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Old 10-14-12, 04:22 AM
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Neurofeedback- some hard evidence at last.

From SharpBrains blog, Oct 5, 2012:

Biofeedback now a “Level 1 — Best Support” Intervention for Attention & Hyperactivity Behaviors

[quote]
The AAP has accepted the neurofeedback has level 1 support in evidence based practice based in part on the following references.

Beauregard, M., & Levesque, J. (2006). Functional magnetic resonance imaging investigation of the effects of neurofeedback training on neural bases of selective attention and response inhibition in children with attention-deficit/hyperactivity disorder. Applied Psychology and Biofeedback, 31, 3-20.

Gevensleben, H., Holl, B., Albrecht, B., Vogel, C., Schlamp, D., et al. (2009). Is neurofeedback an efficacious treatment for ADHD?: A randomized controlled clinical trial. Journal of Child Psychology and Psychiatry, 50, 780-789.

Levesque, J., Beauregard, M., & Mensour, B. (2006). Effect of neurofeedback training on the neural substrates of selective attention in children with attention deficit/hyperactivity disorder: A functional magnetic resonance imaging study. Neuroscience Letters, 394, 216-221.

Omizo, M. M., & Michael, W. B. (1982). Biofeedback-induced relaxation training and impulsivity, attention to task, and locus of control among hyperactive boys. Journal of Learning Disabilities, 15, 414-416.

Rivera, E., & Omizo, M. M. (1980). The effects of relaxation and biofeedback on attention to task and impulsivity among male hyperactive children. The Exceptional Child, 27, 41-51.
[quote]
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Old 10-14-12, 04:33 AM
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Re: Neurofeedback- some hard evidence at last.

Excellent! Now to get this as a mainstream treatment. Maybe another 20 - 30 years I suspect...
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Old 10-14-12, 06:35 AM
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Re: Neurofeedback- some hard evidence at last.

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Originally Posted by tudorose View Post
Excellent! Now to get this as a mainstream treatment. Maybe another 20 - 30 years I suspect...
Well- that is always the catch-

- getting it recognised
- getting enough practitioners trained
- getting funding for it
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Old 10-16-12, 06:57 PM
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Re: Neurofeedback- some hard evidence at last.

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Originally Posted by tudorose View Post
Excellent! Now to get this as a mainstream treatment. Maybe another 20 - 30 years I suspect...
Only IF there is money to be made. . . otherwise the powers that make millions will continue to drown out all supportive evidence that stand contrary to the profit margin - This is especially true in the good ole USA where medical care is still privatized {read for profit business}. . ..

Gee did I type that out loud?????
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Old 10-16-12, 07:20 PM
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Re: Neurofeedback- some hard evidence at last.

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Originally Posted by meadd823 View Post
Only IF there is money to be made. . .
Oh, there is plenty of money to be made (at least in the technology-assisted forms of therapeutic or therapeutic-style interventions)!

Look at CogMed (not EEG neurofeedback, but another nonpharmaceutical intervention) -- they recruit and train doctors to sell (err, I mean, advise and train and coach clients on) their program for them, and both the doctor and the company make money from it.

I think it will be wonderful to have a broader range of effective interventions, and I'd love for them to have fewer risks than medications, and to be available to people who can't take or haven't benefited from the meds available.

Still, I think it's important to recognize that pharmaceutical companies aren't the only ones looking for profit. Not that we should be hopelessly cynical about everything, just cautious and informed consumers.
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Old 10-16-12, 08:34 PM
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Re: Neurofeedback- some hard evidence at last.

The article says it's going to be elevated to Level 1, but all the links show it at Level 2. Another article has the levels reversed as far as efficacy goes. My brain isn't up to figuring out which piece of this constitutes hard evidence, so I'll just leave it at that.
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Old 10-22-12, 01:44 AM
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Re: Neurofeedback- some hard evidence at last.

Quote:
Originally Posted by namazu View Post
Oh, there is plenty of money to be made (at least in the technology-assisted forms of therapeutic or therapeutic-style interventions)!

Look at CogMed (not EEG neurofeedback, but another nonpharmaceutical intervention) -- they recruit and train doctors to sell (err, I mean, advise and train and coach clients on) their program for them, and both the doctor and the company make money from it.

