Is VNS Therapy a crude form of EEG Neurofeedback?

[Bernard]

Researchers at the Medical University of South Carolina (MUSC) announced the results of a 9 person functional MRI (fMRI) study examining the effects of VNS (Vagus Nerve Stimulation) Therapy for patients with severe depression which appears in the August 2007 issue of Neuropsychopharmacology:

The results show that VNS Therapy modulates areas of the brain that control mood. ... A critical time for such effective modulation occurs approximately at 30 weeks of treatment. Such modulation could support VNS Therapy's unique mechanism of action as a long- term treatment for chronic or recurrent depression and directly corresponds with the timeframe in which patients typically experience a decrease in symptoms. Further analysis of the data demonstrates that modulation of the brain is a dynamic process that over time leads to indirectly related improved response with continued use.

So, the study is claiming that over time, the VNS is training the brain ("modulates") to operate in a more normalize fashion. This is something that has been in the back of my mind for a long time regarding the VNS and the reports of it's efficacy increasing over time - the reason it works (for some) is that it performs a similar function to EEG neurofeedback - training the brain (with steady, repetitive stimulations) to work within more normalized parameters. A good description of neurofeedback treatment for depression is given here:

The basic idea behind the treatment of these problems in general, and in the treatment of depression in particular, is that in each case there has been an alteration in the normal, rhythmic electrical activities of the brain. With depression, what is frequently seen is a tendency toward a slowing down of brain activity. The result is what we refer to as a state of "low arousal." The depressed person has low energy, poor attention, poor memory, a feeling of lethargy and a mood of pervasive sadness.

At our clinic, we begin by analyzing brain activity in order to look at how the EEG might show such a profile. Afterward, we design a program of self-training with Neurofeedback which allows one the opportunity to "normalize" brain activity. In the case of excessively slow activity , for example, a program will be designed which requires the individual to produce faster brain activity. Both research and clinical experience have shown the effect to be the production of a state of increased arousal. The process is something like going to a gymnasium to exercise one's muscles . When muscles are challenged, they get stronger. When the brain is challenged, it gets stronger also. In both cases, you take the benefits home with you. They are not left in the room where you exercised.

Only, EEG neurofeedback is non-invasive (no surgery) and works by allowing the patient to learn how to modulate the brain themselves (without the requirement for a permanent, external device). It also doesn't have a single case of known adverse events in over 60 years of study and use.

When is the medical community going to wake up and start giving neurofeedback greater consideration? This was written in 2002:

"Critics of EEG neurofeedback hold this treatment to more rigid standards than many of the drug treatments," David F. Velkoff, M.D., medical director of the Drake Institute of Behavioral Medicine in Los Angeles, who has treated over 1,000 patients with neurotherapy, told the press. "Yet unlike drugs, neurofeedback is benign." According to Frank H. Duffy, M.D., associate editor for Clinical Electroencephalography, any pharmaceutical drug that had as wide a range of effectiveness as neurofeedback would be universally accepted and widely used (Duffy, 2000).

EEG Neurofeedback for Treating Psychiatric Disorders

[BIGMAN131307]

I'm all for giving EEG Neurofeedback a try. When I go to my next neurologist appointment in October I'm going to look into it. Before I go, I will print out some info. to bring with me. The main obstacle is not the doctor, it's the insurance company. Most insurance companies will not pay for EEG Neurofeedback. If a treatment is proven successful, then it should be covered by all insurance companies.

Ex. A family member while attending high school was in a similar situation. This person while playing sports for the high school got hurt. The only thing that helped to relieve the pain was seeing a chiropractor. But the school refused to pay for the treatments. So my family member had to pay out of pocket.

[Bernard]

Many insurers are approving EEG Neurofeedback as a treatment for ADD/ADHD right now. There is hope for the future.

[BIGMAN131307]

Many insurers are approving EEG Neurofeedback as a treatment for ADD/ADHD right now. There is hope for the future.

