DIY Neurofeedback?

Background: A year or two ago, at a point that I was really grappling with T badly, I did ~8-10 neurofeedback sessions. I didn't stick with it longer than that, because I didn't have a high degree of confidence in the practitioners. They were nice and meant well, but I didn't have the sense that they were giving me, as an adult tinnitus patient, a radically different treatment program than they might perform on a high school student with attention problems. So, while there are some reasons I think that it makes sense to believe neurofeedback might be able to help with tinnitus, I did not think the considerable money I invested was fair test of that.

I must point out at this point that I have a layman's view of neurology; my background is in computer science. That said, the reasons that I think neurofeedback is an interesting approach are:
* there have been a few studies of which investigated this, and appeared to have a positive result:
http://www.ncbi.nlm.nih.gov/pubmed/23700271
http://www.ncbi.nlm.nih.gov/pubmed/21592701
http://www.ncbi.nlm.nih.gov/pubmed/19163873
* there's a much larger body of information to suggest that biofeedback and neurofeedback can cause the physical structure of the brain to change

I've got the fulltext of one of these someplace; I will get the other rest at some point soon. The last summary appears to me to suggest that attentional processes increase or decrease electrical output in the auditory cortex; this is in line with my own observation that my tinnitus will occasionally seem to disappear -- until I "look" for it. That's the basic "don't think of an elephant" problem.

So, there's some interesting data, but there's an apparent lack of neurofeedback practitioners who have this specific issue as an interest. I've seen some other people online who have attempted neurofeedback -- one or two who thought it helped -- but I've never heard of a clinic where an MD audiologist works with a team of EEG technicians to exclusively treat tinnitus patients. Without someone doing that, it's very hard to be certain if it can be effective, and it's also very hard as a patient to have a high degree of confidence that forking over a few thousand dollars and investing ~100 hours of time into it.

One word of caution at this point: I've seen some anecdotes to the effect that neurofeedback, done improperly, can cause problems and maybe even seizures. On the one hand that's pretty alarming; on the other hand, anything that's totally safe seems unlikely to be doing enough to be helpful.

Neurofeedback depends on real-time analysis of the output of multiple electrodes placed on the head. It is now possible to do this using consumer technology - http://emotiv.com/ being the best example. For about $800 you can get a headset with a dozen electrodes, and software that provides the data from them. They also have some software available that lets you interact with the device in various ways. I'm not necessarily optimistic that their canned solutions will be sufficient to really implement one of the tinnitus protocols that have been attempted in the literature -- but if there's one angle to this problem that I feel remotely qualified to dig into, it's the software side.

So, there's a lot of people with tinnitus out there, there's a bit of research that this approach might be reasonable, but I've never seen an account of someone attempting to really hack on the problem themselves. This seems like a kind of interesting angle to attack this problem from, and if nothing else maybe focusing on it would distract me from all the noise

Has anyone thought about this? Are there by chance any EEG technicians or other software people out there who would be in thinking about this?

 

Haha, no takers, eh? Well, I'll just keep looking in to this, and if I get anywhere, I will let you know.

 

This is very interesting; let me know how that goes! From the perspective of actually trying to put a tinnitus-specific protocol together, I like the EMOTIV for two reasons:
* they appear to provide an API for getting raw voltages off the sensors in realtime, so there should not be any limit to what can be done with the data
* since it's a widely available, consumer-level device, if such a treatment ended up being helpful to me, it'd be easy for other people to try it (provided they had ~$500 to throw at the hardware)

But, I must admit that on some level I'm also looking for an excuse to buy something that will let me play video games with my brain :-p

 

Yes, you've selected the right one. I've been eyeing that one for a while.

https://emotiv.com/store/epoc-detail/

I'll compose a thoughtful reply in a few days. (I have some personal issues I'm attending.) But I've read extensively on neurofeedback for tinnitus, and I have the same issues that you do. I tried last year to find an practitioner (Ph.D. level) with experience beyond ADHD, etc., and had no luck. Plus, some of the EEG equipment the practitioners were using was inferior. By this, I mean their EEG equipment is automatically set to optimize your brain. (Some type of preset algorithm.) And, personally, I'd never let an EEG device autopilot my brain. You need a skilled practitioner who understands the deficits (specifically, the lack of inhibitory alpha waves) in the AC that is created by tinnitus.

