Originally Posted by Mark in Idaho

Neuro-stimulation, what is it, and is it the same as neurofeedback.

Again, the same disclaimer that started the previous post applies here.

The brain can be stimulated by a number of avenues.

CHEMICAL, as in drugs like Ritalin and other stimulants. These drugs speed up the way the brain processes information. The pharmacokinetics (the way the drugs are handled by or processed or metabolized by the body) and pharmacodynamics (the way the drug effects the body) are beyond the scope of this post. Most drugs that act on the brain are not FULLY understood. They are prescribed because they cause an effect that appears to improve a situation that is more valuable than the negative value of the side-effects.

NUTRITIONAL, caffeine, dense sugars and other food substances can cause the brain to be stimulated.

SENSORY, The visual, auditory, olfactory (smell), and tactile (touch) senses can be used to stimulate the brain into targeted responses.

ELECTRO-MAGNETIC, energy can be directed at the brain with electric currents and magnetic fields. The nervous system is a complex electro-chemical network. Altering this electro-chemical network can cause changes to how the nervous system processes information.

The last two are the focus of Neuro-stimulation as it relates to neurofeedback.

There are a variety of Neuro-stimulating therapies on the market. Their promoters use a variety of brand names to attempt to differentiate their system from the others. The two most common are LENS and ROSHI/pROSHI. There are others that appear to be a rebranding of LENS and ROSHI type systems. TMS and H-Coil are terms used to describe Transcranial Magnetic Stimulation.

They all have one thing in common. An energy force is applied to the brain as a stimulant. This can be electrical pulses to the scalp or skin, magnetic fields aimed at specific parts of the brain, visual stimulation inputted through the eyes/optic nerve, olfactory stimulation through the nose (aromatherapy is the common term) and tactile stimulation through the skin.

Each of these stimulates a specific part of the brain. They often start with a analysis of the brain with Electroencephalographic (EEG) equipment. This is done to find the area of the brain that is 'misbehaving.'
This misbehaving usually manifests outwardly as behavioral (psychological) symptoms. ADD/ADHD, anxiety, depression, anger, paranoia, etc. These psychological symptoms can exacerbate (make worse) physiological symptoms from an injury or disease process, such as concussion, dementia, stroke, etc.

The practitioner will analyze the EEG waveforms, choose the part of the brain to be targeted, and set the equipment to stimulate an associated part of the brain.

This can be done with flashing lights. The ROSHI and pROSHI system works on this principle. The flashing lights stimulate the optic nerve pathways with a flashing frequency that attempts to either disrupt the current nerve processing with a negative (uncomfortable) stimulation or enhance it with a positive (rewarding) stimulation. The desired goal it to train the brain to suppress the unwanted nerve processes and encourage the positive nerve processes.

It can be done with electromagnetic fields. This electromagnetic field is similar to the transmission from a cell phone. Instead of being received by a cell tower antenna, these electromagnetic fields are received by the brain cells.

These electromagnetic fields can disrupt the electro-chemical processes between brain cells. It may try to input a better timing frequency that is either faster, slower, stronger or weaker. It also may just try to get an area to have homogeneous frequencies. That is, most or all of the nerve pathways are working at the same speed.

One could think of this as telling parts of the brain to relax and telling other parts to work harder. In an ADD brain, it is telling the over attentive part of the brain to slow down and stop misbehaving and telling the inattentive part of the brain to speed up and pay attention.

These two parts of the brain are not necessarily in different physical locations. They are usually intertwined and may share common brain cells and pathways. Think of it as an ambulance with lights and siren needing to get past the traffic congestion on the road. Its lights and sirens are telling the cars to slowdown, pull to the side of the road and stop so the ambulance can go by. It is also the cop pulling the weaving drunk driver over so the other traffic can safely go on its way.

The brain wants to do this. It is called self-regulation or neuroregulation. If there is a malfunction in this self-regulation, the brain may need help to re-establish a proper self regulation.

