How Neurotherapy Works
Medically reviewed by Brigid Dwyer, MD
Neurotherapy helps people improve brain functions using technological devices. Drug-free neurotechnologies modify brain activity without medication. Most neurotherapy techniques are non-invasive, painless, and safe when administered by a trained professional in a clinical setting.
Neurotherapy technology and methods aren't set in stone. Because neurotechnology is constantly evolving and still experimental, treatments and procedures are also ever-changing.
Read on to learn more about this therapeutic technique, the conditions it treats, and warnings.
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What Is Neurotherapy?
Neurotherapy is a form of biofeedback that uses a patient's brainwave activity to help patients understand how they can self-regulate their state of mind to address mental health conditions, headaches, sleep disorders, substance use disorders, and more.
There are two primary forms of neurotherapy: neurofeedback, which uses the brain's waves to teach patients to regulate, and neurostimulation, which uses magnetic or electrical impulses to alter brainwaves.
Who Neurotherapy Helps
Neurotherapy is used to treat a wide range of conditions, such as:
Drug-resistant epilepsy
Depression and major depressive disorder (MDD)
Sleep disorders like insomnia
Neurotherapy can be used for people who don't respond to pharmaceutical treatment as a supplemental or alternative way to treat a condition.
History of Neurotherapy
In 1962, Dr. Joe Kamiya identified that people could self-regulate their alpha brainwave rhythms in the presence of neurofeedback. The earliest form of neurotherapy was electroencephalogram (EEG) biofeedback. EEG neurofeedback was first used during the 1970s.
How Neurotherapy Works
During neurofeedback training, real-time brain activity is monitored using technological tools such as electroencephalography (EEG-NF) or functional magnetic resonance imaging (fMRI-NF). With practice, neurofeedback teaches people how to self-regulate their brainwave activity. Over time, neurofeedback may also "rewire" the brain.
Neurofeedback
Neurofeedback may use reward-based operant conditioning to teach people how to control brainwave patterns by rewarding them for creating certain brainwave states on demand.
For example, alpha brainwaves are associated with a calm and relaxed state of mind, whereas beta brainwaves are associated with attention and focus. So, if lowering anxiety is the goal, neurotherapy teaches someone how to create alpha brainwaves on demand. Conversely, to address ADHD symptoms, someone would practice creating beta brainwaves.
During a session, a patient sits comfortably with electrodes attached painlessly to the scalp, measuring their brainwaves. The patient is asked to perform some simple tasks, and based on the brain's waves, there is positive feedback to reinforce the desired outcome.
Neurostimulation
Neurostimulation therapies use low-voltage electromagnetic or direct electric currents to modify brain activity and stimulate specific brain regions. Non-invasive neurostimulation devices such as transcranial magnetic stimulation (TMS) or transcranial direct current stimulation (tDCS) are placed above the head and do not penetrate the skin.
TMS might feel like tapping on the area of the scalp that is being targeted. tDCS feels a little like tingling or warmth in the area that is being stimulated.
Although some neurotherapeutic stimulation devices are implanted during surgery, most are non-invasive and portable.
Types
There are several types of neurotherapy available. Some types are described below.
Electroencephalography (EEG) neurofeedback: By allowing subjects to watch EEG brainwaves in real time, people learn to gain more control over what thought processes produce the desired brainwaves.
Functional magnetic resonance imaging (fMRI) neurofeedback: In fMRI neurofeedback, patients are given real-time information about their brain activity as measured by functional MRI. As they receive this feedback, they try to regulate their brain activity to achieve a certain result.
Slow cortical potentials (SCPs) neurofeedback: Slow cortical potentials, which are short, small changes in an EEG, can be used to teach patients how to cself-regulate for possible use in conditions like ADHD and autism.
Low-energy neurofeedback system (LENS): LENS uses low-frequency electromagnetic waves to stimulate the brain and promote healthier patterns of brainwave activity.
