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The Improvement/Rehabilitation of Auditory Memory Functioning With EEG Biofeedback. NeuroRehabilitation 2002 Thornton KE. Center for Health Psychology Five clinical case studies (1 normal, 3 brain injured and 1 subject who had a left frontal hematoma) are presented which addressed the effectiveness of EEG biofeedback for auditory memory impairment. A normative QEEG activation database of 59 right-handed subjects was developed, which delineated the QEEG variables which were positively related to auditory memory performance (paragraphs). Persons who had experienced a brain injury underwent the same procedure employed in the development of the database. The person's values on the effective parameters of memory functioning were determined. EEG biofeedback interventions were determined by the individual's deviation from the normative reference group in terms of the relevant QEEG parameters of effective auditory memory (paragraph recall). Improvements ranged from 39% subjects who had a follow up assessment that occurred from one month to one year following termination of treatment. `New' Medicine: Increasingly, Insurers Offer Alternative Care Coverage South Florida: The Business Journal Becky Toosya   Proponents of alternative medicine would like to be able to pay a $15 insurance co-payment for a massage therapy session or acupuncture treatment just the same way they do for a doctor visit. Even though almost half of all Americans use some form of alternative medicine and spend some $27 billion a year to do it, insurance companies have been hesitant to extend such coverage. That resistance appears to be changing, however, as public acceptance grows for alternative care methods and insurance companies recognize the increasing appeal of such care. The most significant indication that the industry is gaining strength occurred last year when some of the state's largest insurance companies including Blue Cross and Blue Shield of Florida began offering discounts on certain alternative care. "It's a way of testing the water," said Allan Baumgarten, a Minnesota analyst for the health care industry. "Health plans have been sort of slow to include these kinds of services. They are now realizing that consumers are paying billions of dollars out of their own pocket for these services. "I think there's a business opportunity for the insurance plans." Ultimately, alternative care proponents want their benefits program to cover treatment, instead of just reducing the cost of a visit. Still, the discount plans are seen as a significant move toward extensive coverage. Once a few of the major insurance companies succeed in integrating alternative medicine, others will likely be prompted to develop their own programs, Baumgarten said. Mohit Ghose, spokesman for the American Association of Health Plans, said that has begun to happen on the West Coast where some alternative care is covered in the benefits package. "As more and more employers begin to ask for these health plans, you will see an emergence of coverage based on the available scientific evidence," Ghose said. "Health plans also need to make sure that these services are safe and effective, but not enough research has been made available. "We are still in the beginning stages." Blue Cross and Blue Shield of Florida began offering its Florida members an alternative care program called Blue Compliments in December. The program provides a 15 percent to 45 percent discount on chiropractic, acupuncture and massage therapy treatments as well as on the purchases of vitamins, minerals and herbal supplements. The initial response has been encouraging, said Bob Nay, director of product development for Blue Cross and Blue Shield of Florida. "It's a way to provide more value to our members without the additional cost," he said. Complementary medicine Alternative medicine, also referred to as Complementary Alternative Medicine (CAM), is generally accepted to be a type of healing treatment that is not used in conventional medicine. The treatment usually encompasses acupuncturists, massage therapists, chiropractors, homeopathy and nutritional counseling, but it may include folk remedies, prayers, meditation and other forms of spiritual healing. A study lead by Dr. David M. Eisenberg, published in the Journal of the American Medical Association in November 1998, estimated that in 1997 consumers spent $27 billion outúofúpocket for alternative medicine services and products, a 45 percent increase from 1990. Florida, apparently, is one of those receptive markets for the alternative medicine industry. A 2000 survey by the National Research Corp. determined that 43 percent of Floridians use some form of alternative medicine and an additional 24 percent have considered using it. This widespread interest is a primary reason why insurance companies are looking at complementary alternative medicine programs as a way to add more value to their plans, said Michael Close, the sales and marketing officer for American Specialty Health. ASH is a San Diegoúbased company that offers a network of alternative health care providers. It started offering services to insurance companies in 1987. Significant interest didn't start to grow until the 1990s, before a rapid expansion within the past few years as an increasing number of baby boomers looked for ways to avoid illnesses, Close said. His company now serves more than 40,000 employers nationwide, covering more than 68 million people under various benefits and discount programs, he said. The company has contracts with more than 100 health plans around the country including Blue Cross and Blue Shield, AvMed, Cigna and Health First Health Plan in Florida. "Several health plans and insurance plans in Florida are currently evaluating the potential of adding benefits programs for complementary health care in their market," said Close, who declined to identify the companies. Humana considers coverage Humana is one of the major health plans working on a plan to integrate both alternative and conventional medicine. Before that can happen, the industry must first address the criticism that there are too few mainstream professionals who work with insurance companies to train and advise on alternative care, said Dr. Samuel Benjamin, who was brought in by Humana as its new director of integrative strategies. "Just because it is natural doesn't mean it's safe," Benjamin said. "That's why it's got to go mainstream." If it does, insurance companies would be the logical entities to facilitate and provide information about treatments and services, he said. Alternative care practitioners are interested in working with insurance companies but only if they are compensated at the same level as their traditional medicine counterparts. Boca