Is brain-behavior behavior?

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Is brain-behavior behavior?

• If so, it can be conditioned just like other
  behaviors
• In 1960s, certain rhythms could be trained
• Led to Neurotherapy and Brain-Computer interfaces
  (BCI)

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When you become aware of your own brain activity
you can change it also.
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Electrical stimulation of brains (ESB)

• Electrical stimulation of brains of rats - James
  Olds in 1950s
• Jacobsen and Torkildsen replicated work in
  humans
• some epileptics stimulated themselves into
  convulsions

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INTRA-CRANIAL SELF-STIMULATION

• Rodent wireheads
• 0.0005 amps whenever rat pushed lever
• Up to 10,000 bar-presses an hour recorded
• Animals self-stimulate gt 24 hrs continuously
  without rest, and cross electrified grid to gain
  access to lever
• Reward center Medial forebrain bundle passing
  through lateral hypothalamus and ventral
  tegmentum
• Other brain centers are aversive, such as
  periaqueductal grey matter (PAG)
• Ventral tegmental area (VTA) neurons manufacture
  dopamine and they are under continuous inhibition
  by gamma-aminobutyric acid (GABA) system, an
  important component of the final common pathway"
  of reward, implicated in addiction, mood, and
  learning.

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Delgado, Primate wireheads, and Circuitry man
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Electrical stimulation of brains (intracranial
stimulation)

• Pavlov conditioning experiments
• Tone for food, buzzer for shock
• Moved them closer together in time
• confounded dog fell asleep
• Termed internal inhibition
• Animal can close down own systems to avoid stress
• Neal E Miller trained autonomic functions
• Dogs salivate to get food
• Rats control heartrate to get water

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History of Biofeedback

• JH Bair, 1901, instrument used to teach ear
  wiggling
• In early 20th century, J.H. Schultz in Germany
  developed a technique called Autogenic Training.
  Verbal instructions are used to guide a person to
  a more relaxed and controlled physiological
  state.
• The method flourished, and the results were
  reported upon by Wolfgang Luthe in 1969 in the
  United States.
• Increased awareness in Western world of yogic
  ability to alter physiology volitionally. E.g., a
  yogi could survive in a sealed box by voluntarily
  reducing his metabolic rate significantly,
  surviving hours with a limited supply of oxygen.
• Peripheral biofeedback techniques include
• GSR, thermal, breathing, cardiac

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History of EEG biofeedback

• 1934, Adrian watched his EEG in front of
  oscillograph and created alpha at will
• Alpha biofeedback or deep states
• Joe Kamiya at Univ of Chicago, 1958
• Kamiya 1958
• 1st subject - 60 tones and 60 guesses, half right
• 2nd trial, 65 correct
• 3rd 85 correct
• 4th, after a few mistakes, 400 correct in a row
• 1968 first congress in Aspen Colorado, called
  biofeedback
• Alpha training adopted by flower culture of
  late 1960s, and practitioners oversold its claims

1978 Science paper
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History of SMR biofeedback

• In 1960s Mercury astronauts claimed they saw
  natives waving at them when the flew over the
  Pacific.(i.e., they hallucinated)
• In 1967, Gordon Allies, inventor of amphetamine,
  was contracted to test toxicity of the Mercury
  capsule rocket fuel with David Fairchild
• However Allies tested another chemical compound
  on himself and shortly died, before contract
  over. Fairchild asked Sterman to help finish
  work.

• MB Sterman

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Sterman was studying EEG-behavioral correlates in
cats
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If EEG behavior is like any other behavior, it
could be shaped with operant conditioning

• Two prominent rhythms in cat EEG SMR and PRS
• Couldnt train PRS, but could train SMR
• More on the PRS later

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Cat Wireheads cortical electrodes, not brain
stem or hypothalamic

• Cats often used in electrophysiology because head
  size the same regardless of breed, unlike dogs

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10 cats trained to produce SMR (sensorimotor
activity over motor strip) for chicken broth
milk
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Acquisition resembles normal behavior under O.C.
training
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Classic abundance response at extinction
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History of SMR biofeedback

• Then Sterman and Fairchild went on to another
  study, testing rocket fuel on 50 cats, 10 from
  Stermans previous SMR training study.
• Inject 100 mg/kg or so of fuel into each cat
• After one hour, all usually go into grand mal
• but not all - 7 delayed, 3 not at all.
• seizure thresholds changed in these 10
• Not explainable by placebo (i shall please in
  Latin) as cats didnt know what to expect, and
  experimenter blind because effect was entirely
  unexpected

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Sterman et al (1967) showing usual toxic prodrome
and resistance to MMH-induced seizures in a
subgroup
Time
Avg 2 hours for seizures with EEG trained cats
vs. 1 hour for normal cats
NASA Rocket fuel
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History of SMR biofeedback

• Replicated findings in monkeys, then moved to
  humans at colleagues urging.
• Human epileptics
• First case study published in EEG Clin
  Neurophysiology
• N4 study, 65 seizure reduction, in Epilepsia
  1976
• Then n8, ABA three-year study, Epilepsia 1978
• Finally, full blown study funded by NIH
• Sham control, n24, three years
• Double yoked n8, n8 NF, n8 log books
• many went seizure free
• controls after study received NF
• Reliable increase in sleep spindle density and
  decreased awakenings

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A major study showed 60 reduction in seizures 12
months after training
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Turf war with medicine

• In 1982 Stermans NIH grant for 3 y was funded,
  but then they demanded double blind after
  approving the initial design, then they pulled
  funding saying goals already reached
• Cost of temporal lobe resection for epilepsy
  200,000
• Money lost if patient undergoes neurotherapy
  successfully

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Review of 19 studies with EEG Biofeedback for
EpilepsyMedical Journal, Jan 2000

• 82 of studies demonstrated significant seizure
  reduction
• Average reduction exceeded 50.
• Studies reported reduction in seizure severity.
• About 5 had complete control for up to one year
• Sterman, MB (2000). Basic Concepts and
  Clinical Findings in the Treatment of Seizure
  Disorders with EEG Operant Conditioning.
  Clinical EEG, 31(1), 45-55.

