotherapy

At work, a pipe fell off a rack, striking him in the head

Days later: he’s fine

Time progressed: increasingly depressed

Dizzy & nauseous at times

Dizziness & nausea resolved

Depression 100% resolved

Before After

BRAIN INJURY CONQUEROR: PETE

Hill, PhD, Robert & Eduardo Castro, PhD. Healing Young Brains: The Neurofeedback Solution. Charlottesville, VA: Hampton Roads, 2009, p. 157.

Motorcycle accident;no helmet

77-day coma; died 2x 2 emergency

surgeries Short-term memory:

gone Gave up his business Major depression

After 1 session, memory started returning

4 months later—one-hour/week sessions— memory issues resolved

Before After

BRAIN INJURY CONQUEROR: DAVID PERA

Robbins, Jim. A Symphony in the Brain. New York: Grove Press, 2008, p. 81.

Cycling accident; undiagnosed MTBI

Took 2 one-hour naps/day while at work; 2 med leaves

Woke multiple times/night

Stopped reading: severe concentration & focus deficits

Forming & speaking sentences was exhausting

ADHD symptoms Debilitating fatigue Incessant muscle

pain & weakness Severe short-term

memory deficits Blank mind

Before

BRAIN INJURY SUFFERER: LINDA

No daytime naps needed

Sleeps through the night

Reads for hours at a time

Speaks with ease: regularly socializes with friends

Loves giving presentations about neurofeedback

Alert & energetic Muscle pain &

weakness: gone Short-term

memory: resolved Blank mind:

resolved

After

BRAIN INJURY CONQUEROR: LINDA

NEUROFEEDBACK

IS

The 21st Century’s Best Kept SecretII.

TheInjuredBrain

SIGNIFICANCE OF BRAIN INJURY

BRAIN INJURY: LIKE AN EARTHQUAKE

http://www.brainlinemilitary.org/content/multimedia.php?id=9081

Buildings remain

standing

Bridges & freeways

are destroye

d

BRAIN INJURY: LIKE AN EARTHQUAKE

Buildings (brain cells) remainBridges & freeways (axons) are damaged

Axons can no longer carry info to target cells: unable to conduct electrical impulses

No self-repairDr. Jonathan Walker, neurologist at Neuroscience Center, Dallas, TX. Has treated over 300 brain injury patients with neurofeedback.

Per Jim Robbins’ A Symphony in the Brain, p. 82-83.http://www.brainlinemilitary.org/content/multimedia.php?id=9081

EFFECTS: DELETERIOUS CASCADE

BrainInjury

Brain is under

immense

stress

Brain goes into

“defense” mode:

often retreats to low

frequencies– 3- to 4-hertz

range


Brainbecomesstuck in

this patternof low

frequencies: dysregulation

EFFECTS: DELETERIOUS CASCADE


Brain needs homeostasis; usually, it will stay stuck in

its dysregulationof abnormal,

low frequencies

PHYSICAL IMPAIRMENTS

COGNITIVE IMPAIRMENTS

EMOTIONAL IMPAIRMENTS

speech short term memory deficits mood swings vision impaired concentration denial

hearing slowness of thinking self-centeredness headaches limited attention span anxiety

motor coordination impairments of perception depression spasticity of muscles communication skills lowered self-esteem paresis or paralysis planning sexual dysfunction seizure disorders writing restlessness

balance reading lack of motivation fatigue judgment difficulty controlling emotions

Brain Injury Association of America, http://www.biausa.org/brain-injury-children.htm

MANIFESTATIONS OF DYSREGULATION

BRAIN INJURY LEAVES THE BRAIN STUCK

IN A STATE OF DYSREGULATION

The 21st Century’s Best Kept Secret

III.Brain

Regulationvs.

Brain Dysregulation

WHAT IS A REGULATED BRAIN?

A body of 50 years of research has proven that there is an accepted normal pattern of brainwave activity for any given situation

Brain and Body Solutions. http://www.brainandbodysolutions.com/neurological-dysregulation-syndrome.html

A REGULATED BRAIN:

A Command Center, running efficiently & productively in all circumstances

A harmonious symphony whose conductor’s timing is precise

A REGULATED BRAIN:

What Does the Brain Regulate?