Raton acupuncturist Stuart Zoll, who has been practicing for 25 years, said he charges patients $75 a session, with most patients requiring at least six visits. Zoll said it wouldn't be acceptable if insurance companies wanted to pay only $20 a visit. Alternative medicine, which promotes preventive measures, could probably save insurance companies and employers expensive health care costs in the future, said acupuncturist Richard Freiberg, legislative chairman for the Florida State Oriental Medicine Association. "Medicine is a big business, and they don't want to share it," Freiberg said. One of his patients, retired pharmacist Lawrence Lazarus, credits alternative medicine for his recovery from colitis, a severe case of an inflammation of the colon. A formula made of 18 herbs ultimately saved him from surgery, he said. "Oriental medicine is not to be ignored or disregarded out of hand," he said. "It's been used in China for thousands of years. What makes Western medicine think that it knows better?" Cardiovascular Disease Leads To Higher Risk Of Dementia University Of Pittsburgh Medical Center PITTSBURGH, People with cardiovascular disease have an elevated risk of developing dementia, including both Alzheimer’s disease and vascular dementia, according to a study presented at the annual meeting of the American Geriatric Society in Washington, D.C. The study, by Anne B. Newman, M.D., M.P.D., a geriatrician at the University of Pittsburgh School of Medicine and an associate professor of medicine and epidemiology, investigated the associations between the risk of dementia, Alzheimer’s disease and vascular dementia in people with a history of clinical cardiovascular disease (heart attack, angina or peripheral vascular disease) or markers for cardiovascular disease (including ECG abnormalities, left ventricular hypertrophy, carotid artery thickness or carotid stenosis). “We found that those with cardiovascular disease had an increased risk of dementia of about 30 percent, only partially explained by stroke,” Dr. Newman said. “Although the relative risk was moderate, the high prevalence of cardiovascular disease coupled with the high risk of dementia in older adults would suggest that prevention of cardiovascular disease may be the most effective preventive measure we have for the prevention of dementia.” The study is part of the Cardiovascular Health Study, which included 5,201 people aged 65 and older in 1989/90 and an additional 687 African-Americans enrolled in 1992/93 from four U.S. communities. Ten annual clinical exams took place from study entry until 1999. These exams included cognitive testing and other physical, psychosocial and laboratory measures. Of that group, 3,602 participants who had undergone an MRI in 1992/93 were selected for further cognitive assessment, which was concluded in 1999. The study found that of the 3,602 participants in the Cognition Study Group, 480 had some type of dementia. Of these, 330 had Alzheimer’s disease (69 percent), 52 had vascular dementia (11 percent), 76 had mixed vascular and Alzheimer’s disease (16 percent) and six had Parkinson’s disease (1 percent). Vascular dementia is the result of insufficient blood flow to the brain. “The risk of dementia was highest in those participants with peripheral arterial disease,” Dr. Newman reported. “The risk of Alzheimer’s disease was also higher in those with cardiovascular disease, though this was partly explained by other dementia risk factors.” The study is supported by grants from the National Institutes of Health

Multi-tasking Behaviors Mapped To The Prefrontal Cortex NIH-National Institute Of Neurological Disorders And Stroke Investigators have mapped a region of the brain responsible for a certain kind of multitasking behavior, the uniquely human ability to perform several separate tasks consecutively while keeping the goals of each task in mind. Using imaging technology, scientists from the National Institute of Neurological Disorders and Stroke (NINDS) found that a specific type of multitasking behavior, called branching, can be mapped to a certain region of the brain that is especially well developed in humans compared to other primates. "The results of this study suggest that the anterior prefrontal cortex, the area of the brain that is most developed in humans, mediates the ability to depart temporarily from a main task in order to explore alternative tasks before returning to the main task at the departed point," says Jordan Grafman, Ph.D., Chief of the Cognitive Neuroscience Section at the NINDS and a co-author of the study. "We believe that this finding is important because branching processes appear to play a key role in human cognition," says Etienne Koechlin, Ph.D., also of the NINDS Cognitive Neuroscience Section and a co-author of the study. "In everyday life, we often need to interrupt an ongoing task to respond to external events and we all experience how demanding it is to react to these events while keeping our minds on the original task." According to previous studies, humans may be the only species capable of performing branching, which involves keeping a goal in mind over time (working memory) while at the same time being able to change focus among tasks (attentional resource allocation). For example, people who are interrupted by a phone call while reading must be able to keep in mind the memory of what they were reading just before talking on the phone. Once the phone call is over, they should be able to return to the last sentence read and continue reading. The investigators used functional magnetic resonance imaging (fMRI), which measures changes in blood flow to the brain, to view the brains of volunteers while they performed branching tasks. When a particular part of the brain is being used, there is an increase in blood flow to that area. The increase in blood flow means that there is an increase in the amount of oxygen-carrying hemoglobin in the blood. fMRI can measure the presence (or absence) of oxygenated hemoglobin and use that information to create an image of the brain at work on a screen. The image of the brain shows activation in the areas receiving increased blood flow. The region of the brain that is involved in multitasking is called the fronto-polar prefrontal cortex (FPPC). Tasks performed by the volunteers involved exercises to test working memory, attentional focus, and a combination of the two. All of the subjects, who were healthy, normal volunteers, participated in all of the task groups. The task groups consisted of a control task, a delayed-response task, a dual-task, and a branching conditions task. Dual-task involves changing focus between alternative goals successively. The investigators predicted that subject performance on the individual delayed-response task and