Well there may be a chance that me insurance would cover it.

ADHD is not considered to be a learning disability. It can be determined to be a disability under the Individuals with Disabilities Education Act (IDEA), making a student eligible to receive special education services. However, ADHD falls under the category “Other Health Impaired” and not under “Specific Learning Disabilities.”

As far I know I don't have ADD/ADHD. But I suspect that I do have Dysgraphia. I haven't been tested for it yet. But if I do test positive for it, then I might beable to try EEG Neurofeedback. I don't know if it will help with the possible Dysgraphia, but you never know.

Bernard if you can find any information about EEG Neurofeedback being used to treat Dysgraphia let me know.

[Bernard]

It appears that EEG neurofeedback is used to treat dysgraphia:

Neurofeedback may be considered a non-medical alternative/adjunct for the following conditions (levels of scientific evidence for each is highly variable among the conditions):

...
Dysgraphia
Dyslexia
...

Conditions Potentially Affected by Neurofeedback Training

WS28: QEEG-Guided Neurofeedback Training for Leaning Disabilities
Jonathan Walker, M.D., Neurotherapy Center of Dallas

... We have been using the modular activation/coherence model, for some time now, as a guide to neurofeedback training for ADHS and learning disabilities. This approach has been effective in remediating problems, including subtypes of ADHD, ADHD comorbidities, dyslexia, dysgraphia, dyscalculia, auditory processing difficulty, visual processing difficulty, and sensory integration disorders. ...

September 8, 2007 Annual Conference Workshop

And then there is dysgraphia. No one fails out of school because of an inability to draw, so this particular disability does not get much attention, except perhaps from those who do assessments on children. The inability to draw reflects more on right hemisphere skills, and on inter-hemispheric communication. Whereas this disability may be harmless in itself, it can be an indicator for other deficiencies in right hemisphere skills that could indeed be important. To assess drawing skills, children are asked to draw their family during the intake interview. We have seen many children improve with the training from the point at which they are drawing stick figures to where they acquire full-bodied relatives-all within the span of a few weeks, with some twenty to forty training sessions.

It is the lack of systematic, predictable success with learning disorders-more than perhaps any other reason-that has kept the professional community of EEG biofeedback practitioners from promoting this application more overtly. However, the very striking results that can be achieved with many children also place an obligation on us to make this information available. As long as the potential trainee is aware of the finite likelihood of success, he should certainly have the opportunity to train. Clinicians have an understandable reluctance to promote a technique where the outcome may be so highly variable, in addition to being unpredictable, particularly in a field that is still trying to gain recognition by the mainstream educational and medical communities.

For the future, things look very bright indeed. The new imaging studies give us indications for what protocols to try in order to improve the likelihood of success. For example, Shaywitz et al (1998) recently published a study on PET scans in dyslexic subjects. Regions of heightened oxygen uptake may reflect areas where reading is being bottlenecked in such subjects. It is relatively straight-forward to try a variety of training schemes involving the identified sites. The combination of functional imaging and EEG biofeedback may yield near-term breakthroughs in the remediation of various specific learning disabilities that have been relatively intractable to date.

Introduction to Neurofeedback and Learning Disabilities (there are many citations/references on this page for further study of neurofeedback and learning disabilities)

You might try contacting these guys to find out if any insurance companies cover it:

CES is a unique service dedicated to providing education, treatment and consultation to students, families and schools of Connecticut and surrounding states. Our mission is to apply the latest technological innovations in psychology and educational research to the diagnosis and treatment of conditions such as ADHD, learning disabilities (Dyslexia, Dysgraphia, Dyscalculia), central auditory processing deficits as well as emotional and behavioral disorders.

Robert F. Reynolds, Connecticut Educational Services (CES)

[Birdbomb]

Zoe has ADHD, it runs rampant in my family and her sperm donor STILL is on Ritalin at age 25. I had one medical professional suggest I even be tested for adult ADD. Sure would explain a lot.