(In the Context of Neurofeedback)Anger Empathy Obsessive

Thoughts

Anxiety Headaches/Migraines

Perceptionof Pain

Attention Impulsivity ResponseTime

Behavior Mood Self-Talk

Emotions Motivation Sleep

The 21st Century’s Best Kept SecretIV.Brain

Dysregulation

WHAT IS A DYSREGULATED BRAIN?

ImbalancedImproperly regulatedProducing inappropriate brainwave activity

Imprecise timing

Brain and Body Solutions. http://www.brainandbodysolutions.com/neurological-dysregulation-syndrome.html

BRAIN DYSREGULATION:LITERALLY, THE BRAIN IS OUT OF

ORDER

DYSREGULATIONEXAMPLE 1: TOO MUCH

BETA

http://neurofeedbackdefined.com/what-is-neurofeedback

It’s not optimal for thebeta frequency—

the “go” brainwave—to be dominant at night,

or it causesinsomnia

DYSREGULATIONEXAMPLE 2: TOO MUCH

DELTA


It’s not optimal for the delta frequency—

the “sleep” brainwave—to be active during the

day,or it causes

daytime drowsiness

DYSREGULATIONEXAMPLE 3:

INATTENTIONIt’s not optimal for

the theta frequency—the “relax” brainwave—

to be active while a studenttries to learn new material,

or it causesinattention & spaceyness

The Dysregulated BrainManifests In Such Issues as…ADD/ADHD (Attentional Issues)

Cognitive Issues (Focus, Memory, Processing Speed, Flexibility—Especially Cog Issues Due to Anesthesia or Chemo Brain)

Migraines& Headaches

Addiction Depression PTSD/Trauma

Anxiety Fibromyalgia Stress

Autism & Asperger’s

Hypersomnia (Daytime Sleepiness)

Nightmares & Night Terrors

BrainInjuries

Insomnia Tantrums


Re-Cap

1.Brain Regulation2.Brain Dysregulation

The 21st Century’s Best Kept SecretV.

How Can the Dysregulated

BrainBecome

Regulated?

A POWERFUL INTERVENTION: NEUROFEEDBACK

ALSO CALLEDEEG BIOFEEDBACK ORNEUROTHERAPY

NEUROFEEDBACK IN A NUTSHELL


THE ESSENCE OF NEUROFEEDBACK

When your BRAIN becomes aware of its own activity…

Your brain can change it

NEUROFEEDBACK FOR BRAIN INJURY

The brain learns to work around the damage: nearby cells are trained to take over the functions of the damaged ones

Stimulating nearby neurons strengthens pathways—improves communication along the freeways of the brain

Dr. Jonathan Walker, neurologist at Neuroscience Center, Dallas, TX. Has treated over 300 brain injury patients with neurofeedback. Per Jim Robbins’ A Symphony in the Brain, p. 82-83.

Operant Conditioning: The brain learns self-regulation through rewards & inhibitors

NEUROFEEDBACK IS OPERANT CONDITIONING

NEUROFEEDBACK: A PERSONAL TRAINER

Trainselectricalactivity &

timingof the brain

NEUROFEEDBACK CAN BE COMPARED TO LEARNING HOW TO

RIDE A BIKE

Extra tools such as training wheels or a friendly hand help guide the process of learning how to ride a bike


THE LEARNING IS LOCKED IN

Changes are permanent

Just as you never forget how to ride a bike, your brain typically never forgets how to self-regulate


Better Brain

Regulation

Better Brain

Regulation

Improved Brain

Performance

Better Brain

Regulation Better attention More alert Calm focus Better control

over behavior & emotions

Increased resilience to stress

Improved sleep patterns

Grace under pressure

Improved Brain

Performance

The 21st Century’s Best Kept SecretWhat is Neurofeedback

NOT?

NEUROFEEDBACK IS NOT…. A cure to make

your little brother vacuum the house

A panacea A quick fix A “Holy Grail” A 100% guarantee

that all symptoms will be resolved

NEUROFEEDBACK IS NOT….

