Vol3Iss2

Neurofeedback practices can thrive when the local population has good insurance or disposable cash. However, such is not always the case. Your clinical practice may be in an economically depressed area. If that is the prevailing economy you may wish to adopt a module or cubical style of training. For example, Michael Tansey, a well-known historic neurofeedback trainer, did all of his training with one protocol at one monopolar site (the motor side of the sensorimotor cortex-about 1/2 inch anterior to Cz) and by rewarding: just 14 Hz (no inhibits). His professional writings indicated that one simple protocol can promote neuronal regulation and improved cognitive performance. A similar protocol would be SMR training at Cz. What I am suggesting is a three filter design with 12-15 Hz rewarded and 4-7 Hz & 20-30 Hz inhibited. For younger children consider changing the reward to a lower bandwidth: 11-14 Hz.

Taking the Tansey model one step further: Let's say you organized one room in your office to accomodate several smaller cubicals, separated by partitians. Next, invite parents to come in for a orientation session in which you train parents to place scalp electrodes for a monopolar montage at Cz. Parents in turn pay a modest monthly fee and are allowed to train their children several times each month. Likely, you would hire a technician to oversee the parents.

Neurofeedback is presented to participants as a stress reduction model that will promote calmness and self-regulation. The words "treatment" or "disorder" are avoided.

This model has already been sucessfully applied by one clinician in the USA and a similar approach was used in the public school system at Yonkers NY.

The Advantages of this model

1. Increased traffic with monthly fees to your office will likely improve income.

2. Some parents will request more intensive care for their child.

3. No insurance is accepted.

4. Older computers may be utilized.

5. Parent/child trianing sessions are limited to 15-20 mins.

The Disadvantages of this model

1. Need for adequate office space

2. Careful screening is required; some families are definitely not ready for this model.

3. Several training units with electrode sets must be carefully maintained. Computers must work.

4. Collecting monthy fees must be carefully monitored to avoid undue paperwork or headaches.

5. Boundaries must be clearly set. Discussions with licensed clinician are professional fees.

Options

1. The Quirk model is similar to the Tansey model however he chose a bipolar montage C3-C4 rather than Cz. Quirk rewarded 12-14 Hz.

2. The Yonkers model did 3F Beta training at C3 for depression and focusing - OR - Cz 3F SMR training at Cz for calmness.

Caveats

1. Do not assume that rewarding SMR is appropriate for all concerned. Assess each child at Cz; compare the ratio between SMR (12-15Hz) and Beta (13-21 Hz).

If SMR/Beta = > 80% do not reward SMR.

2. Never, Never reward Theta or use any form of photic stimulation. To do so would put the trainee at risk for seizure disorder--if trainee had low siezure threshold or if trainee was taking Welbutrin.

3. Of course, inhibiting Theta is likely safe.

Setting up coherence training on BrainMaster 2.5 software when your topographical brain map has indicated that there is either hypo or hyper coherence between any two International 10-20 sites:

1. Create new folder - name, etc.

2. choose Alert

3. Data channels: Two channels

4. Training protocol: NONE (set all to ignore)

5. Auto-Threshold off

6. Display: raw, filtered, Coherence/Phase

also check the bandwith component that you wish to train (also UP or DOWN as needed)

7. Feedback control: uncheck reward and instead check coherence (MIDI)

8. Type of coherence: Assessment pure

9. Session control Run: 60, Trials: 10

Using the above method manual coherence training is possible, remember to use the "c" key on the key board to adjust feedback. Correct feedback will render tones about 50-70% of the time.

**********************************

Setting up coherence training using the Event Wizard for simultaneous Theta and Alpha coherence using range training. For this model, I will draw from my reference data base. The follwing percentages are applicable to adults only with Eyes closed using the followng montage: Ch 1 C3 & Ch 2 C4. The training target is 65% Alpha coherence and 67% Theta coherence.

1. Follow all of the steps above with two exceptions: Feedback control must be set to Event Wizard sounds.

2. Display thermometer and check User and gamma bandwidths.

The following formulas must be entered:

Event one: K=UTHR;x=Rng(C1AC,K,65);

Event two: J=GTHR;x=Rng(C1TC,J,67);

The entered value is 0, no damping!

Choose different sounds for the two events and set them to ON/OFF.

Finally, the clinician must adjust the User Threshold and the Gamma Threshold in order to obtain feedback for both Alpha coherence and Theta coherence. Again, you want the two different tones that you have chosen to resound about 50-70% of the time.

*****************************

Finally, you may wish to choose the BrainMaster file called "Demo Beta coherence training with chaning sounds" if you do so and if you have checked "assessment pure" for coherence you may wish to note that 13-21Hz Beta coherence between C3 and C4 are approximately 45-50% as indicated by my reference database.

*****************************