Migraine-relief training

moleculemolecule United States
edited July 2018 in Research
Hello! I struggle with migraines, and am very interested in pursuing neurofeedback to potentially resolve them. I am VERY excited to see this community. However, after searching I didn't see much info about migraines. Find my questions and ideas so far below.

I'm going off of these references:

- Walker, 2010 (they reduced 21-31 Hz activity (beta) and uptrained 10Hz (alpha) activity). 
- Tansy, (increased beta 12-15 and decreased theta, 4-7).
- Stokes et al, (sampled at 256 Hz, personalized decrease/increase per patient).
- Martic-Biocina et al.  followed a more complex protocol:
  • CZ - inhibition of theta waves (4-9 Hz), strengthening
    of SMR and beta waves (12-15 Hz), inhibition of
    high beta (22-30 Hz) – 10 sessions 
  • C4 - inhibition of theta waves (4-9 Hz), strengthening
    of SMR and beta waves (12-15 Hz), inhibition of
    high beta (22-30 Hz) – 7 sessions 
  • C3 - inhibition of theta waves (4-9 Hz), strengthening
    of SMR and beta waves (14-18 Hz), inhibition of
    high beta (22-30 Hz) – 8 sessions 
- Marzbani et al.'s excellent paper describes in great detail what each frequency is for and the effect of treatments on it.
  • delta (less than 4 Hz), theta (4–8 Hz), alpha (8–13 Hz), beta (13–30 Hz), and gamma (30–100 Hz)
  • Alpha training is usually used for the treatment of various diseases such as pain relief (by 9 Hz simulation), reducing stress and anxiety (by 10 and 30 Hz simulation)
  • Delta waves are the slowest brain waves, they are used to alleviate headaches.
  • Gamma waves have the highest frequency, and they are associated with cognitive processing and memory, training these reduces the number of migraine attacks.
- I plan to follow Walker's protocol at first.

I have not done a QEEG. From what I've read, it is not necessary.

Questions:
1. From the Neurofeedback I've done with a practitioner, I only need 3 electrodes. But most of the papers I've seen used many more. Does anyone have opinions or info to help me decide? Right now I'm leaning towards getting the Ganglion (4-channel) for cost and hassle savings.
2. Do any of the SW options have specific vis for migraine reduction? 
3. If not, do any of the SW options let you specify which frequencies to uptrain and which to downtrain? (I found the BrainBay tutorial, but it seems general purpose and I wasn't clear on whether it would be enough for my goals). 
5. Anything else I should be asking but haven't asked yet? Recommendations? Warnings? Suggestions? More reading to do/

Comments

  • wjcroftwjcroft Mount Shasta, CA
    Molecule, hi.

    The BrainBay tutorial link you mention, is a single channel protocol that rewards alpha (8-12) and inhibits beta. You could easily experiment with it to for example reward SMR (12-15) instead. Look through the tutorial to see how the alpha reward frequency is set. You could also extend the protocol to more channels if you wished, but single channel trainings have value. SMR (sensory motor rhythm) has the most amplitude in the motor strip at for example Cz or C3 or C4. Alpha is typically trained at Oz, O2, O1 or Pz, P3, P4.

    You are correct that we don't have Bioexplorer for OpenBCI yet. We are crossing our fingers that Larry Janow (Bioexplorer developer), will come back from his extended 'vacation'.

    You mentioned that you had done previous one channel (1 electrode, 1 reference, 1 ground) with a practitioner for migraine. Was that helpful, what protocol did he use? Were the effects / relief helpful, what you expected, etc.

    Regards,

    William

  • wjcroftwjcroft Mount Shasta, CA
    There are also related forms of biofeedback that have been useful. I'm not sure which modality (forms of biofeedback vs. neurofeedback) has had the most success. Some practitioners would likely use more than one modality.