Live Z-score training (LZT): In LZT, patients receive input about their EEG results in response to different stimuli. Patients receive positive feedback when their Z-score value falls within a specified range, and the hope is this will allow patients to induce this state at will.
Hemoencephalographic (HEG) neurofeedback: This form of neurofeedback is being researched in particular for its possible usefulness in patients with ADHD.
In addition to neurofeedback and neurostimulation devices, researchers at the University of California, San Francisco (UCSF) have developed a first-of-its-kind video game called NeuroRacer that is FDA-approved to treat ADHD in children ages 8 to 12.
Other new technologies on the horizon include non-invasive vagus nerve stimulation (nVNS) devices for the treatment of post-traumatic stress disorder. Two neurotherapy devices that stimulate the vagus nerve via an earbud or handheld device were recently given "breakthrough device designation" by the FDA for treating PTSD.
What Is the FDA's Breakthrough Devices Program?
The U.S. Food and Drug Administration's Breakthrough Devices Program fast-tracks the development of specific medical devices and neurotechnologies without compromising the agency's commitment to promote and protect public health.
What Research Says About Neurotherapy
Researchers note that more evidence is needed to recommend neurotherapies as a first line of treatment. However, there is demonstrated value as a complementary or alternative therapy, meaning some of these therapies should not be used as the first line of treatment. For example, in a patient with anxiety, there is far more evidence for treatments like cognitive behavioral therapy (CBT) than for neurofeedback, so evidence-based medicine would indicate that CBT should be the first line of treatment.
Most non-invasive neurotherapy treatments have few side effects and are generally considered safe when performed by a trained professional. Although outcomes may vary, recovery from these procedures is typically very fast, if any recovery is needed at all.
Costs of Neurotherapy
Costs for different neurotherapy treatments can vary widely depending on the treatment and where in the country you live. Some insurance will cover treatments like TMS. For others, a session can cost anywhere from $100-$300 and often at least 10 sessions are recommended.
Warnings
Although the earliest neurofeedback studies were conducted over a half-century ago, there's still much debate about the legitimacy of many types of neurotherapy. There aren't enough studies to be confident that every type of neurotherapy will have reliably positive outcomes.
Takeaway
A few studies have been done examining whether neurotherapy, particularly a game called NeuroRacer, can help patients with Alzheimer's or dementia. While more research needs to be done, the data gathered so far is not compelling enough to come to any conclusions. In the case of NeuroRacer, which is a driving-based video game once thought to enhance cognitive function, any benefit is short-lived and unsustainable.
Most neurofeedback treatments are well-tolerated and low-risk. Neurostimulation, on the other hand, is riskier because some modalities, like TMS, carry a risk of seizures. Always ensure that any neurostimulation device you use is FDA-approved, and speak with a healthcare provider about potential risks.
Takeaway
Be wary of products making lofty promises or overhyping the effectiveness of any direct-to-consumer neurotechnology sold for in-home use. Many of these products may be potentially dangerous.
Who to Ask About Neurotherapy
Generally speaking, neurotherapy is performed by a neurotherapist, which could mean a physician, nurse practitioner, or other trained medical professional, or someone who is trained specifically on a neurotherapeutic mechanism, as in people who administrate TMS. However, most healthcare providers trained to perform neurofeedback or neurostimulation also have other qualifications and certifications related to their specialty.
Locating a Provider
The International Society for Neurofeedback & Research (ISNR) is a non-profit organization dedicated to advancing the use of neurotherapy to help people optimize brain function and improve symptoms of neurological or mental health disorders. ISNR has a searchable "Find a Provider" directory on its website.
Summary
Device-based neurotherapy is a growing field of drug-free therapeutics that can help people improve brain function without taking medications.
Neurofeedback is based on the principle that you can consciously alter the electrical activity in your brain. Neurostimulation uses neurotechnology to stimulate targeted brain areas with electricity.
The FDA's breakthrough device program fast-tracks the development of pioneering technologies that have the potential to improve how our minds and brains work.
Read the original article on Verywell Health.
