Report from the AAPM Conference

The American Academy of Pain Management is an organization oriented toward integrated pain management, and welcomes health professionals of any stripe. To further insure that hierarchical status is not promoted, the name tag does not give a hint of pedigree. The ISNR did the same, with both standing in contrast to the AAPB, where labels could be attached to labels down the lapel, to make sure the world knew who the truly important people were.

There were lots of talks on migraine, so it is still very much an issue in pain management. One talk in particular was memorable. It was by an Alaskan who interspersed his talk with a slide of his ultralight sitting on the snow. This could hardly be a conventional talk. He insists on the patient making all the necessary lifestyle adjustments (such as improving sleep hygiene) before any medical intervention is even considered. He announces perfectly seriously that “I make the patient do everything before I do anything.” He makes people maintain a headache diary, one that makes them track known triggers and other lifestyle factors, as well as recording any aspects of prodromes. This helps to identify and confirm the connection with specific triggers, and thus increases commitment to the program. He also asks them to start taking certain supplements, such as Vitamin B-2, magnesium, and CoQ-10 and he closely monitors their progress. These measures alone are sufficient in his experience to bring about a reduction of between 50 and 90% in migraine incidence over a period of weeks to months. Continue reading “Report from the AAPM Conference”

Reflections on the ISNR 2004 Conference in Fort Lauderdale

I came a day early to the ISNR Conference to hear Val Brown at an all-day Workshop under conditions where he had a friendly audience, and where he wasn’t being challenged. Most of what was presented was already familiar to me, but it was nice to hear how he chose to present the information. Val often relies on the sailing analogy, that one cannot trim the sails in advance, but rather must adapt to the conditions. When the sails luff, an adjustment is called for. In the case of the EEG, the luffing is most likely to occur in the high and low frequency ranges. Running NCP is a matter of keeping the sails in proper trim (in this case sixteen of them), and so is neurofeedback in general.

In the afternoon Sue Dermit Brown talked about her utilization of NeuroCarePro. She now does all of the clinical work, since Val does not have a license to practice in Canada. Sue said that after a period of experimentation with other site pairs than C3 and C4 she is now utilizing those other site pairs less and less. This trend is opposite from ours. Val suggests that the way he uses information from the whole EEG spectrum makes other sites more superfluous. That must be true at least to some extent, or Sue would feel more rewarded for site-shifting than is apparently the case. Sue is also doing less alpha-theta training than before, and she does not know why that is the case. “Becoming asymptomatic is really a matter of the eyes-open work,” says Sue, and we very much agree. It is quite possible in our own case that the extension of eyes-open work to lower frequencies gets some of the work done for which we used to rely on alpha/theta. NCP intrinsically covers the whole band, and Sue may be benefiting from the same effect as experience is gained with the system. Continue reading “Reflections on the ISNR 2004 Conference in Fort Lauderdale”

The Unruly Power Grid Revisited

The current issue of the IEEE Spectrum, house organ for electrical engineers, revisits the state of the power grid one year after the blackout of August 14, 2003. This topic is of interest to us on many levels, and the present newsletter iterates the one I wrote last year on this topic.

First of all, the issue of grid stability has been getting the attention of system theorists working with nonlinear dynamical models. In simulations of ever greater complexity, it is found that cascading failures in which little blackouts become big ones seem to be a fact of life. But this instability is already evident when we have only three systems to coordinate as opposed to thousands. Sufficient complexity to make predictions nearly impossible in practice is already there at the level of three interacting systems. So we are into modeling complexity, in other words into chaos theory. Continue reading “The Unruly Power Grid Revisited”

The Personal ROSHI

The pace of change is increasing in our field, rather than leveling off. How exciting, except of course for those who are connected with the Efficacy Document, who got left behind in the last century.

Now Chuck Davis is challenging us to change our thinking once again. What excited me about the Magnetic Stimulation capability in the previous ROSHI is that it involves the use of an EEG tracking capability. This allows us to stimulate the brain whenever a certain threshold in EEG amplitude is exceeded, irrespective of the frequency at which this occurs. This represents a kind of limit to which the standard inhibit strategy can be taken. It is like Reuters having a search routine that always finds its way automatically to what should be generating headlines at a particular moment. Continue reading “The Personal ROSHI”

Innovations in Education Conference

I reported on this conference in Salt Lake City two weeks ago, and here is another installment. On the second day of the conference there was a lot of discussion about juvenile probationers. Ron Muir presented on an innovative Charter School that he had started for probationers, which despite many handicaps was producing some excellent results with a program focused almost entirely on the kids’ educational needs.

Jerry Ross and Mike Phillips presented on initial outcomes of a demonstration program in Orem Utah for at-risk youth. This comprehensive program was based on earlier successes of Narconon, an anti-drug program started under the aegis of Scientology. This parentage made a lot of people uncomfortable, but I was there to see the data. The program involves detoxification combined with nutritional intervention, along with other aspects of the program that addressed educational and social needs. Continue reading “Innovations in Education Conference”

The Efficacy Document: A Celebration and a Critique

The AAPB has just published the document “Evidence-Based Practice in Biofeedback and Neurofeedback,” by Carolyn Yucha and Christopher Gilbert. It has been more than ten years since the AAPB has issued an official statement of conditions where efficacy of biofeedback is recognized by the organization. Since that earlier document, we have witnessed the continuing thrust toward evidence-based medicine. As a professional community, there was no choice but to respond in a fashion such as this.

So let’s look at the good news: First of all, the document puts together under the same covers the case for neurofeedback and for peripheral, somatic neurofeedback. The document makes the case for “self-regulation” as the active ingredient (page 2), irrespective of how it may be achieved with biofeedback. The document acknowledges that evidence-based practice must take into account not only efficacy in controlled studies but effectiveness in actual clinical practice. It forthrightly acknowledges the methodological problems confronting biofeedback when it is placed in random controlled studies under blinded conditions. Continue reading “The Efficacy Document: A Celebration and a Critique”