  • moleculemolecule United States
    More references for myself:


    Kubik et al wrote another overview looking specifically at pain management in 2013. 
  • wjcroftwjcroft Mount Shasta, CA
    You mentioned that you had done previous one channel (1 electrode, 1 reference, 1 ground) with a practitioner for migraine. Was that helpful, what protocol did he use? Were the effects / relief helpful, what you expected, etc.

  • moleculemolecule United States
    Thank you for the response!

    * Brain Bay tutorial
    Ah thank you for clearing that up. It makes more sense now.

    * BioExplorer
    Great! I wish him a restful and restorative 'vacation' that results in a peak of productive activity when he returns ;)

    * Protocols
    At my appointment (I have only had one) I assume it was a single channel based on what you said! Only three electrodes. (In my previous experience with EEG (sleep study), ground needed to be on the bone behind the ear, but this practitioner put them much higher on my scalp on the side of my head. Is that right?) Is a reference and ground needed every time? In that case, when the Ganglion says "4 channels" does that really mean 6 electrodes (4 channels + reference + ground)? I looked at the HW info for the Ganglion board on the OpenBCI page, but it looks like "ground" there refers to the connection to the battery so I was still not sure.

    The doctor didn't really explain the protocol at all: I can ask her at my second appointment. There have been no effects yet, but that seems to be expected for a single 30-minute session. I've also read that most people do training 2-3x a week up to approximately 40-75 sessions, so I'm also not sure if meeting 1x a week will have as much impact as I've read is possible in the papers.

    I've seen some descriptions of protocols in papers, but this is the part I feel the least sure about. They say things like "inhibit xyz in abc area" without clearly explaining what that means. For example, this paper lists the frequencies, but just says migraineurs "were trained" to increase/decrease certain frequencies. I'm unclear on what that means: as you said, what was the reward? (This is also a general question: what does it mean to reward a brain frequency? Especially since my doctor didn't explicitly say "you want xyz to happen on the screen" it didn't seem like I could be rewarded. But I also saw that Pete Van Deusen's website says it happens unconsciously...I'd just like more insight into that process.)

    * Multiple modalities
    Yes, from what I've seen clinical treatment tends to involve multiple modalities. I'll be looking into that as well (but it's much easier to do without specialized hardware, so didn't think it was relevant for this post here).

  • wjcroftwjcroft Mount Shasta, CA
    re: BrainBay tutorial. Reading through that will answer some of your questions about how rewards and inhibits work. Reward = increases that frequency. Inhibit = reduces that frequency.

    re: ground placement. It can be anywhere on the head, position not important.

    re: reference, yes reference connection and ground are always used every time. A typical setup would place reference on one ear lobe and ground on the other, in a 1 channel neurofeedback. The differential amplifier in the EEG unit, measures the differential voltage between reference and the channel. So many channels can share the same reference.

    re: conscious vs unconscious training. Generally you want to just relax and not "try" to produce results. The brain figures out what is happening at a low level that is not conscious. "Trying" to push in a direction will usually disrupt the effect.
  • moleculemolecule United States
    edited July 2018
    • Ground and ref: thanks for clarifying that! Makes sense.
    • Reward = increases that frequency. Inhibit = reduces that frequency.
      • Yes...but I still don't understand how it happens :) I think my question is relating to your last answer: the brain just "figures it out". I don't "get it" but I trust it (after reading so many very inspiring papers, it seems clear the effect is quite strong).
    New questions!
    1. Apparently the protocol my practitioner uses is "InfraLow". I haven't seen it mentioned in any of the papers I've read. Do you know anything about that? Or I can press for more info, but I get the sense that she's following a checklist, and doesn't have much background in the subject. (EDIT: I found more info, hopefully this will clarify things for me: https://www.eeginfo.com/research/pdfs/Infra-Low-Frequency-Neurofeedback-for-Optimum-Performance.pdf)
    2. When the Ganglion says "4 channels" does that really mean 6 electrodes (4 channels + reference + ground)? Or does it mean 8 electrodes (6 channels + reference + ground)? Or does it mean 4 electrodes (4 channels, of which one is reference and one is ground).
    3. I see that the Cyton is supported by more SW than the Ganglion...is that a sign the Ganglion is nearing EOL and I shouldn't purchase it? The Cyton is definitely near the top of my budget, but I dont' want to buy HW that's about to be completely obsolete.
    4. Is this OpenBCI python library compatible w/ the Ganglion? I'm a little confused about why it's not listed in the "compatible SW" section I linked in Q3 above.