And where did you read about neurofeedback inducing epilepsy? I do know this is a rare side effect of TMS, but I never read about it for neurofeedback. I hope you're misinformed.

 

That was an anecdote I got from a feedback practitioner, I suppose I hope she was misinformed

I look forward to hearing what you have to say!

 

Great. Will start reviewing my notes tomorrow or the next day. Right now, I am so loud I can barely think.

Anyway, below is an link to an article on auditory alpha. Auditory alpha the modulator for tinnitus loudness. I'd comment further but, like I noted, I'm just too loud tonight to think. Both rTMS and neurofeedback can target auditory alpha. I'm not sure we could do this is a DIY approach, however. Auditory alpha is hard to detect in the auditory cortex. In fact, for years researchers doubted if an auditory alpha actually existed in the auditory cortex.

Enjoy!

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4055153/

 

I believe there are at least two protocols for neurofeedback for tinnitus. The one that I found is based on a 2007 article by Weisz et al. I'll put the link below.

Apparently, the protocol works by a person's ability to change ratio between tau (alpha) and delta waves. We know in tinnitus, auditory deafferentation caused by damage to the cochlea results in a decrease in alpha waves, which are inhibitory, and an increase in gamma waves, which are excitatory. In general, these two waves control the excitation levels in our brains and their imbalance occurs in brain disorders. See, for example, the following explanation:

[In the brain,] the excitation-to-inhibition (E/I) ratio is always constant. This means that the number of connections the brain's neurons make with excitatory neurons tends to equal the amount of inhibitory neurons. An imbalance in this ratio is thought to be responsible for conditions like Down syndrome, and excessive excitation has been linked to seizures while too much inhibition has been shown to block learning and memory function. (See http://www.medicaldaily.com/brains-neurons-balance-excitement-inhibition-order-remain-healthy-289338 I recommend everyone interested in tinnitus read this article, which is easy to understand.)​

In addition to disrupting the excitation/inhibition balance--especially, though not limited to, the auditory cortex--tinnitus also affects delta waves. Delta waves are very slow and are associated with sleep. They are also associated with phantom pain, which, like tinnitus, is in part a disorder of sensory deafferentation. Delta waves are increased in people with tinnitus.

Now, another protocol is/was being explored by Langguth (TRI) et al that focused on increasing auditory alpha. I don't know the protocol for this, however. But I do know that after three years, auditory alpha is no longer responsive to neurofeedback. Other protocols may also exist, but I haven't found them yet.

We would also need software that would measure our ability to achieve program goals, e.g., changing the ratio of tau/delta. Finally, I am not positive we could do it ourselves even with the software.

However, your willingness to try to write something is very encouraging!

Here's the link to the neurofeedback article:

http://www.ncbi.nlm.nih.gov/pubmed/17943012​

 

I have been trying neurofeedback myself. There are some insurance in some states that are covering. There is not too many practitioners who specialize in tinnitus. Any new information or updates?

 

How did you go with neurofeedback Steve? Did you ever invest in the device you posted a link about?

 

Hi Steve,

thanks for your reply.

Im interested in biofeedback too. But, unsure which one as there seems to be a 'passive one' and another which you have to participate in cognitive exercises. need to do some homework on this.

 

Hi

Ive done ten weeks of neurofeedback. I want to buy my own, most importantly I know with my chronic tinnitus and pulsatile Ill have to do this for the rest of my life. Can anyone tell me a good neurofeedback machine to buy for doing it myself?

Thank you so much

Friend

 

Hi everyone,

I have been interested in the possibility of performing neurofeedback autonomously, without the help of a therapist. Did anyone try it?

And for everyone who has tried neurofeedback with or without a therapist, What do you think are the pros and cons of both DIY and with a therapist? (apart from the technical issues like getting the sensors)

Thank you so much,

Simon