Bipolar Disorder & Schizophrenia
ArticlesThe Bipolar Child by Demitri and Janice Papolos [pdf book review]
by Othmer S
A new diagnostic category is emerging: Childhood bipolar disorder. It was traditionally thought that as few as one in 200 cases of bipolar disorder had an onset which could be traced to childhood. Biederman's recent research shows that perhaps on the other of 20% of children identified as ADHD could be on the way to developing full-blown bipolar disorder. To make this identification, however, the markers of childhood bipolar disorder are destructive rage and irritation rather than the euphoria and elation that characterizes the adult form. The proof that the childhood form of the disorder metamorphoses into the adult form eventually must still be outstanding. The model is still too new.
A 12-year-old boy with signs of Bipolar Disorder has been on Concerta, Risperdal, and Zoloft for the last three years. He has trichotillomania (involuntary hair-pulling) since beginning the Concerta. He is very anxious. He is verbally inappropriate with peers. He exhibits manic sleep behavior, in that he sleeps very few hours.
At session 24, his mom has halved the Concerta dose; he is now off the Risperdal, and the Zoloft dose is being weaned down. He now sleeps. He is a happier boy, is getting better grades, and for the first time in years has eyelashes. His parents are ecstatic. The mother fired the psychiatrist last week because she (the doc) insists the kid 'needs' the drugs and two counseling sessions per week, which he has had for four years. But the mom observes that he has not improved at all. In fact, things had gotten much worse. "Neurofeedback is the only thing he's done which has produced positive results," according to the mother.
On the construct of "The Bipolar Child," proposed by Demitri and Janice Papolos [pdf]
by Othmer S Ph.D. Chief Scientist
Over the years we have talked about our own son Brian in terms of his temporal lobe epilepsy, and we generalized from there to severe behavioral disorders. That always had limited appeal as a model for both practitioners attending our classes and for parents of difficult children. Most professionals don't relate readily to "subclinical seizure phenomena," nor are parents thrilled to see the term seizure disorder used in connection with their children unless the diagnosis is obligatory. Talking about seizure disorder in larger terms was a non-starter.
Research PapersNeurofeedback for the Bipolar Child [abs.]
by Othmer S Ph.D.
Bipolar Disorder used to be a rare diagnosis in childhood. Recent research has elevated the importance of Bipolar Disorder as an issue in perhaps 20% of children formally diagnosed as ADHD. The medical management of these children is problematic, tending to involve anti-convulsants and neuroleptics rather than stimulants and anti-depressants.
Self-Regulation of Electrocortical Activity in Schizophrenia and Schizotypy: A Review [abs.]
by Gruzelier J
Contrary to the belief that schizophrenic patients will be unable to learn self control of electrocortical activity due to attentional and motivational deficits, the two studies which have investigated this, both involving operant conditioning of slow cortical potentials, have demonstrated that self regulation can take place.
Learned Control of Slow Potential Interhemispheric Asymmetry in Schizophrenia [abs.]
by Gruzelier J, Hardman E, Wild J, Zaman R
We report on the feasibility of teaching 16 (DSM-IV) schizophrenic patients, subdivided by syndrome, self-regulation of interhemispheric asymmetry having demonstrated efficient learning of interhemispheric control in normal subjects. Reversal of asymmetry may be important to treatment and recovery in schizophrenia for following improvement on neuroleptic drugs functional hemispheric asymmetries have reversed, with directions of reversal and pre-existing asymmetry dependent on syndrome.
Self-Regulation of Slow Cortical Potentials in Psychiatric Patients: Schizophrenia [abs.]
by Schneider F, Rockstroh B, Heimann H, Lutzenberger W, Mattes R, Elbert T, Birbaumer N, Bartels M
Slow cortical potentials (SCPs) are considered to reflect the regulation of attention resources and cortical excitability in cortical neuronal networks. Impaired attentional functioning, as found in patients with schizophrenic disorders, may covary with impaired SCP regulation. This hypothesis was tested using a self-regulation paradigm. Twelve medicated male schizophrenic inpatients and 12 healthy male controls received continuous feedback of their SCPs, during intervals of 8 s each, by means of a visual stimulus (a stylized rocket) moving horizontally across a TV screen.
by Sürmeli T MD BCIAC-EEG, Psychiatrist, LHC for Research and Education, Istanbul, Turkey
EEG studies of schizophrenic patients indicate a higher number of patients with abnormal records decreased in alpha activity, increased delta and theta activity and possibly more left sided abnormalities, and some coherence abnormalities. The clinical Antipsychotic Trials for Interventions Effectiveness raise important questions about relapse, treatment resistance, minimizing adverse effects and improving treatment adherence in schizophrenia. We thought neurofeedback treatment may address those problems.