A parenting replacement

Counseling/therapy A new age fad Hypnosis “Mind over matter” Invasive Painful


Re-Cap

1. Brain Regulation2. Brain Dysregulation3. Neurofeedback is….4. Neurofeedback is not….

The 21st Century’s Best Kept SecretWhatDoes

NeurofeedbackLookLike?

THE 1ST SESSION: INTAKE

A practitioner will ask 90 questions to come up with an individualized protocol tailored for each individual In subsequent sessions, 14 questions are asked to individualize & fine-tune protocols and to track progressBrainPaint does not require an expensive brain scan to get started. A study compared the technique BrainPaint uses for protocol selection to that of a brain map

and concluded: “…it is not possible to draw conclusions regarding any advantage regarding QEEG-versus Scott/Peniston-specific training using current analysis.” ~ Roger J. deBeus, PhD, BCIA-EEG; http://neurofeedbackdefined.com/neurofeedback-therapy

Sensors are placed on ear(s) & scalp

Sensors pick up electrical activity coming from brainwaves

Each session: 25-35 minutes of feedback

http://neurofeedbackdefined.com/neurofeedback-therapy

WHAT HAPPENS IN A NEUROFEEDBACK SESSION?

The computer provides the brain feedback on: a) how each

brainwave frequency is performing, and

b) how the brain might improve its performance


The brain responds to the feedback, learning new developmental skills


There may be 1-3 sensor placement changes throughout neurofeedback sessionsfor a total of 25-35 minutes of feedback

EACH SUBSEQUENT NEUROFEEDBACK SESSION


Clients just relax, enjoy, and let the BrainPaint system do the rest



With eyes-open neurofeedback training, one watches the fractals morphing on the screen



With eyes-open neurofeedback training, one watches the fractals morphing on the screen

One is also mindful of the green & red graph



HOW MANY SESSIONS? 2-3x/week (up to

10)

HOW MANY SESSIONS? 2-3x/week (up to

10)

Generally, in the first 5-8 sessions, clients notice improvements

HOW MANY SESSIONS? 2-3x/week (up to 10)

Generally, in the first 5-8 sessions, clients notice improvements

20-30 sessions are recommended to achieve one’s goals to maintain lasting results

HOW MANY SESSIONS? The greater the

brain dysregulation, the more sessions an individual will need


VI.What Does

Research Tell Us about

the Efficacyof Neurofeedback?

The 21st Century’s Best Kept SecretBrainPaint’s

Efficacy

BRAINPAINT RESULTS: ALL CLIENTS

0102030405060708090

100All Clients & All Issues

(n=16,490)

Percentage of People Reporting Progress

80% report

symptoms are “better”

or “resolved” by the 20th session.

Per BrainPaint Rack Card

BRAINPAINT RESULTS: ADHD

0102030405060708090

100ADHD (n=1185)


78% report




BRAINPAINT RESULTS: CHRONIC PAIN

0102030405060708090

100Chronic Pain (n=298)


67% Report

“better”or

“resolved” by the 20th session.


BRAINPAINT RESULTS: DEPRESSION

0102030405060708090

100Depression (n=1544)


78% symptoms

are “better” or

“resolved” by the 20th session.


BRAINPAINT RESULTS: INSOMNIA

0102030405060708090

100Insomnia (n=1661)


79% report




BRAINPAINT RESULTS: MOOD SWINGS

0102030405060708090

100Mood Swings (n=90)


84% report




BRAINPAINT RESULTS: NIGHTMARES

0102030405060708090

100Nightmares (n=222)


85% report




BRAINPAINT RESULTS: PTSD

0102030405060708090

100PTSD/Trauma (n=819)


99% report




The 21st Century’s Best Kept SecretResearch, in General,

DemonstratingNF’s Efficacy

withBrain Injury

& Mild TraumaticBrain Injury

NEUROTHERAPY FOR HEAD INJURYDr. Jonathan Walker, neurologistwho runs Neuroscience Center,Dallas, TX:

Has provided neurofeedback to 300+ head injury patients

“Most of the time, it improves symptoms or completely eliminates the problem”

“There’s no effective drug treatment, no effective treatment at all, except biofeedback, and the brain stays recovered”

Robbins, p. 82-83

NEUROTHERAPY FOR TBI

2012 International Brain Injury Association Review of Evidence:Neurofeedback remediates

symptoms of both open- & closed-head injuries

Serious cognitive deficits were ALLEVIATED in individuals who failed to improve under conventional treatment

Moss, Donald, et al. “The Use of Heart Rate Variability Biofeedback and Neurofeedback for Traumatic Brain Injury.” Biofeedback.

