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A Mumbai-based hospitality professional discovered that her son, who is 13 now, had some sort of learning disability very early into his childhood. “When he was four years old, we found something amiss about his studying and learning patterns. So, we took him to a psychiatrist, but learned that it was too early to do anything about it," says the mother, 45. She eventually found out that besides attention deficit hyperactivity disorder (ADHD), her son had a host of other learning disabilities, including dyslexia and dyscalculia. Given that the son also had a heart condition that prevented him from taking mainstream medication (for ADHD), the mother tried sensory and occupational therapy. Nothing really helped, and the son was eventually put into special schooling.

However, earlier this year, the mother learnt about an alternative therapy: neurofeedback.

This type of therapy attempts to gauge the brain’s electrical activity by creating a map of an individual’s neural oscillations, aka. “brainwaves", using electroencephalography (EEG). Neurofeedback practitioners, who need not come from a medical science background, then compare this map to reference values from global databases—in the same way, for instance, laboratories do for blood tests. They are then able to correlate irregularities in the brainwaves to conditions like depression, anxiety and addiction. The final therapy aspect then attempts to correct those dysfunctional brainwaves using images and sounds. This process takes place over dozens of sessions, spread out over months.

The mother went on to research more about neurofeedback and finally came across NeuroLeap, a Mumbai-based firm that specializes in this type of treatment.

After 9-10 sessions of neurofeedback, the mother claims, there was a marked improvement in her son’s behaviour. His aggressive and impulsive temperaments reduced, he started to listen more, and responded less impulsively to anything asked of him. “I feel it’s made a big difference," she says. “In the past, he never fully completed any hobby or class that he took up. But after the 20 sessions of therapy, he signed up for a DJ class, and diligently attended it every day. Even he feels the therapy has made a difference," she says.

NeuroLeap, launched in April and based in Tardeo, typically sees six-seven new clients per month. It is a project of Kumaar Bagrodia, 40, an entrepreneur with an MBA from the University of Oxford . Though he has no background in psychiatry or neuroscience, Bagrodia believes that neurofeedback is a non-invasive and safe way to read and interpret a person’s brainwaves.

“Psychiatric drugs are certainly not the solution to a healthy brain, and their disadvantages are becoming widely known. Often, stopping them causes the problem to reappear or worsen. Dependence is yet another issue," he says. Bagrodia claims that his therapy can treat brain disorders, migraines, tinnitus—and even improve a healthy person’s memory, attention, decision-making abilities, and sleeping and eating habits. “Almost any brain, regardless of its level of function (or dysfunction), can be trained to function better," he says.

Bagrodia’s other patients include a 79-year-old from Pune who got treated for tinnitus, and a Mumbai-based 42-year-old event management professional, who has been suffering from debilitating migraines since the age of 11. Both claimed significant improvements after 20 or so sessions.

There are a couple of other such centres in Mumbai, such as Mind Over Image Consulting in Lower Parel, and for that matter, many more in the US and Europe.

Even so, many arguments remain about neurofeedback’s efficacy and efficiency. I went through scores of research papers and controlled experiments to understand this treatment’s viability, and its standing in the medical and neuroscientific communities, such as a 2011 study on ADHD and EEG-neurofeedback at Radboud University Nijmegen Medical Centre, the Netherlands; a 2015 study on neurofeedback and anxiety at the University of Texas at San Antonio, US; and a 2014 study at University of California, San Diego, on neurofeedback and autism. Most studies had small sample sets (usually 10-20 participants) and vague outcomes.

The most compelling research was published in August in the medical journal The Lancet. It involved a new study conducted over 34 months at the University of Tubingen, Germany, on EEG-based neurofeedback and adult ADHD. This study is unique in that it’s quite possibly the largest one ever undertaken on the subject.

Of the 761 applicants who enlisted for the experiment, only 118 were finally selected. These participants, in near-equal numbers male and female, were then randomly split into three equal groups: the first received genuine neurofeedback, the second received “sham" or fake neurofeedback (but they were told it was real), and the last participated in conventional psychotherapy. The testing took place over 20-30 sessions spread over 10-15 weeks. The groups were created in a randomized manner, and the tests were concurrent and “triple-blind"—i.e. the identities of the participants, individuals administering treatment, and those assessing the outcomes were masked. You could say the results were damning. All three groups showed an equal level of improvement at the end of the experiment. The report concluded that “neurofeedback is not superior to a sham condition or metacognitive therapy in the treatment of adults with ADHD. Thus, owing to its comparative simplicity, meta-cognitive therapy should be viewed as a viable and efficient treatment option for adults with ADHD".

According to Manilal Gada, a senior psychiatrist and retired professor of psychiatry from Dr DY Patil Medical College, Nerul, Mumbai, who has decades of experience with brain biofeedback (neurofeedback’s predecessor), neurofeedback can be used as an add-on therapy—especially in certain stress-induced disorders—but cannot replace mainstream medication or proven therapies. “There just isn’t enough research on this yet for it to be a compelling option. It’s also scary that there are no regulations, guidelines or standardized procedures for it. One centre may propose 20 sessions, another may offer 40. Who’s to say which is the right way forward?"

We also need to understand the cost-benefit ratio. Taking NeuroLeap’s treatment as an example, the fees, for the preliminary scan and report, are Rs25,000. Each therapy session costs Rs10,000. This means most patients will end up spending upwards of Rs3 lakh for 25-30 sessions. Centres in the US and Europe also charge approximately $100-150 (around Rs6,400-9,600) per session.

For Amresh Srivastava, a psychiatrist and associate scientist at the Lawson Health Research Institute and Western University, Ontario, Canada, neurofeedback can help one train their brain to relax, just like yoga. “It might provide the initial training to help you to carry on. But there is no conclusive evidence whether this benefit of biofeedback training will stay on in the long run," he says, adding, “Why to spend so much money on neurofeedback when you can do yoga for free?"

Both Srivastava and Gada emphasize that no medical associations (that they are aware of) have approved of this as a recommended line of treatment.

When I contacted Olympic shooting champion Abhinav Bindra for his experience with neurofeedback (which his coach had recommended for enhanced focus and reduced stress) while training for the 2008 Beijing Olympics, he asked me to read his autobiography.

In Chapter 16, The Embrace Of Obsession, Bindra says that neurofeedback was a fantastic tool for him, especially when his form began to splutter. He says, “It was terrific at bringing back a shooter’s focus. But it’s best to train on it, learn, and then forget. In competition, you’re never going to be in complete control, suffering will never cease. Essentially, you have to call on courage because you are not a machine and you can’t behave like one. Or to put it another way, the machine will help you, it can’t do it for you."

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