Most of the patients were diagnosed with chronic schizophrenia before coming to our center and did not improve in their symptoms with antipsychotic medications. Neurometric analysis of the QEEG of the patients suggested chronic schizophrenia consistent with the clinical judgment of the author. All 52 patients received QEEG analysis with the Nxlink data bank, PANSS and 31 out of 52 patients also received T.O.V.A. and MMPI at baseline and at the end of the treatment. Responses to PANSS were analyzed to evaluate the effectiveness of neurofeedback between 40-120 training sessions. Forty-three patients improved after neurofeedback treatment. 7 dropped the treatment and 2 did not respond. The patients who showed coherence abnormalities in the QEEG responded better and quicker to treatment. Antipsychotic medications may increase coherence abnormalities in the brain but coherence abnormalities can be diminished with neurofeedback treatment to get a better outcome. NF treatment may increase adherence to treatment and reduce possible side effects of antipsychotics in schizophrenia. Further study with controls is warranted.
Mind over chatter: Plastic up-regulation of the fMRI salience network directly after EEG neurofeedback.
Ros T, Théberge J, Frewen PA, Kluetsch R, Densmore M, Calhoun VD, and Lanius RA
NeuroImage, 65, 2013, pp 324-35
Improving Visual Perception through Neurofeedback.
Scharnowski F, Hutton C, Josephs O, Weiskopf N, and Rees G
Journal of Neuroscience, 32, 2012, pp 17830-41
The effectiveness of neurofeedback training on EEG coherence and neuropsychological functions in children with reading
Nazari MA, Mosanezhad E, Hashemi T, and Jahan A
Clinical EEG and Neuroscience, 43, 2012, pp 315-22
Self-regulation of brain oscillations as a treatment for aberrant brain connections in children with autism.
Pineda JA, Juavinett A, and Datko M
Medical Hypotheses, 79, 2012, pp 790-8
Evidence-based information on the clinical use of neurofeedback for ADHD.
Moriyama TS, Polanczyk G, Caye A, Banaschewski T, Brandeis D, and Rohde LA
Neurotherapeutics, 9, 2012, pp 588-98
Current status of neurofeedback for attention-deficit/hyperactivity disorder.
Lofthouse N, Arnold LE, and Hurt E
Current Psychiatry Reports, 14, 2012, pp 536-42
Individual alpha neurofeedback training effect on short term memory.
Nan W, Rodrigues JP, Ma J, Qu X, Wan F, Mak PI, Mak PU, Vai MI, and Rosa A
International Journal of Psychophysiology, 86, 2012, pp 83-7
Neurotherapy of traumatic brain injury/posttraumatic stress symptoms in OEF/OIF veterans.
Nelson DV, and Esty ML
Journal of Neuropsychiatry and Clinical Neurosciences, 24, 2012, pp 237-40
Schizophrenia and the efficacy of qEEG-guided neurofeedback treatment: a clinical case series.
Surmeli T, Ertem A, Eralp E, and Kos IH
Clinical EEG and Neuroscience, 43, 2012, pp 133-44
Which attention-deficit/hyperactivity disorder children will be improved through neurofeedback therapy?
Ahmadlou M, Rostami R, and Sadeghi V
Neuroscience Letters, 516, 2012, pp 156-60
Neurofeedback in children with ADHD: validation and challenges.
Gevensleben H, Rothenberger A, Moll GH, and Heinrich H
Expert Review of Neurotherapeutics, 12, 2012, pp 447-60
Taking back the brain: could neurofeedback training be effective for relieving distressing auditory verbal hallucinations in patients with schizophrenia?
Schizophrenia Bulletin, 38, 2012, pp 678-82
A review of neurofeedback treatment for pediatric ADHD.
Lofthouse N, Arnold LE, Hersch S, Hurt E, and DeBeus R
Journal of Attention Disorders, 16, 2012, pp 351-72