Spring 2015, http://www.aapb-biofeedback.com/doi/abs/10.5298/1081-5937-43.1.03?journalCode=biof

NEUROTHERAPY FOR MTBISignificant improvements in:

Attentionresponse accuracy of continuous

performance taskSignificant decline in symptoms,

per self-reportingErrors on a problem-solving task

decreased in the mTBI group

Timothy P. Tinius, PhD Kathleen A. Tinius, MSW“Changes After EEG Biofeedback and Cognitive Retraining in Adults with Mild Traumatic Brain Injury and Attention Deficit Hyperactivity Disorder “ ; http://www.littlepsych.com/pdf/Tinius.pdf

Participants: 44 total; mTBI group=16; ADHD group=13; control group=15 ; Adults diagnosed with mild traumatic brain injury (mTBI) or Attention Deficit Hyperactivity Disorder (ADHD) were treated with EEG Biofeedback and cognitive retraining.

NEUROTHERAPY FORAUDITORY MEMORY

IMPROVEMENTIN TBI PATIENTS

Significant improvements

68%-181%in 59 participants

completing 2 auditory memory tasks

J Head Trauma Rehabil. 2000 Dec;15(6):1285-96. Improvement/rehabilitation of memory functioning with neurotherapy/QEEG biofeedback. Thornton K1.; http://www.ncbi.nlm.nih.gov/pubmed/11056409

NEUROTHERAPY FOR SEVERE TBI

2015 Biofeedback Journal:Severe brain injury caused:

emotional & cognitive dysregulation Neurofeedback resulted in:

improved attention emotional control life-satisfaction self-esteem



NEUROTHERAPY FOR POST-CONCUSSIVE SYNDROME

Neurofeedback: effective in significantly improving or redressing symptoms of post-concussion syndrome, as found in “a number of different studies” (2004)

Core deficits of post-concussion syndrome: Attention deficits & difficulty sustaining mental

effort Fatigue & tiredness Learning & memory problems Socialization problems Frequent headaches

Post-concussion syndrome: (a range of residual symptoms that persist 12 months or more after the injury, often despite a lack of evidence of brain abnormalities on MRI and CT scans). Duff, Jacques. “The usefulness of quantitative EEG (QEEG) and neurotherapy in the assessment and treatment of post-concussion syndrome.”

Swinburne University of Technology, Brain Sciences Institute, 400 Burwood Rd, Hawthorn 3122, Australia. Clinical EEG and neuroscience: official journal of the EEG and Clinical Neuroscience Society (ENCS) (Impact Factor: 3.16). 11/2004; 35(4):198 .209. http://www.researchgate.net/publication/8222613_The_usefulness_of_quantitative_EEG_(QEEG)

_and_neurotherapy_in_the_assessment_and_treatment_of_post-concussion_syndrome


2013 Study Results: Incidence and severity of

headaches: reduced after 5 neurofeedback sessions

eliminated after 20 sessions Brainwave activity was measured at

normal levels via EEG (electroencephalography)

Linden, M., PhD. “The Effects of QEEG Guided Neurofeedback on Post-Concussion Syndrome: Case Study” http://www.lindenalc.com/wp-content/uploads/2013/09/Sport_Neuropsych_Society_Concussion_Poster_May2013-2.pdf


2015 in Biofeedback Journal:Post-Concussive Syndrome has

similar symptoms to PTSDNeurofeedback results in

physiological release of trauma, further resulting in overall improved physiological functioning




If Neurofeedback is Backed by Such a

Large Body of Research,

Why is it Neither Widely Known

nor Widely Offered?