dual-task conditions would not activate the FPPC. They did predict that the branching task which involves problem solving and planning would stimulate activity in the FPPC. According to the fMRI data, their predictions were correct. The FPPC was activated only during those tasks that involved an interaction between working memory and attentional focus decisions. The FPPC is the region of the brain that controls complex problem solving and is especially well developed in humans as compared to other primates. The study showed that the FPPC selectively mediates the human ability to multi-task. Improvement/Rehabilitation of Memory Functioning with Neurotherapy/QEEG Biofeedback. Thornton K. Center for Health Psychology, South Plainfield, New Jersey, USA. This article presents a new approach to the remediation of memory deficits by studying the electrophysiological functioning involved in memory and applying biofeedback techniques. A Quantitative EEG (QEEG) activation database was obtained with 59 right-handed subjects during two auditory memory tasks (prose passages and word lists). Memory performance was correlated with the QEEG variables. Clinical cases were administered the same QEEG activation study to determine their deviations from the values that predicted success for the reference group. EEG biofeedback interventions were designed to increase the value (to normal levels) of the specific electrophysiological variable that was related to successful memory function and deviant in the subject. Case examples are presented that indicate the successful use of this intervention style in normal subjects and in subjects with brain injury; improvement cannot be fully explained by spontaneous recovery, given the time postinjury. Five cases (two normal, two subjects with brain injury, and one subject who had stereotactic surgery of the hippocampus for seizure control) are presented. Improvements ranged from 68% to 181% in the group of patients with brain injury, as a result of the interventions.

Positive Outcome With Neurofeedback Treatment In a Case of Mild Autism Arthur G. Sichel, Lester G. Fehmi, and David M. Goldstein This article looks at the experience of Frankie, an autistic 8 and 1/2 year old boy. He was diagnosed mildly autistic by several specialists. One specialist claimed he was brain damaged and "autistic-like " and that there was no hope for improvement. At Frankie's mother's request, neurotherapy diagnosis and treatment was begun. After 31 sessions, Frankie showed Positive changes in all the diagnostic dimensions defining autism in DSM-111-P, This has profound implications for treatment in a field with few low-risk alternatives. Introduction The DSM-III-R (American Psychiatric Association, 1987) defines autism as "characterized by qualitative impairment in the development of reciprocal social interaction, in the development of verbal and nonverbal communication skills, and in imaginative activity. Often there is a markedly restricted repertoire of activities and interests. . ." The mother of an 8 1/2 year old autistic boy contacted one of the authors seeking treatment for her son,Frankie. She was at first referred elsewhere but returned and we agreed to evaluate him. The first referral was to Jonathan Cowan who, in verbal communication to one of the authors, reported symptom amelioration in EEG treatment of an autistic child. Pretreatment Behavior Frankie exhibited a seeming lack of awareness of the existence of others. He once forgot his glasses after a training session. When he came for his next session, one of the authors held his glasses up for him to take. He did not appear to visually focus on or attend to the author. He focused on the glasses. He reached out and took them, looked at them, looked up, as though focusing on the wall through and behind the author, put on the glasses and walked away. The author had the distinct impression of being looked through, never looked at or attended to. Frankie did not seek comfort when distressed. He showed no imitation of his siblings and did not engage in ' social play. His mother reported that he did not vocalize until the age of three, when he began to babble. She said she has worked a great deal on his verbal communication. Verbalizations appeared quite minimal at the beginning of treatment. He did not make eye contact, did not look at the person or smile in social approach. He had a fixed stare in social situations. Frankie did not change facial expression or respond verbally when addressed. However, he usually did as his mother directed. Directions were simple and responses were slow. When questions were asked of him, his mother would repeat the question until he made some minimal response and she would interpret that response to the neurofeedback provider. He showed very little imaginative play. He read with a monotonous tone of voice. His brief sentences often had odd inflection, almost a sing song quality. He referred to himself as "Frankie" and rarely spoke unless spoken to. He displayed stereotyped body movements in the form of hand flapping. He was attached to a number of objects which he insisted on carrying around with him. In summary, pretreatment behavior included symptoms which meet the diagnostic criteria for Autistic Disorder listed in the DSM-III-R, sections A, B, C and D. Patient Assessment Two separate psychologists, each in private practice, one also a school psychologist, diagnosed him autistic. A neurologist specializing in autism, who is on the faculty of a medical school, diagnosed him autistic. A special education professor at a state college said he was autistic-like but brain damaged and said there was no hope for improvement. His mother said the psychologists and physician described him as high level or mildly autistic. A test of variables of attention (T.O.V.A.) was administered. It is used as an aid in diagnosing attention deficits in children and adults. He did not respond to the tester, but appeared to be participating in the test during practice and during the test. His T.O.V.A. performance showed a variability score which was statistically interpreted by comparison with age related norms to be consistent with an attention deficit disorder. Electrical activity of the brain was recorded at 19 sites (jasper, 1958) using a Lexicor Neurosearch-24 while Frankie was engaged in six different activities (sitting still with eyes closed, with eyes opened, reading, listening, doing a mental arithmetic task and drawing). Calculation of the percent power ratios of theta to beta brain wave activity showed the kind of deviations from normal which are seen in attention deficit disorders (i.e., percent power ratios above 3). Mean ratios, averaged across the five conditions in which his eyes were open, were highest in the parietal and central