Biomarkers – ‘Precision Medicine’ for the Brain

From the time of the ancient Greeks, medical practitioners have searched for biomarkers for physical illnesses. Hippocrates tasted patients’ urine for sweetness (he is thought to have been the first to diagnose diabetes mellitus).  More recently, doctors relied on patients’ complaints about the severity of their chest pains in order to diagnose a heart attack. Today, they measure cardiac enzymes in the bloodstream.

Think of it this way: Cancer treatment doesn’t treat the symptoms of cancer.  You don’t want the swelling to go down or the pain to disappear; you want to get rid of the cancer.  But that’s the protocol clinicians and researchers have used for years – the cataloging of symptoms such as sadness, fatigue and loss of appetite, rather than looking for biological clues associated with the symptoms in a blood test, a brain image or a saliva sample. The focus was treating the symptoms of mental disorders, not the causes.

Neuroscience’s inroads have emboldened a small but growing number of clinicians and researchers to reject diagnostic protocols on which mental health practitioners have relied for years and instead focus on finding the biomarkers, the concrete measurements of mental illness.

There was a huge shift in the approach to diagnose and treat mental illnesses beginning in 2013, when the National Institute of Mental Health announced that the government, the largest funder of mental health research in the world, drastically shifted its priorities.  Research based solely on the Diagnostic and Statistical Manual of Mental Disorders, the chief tool of mental health professionals, would no longer be funded.  The reason was “its lack of validity.”   First published in 1952, the manual has changed over the years, but its categorization of mental illnesses was based nearly entirely on symptoms either reported by the patient or observed by the clinician.  New funding is based on the premise that mental disorders are biological disorders involving brain circuits. Research into diagnosis and treatments such as talk therapy became relegated to the bottom rung of the research ladder.

New psychiatric methods visualize the nervous system and its activities, monitoring the physiological dynamics of mental health.  Rather than targeting brain chemistry to reduce symptoms, researchers now want to focus on brain circuitry.  Their efforts have been bolstered by advances in technology and imaging that now allow scientists not only to see deeper into the brain, but also to study single brain cells to determine which circuits and neurons underlie specific mental and emotional states.

Because of this huge shift from ‘brain chemistry’ to ‘brain circuitry’ some traditional psychotherapists are evolving onto “neurotherapists,” someone who first tries to understand a patient’s brain circuitry, then combines that with both psychological and physiological information to create a treatment plan.

While traditional psychotherapists might begin sessions by asking patients about their thoughts, feelings and problems, new diagnostic protocols might have patients fill out a color-coded form that matches statements about their thoughts and feelings with the parts of the brain most likely involved. Then patients undergo a quantitative electroencephalograph, or qEEG.

The EEG is a map of the brain’s electrical activity and reflects a patient’s emotional and cognitive states. The qEEG compares that information, in real time, to a digital database of hundreds of EEGs of healthy subjects. A patient’s brain map will pulse with red or blue if it is either overactive or under-active, compared with the norm.

Patient treatment plans can include psychotherapy and medication as well as neurofeedback, a technique in which patients are trained to increase or decrease brain-wave activity in the parts of the brain related to their complaints. Another tool is transcranial magnetic stimulation, a noninvasive method of delivering pulses of energy to the head, which has been approved by the Food and Drug Administration for the treatment of depression.

A person’s mental makeup is a kind of hierarchy, with personality on top, which is created by brain states that arise from circuits firing in a certain pattern below. With psychotherapy, you tweak the brain from the top down, dealing first with a patient’s personality and temperament. But with neurofeedback, combined with qEEG, patients are tweaked his from the bottom up, identifying the brain areas involved and then retraining those circuits to fire differently, resulting in changed moods or mental outlooks.

It’s a more precise way to  and it sure beats trial and error.

Are you overthinking things??

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It  happens all the time.  Someone you know is going through something really tough.  You want to reach out to them, but you just don’t know what to say.  The more you think about it, the more your mind begins to overthink it.

We all have thoughts that inhibit our actions.  We question ourselves, should I call or email, or maybe text my friend in need? What if I say the wrong thing and make it worse? What if they don’t want to talk to me?  What if I make it worse?  Those negative self defeating thoughts keep coming and coming.  Sadly,  we end up not reaching out and continue to overthink the situations.

Our brains directly control our behavior. When the brain is ‘regulated’ properly it works better. It gives us clarity.  How do we get that clarity?

Biofeedback and Neurofeedback provide clearer thinking.

Biofeedback and  Neurofeedback are a great ways to help open our brain’s neural pathways that create self regulation to improve, and enhance our neurological and physiological responses. It can help us think more clearly and teach us how to respond to everyday stress in a healthy way. Biofeedback and neurofeedback provide the kind of evidence-based therapy that can benefit everyone. It enables an individual to learn how to change physiological activity for the purposes of improving health and performance in our daily lives.

Clear thinking allows action:

  • Don’t assume others have called. Often, even good friends don’t call because they know what to say.
  • Don’t text or email. A phone call can make someone feel loved at a time they need it most. They will remember it.
  • Don’t worry about saying the wrong thing. The act of you picking up the phone and giving your voice to their pain trumps any of the actual words you’d use in the conversation.
  • If they don’t want to talk, they won’t answer. Leave a message. It means just as much.
  • If you’re worried about it being uncomfortable, you’re focusing too much on yourself. The phone call isn’t about you. It’s about them, and there is nothing uncomfortable about taking a few minutes to let another human know they matter.

Don’t overthink things.  Just call.

What’s New in Neurofeedback? LOTS!!

NeurofeedbackThe field of EEG brain wave biofeedback, neurofeedback,  has advanced dramatically in recent years.  Advances in neuroscience have provided a richer understanding of the mechanisms of EEG operant conditioning, allowing for improved treatment across the different types of neurofeedback, especially in Z score training.

The most recent discovery is LORETA, Low Resoulution Electromagnetic Tomographic Analysis that was developed by Roberto Pascal Marti, Key Institute, in Zurich.  LORETA Z score Neurofeedback was developed at the University of Tennessee, and has had it’s clinical efficacy supported by a number of publications.  The goal of LORETA is to train the activity inside the brain, not just the surface EEG on the cranium of the brain, as it trains the amplitude (power), the coherence (connectivity), and the phase lag (timing).

LORETA Z score neurofeedback trains the whole brain

Emotion, memories, and behavior depend on the coordinated activities of multiple regions in the brain that are connected by the limbic system.  LORETA Z score training allows us to train the different systems (networks and hubs) in all three dimensions, amplitude, coherence, and timing.  LORETA connects the data from your QEEG to the Broadmann areas of the brain that research associates with the desired symptom you are wanting to train.  Relying solely on brain maps can be misleading, as the brain can develop compensatory systems to work around the problem, and thus misrepresent what is truly causing the problems. With the LORETA Z score training, you are utilizing over two hundred years of research linking symptoms to the Broadman areas in the brain, with the end result of treating the root and not a symptom.

LORETA Neurofeedback is offered now in both the Dallas and Irving centers

The Brain Performance Center is proud to offer LORETA Z score neurofeedback, being one of approximately 100 clinics in the USA to offer this type of neurofeedback