NEUROSCIENCE’S “BEST KEPT SECRET”

Lost government funding in the 1970s: The National

Institutes of Health (NIH) chose to focus funding on pharmaceuticals

Has not been widely available

NEUROSCIENCE’S “BEST KEPT SECRET”

Lousy P.R.: No large, formally organized marketing group (as the pharmaceutical industry does well)

Only 21st-century technology has made it possible for greater availability, such as Bill Scott’s BrainPaint system


Final Re-Cap1. Brain injury results in brain

dysregulation



dysregulation2. Neurofeedback is an effective process

to teach the brain to properly regulate again



dysregulation2. Neurofeedback is an effective process

to teach the brain to properly regulate again

3. Neurofeedback is a powerful, evidence-based tool—helping people feel better and function better—with no adverse side effects

Neurofeedback Improves or Resolves Issues of Brain

DysregulationADD/ADHD (Attentional Issues)

Cognitive Issues (Focus, Memory, Processing

Speed, Flexibility—Especially Cog Issues Due to Anesthesia or Chemo Brain)

Migraines& Headaches

Addiction Depression PTSD/Trauma

Anxiety Fibromyalgia Stress

Autism & Asperger’s

Hypersomnia (Daytime Sleepiness)

Nightmares & Night Terrors

BrainInjuries

Insomnia Tantrums


Final Thoughts, or Takeaway

Neurofeedback is a powerful tool for brain injury , as well as many other modern ills




Neurofeedback is easy!




Neurofeedback is easy!Trains brain to function at its pre-injury

levels





levelsResults are relatively quick





levels, or betterResults are relatively quickResults are permanent

NEUROFEEDBACK HAS HELPEDOLYMPIC ATHLETES, CEOS, BRAIN INJURED

FOLKS, TRAUMA VICTIMS, AD/HD SUFFERERS, VETERANS WITH PTSD, & THE LIST GOES ON….

NEUROFEEDBACK

IS

Linda Guzman EllenbergerProprietor & ClinicianElevate Brain Training

Email: [email protected] 2015

APPENDIX: SOME OF MY CLIENTS’ STORIES

“Every time I close my eyes, I see my 6-year-old son dying on the operating table”

After only 1 session, John reported: “This is the 1st time I’ve closed my eyes since the accident, that I have *not* seen my son on the operating table”

Before After

29-YEAR-OLD TRAUMA VICTIM, JOHN

Hayley suffered chronic stress for over a decade of workplace sexual harassment

She finally filed a lawsuit that took 3 years to complete

Symptoms: lethargy, lack of concentration, lack of restful sleep, anxiety, depression; chronic pain

During 2nd session, she felt her entire body from head to toe relax: she hadn’t felt that in years

After her first double-session, she slept better than she has in years

After only 4 sessions, she’s alert in the morning: no lethargy

Before After

45-YEAR-OLD HAYLEY

Before After

Night terrors for 6 yrs

Rarely stayed in her own bed: would awake & sleep on the floor in her sibling’s room

She regularly whined Her morning

tiredness & daily crankiness disrupted the entire family mood & flow

Regularly complained of headaches

4 sessions: Night terrors have significantly diminished; not disruptive as before

Stays in her own bed Sleeps through the night No more whining or

headache complaints Family mood & flow is

much improved

Before After

7-YEAR-OLD ELLIE

Before After

High-functioning CEO & mechanical engineer

Developed severe fatigue during 3-year high-stress project

Brain got stuck in “problem-solving mode” at night: would not turn off, keeping him up

3 sessions: significant sleep improvements

After 25 sessions, his symptoms are completely resolved

He works 8- to 14-hour days with ease

Before After

57-YEAR-OLD JOHN

Her anxiety was so paralyzing & painful that shecouldn’t go to school

couldn’t fall sleep hours after being around an alcoholic family member

Anxiety attacks: gone

She’s able to attend school more regularly

She can now fall asleep with ease—after being around her alcoholic family member

Before After

13-YEAR-OLD ANNA

Before After

Severe depression & anxiety kept him from being able to attend school since 5th grade

11th grade: he could complete 0 of his 20 weekly independent study assignments

His mom spoke to his teachers for him

After only 6 sessions, Eric is able to complete all 20 of his weekly assignments

He doesn’t want his mom talking for him anymore: He speaks to his teachers directly

He has hope

Before After

17-YEAR-OLD ERIC

Neurofeeedback for Brain Injury 06 2015

Healthcare

Transcript of Neurofeeedback for Brain Injury 06 2015