I think it will be wonderful to have a broader range of effective interventions, and I'd love for them to have fewer risks than medications, and to be available to people who can't take or haven't benefited from the meds available.

Still, I think it's important to recognize that pharmaceutical companies aren't the only ones looking for profit. Not that we should be hopelessly cynical about everything, just cautious and informed consumers.
That is a very well balanced comment Namazu.

However- if we do not make a profit- we cannot stay in business.

The case of the pharmaceutical companies is different though-- in that they have the funds to buy votes in congress, and reward previous heads of the FDA with VERY profitable jobs. ( and that this has happened is well documented).

I had my first session of neurofeedback last week. I am on holidays this week and will not have the second session till Friday, but the results of the first session were really pleasing.

I always think that "caveat emptor" is the key here- find a practitioner who is up front and honest- as him what effect to expect, and how soon. Ask him what he will do in the event of a failure- and assess whether or not you are being listened to.

The sooner we as patients learn to trust ourselves, and our own judgement- the better.
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Old 10-22-12, 08:06 AM
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Re: Neurofeedback- some hard evidence at last.

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Originally Posted by Barliman View Post
However- if we do not make a profit- we cannot stay in business.
True. But doctors needn't sell software to do so.

Quote:
The case of the pharmaceutical companies is different though-- in that they have the funds to buy votes in congress, and reward previous heads of the FDA with VERY profitable jobs. ( and that this has happened is well documented).
Pearson, the company that now owns CogMed, reported £5.862 billion in sales in 2011 (just under £1 billion in profit) [source: pearson.com/investors/financial-information/financial-highlights.html]. They also "develop and score large-scale assessments for the US federal government and more than half of US states, as well as national consortia", including school exit exams, GED exams, the GRE, etc. This, too, is big business. It would not at all surprise me if they, too, have lobbyists.

Again, my point is not to encourage conspiracy theory, just to note that the pharmaceutical companies aren't the only ones who stand to profit from selling treatments for ADHD.

Currently, the FDA does not regulate medical software applications like it does drugs and implantable devices.

My concern is not so much lobbying, but rather that some doctors who would have little to do with drug company reps, etc., seem not to recognize even the merest hint of a possibility of a conflict of interest in pushing commercial software that has shown promise, but remains far from "proven". This is not to say it won't someday be shown to be effective and generalizable -- maybe as good an option or better than medications for some people -- but that the marketing department has sure managed to influence a lot of doctors in a short time, without (in my opinion, and in the assessment of recent reviews) demonstrating the product's efficacy as a treatment for ADHD.

And again, not all neurofeedback and not all brain-training programs are like this. But I still think it's worthwhile to be cautious (and I wish the APA would consider drafting some ethics guidelines about adoption and administration of emerging technological interventions, and avoiding conflicts of interest in doing so).

Quote:
I always think that "caveat emptor" is the key here- find a practitioner who is up front and honest- as him what effect to expect, and how soon. Ask him what he will do in the event of a failure- and assess whether or not you are being listened to.
That's sound advice, no matter what course of treatment(s) one pursues.

I'm glad to hear your neurofeedback session went well.

Last edited by namazu; 10-22-12 at 08:16 AM..
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Old 10-22-12, 10:12 AM
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Re: Neurofeedback- some hard evidence at last.

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Originally Posted by Barliman View Post
I had my first session of neurofeedback last week. I am on holidays this week and will not have the second session till Friday, but the results of the first session were really pleasing.
Did you ever try the Australian neurofeedback software called Focus Pocus? I look forward to your neurofeedback updates. I'll be going to a free "11th Annual Learning Disabilities & ADHD Resource Fair and Speakers Corner" next week where I can ask neurofeedback and other ADHD/LD providers my final questions before proceeding with the treatments.
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Old 10-22-12, 10:52 AM
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Re: Neurofeedback- some hard evidence at last.

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Originally Posted by ConcertaParent View Post
Did you ever try the Australian neurofeedback software called Focus Pocus? I look forward to your neurofeedback updates. I'll be going to a free "11th Annual Learning Disabilities & ADHD Resource Fair and Speakers Corner" next week where I can ask neurofeedback and other ADHD/LD providers my final questions before proceeding with the treatments.
No I have not heard of it.
Having seen standard neurofeedback in action though I would be wary of any approach that was not well personalised.
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