Is brain-behavior behavior?Is brain-behavior behavior?

If so, it can be If so, it can be conditioned just conditioned just like other like other behaviorsbehaviors

In 1960s, certain In 1960s, certain rhythms could be rhythms could be “trained”“trained”

Led to Led to Neurotherapy and Neurotherapy and Brain-Computer Brain-Computer interfaces (BCI)interfaces (BCI)

History of BiofeedbackHistory of Biofeedback JH Bair, 1901, instrument used to teach ear wigglingJH Bair, 1901, instrument used to teach ear wiggling

In early 20th century, J.H. Schultz in Germany developed a In early 20th century, J.H. Schultz in Germany developed a technique called technique called Autogenic TrainingAutogenic Training. Verbal instructions are . Verbal instructions are used to guide a person to a more relaxed and controlled used to guide a person to a more relaxed and controlled physiological state. physiological state. • The method flourished, and the results were reported upon by The method flourished, and the results were reported upon by

Wolfgang Luthe in 1969 in the United States.Wolfgang Luthe in 1969 in the United States. Increased awareness in Western world of yogic ability to Increased awareness in Western world of yogic ability to

alter physiology volitionally. E.g., a yogi could survive in a alter physiology volitionally. E.g., a yogi could survive in a sealed box by voluntarily reducing his metabolic rate sealed box by voluntarily reducing his metabolic rate significantly, surviving hours with a limited supply of significantly, surviving hours with a limited supply of oxygen. oxygen.

Peripheral biofeedback techniques include Peripheral biofeedback techniques include • GSR, thermal, breathing, cardiac GSR, thermal, breathing, cardiac

Internal inhibitionInternal inhibition

Pavlov conditioning experimentsPavlov conditioning experiments• Tone for food, buzzer for shock –Tone for food, buzzer for shock –• Moved them closer together in timeMoved them closer together in time• confounded dog fell asleep confounded dog fell asleep

Termed “internal inhibition”Termed “internal inhibition” Animal can close down own Animal can close down own

systems to avoid stresssystems to avoid stress

History of EEG biofeedbackHistory of EEG biofeedback 1934, Adrian watched his EEG in front 1934, Adrian watched his EEG in front

of oscillograph and created alpha at willof oscillograph and created alpha at will

1958, alpha biofeedback or deep states1958, alpha biofeedback or deep states• Joe Kamiya at U ChicagoJoe Kamiya at U Chicago• Subject 1, Subject 1,

1st trial, 60 tones 1st trial, 60 tones 60 guesses, half right 60 guesses, half right 22ndnd, 65 % correct, 65 % correct 33rdrd, 85% correct, 85% correct 4th, after initial mistakes, 400 correct 4th, after initial mistakes, 400 correct

guesses in a rowguesses in a row

1968, 1st congress in Aspen Colorado, 1968, 1st congress in Aspen Colorado, field named biofeedbackfield named biofeedback

““Alpha training” adopted by Alpha training” adopted by counterculture and practitioners counterculture and practitioners oversold its claimsoversold its claims From Kamiya (1978) Science paperFrom Kamiya (1978) Science paper

History of SMR biofeedbackHistory of SMR biofeedback In 1960s Mercury astronauts In 1960s Mercury astronauts

claimed they saw natives claimed they saw natives waving at them when they waving at them when they flew over the Pacific.flew over the Pacific.• (i.e., they hallucinated)(i.e., they hallucinated)

In 1967, Gordon Allies, In 1967, Gordon Allies, inventor of amphetamine, was inventor of amphetamine, was contracted to test toxicity of contracted to test toxicity of Mercury capsule rocket fuel Mercury capsule rocket fuel with David Fairchildwith David Fairchild

However Allies tested another However Allies tested another chemical compound on chemical compound on himself and died before himself and died before contract over. Fairchild asked contract over. Fairchild asked Sterman to help finish work.Sterman to help finish work.

MB StermanMB Sterman

History of SMR biofeedbackHistory of SMR biofeedback Then Sterman and Fairchild went on to another study, Then Sterman and Fairchild went on to another study,

testing rocket fuel on 50 cats, 10 from Sterman’s previous testing rocket fuel on 50 cats, 10 from Sterman’s previous SMR training study.SMR training study.

Inject 100 mg/kg or so of fuel into each catInject 100 mg/kg or so of fuel into each cat• After one hour, all usually go into grand malAfter one hour, all usually go into grand mal

but not all - 7 delayed, 3 not at all.but not all - 7 delayed, 3 not at all.