regions, as shown in Table 1. For the three parietal sites, averaged across the five eyes opened conditions, the pre-therapy theta (4-8 Hz) to beta (13-21 Hz) ratios were 4.07 (P3), 3.98 (PZ) and 3.63 (P4). Neurotherapy Because of high theta/beta ratios and with his mother's urging, it was decided to give Frankie the kind oftheta/beta/EMG treatment which is being used successfully for attention deficit disorders (cf. 4, 5, 6, 7, 8). As of this writing, Frankie has received 31sessions of training in which he has been rewarded for raising his SMR (12-15 Hz) and decreasing theta (4-8 Hz) activity at various brain loci on the sensory-motor strip and parietal lobe. EEG training during early sessions was provided by an EEG Spectrum and for later sessions on the Lexicor using the Biolex program, based on Frankie's choice of computer game. Both utilized a monopolar electrode placement with the ear lobes as reference and ground. Training emphasis was given to parietal activity based upon patient assessment, with the sites showing the highest ratios receiving the most neurotherapy. Post Treatment Behavior The following description of changes since initiation of neurofeedback training comes from his mother, from a female caretaker who has seen him daily for 3-4 hours per day, and from our own observations. His mother reported significant changes after three training sessions. She said he was talking more and had been affectionate with his siblings. For the first time in his life he played with his sister, and even kissed her, and he put his arm around his older brother. Over the course of training Frankie's behavior continued to change. He began attending to and reacting to others. He started making eye contact. He presented his biofeedback trainers with valentine cards he had made; he appeared shy while presenting them and seemed thrilled when the cards were praised. After 31 neurofeedback sessions he notices his sister's distress and tries to interfere when she resists taking a bath or going to bed. He seeks comfort when he reads something upsetting. He imitates his older brother and plays with his brother, his sister and a friend. He no longer tires easily and no longer has trouble falling or staying asleep. His headaches are significantly reduced, as is his tendency to appear anxious and worried. He is much less shy and withdrawn. At this point in treatment, Frankie's verbalizations are still limited and responses continue to appear slow. He now sometimes makes eye contact and no longer has a fixed, vacant stare in social situations. He engages in a lot of imaginative play with his sister. He now reads with some expression. He does not speak much and speaks monotonously, but a singsong quality was not present during later sessions. He now refers to himself as 'T" He initiates conversations at home and asks for what he wants. Before, he frequently engaged in a repetitive jumping activity. Now, he rarely does this. Before, he showed great attachment to a number of unusual objects, insisting on carrying them around. He now carries markedly fewer things around with him. He is evaluated annually by a speech therapist. His most recent evaluation was just prior to this writing. The speech therapist reported that he has improved one whole diagnostic category since his last evaluation. Last year he was found to have profound language deficits (over 40 months delay in development). This year he showed severe language deficits (30 months delay). The speech therapist specified that no hand flapping or self-stimulating behavior was observed. He did confuse pronouns and omit articles. He could not follow two and three step commands and echolalia was present. However, he had improved so much that, for the first time, the speech therapist was able to use age appropriate tests. In summary, Frankie has demonstrated positive changes on all the diagnostic dimensions defining autism in DSM-III-R. Brain Wave Changes QEEG mapping of Frankie's brain activity was repeated after completion of 31 sessions of neurotherapy. The pre- and post-neuro therapy theta to beta percent power ratio for each of the 19 sites recorded, averaged across the five eyes opened conditions, are shown in Table 1. Prior to neurotherapy, seven sites had percent power ratios above 3.00 (see values denoted by asterisk), and the highest ratio (4.07) was at P3. As shown in Table 1, two sites (P3 and CZ) remain slightly above 3.00 after neurotherapy. Fifteen of the 19 sites showed reduction in their power ratios after neurotherapy. Ranked among the largest reductions in percent power ratios were the changes that occurred at P3 and PZ. These represent the sites which received the predominant proportion of training time. Discussion The behavioral changes and the brain wave changes in this 8-year-old autistic boy are viewed as a positive outcome of neurotherapy. These results are suggestive that neurotherapy can be an effective treatment for some of the symptoms of mild autism. It would be interesting to follow possible further gains with additional neurotherapy sessions. The core deficit in autism as discussed by Pennington (1991) is the inability to imagine what is going on inside another person in terms of thoughts, feelings and images. It seems reasonable that one has to discriminate and be able to represent these internal states to oneself before one can imagine what internal states another person might be experiencing. Neurotherapy has led to the reduction of the power ratios in the parietal region, where Frankie's ratios were highest prior to neurotherapy, and where the experience of his body is mediated. The findings reported here support the hypothesis that neurotherapy training has led Frankie to pay attention to the experience of his body, or to attend to it or experience it differently, we suggest both more objectively and more intimately. We believe this newly learned and qualitatively different way of attending to and experiencing his body has had profound consequences (Fehmi, In press). The same type of neurotherapy which is used to treat attention deficit disorders has initiated a process which reduced autistic symptoms and supported the development of normal patterns of social interaction and communication. This has profound implications for treatment in a field with few low risk alternatives. These results are consistent with the view that a basic defining characteristic of autism is the failure to pay attention appropriately to the experience of one's body. That is, mild autism may be profitably considered a form of attentional limitation or rigidity to which other attention treatments may also be useful (cf. 10). The authors look forward to further clinical research with mild autistic patients to support or refute the above findings and interpretations.

