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Journal of Neurotherapy
Volume 3, Number 4   -    Fall & Winter 1999
 
Clinical Observations with Brain Blood Flow Biofeedback - the “Thinking Cap”.
Hershel Toomim, Sci.D. and Marjorie Toomim, Ph.D.

Purpose of study: Report of clinical results using brain blood flow neurofeedback, hemoencephalography (HEG). Many brain diseases are characterized by hypoperfusion. Brain exercise is shown to enhance cerebral blood flow.

Method: HEG Infra-red spectrophotometry allows examination of the oxygenation of the cerebral cortex non-invasively. Lights, shone through the skull, impinge on the brain and are reflected and backscattered to the surface. Oxygenated tissue is red, deoxygenated tissue is blue. The color of the returned light therefore shows blood oxygenation. The HEG technique requires no skin preparation, electrodes or electrode creams. It is very resistant to movement artifact and does not respond to eye movements or EMG. This makes frontal cortical exercise practical. SPECT and PET studies have implicated insufficient blood flow (hypoperfusion) in specific areas brain areas as a factor in various brain dysfunctions. Most brain disorders are candidates for improvement by means of increased cortical vascularity. Measurements with a spectrophotometer support the hypothesis that increased vascularity results from brain exercise in patients with Depression, Stroke, ADD, Working Memory deficit and Cerebral Toxemia. It is here reported that brain exercise increases regional cerebral blood flow (rCBF) and results in increased vascularity in the areas observed. rCBF is generally higher at the beginning of a session than at the beginning of the previous session.. This effect is similar to that found by Marion Diamond et al. Rat brains grew increased tissue and vascularity as a result of enhanced brain activity. Trainees report rapid improvements in memory and cognitive functioning within the first 10 sessions. These subjective reports are substantiated by significant changes in the MicroCog test of mental abilities and T.O.V.A.

Evaluation and treatment procedure: The computer administered and scored MicroCog test, normalized against a large population, available from the Psychological Corporation, examines Working Memory, Attention and Mental Control, Reasoning and Calculation, Spatial Processing, Reaction Time,Information Processing Speed and Accuracy, as well as General Cognitive Abilities. T.O.V.A. measures reaction time, variability of reaction time, impulsivity, and attention. The attributes of the brain measured by these tests show impairment in Attention Deficit Disorder, Stroke, Alzheimer’s Disease, Chronic Fatigue, Depression and Affect Disorder, Schizophrenia, Autism and Aspberger’s Disease as well as in many other syndromes. These observations lead to the general conclusion that various brain locales, when hypoperfused, give rise to a wide variety of functional disorders, From this it is evident that the fundamental quest for a treatment should not be guided by such names as above but are better conceived as localized positions in need of position targeted therapy. ADD, Autism, Schizophrenia, Epilepsy, and many others have been shown to be closely linked to electrical activity of the cerebral cortex (EEG). Hypoperfusion, with low metabolic rates of glucose, in the superior prefrontal and premotor cerebral cortex have been shown to characterize ADHD parents of ADHD children. Rosenfeld, as well as Birbaumer & Gruzelier demonstrated that excessive alpha activity of the left compared to the right frontal cortex is involved in depression. Drevets showed that hypoperfusion in the medial subgenual prefrontal cortex is reliably associated with suicidal and bipolar depression. Eye movement and forehead muscle artifacts make the frontal cortex difficult to train with EEG neurofeedback. New patients are administered the T.O.V.A., MicroCog, an EEG brain map of 12 sites or SPECT study to locate likely treatment sites. We target for treatment sites with EEG Beta to Theta ratios below 1.2 which drop to lower values under challenge. Abnormal T.O.V.A., and areas of the brain consistent with below normal measurements by MicroCog as well as a comprehensive history are also considered to locate training areas. After each 10 sessions MicroCog and T.O.V.A. are re-administered.

Results: Clinical data reported here suggest that exercising enhanced blood flow is more efficient and effective than EEG training and the effects are accomplished in less time. The MicroCog and T.O.V.A. data show that increasing blood flow in areas of hypoperfusion produced by stroke and other brain injuries is beneficial). Case studies in Stroke, ADD/ADHD, Depression, Toxic Encephalopathy, and Autism, successfully treated with HEG, are presented.

Discussion: The Thinking Cap cerebral blood flow enhancement technique is very easy to use, requiring no skin preparation, electrodes or electrode creams. It is very resistant to movement artifact and does not respond to eye movements at all. This feature makes pre-frontal cortex exercise simple and practical. Voluntary control of blood flow in the pre-frontal area is quickly learned, seldom requiring as much as 5 minutes and most often happening in less than one minute. The results are quantifiable as growth in vascularity between exercise sessions.

Key words: Brain blood Flow, Spectrophotometry, Infrared, Thinking Cap.

(Contact Hershel Toomim, Sci.D., Biocomp Research Institute)