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SMR attenuated (compared to cat subdural
recordings) but also present at the scalp in
humans
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Mechanisms of SMR training

• Enhancing GABA circuitry involved in motor
  regulation, dampening excitability to
  sensorimotor excitation

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10-20 International System of Electrode Placement
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History of Motoric Hyperexcitability

• 1905 Hyperkinetic syndrome
• (George Frederic Still, Lancet)
• wanton destructiveness and a deficit in moral
  behavior
• Now known to be due to slowed maturation
• only partly related to will power, if at all
• Lubar (1975) ABA study, n4
• Cz theta/beta ratio

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Patterns of behavior indicative of ADHD

• Inattentive
• Easily distracted
• Fails to pay attention to details
• makes careless mistakes
• rarely follows directions completely or properly
• Forgets things needed to complete tasks (e.g.,
  pencils)
• Hyperactive
• Unable to sit still
• Leaves seat when sitting expected or instructed
• Talks non-stop
• Impulsive
• Unable to suppress impulses
• inappropriate comments or shouts out answers
  early
• Hits
• Often puts oneself in danger, such as dashes into
  street

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Attention Deficit Hyperactivity Disorder

• ADHD affects 2 million children in USA
• 5 of all boys
• 2 of all girls
• 60 will remain symptomatic as adults
• 1 M children take Rx to control hyperactivity.
• Genetic component MZ concordance is 75-91
• EEG frontal slowing due to immature frontal lobe
  in impulsive subtype

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Ritalin

• Controversy
• Commonly prescribed drug for children
• Worries about long-term effects.
• No studies on children who have taken Ritalin gt
  14 months.
• Very similar to cocaine in composition and effect

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Monastra study ADHD and biofeedback vs.
stimulant therapy

• 100 ADHD children, ages 6-19, inattentive or
  combined types
• 1-year multimodal outpatient program
• included Ritalin, parent counseling, academic
  support
• 51 with EEG biofeedback
• RESULTS
• Post Tx assessments with and without stimulant
  therapy.
• Ritalin produced significant improvement on TOVA
  and ADDES
• Did not sustain when Ritalin removed
• EEG biofeedback group sustained gains when
  Ritalin removed.

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First Year of specific Neurofeedback Application

• 1967 SMR conditioning in general
• 1973 Epilepsy
• 1975 Peak Performance
• 1976 ADHD
• 1977 Addiction
• 1978 Anxiety disorders
• 1978 Learning disabilities
• 1980 Sleep Disorders
• 1995 Brain Injury
• 1995 Lyme's Disease
• 1996 CFS
• 1997 Mood disorders

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Neurotherapy -start

• Revives Hess CNS model of 1950s
• overaroused
• underaroused
• Added by Othmers
• instability
• Related issue of plasticity
• Cajal thought adult brain fixed
• finally countered by Peter Eriksson 1998

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Most important figure in behavioral neuroscience
(i.e., psychology)
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Elegant design to counter any intrinsic
(non-contextual) reward
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Earned PRS
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PRS and learning
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PRS characteristics

• Reward-based inhibition of MRF
• Mesencephalic Reticular Formation (originally
  called ARF) turns off the DC, i.e., volitional
  aspect of mind
• PRS does not occur initially
• animal must be fully habituated to environment
• any novelty or change will disrupt it.
• Light must also be on for PRS to emerge, even
  when light off is a signal of food delivery
  trials.
• 3-5 s burst indistinguishable from sleep onset or
  SWS
• Signal transmission in thalamus (LGN) and cortex
  is suppressed by PRS (similar to SWS)

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Unresponsive during PRS, like sleep
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PRS (6-9 Hz in cats, 8-13 Hz in humans)
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Alpha burst reflect preparation
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Impact human learning
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Field of Neuroregulation

• Clinical aspects
• Thalamocortical dysrhythmias
• Cognition
• Time binding
• Information processing, recruitment
• ERD and ERS

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NF PracticeTherapist and client/game screen
Therapist Monitor
EEG Sensors
Feedback Screen
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Game provides client feedback
Mazes
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Space Race
So how do you do it?
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The Therapist Screen
Raw
Inhibit
Reward
Inhibit
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Scoring Charts Provide Periodic Feedback
Operant Conditioning
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A normal looking EEG is small in height
Small EEG
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Reducing excessive (tall) slow brain waves helps
the brain function better
Examples of excessive slow brainwaves
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Example of EEG Brain Map
Courtesy of Q-Metrx
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This man has way too much alpha with his eyes
open. Hes got problems with obsessive thinking
getting stuck
Slow alpha increased with eyes open. Thats not
normal.
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PRE/POST ASSESSMENTSMale, age 9. Drawing before
Neurofeedback training
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Male, age 9. Drawing after 4 months of
Neurofeedback training, 5/2/95
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Childs Family Drawing at Beginning of NF - 8/3/94
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Drawing after Twenty Sessions - 9/8/94
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Drawing after forty sessions -11/25/94
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Neurofeedback Outcome 2003 Courtesy of Moshe
Perl, Ph.D.
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One year follow-up
Courtesy of Moshe Perl, Ph.D.