Using Spatial Illusion To Learn How The Brain Processes Sound University Of Michigan ANN ARBOR---Next time your pager starts beeping in a crowded room, try this little experiment in auditory perception. After a few beeps, notice how everyone starts looking around in all directions trying to hear where the noise is coming from. Try the same experiment in a room full of cats and you'll see the feline version of aural confusion. People and cats have no problem localizing natural sounds like a snapping twig or rustling leaves, which include a broad spectrum of sound frequencies, according to John C. Middlebrooks, Ph.D., an associate professor of otolaryngology in the University of Michigan Medical School. But our auditory system lacks the ability to pinpoint the location of narrow-band sounds with just a few frequencies, like a beeping pager. Middlebrooks and his colleagues at the U-M Kresge Hearing Research Institute are taking advantage of this inability to localize narrow-band frequencies in research designed to learn how the brain processes and perceives sound. "We know that sound is recorded in the firing pattern of neurons in the auditory cortex---the part of the brain that processes electrical signals generated in the inner ear," Middlebrooks said. "We're trying to break the code---to understand the rules the brain uses to translate this neural activity into what we hear as sound." In a paper published in Nature, U-M scientists Middlebrooks and U-M post-doctoral researchers Li Xu, Ph.D., and Shigeto Furukawa, Ph.D., describe how localization errors made by nerve cells in the brains of cats exposed to filtered sounds are consistent with errors made by humans in previous experiments. In earlier experiments, human volunteers stood in a soundproof room surrounded by 14 loudspeakers and listened to a random series of broad-band and narrow-band tones, which sound something like quiet crickets. People turned toward each sound's origin, while sensors recorded the orientation of their heads when they did so. Consistently, volunteers listening to narrow-band sounds turned toward locations that differed in predictable ways from the actual loudspeaker. For experiments described in the Nature paper, U-M scientists played the same sounds for anesthesized cats with miniature probes surgically implanted in their auditory cortex. Created at the U-M Center for Neural Communication Technology, these neural probes are the size of a grain of pepper and sensitive enough to record signals from a single nerve cell. Using the microelectrode probes, U-M researchers recorded electrical activity from individual neurons in the cat's auditory cortex as it heard the sounds. "With the probes, we can record from the neuron directly," said Xu. "In effect, the neuron tells us where the cat believes the sound is coming from." "The auditory systems in humans and cats appear to use the same spectral sound characteristics to determine sound locations," Middlebrooks said. "We interpret these results as evidence that the firing pattern we see in cat neurons could be a model for brain processes that underlie spatial perception reported by humans exposed to the same sounds." If future research confirms that neurons in human brains respond in the same way as those in the brains of cats, Xu added, it will have immediate applications for the development of new implantable hearing devices designed to stimulate the auditory system directly. Helping To Better Understand The Development And Maturation Of The Auditory Pathway Johns Hopkins Medical Institutions Scientists at Johns Hopkins have discovered the function of a group of nerve fibers that originates in the brain stem and fires off signals even before newborn rats can hear. The signals may be a process for wiring the ears and brain for hearing, much like laying down circuits on a computer chip. The study, published in Science, moves researchers a step closer to understanding the development of human and mammalian hearing. Rats are born deaf and do not hear for the first two weeks of life. It is during this time, according to the Hopkins researchers, that the brain appears to provide a feedback mechanism onto the sensory organ that may turn the system on and off. Scientists have found a similar process in the eyes and brains of newborn cats, who are born blind. Specifically, the investigators report the identification of a working "inhibitory synapse," a nerve cell communications pathway, between neurons in the brain and hair cells in a part of the inner ear known as the cochlea. They also developed a method to directly record this synaptic activity, a chemical signal released from a neuron that activates an electric impulse in the hair cell. "Even before an animal can make sense out of sound, we have long surmised that as with the visual system's connection between eye and brain, there is some spontaneous activity that allows for the development of more hard-wired connections between the brain and the hair cells," said Elisabeth Glowatzki, Ph.D., lead author of the article. "This has to occur because it's the hair cells of the cochlea (the spiral tube in the inner ear containing nerve cells) that respond to sound, but the brain that feeds signals back through the pathway to regulate the sensory information," she added. In the past, scientists found no evidence that these synapses have a particular purpose before the animals begin hearing. The Hopkins work, however, suggests that they play a role in the development as a feedback system will organize hearing about two weeks after birth. "What's unusual and striking is that that is happening before the animal hears. That says that this isn't only there as a way of filtering the world in real time, it must also play some complex role in setting up the relationship between the sense organ and the brain," says Paul Fuchs, Ph.D., professor of otolaryngology and co-author of the work. Working with the cochlea surgically removed from newborn rats, Glowatzki placed electrodes directly on the hair cells to record electrical activity and found that the neurons from the brain release the neurotransmitter acetylcholine, which inhibits or turns off the hair cell's signal to the brain. "The purpose of this inhibition may be that it imposes some kind of rhythmicity or pattern onto the developing auditory pathway," she said. The Hopkins researchers plan to use this information to continue to map out the activities of the auditory system.

