A New Neurofeedback Approach for Mental Health

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Neurofeedback research started ninety years ago, and clinics have been offering it as a treatment for ADHD and other mental health conditions for half a century. But as I described in a previous video () the research supporting whether neurofeedback really helps ADHD symptoms to improve is incredibly weak and inconsistent. This is tragic, both because many individuals can't tolerate stimulants and other medications, and because many individuals have been spending hours of their lives and hundreds or even thousands of dollars a month for neurofeedback treatments that may or may not be of benefit.

Neurofeedback using brain wave information provided by EEG can show what the brain is doing in almost perfect real time, but the localization of brain activity is imprecise. In contrast, fMRI can localize brain activity to a few millimeters, but is too slow to capture brain states that happen too quickly or briefly. Standard protocols for EEG neurofeedback commonly focus on certain brain waves (changing the ratio of theta to beta waves) or target brain wave activity emanating from a specific region of the brain (sensorimotor cortex).

A new set of studies by Gou and colleagues in China used a new approach. They individualized treatment for each subject, and the brain activity that they had each subject try to decrease was a rendering of activity throughout the whole brain when it was exposed to a cue that triggered methamphetamine craving. Subjects were able to learn to deactivate this pattern of brain activity, and subsequently were far more likely to react or feel cravings when exposed to methamphetamine cues. The authors suggest that both the individualization, and the whole-brain approach contributed to the success. It implies that for addiction (and other mental health conditions) similar-appearing behavior may be generated by different combinations of pathways, and that changing this composite picture is more important for treatment success than targeting a specific brain circuit or pathway.

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