These neuro-stimulation therapies are very short acting at first. Through repeated application of the neuro-stimulation therapies, the brain gets trained into a habit of proper self-regulation or neuro-regulation. These therapies are not a cure. Most of the manufacturers and practitioners will state this outright. Others will allude to the need for ongoing therapies at less frequent intervals.

Some therapies will effect lasting improvements in only 10 or 20 treatments. Others will require a hundred or so with sporadic booster therapies. The root value of these therapies is to create an cognitive environment where the patient can cognitively participate in this self-regulation.

A comparison would be a student pilot. His instructor will only let him take a flying lesson when there are no wind gusts at the airport. Once he has learned the basic flying skills, he can learn to land in gentle winds. As he improves, he can land the plane in gusting crosswinds.

The neuro-stimulation starts be stopping the wind gusts in the brain. As the brain establishes better neuro-regulation, it can properly function in light wind gusts and can slow the strong wind gusts. Occasionally it may need some remedial training to strengthen these skills.

These neuro-stimulations only effect the nerve processes. They do not cause a physiological repair of damaged brain cells. These re-regulated processes allow the brain to better tolerate the damaged brain malfunctions. For example, the frustration of a damaged memory can be made much worse by stress.

The stress hormones speed up brain processes. The damaged brain will likely be more dysfunctional at these higher processing speeds so the frustration of the memory dysfunction becomes worse. This leads to even more memory dysfunction and so on. Teaching the brain and the patient to regulate these stress reactions can drastically reduce symptoms.

The new process of Transcranial Magnetic Stimulation is being studied for it benefit to people with various thought dysfunctions. Hallucinations, paranoias, depression, etc. can be due to thought malfunctions or physiological damage that leads to thought malfunctions.

It tries to disrupt these nerve processes by inputting a magnetic field that alters the current faulty process. The early research shows promise but has not yet been able to chart long term results. It is expected that there will be a need for "booster" therapies in many cases.

Many will call Nuero-stimulation therapies neurofeedback. This is an inaccurate term. Yes, the neuro-stimulation is often directed after observing feedback from the brain by way of an EEG waveform. Some call the stimulation directed at the brain the feedback. This is an improper use of the term neurofeedback. As discussed in the previous post, the neurostimulation is a "response" to the "feedback."

Unfortunately, this field is unregulated by the FDA so consistent terminology is problematic. All of the neuro-feedback and neuro-stimulation therapies are only approved for treating the psychological/psychiatric symptoms. Even the best research has failed to show them to be effective at promoting physiological brain cell healing. The reduction of psychological symptoms creates a better environment for the physiological healing to take place, if it is possible.

The reduction of psychological symptoms can go a long way toward improving function across all areas of daily living.

I am not a strong proponent of these various neurotherapies because USED ALONE, they can become a horrible money drain and frustration to the patient. If the environment the patient has to live and work in is not improved, these therapies will likely need to be repeated. If the patient has not developed work-arounds and accommodations for their symptoms, these therapies will be much less effective.

It is like throwing water on a person standing in a burning building. It is better to help him out of the burning building first. Then you can work to help him heal. I am a proponent of the start local process. If the patient has things in their life and environment that can be changed to improve their functions, those things need to be done first. Save the neurofeedback and neurostimulation for what is left over.

There are some uses of neuro-stimulation that can be effective for serious nervous dysfunction. Research is being done regarding using neurostimulation to help a comatose person awaken or improve cognitive awareness, i.e. become more aware of surroundings.

My neurologist used some of these neurotherapies in his practice but did not suggest them for me. He agreed that I had been very effective at modifying my though patterns (CBT) and environment to reduce the psychological effects on my cognitive dysfunctions. These CBT and other skills had served me very well over the decades of Post Concussion Syndrome/Multiple Impact Syndrome symptoms.

Those of you who have read this far and understand what I am saying could help me by clicking on the "Thanks" button. If you have questions or comments , please post them as replies or Private messages.