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ALCOHOL ADDICTION
Neurofeedback Therapy in Alcohol Addiction Treatment:
There are controlled studies demonstrating the success of Neurofeedback in alcohol treatment. The success rate with the addition of Neurofeedback therapy is 78%.
Neurofeedback therapy can be applied to drug and alcohol addicts without medication or as an additional treatment to existing medication.
In these and similar studies where Beta/SMR and Alpha wave alteration methods are used, the rate of relapse within a year has been observed to be lower.
Successful results are obtained with Neurofeedback therapy.
Drug-Free Treatment for Alcohol Addicts:
Studies since 1949 have shown that alcoholics have low levels of alpha waves, which are responsible for brain relaxation. Increasing alpha waves can be achieved through neurofeedback therapy.
**Alpha and theta wave work has proven to be an effective method for alcohol use. Some users of other drugs have high levels of alpha waves in the frontal lobe of the brain and/or coherence disorders in alpha, theta, or beta waves. When these irregularities are corrected using neurofeedback, a significant portion of them stay away from drug use and develop insight into the wrongness of their actions.
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Studies conducted on the SMR band in the midline of the brain help develop insight. Furthermore, increasing beta/SMR waves, which are helpful for taking responsibility and understanding the seriousness of one's actions, has positively influenced the outcome.
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** (Trudeau DL,2000;2005: Horrell T. et al,2010: Peniston EG, Kulkosky PJ.,1991: Peniston EG,1994: Peniston EG, Kulkosky PJ.,1995: Peniston EG, Saxby E.,1995: Ross SM.,2013: Kaiser DA, et al,1999: Bodehnamer DE, Callaway T., 2004: Bodenhamer DE, BeBeus M., 1995: Cowan JD., 1994: Fahrion SL. et al, 1992: Ochs L., 1992: Passini FT, 1977: Taub E. et al, 1994: Saxby E. et al, 1995)
EEG research findings with alcoholics (and children of alcoholics) show that long periods of abstinence Even then, it is documented that this group mostly has fewer alpha and theta brain waves and more beta activity. This finding shows that alcoholics and their children have difficulty relaxing because their brain connections are different from those of other people. However, alpha and theta wave levels increase after consuming alcohol.
For this reason, those who are biologically predisposed to alcoholism (and their children) are more vulnerable to the effects of alcohol because, unknowingly, alcoholics are self-treating to correct the pathology in their brains. The relaxing mood that occurs after consuming alcohol is highly reinforcing due to the underlying brain activity pattern.
Many studies have shown that excess beta brain activity is the best indicator of relapse in alcoholics and cocaine addicts (Bauer LO, 2001; Prichep L. et al, 1996a; Prichep L et l, 1996b; Winterer et al., 1998). As an adjunct treatment for alcoholism, neurofeedback training, which increases theta and alpha and reduces rapid beta brainwaves, to reduce stress and achieve a deep, relaxing state of mind in alcoholics, holds promising potential.
Peniston and Kulkosky (1989) used this type of training in a study comparing chronic alcoholics with a non-alcoholic control group and alcoholics receiving conventional treatment. Alcoholics who received 30 sessions of neurofeedback training showed a significant increase in the percentages of EEGs in alpha and theta frequencies and in alpha rhythms. However, compared to the control group, a definite decrease in depression was also observed in the neurofeedback group. Alcoholics receiving conventional treatment showed a significant increase in serum beta-endorphin levels (an indicator of stress and caloric intake [e.g., ethanol]. In contrast, those who had neurofeedback training added to their treatment did not show this increase in beta-endorphins.
In four-year follow-ups (Peniston EG., Kulkosky PJ., 1990), only 20% of the conventionally treated group completely abstained from alcohol, while this rate was 80% in the experimental group that received neurofeedback training. Furthermore, this experimental group showed an increase in psychological adjustment on 13 scales of the Millon Clinical Multiaxial Inventory, while alcoholics receiving conventional treatment showed an increase on only 2 scales and a deterioration on one scale. In the 16-PF Personality Inventory, the group that received neurofeedback training showed improvement on 7 scales, while the group that received conventional treatment showed improvement on only 1 scale.
Similar positive results were reported by Saxby and Peniston (1995) in a study of 14 alcoholics with depression, where 92% remained alcohol-free after 21 months of follow-up, and promising results were also seen in a study with Native Americans after 3 years of follow-up (Kelley MJ, 1997).