UCSF-Led Team Offers New Insight Into Neurological Basis Of Dyslexia University Of California, San Francisco Researchers are reporting direct neurological evidence that the region of the brain that processes brief, rapidly successive sounds is functionally abnormal in adults with the reading disability known as dyslexia. The findings, documented through simultaneous brain imaging and behavioral tests, strongly indicate, the researchers said, that adult dyslexics have an enduring neurological deficit in their ability to process these brief, rapidly successive sounds. They suspect that the deficiency contributes to difficulties in early speech and language learning, and leads to a weakness in the subsequent mental leap in abstraction to words on a page that enables people to learn to read. The study was published in Proceedings of the National Academy of Science. Perhaps the most provocative aspect of the finding, the researchers said, is the clear and direct neurological evidence that reading deficits are generated, at least in part, by a deficit at a very fundamental level of cortical processing of sound inputs. "Our findings indicate that there is a basic problem in signal reception, as complex sound information streams into the cerebral cortical system underlying aural speech representation," said the senior author of the study, Michael Merzenich, PhD, the Francis A. Sooy Professor of Otolaryngology and a member of the Keck Center for Integrative Neuroscience at UC San Francisco. "The way that the brain processes sound in poor readers is very different from its processing and representation of rapidly changing sound inputs in competent readers." "Our research indicates that adult dyslexics are representing the sound parts of words by the activation of cortical neuron populations in a weaker and less salient form within their cortical aural speech processing system. We believe that they, therefore, are not delivering the normal forms of representation of the separable sound parts of words to the regions of the brain involved in speech perception and reading," he said. The authors emphasize that their findings do not discount the additional involvement of higher levels of brain processing in dyslexia, where more complex combinations of information lead to the recognition and interpretation of speech. At the same time, they argue that the very elementary defect in the brain's processing of sound must be playing an important role in the generation of relatively weak neuronal representations of the sound parts of aural speech. And this elementary neurological deficit, they said, could provide a target for remedial therapies aimed at training the brain to increase the speed and accuracy with which it processes rapidly successive and rapidly changing sounds. The sound-processing function occurs at a base, or entry, level of sound processing in the brain, and is believed to be a primary step in the brain's representation of normal speech sounds and its creation of speech and language-reception abilities. The process ultimately culminates with a listener learning to recognize the sound parts of words, and to translate these word sounds as written letters. Previous behavioral studies have suggested that the inability to parse the rapidly successive, changing sounds that make up words, the phonemes of language, may be the primary basis of language-learning impairments in children. Scientists have long argued that children who have difficulty parsing word sounds are destined to have difficulty successfully initiating reading. Other behavioral studies have indicated that most people with dyslexia, characterized by a difficulty with reading, also have impairments in the fidelity of their auditory reception. However, because most dyslexics ultimately develop facile speech reception and production capabilities, the significance of this problem for the origin of reading impairments has been unclear. The researchers conducted their current study in seven dyslexic adults who were of normal intelligence but severely challenged by reading, spelling and writing. Results were compared with those recorded in seven adults of normal intelligence who were competent readers. The dyslexic adults performed poorly on standardized reading tests. And, as has been shown to be the case with the great majority of adult dyslexics, these poor readers (ages 18-42) also performed poorly on a variety of tests that measured their ability to discern rapidly successive sound stimuli. In one of these sound-discerning tests, adults were exposed to two sounds that differed in frequency and that occurred a tenth or a fifth of a second apart. They were then asked to identify the sounds and to replay the sequence in which they were presented. Their brain activity was simultaneously recorded using magnetoencephalographic brain imaging, which measures magnetic field fluctuations generated by spatially localizable human brain activity with millisecond precision. In these studies, the UCSF team focused on the activity generated by the rapidly successive sounds evoked from the "primary" auditory cortical areas, where information about aural speech flows into the cerebral cortex's processing system for language. Poor readers did report hearing the two very brief sounds, and often knew that in some way they weren't the same, but they were unable to identify them, or to reliably reconstruct the sequence in which they were represented. "The reason," said Srikantan Nagarajan, PhD, an assistant adjunct professor of otolaryngology and a member of the Keck Center for Integrative Neuroscience at UCSF, and the lead scientist of the study, "was demonstrated by the abnormal way that the brain of the poor-reading subjects responded to these rapidly successive sound events." "In normal readers, the auditory cortex generated