Mapping & Reconditioning the Brain
Research finds that chronic fatigue syndrome (CFS), fibromyalgia (FM), and post-polio syndrome (PPS) appear to frequently be accompanied by a generalized slowing of brainwave activity. The brain map below is from a patient with CFS and FM who has excessive slow brainwave activity in the theta and alpha frequency bands, and deficient beta brainwaves. Black is normal. The brown and yellow colors indicate areas of excessive slow activity, and the lighter and lighter colors of blue indicate the areas of an increasingly greater deficiency of healthy beta brainwaves.
This disturbance in brain function appears to be related to the cognitive impairments (“fibro fog”), fatigue, pain, and sleep disturbance that is associated with these conditions. It has been found that an excess of alpha brainwaves is present even during sleep. This “alpha intrusion” into sleep seems responsible for sleeping shallowly so that even little noises can awaken you, resulting in you awakening feeling tired and unrefreshed. Research has documented that with improved, restful sleep, FM patients feel less fatigue and pain, and we believe the same likely holds true for PPS patients. Symptoms almost identical to FM are seen in post-polio patients because the polio virus did not just affect muscles, but also affected regulatory areas of the brain. Research has suggested that cognitive impairments and brain dysfunction are most likely to be found in CFS patients who have had a more abrupt, rather than a gradual onset of chronic fatigue, and who have not previously struggled for a long time with psychiatric conditions such as depression.
During the past several years in working with CFS, FM and PPS, various clinicians have observed considerable evidence for the effectiveness of EEG Neurofeedback training as a modality for assisting in the remediation of these symptoms. In Canada, for example, Dr. Stuart Donaldson and his colleagues have found that Neurofeedback (followed by a small amount of physical therapy or EMG [muscle] biofeedback) produced substantial improvement in 77% of FM patients on long term follow-ups. Neurofeedback training for CFS and FM appears to usually increase energy level, to assist in alleviating cognitive deficits (memory and concentration), and restless and non-restorative sleep. As these things improve in FM (and we believe in PPS), the pain generally decreases and becomes localized to small areas, rather than being diffuse. In PPS, we have also had cases where incontinence improved. Physical therapy, trigger-point work, or muscle biofeedback may then assist in reducing the limited pain that remains. When used with persons who are not entirely disabled by the condition, it has allowed many to return to full-time productive activity within a few of months. In severe cases, the impact of training has generally been felt to be helpful, but full remediation is not always found.
No claim is made that the training directly addresses the fundamental cause of CFS, FM, or PPS, although it might assist in overcoming deficits resulting from a viral influence. The improvements in the quality of life in our cases and in the preliminary research is encouraging, but given the absence of large, carefully controlled studies, this procedure would still be regarded by most people as experimental. However, in work for more than 25 years with somewhat similar, abnormally slow brainwave activity in attention deficit disorder and epilepsy, Drs. Joel Lubar, Barry Sterman, and others have verified (including in blinded, placebo controlled research), that Neurofeedback training can be very effective in improving symptoms and reconditioning brainwave activity. These changes are usually maintained on long term follow-up.
Frank H. Duffy, M.D., a Professor and Neurologist at Harvard Medical School, recently stated in the January 2000 issue of the journal Clinical Electroencephalography that the scholarly literature suggests that Neurofeedback “should play a major therapeutic role in many difficult areas. In my opinion, if any medication had demonstrated such a wide spectrum of efficacy it would be universally accepted and widely used” (p. v.). “It is a field to be taken seriously by all” (p. vii).
Initially, we evaluate the patient with a quantitative EEG (brain map) to determine if abnormal brainwave patterns are present which may benefit from Neurofeedback. If there is disturbed cortical function, CFS, FM, or PPS patients may then wish to evaluate the potential effectiveness of Neurofeedback training for themselves by undertaking an initial sequence of 15-20 sessions. If the training is likely to be of benefit, we usually see early signs of improvement within that time. A judgment can then be made as to whether it seems worthwhile to continue the training. These first sessions should be conducted in close succession, at a minimum three if not four sessions per week. Under these conditions, the gains from training sessions are more cumulative, and the changes induced by it can be more readily distinguished. Completion of Neurofeedback training may take about four months, at a rate of 3 training sessions per week. Cumulatively, some forty or more training sessions may be required. The training is monitored continuously through statistical analysis of brainwave activity, and if expected gains are not observed, then termination of the training should be considered.