Scott et al. (2005) from UCLA conducted a randomized controlled trial with 121 people. Patients received 40 to 50 sessions of neurofeedback. Those who added neurofeedback to their treatment remained in therapy longer – a very important factor in substance abuse. After one year of follow-up, 77% of patients who received neurofeedback remained alcohol-free, while only 44% of those who received conventional treatment were able to remain alcohol-free. They showed improvement on 7 scales in attention scales and the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), whereas the conventionally treated group showed improvement on only 1 scale.
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In a study using a control group, the group receiving only Visual Neurofeedback in addition to their standard treatment showed improvement on the Beck Depression Scale, short psychiatric symptoms, and coping scale (Lackner N. et al, 2015).
In subjects experiencing alcohol withdrawal crises, fMRI Neurofeedback successfully reduced neuronal activity in the anterior cingulate cortex, the insula, the inferior temporal gyrus, and the medial frontal gyrus, while the healthy control group was unable to do so. These areas are known to contribute to alcohol withdrawal crises. Learning to control these areas with neurofeedback is important for reducing alcohol withdrawal crises, but whether this is permanent needs to be investigated (Karch S. et al, 2015).
38 students who consumed excessive amounts of alcohol were able to regulate the activation of striatal regions associated with alcohol consumption by reducing it with fMRI Neurofeedback compared to the control and placebo groups. (Kirsch M. et al, 2015)
Neurofeedback treatment in alcoholics reduced anxiety and depression while improving cognitive skills. It significantly reduced the frequency of alcohol abuse and eliminated the negative influence of drinking friends.
Selection of Diagnosis and Treatment Protocol:
By recording the person's brain waves with the objective digital EEG (QEEG) method and comparing them with their age group in the Data Bank system, we can see the effects of alcohol and drugs on the brain waves and the status of the person's brain waves according to their age group. After our evaluation of the data obtained, Neurofeedback treatment protocols are prepared.
Approved by the American Food and Drug Administration (FDA) and developed by New York University, this Data Bank and diagnostic support methods have been used in the USA for approximately 40 years.
In neurometric QEEG analysis, all QEEG variables are calculated with z scores; A z score of up to +/- 2 standard deviations is considered normal for that age group. If the standard deviation is greater than normal, this determines the severity of neuropathology and abnormality. Among the patients, those who can normalize their z scores are the ones who benefit most from Neurofeedback treatment.
In the brain map example on the left above, the pre-treatment beta, alpha, and theta coherence abnormalities are greater than normal. In the brain map on the right above, these abnormalities have approached normal after neurofeedback treatment. When these electrical currents, which cause repetitive behavior that increases the likelihood of alcohol consumption, are corrected, the brain abandons the desire to consume alcohol.
The Role of QEEG in Alcohol and Drug Abuse:
It is known that children with Attention Deficit Hyperactivity Disorder (ADHD) are more prone to alcohol (No authors listed, 2003) and substance abuse in later years. (Wilens TE. et al, 2011; Langley K. et al, 2010)
Changes in acute intoxication are characterized by the appearance of slow activity on the EEG. This slow activity is seen as a decrease in alpha frequency, an increase in theta activity, and diffuse delta rhythms. (Begleiter H, Platz A., 1972)
These slow waves are associated with excessive alcohol consumption. The discomfort of being sober is related to the amount of slow waves. (Engel GL, Rosenbaum M., 1945)
In the acute phase of chronic alcoholism, an increase in slow activity is frequently observed. This change is proportional to the patient's blood alcohol level, with a decrease in alpha frequency and an increase in theta rhythm, especially in the temporal area. An increase in fast activity is seen in the temporal and frontal areas in connection with neurophysiological impairment, which can be distinguished from muscle artifact. (Coger RW. et al, 1978; Coger RW. et al, 1979)
A family history of alcohol problems is the most important risk factor for this disease. (Bauer LO, Hesselbrock VM., 1993) It is possible to distinguish the EEG findings of those who use alcohol from those who experience alcohol withdrawal syndrome. (Winterer G. et al, 1998)
Recent studies on drug abuse are based on QEEG. Repeated reports have shown an increase in beta (relative power) in alcoholics.
Increased alpha waves, especially in the frontal lobe, have been reported in withdrawal syndrome and also after exposure to cannabis. (Struve FA. et al, 1989; Struve FA. et al, 1994)
Increased alpha and decreased delta and theta have been reported in withdrawal syndrome of first-class cocaine users. (Alper KR. et al, 1990; Roemer RA. et al, 1995)
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