Is brain-behavior behavior?

1. 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)

2. When you become aware of your own brain activity –you can change it also.

3. 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

4. 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 > 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.

5. Delgado, Primate wireheads, and Circuitry man

6. 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

7. 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

8. 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

9. 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 History of SMR biofeedback

10. Sterman was studying EEG-behavioral correlates in cats

11. If EEG behavior is like any other behavior, it could be shaped with operant conditioning • Two prominent rhythms in cat EEG – SMR and PRS • Couldn’t train PRS, but could train SMR • More on the PRS later

12. Cat Wireheads: cortical electrodes, not brain stem or hypothalamic • Cats often used in electrophysiology because head size the same regardless of breed, unlike dogs

13. 10 cats trained to produce SMR (sensorimotor activity over motor strip) for chicken broth & milk

14. Acquisition resembles normal behavior under O.C. training

15. Classic abundance response at extinction

16. Then Sterman and Fairchild went on to another study, testing rocket fuel on 50 cats, 10 from Sterman’s 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 didn’t know what to expect, and experimenter blind because effect was entirely unexpected History of SMR biofeedback

17. 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

18. Replicated findings in monkeys, then moved to humans at colleagues urging. Human epileptics First case study published in EEG & Clin Neurophysiology N=4 study, 65% seizure reduction, in Epilepsia 1976 Then n=8, ABA three-year study, Epilepsia 1978 Finally, full blown study funded by NIH Sham control, n=24, three years Double yoked n=8, n=8 NF, n=8 log books many went seizure free controls after study received NF Reliable increase in sleep spindle density and decreased awakenings History of SMR biofeedback

19. A major study showed 60% reduction in seizures 12 months after training

20. Turf war with medicine • In 1982 Sterman’s 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

21. Review of 19 studies with EEG Biofeedback for Epilepsy*Medical 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.

23. SMR attenuated (compared to cat subdural recordings) but also present at the scalp in humans

24. Mechanisms of SMR training • Enhancing GABA circuitry involved in motor regulation, dampening excitability to sensorimotor excitation

25. 10-20 International System of Electrode Placement

26. 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, n=4 • Cz theta/beta ratio

27. 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

28. 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

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

30. 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.

32. 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

33. 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 Neurotherapy -start

34. Most important figure in behavioral neuroscience (i.e., psychology)

35. Elegant design to counter any intrinsic (non-contextual) reward

36. Earned PRS

37. PRS and learning

38. 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)

40. Unresponsive during PRS, like sleep

41. PRS (6-9 Hz in cats, 8-13 Hz in humans)

42. Alpha burst reflect preparation

43. Impact human learning

44. Field of Neuroregulation • Clinical aspects • Thalamocortical dysrhythmias • Cognition • Time binding • Information processing, recruitment • ERD and ERS

46. NF PracticeTherapist and client/game screen Therapist Monitor EEG Sensors Feedback Screen

47. Game provides client feedback Mazes

48. Space Race So how do you do it?

49. The Therapist Screen Raw Inhibit Reward Inhibit

50. Scoring Charts Provide Periodic Feedback Operant Conditioning