clear, separate representations of sounds occurring within the time dimensions of a syllable," said Nagarajan. "In poor readers, the brain separately generated only very weak representations of sound events past the first sound. "In the normal reader, successive intra-syllabic sound events are separately represented in high fidelity within the processing channels of the 'primary' auditory cortex. In the impaired reader, they are not," he said. "These findings are consistent with the increasing evidence," said Merzenich, "that language-impaired and reading-impaired children are a very broadly synonymous population. Scientists have historically argued that only a small percentage of dyslexics have a clear history of early language impairment and fundamental auditory processing deficits. To the contrary, we have seen that most poor readers and most language-impaired children share these same fundamental listening and brain processing abnormalities." Moreover, he said, "The studies show that these fundamental listening problems clearly persist across a lifetime, even while the basic speech reception abilities of these individuals can ultimately achieve a relatively normal competency." Co-authors of the study were Henry Mahncke, PhD, a research fellow in the Keck Center at UCSF; Talya Salz, of Scientific Learning Corporation in Berkeley, CA; Paula Tallal, PhD, co-director of the Center for Molecular and Behavioral Neuroscience at Rutgers University, Newark, NJ; and Timothy Roberts, PhD, assistant professor of radiology in the Biomagnetic Imaging Laboratory, Department of Radiology, at UCSF. The study was funded by the National Institutes of Health, the Office of Naval Research, Hearing Research Inc., and the Coleman fund.

How We See Things that Move: A Hot Spot in the Brain's Motion Pathway Report from Howard Hughes Medical Institute Researchers have now traced the path of neural connections that make up the motion pathway and tested the responses of cells at different steps along this path. Starting in the retina, large ganglion cells called magnocellular neurons, or M cells, are triggered into action when part of the image of a moving hand sweeps across their receptive field—the small area of the visual field to which each cell is sensitive. The M cells' impulses travel along the optic nerve to a relay station in the thalamus, near the middle of the brain, called the lateral geniculate nucleus. Then they flash to the middle layer of neurons in the primary visual cortex. There, by pooling together the inputs from many M cells, certain neurons gain a new property: they become sensitive to the direction in which the hand is moving across their window of vision. Such direction-sensitive cells were first discovered in the mammalian visual cortex by David Hubel and Torsten Wiesel, who projected moving bars of light across the receptive fields of cells in the primary visual cortex of anesthetized cats and monkeys. Electrodes very close to these cells picked up their response to different moving lines, and the pattern of activity could be heard as a crackling "pop-pop-pop" when the signals were amplified and fed into a loudspeaker. The keystone of the motion pathway was discovered by Semir Zeki of University College, London, in an area of the cortex that lies just beyond the primary and secondary visual areas (V1 and V2), further from the back of the brain—a vast unexplored wilderness vaguely known as the "sensory association cortex." "It was thought that somewhere in this mishmash of association cortex visual forms were recognized and associated with information from other senses, says John Allman of the California Institute of Technology. But studies in the owl monkey by Allman and Jon Kaas (who is now at Vanderbilt) and in the rhesus monkey by Semir Zeki revealed that the area was not a mishmash at all. Instead, much of it was made up of separate visual maps, each containing a distinct representation of the visual field. In 1971, Zeki showed that one of these visual maps was remarkably specialized. Though its cells did not respond to color or form, over 90 percent of them responded to movement in a particular direction. American scientists usually call this map MT (middle temporal area), but Zeki called it V5. He also nicknamed it "the motion area." "This very striking finding of this little hot spot, this little pocket, in which almost all the cells are sensitive for the direction of movement," says New York University's Anthony Movshon, was the impetus for many vision researchers to turn their attention to motion. Nowhere else in the visual cortex was there an area that seemed so functionally specialized. The cells of this motion area, MT, are directly connected to the layer of direction-sensitive cells in the primary visual area, V1. And the two areas have a remarkably similar architecture. Hubel and Wiesel had discovered that V1 is organized into a series of columns. The cells in one column may fire only when shown lines oriented like an hour hand pointing to one o'clock, for instance, while the cells in the next column fire most readily to lines oriented at two o'clock, and so on around the dial. Amazingly, MT has the same kind of orientation system as V1, but in addition the cells in its columns respond preferentially to the direction of movement. "When you see that an area, like V1 or MT, has this highly organized columnar structure," says Wiesel, "you get a sense of uncovering something fundamental about the way the cells in the visual area work." Brain's Visual Cortex Doesn't 'Tell' All It Knows MINNEAPOLIS / ST. PAUL--The print on a page may be too fine to read, but that doesn't mean your brain can't discern the pattern of lines. New research by scientists at the University of Minnesota and the University of California at San Diego (UCSD) has shown that