  • moleculemolecule United States
    edited July 2018
     (why can't I edit comments after some time has passed?)

    Here is more info about the protocol I"ve been using (Infra-Low):

    • " ILF training involves training the very slowest brainwaves (i.e., less than .5Hz), and rewarding frequencies below 0.1Hz, which is below traditional neurofeedback reward frequencies." (src)
    • "ILF is still in it’s infancy, and thus, a range of limitations impact the efficacy of this form of training. The main issue is to do with the difficulty in giving accurate and timely feedback. This is because a slower wave means a lower resolution, resulting in slower, less accurate feedback."
    • " An important aspect of the low frequency protocol, as developed by the Othmers, is the use of
      multiple inhibits. To summarize, you need an amplifier with a stable linear response all the way to DC, and you need
      software that includes the ability to program multiple inhibit bins and coordinate their feedback." I'm not sure I understand what this means yet - doing more reading to figure it out.
    • Excellent resource: https://brainmaster.com/software/pubs/brain/isf/Nexus Low Frequency Protocol P1-4.pdf
    • More of the above resource: https://brainmaster.com/software/pubs/brain/isf/Nexus ISF NXLFFAQ.pdf

    Is the Ganglion capable of rewarding frequencies below 0.1Hz?

  • wjcroftwjcroft Mount Shasta, CA
    ILF / ISF does not 'reward' frequencies the same way that neurofeedback in the .5 to 40 hz band does reward / inhibit. In general the ILF protocols are proprietary and not all details are publically known.


    Ganglion has a built-in hardware high pass filter (in the front end) that limits low frequency usage below .3 hz,


    This is intentional and cannot be changed. So no, ILF on Ganglion is going to miss ILF frequencies below .3 hz. (.3 hz corresponds to waves that repeat about every 3 seconds.) ILF extends much farther down the spectrum, to waves that cycle in tens to hundreds of seconds.

    So for your migraine protocols, you may be better off experimenting and researching the previous links you mentioned.

    Have you found relief of the migraines with the ILF you have done so far? How many sessions? Generally neurofeedback protocols might be done a 2 to 3 times per week for several months.

    Regards,

    William

  • wjcroftwjcroft Mount Shasta, CA
    Both Ganglion and Cyton are current products and will continue to be offered. Cyton was the first released board, so naturally has more supported apps. But Ganglion is still supported by a wide range of apps. OpenBCI_Python supports both boards, but for Ganglion, requires Linux, because of Bluetooth driver issues on Windows. BioEra (the commercial framework behind the Othmer's Cygnet), supports both Cyton and Ganglion.

    The OpenBCI_GUI can output a stream in LSL (LabStreamingLayer) for both Cyton and Ganglion. LSL is an open standard used by many lab BCI applications.

  • moleculemolecule United States
    Thanks for all your helpful responses! I really appreciate all the information.

    Do you know the answer to this question? When the Ganglion says "4 channels" does that really mean 6 electrodes (4 channels + reference + ground)? Or does it mean 4 electrodes (4 channels, of which one is reference and one is ground). 
  • wjcroftwjcroft Mount Shasta, CA
    4 channels, reference, ground. The 4 channels can be accessed like that or as 4 separately referenced channels:

    1+, 1-, 2+, 2-, 3+, 3-, 4+, 4-, and ground. The 'reference' connection is just a signal bus when used as a common reference.
  • moleculemolecule United States
    Awesome! Thanks. I just got it, but my doctor said not to start w/ a new protocol until this one has been in place for a while, so I'll use the next few months to build up the software :)
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