• seizure thresholds changed in these 10seizure thresholds changed in these 10

• Not explainable by placebo (“i shall please” in Latin) as Not explainable by placebo (“i shall please” in Latin) as cats didn’t know what to expect, and experimenter blind cats didn’t know what to expect, and experimenter blind because effect was entirely unexpectedbecause effect was entirely unexpected

When monomethyl hydrazine and nitrogen tetroxide oxidizer come in When monomethyl hydrazine and nitrogen tetroxide oxidizer come in contact, contact,

they ignite automatically( i.e., no spark required) in absence of oxygenthey ignite automatically( i.e., no spark required) in absence of oxygen

Mono-methyl hydrazineMono-methyl hydrazine

Sterman was studying EEG-Sterman was studying EEG-behavioral correlates in catsbehavioral correlates in cats

If EEG behavior is like any other behavior, it If EEG behavior is like any other behavior, it could be shaped with operant conditioningcould be shaped with operant conditioning

Two prominent rhythms in cat EEG – SMR and PRSTwo prominent rhythms in cat EEG – SMR and PRS• Couldn’t train PRS, but could train SMR Couldn’t train PRS, but could train SMR

Operant Conditioning Operant Conditioning Increasing probability of rewarded actionsIncreasing probability of rewarded actions

10 cats trained to produce SMR (12-19 Hz over 10 cats trained to produce SMR (12-19 Hz over motor strip) for chicken broth & milkmotor strip) for chicken broth & milk

Classic abundance response at Classic abundance response at extinctionextinction

History of SMR biofeedbackHistory of SMR biofeedback Sterman and Fairchild tested NASA’s rocket Sterman and Fairchild tested NASA’s rocket

fuel on fuel on 5050 cats, 10 from Sterman’s previous cats, 10 from Sterman’s previous SMR training study.SMR training study.

Inject same mg/kg of fuel into each catInject same mg/kg of fuel into each cat• Cats show usual toxic prodromeCats show usual toxic prodrome

After 1 hr, all usually go into grand malAfter 1 hr, all usually go into grand mal Of 50, 7 cats showed prodrome with Of 50, 7 cats showed prodrome with

delayed seizures and 3 without delayed seizures and 3 without seizing.seizing.

Examining his data carefully, Examining his data carefully, including who made up his sample, including who made up his sample, he realized the seizure thresholds he realized the seizure thresholds changed in cats who underwent SMR changed in cats who underwent SMR trainingtraining

• Not explainable by placebo (“I shall Not explainable by placebo (“I shall please” in Latin) as cats didn’t know please” in Latin) as cats didn’t know what to expect, and experimenter blind what to expect, and experimenter blind because effect was unexpectedbecause effect was unexpected

Sterman et al (1967) showing usual toxic Sterman et al (1967) showing usual toxic prodrome and resistance to MMH-prodrome and resistance to MMH-induced seizures in a subgroupinduced seizures in a subgroup

NASA Rocket fuel

Avg 2 hours+ for seizures with EEG trained cats vs. 1 hour for normal cats

Time

History of SMR biofeedbackHistory of SMR biofeedback Replicated in monkeysReplicated in monkeys Onto humans at colleagues’ Onto humans at colleagues’

urging.urging.• n=1, epileptic case in n=1, epileptic case in EEG & EEG &

Clin NeurophysiologyClin Neurophysiology• n=4, 65% seizure reduction n=4, 65% seizure reduction

((EpilepsiaEpilepsia 1976) 1976) • n=8, ABA 3-year study, n=8, ABA 3-year study,

((EpilepsiaEpilepsia 1978) 1978)• NIH-funded study NIH-funded study

Sham control, n=24, 3yrsSham control, n=24, 3yrs Double yoked Double yoked

• n=8, n=8 NF, n=8 log n=8, n=8 NF, n=8 log booksbooks

Many went seizure free Many went seizure free who received NFwho received NF

Reliable increase in sleep Reliable increase in sleep spindle density and spindle density and decreased awakeningsdecreased awakenings *

** **

60% reduction in seizures 12 mo after training60% reduction in seizures 12 mo after training

Lantz & Sterman, Epilepsia, 1988; Lantz & Sterman, Epilepsia, 1988; Sterman & Lantz, JNT, 2001Sterman & Lantz, JNT, 2001

Improved functioning Improved functioning with SMR trainingwith SMR training

(C3)

Sterman, MB (2000). Basic Concepts and Clinical Findings in the Treatment of Seizure Disorders with EEG Operant Conditioning. •Clinical EEG, 31(1), 45-55.

Why does SMR training work?Why does SMR training work?

Sterman & Bloomfield, 1976Sterman & Bloomfield, 1976

How does SMR training work?How does SMR training work? Likely enhances Likely enhances

GABA circuitry GABA circuitry involved in motor involved in motor regulation, regulation, dampens dampens excitability to excitability to sensorimotor sensorimotor stimulationstimulation• May increase May increase

GABAergic receptor GABAergic receptor density in density in sensorimotor sensorimotor pathwayspathways

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

Neurofeedback Applications by year of 1Neurofeedback Applications by year of 1stst publication publication

Epilepsy ADHD Beyond

Lubar and Bahler (1976) trained epileptics to reduce seizure but noted that a hyperactive epileptic showed decrease in his overactivity after SMR enhancement and theta suppression training

Thalamocortical dysrhythmias may underlying a variety of conditions including depression, dysfunction associated with TBI, etc