neurons in the human visual cortex, a brain center that processes visual information, can respond to patterns of lines too fine for subjects to resolve. The work reveals that some types of visual information, while not consciously perceived, are still conveyed closer to the brain's center(s) of consciousness than was previously thought. The discovery contributes to the understanding of vision and has implications for the age-old question of consciousness. "This is probably the first demonstration that visual cortical neurons are capable of resolving fine lines past the limits previously thought to exist," said Sheng He, assistant professor of psychology at the University of Minnesota and first author of the Nature paper. His coauthor is Donald MacLeod of UCSD. Everyone with normal vision can perceive patterns of lines up to a certain point. But when the spacing of lines becomes too fine, the lines seem to disappear and only a uniform blur is seen. Previously, vision researchers thought this limitation was due to optical blurring in the eye--that is, a failure of the retina to resolve the lines. Now, at least some of the blurring has been shown to occur in the visual cortex, said He. The researchers studied the responses of two subjects to patterns of lines projected directly onto their retinas by lasers. The lines were either horizontal or vertical. It has been known for some time that certain neurons in the visual cortex respond preferentially to either vertical lines, horizontal lines or in-between orientations. With enough neurons responding to every conceivable orientation, humans can perceive lines that run in any direction. It has also been known that when human subjects are shown a pattern of vertical or horizontal lines for several seconds and then shown a second grid of lines, they are better able to perceive the orientation of the second grid if it is perpendicular to the original one. The reason is that the neurons responding to, say, a vertical grid become fatigued and have trouble perceiving a second vertical grid. But the neurons that respond to horizontal lines are fresh and respond strongly. He and MacLeod observed this phenomenon in their subjects. But when they projected lines so fine that they were slightly, but definitely, past the subjects' ability to resolve, the subjects exhibited the same difficulty perceiving a second grid of clearly visible lines with the same orientation. This, said He, is evidence that the cortical neurons geared to that orientation were perceiving the lines the first time, when the lines were invisible to the subjects. Therefore, the subjects' inability to see the too-fine lines must be due to a blurring that occurs after the visual cortex receives input. The visual cortex lies in the rear of the cerebrum. He said that researchers elsewhere have hypothesized that people cannot become aware of optical information unless it reaches the frontal area of the cortex. The work of He and MacLeod is consistent with this theory, He said. The blurring of lines appears to be due to processes inside the visual cortex that prevent some information from reaching other cortical areas and consciousness. "This suggests that not everything in the cortex can become conscious knowledge," said He. "Your visual cortex isn't telling you everything." The work was supported by the National Institutes of Health and the Alfred P. Sloan Foundation. ---University of Minnesota

Hospitals Get Alternative: Acupuncture, Massage, and Even Herbs Pop Up In Mainstream Medical Settings By Jodi Schneider US News and World Report PARK RIDGE, ILL.–The elderly woman, suffering from chronic pain, lies down on the examining table and braces herself for what's to come. "My witch doctor," she affectionately calls Sang Xi Zhou, the acupuncturist who over the next few minutes gently jabs the patient's arms, legs, and back with tiny needles. At first she winces at the sting, but then she lies back and relaxes, even closing her eyes, as the weekly treatment works its "magic." The patient acknowledges she was hesitant to try acupuncture, fearing the needles. "It was just that the pain got to be so bad, I was sitting up crying all night, that I figured: How much worse could this be?" she says. Now, she looks forward to her visits. "I couldn't come last week, and the pain was back. This works." Herbs and needles. There's nothing unusual about this suburban Chicago woman's enthusiasm for so-called alternative medicine; as many as 40 percent of Americans say they've tried one of the treatments, many of them based on Eastern medicine, like acupuncture and Chinese herbal therapy. What's more surprising is the setting: It's not a storefront office or an upscale spalike facility but a new clinic attached to Lutheran General Hospital, a bastion of conventional medical science. Lutheran General's Center for Complementary Medicine is one of a growing number of such facilities operated by mainstream hospitals. One goal is to help treat patients with chronic conditions who have run out of conventional options. Alternative medicine–often called complementary when done in conjunction with standard treatments–is also an attractive business for hospitals. Because insurance, Medicare, and Medicaid cover relatively few of these services, patients typically pay out of pocket. About 15 percent of U.S. community hospitals offered alternative or complementary therapies in 2000, according to the most recent survey by the American Hospital Association, nearly double the number just two years earlier. The clinics are typically run by family-practice physicians or internists and are closely monitored by the affiliated hospitals. Yet such treatments are not as mainstream as they may appear. Many doctors believe that alternative therapies–which include acupuncture, herbal medicine, chiropractic, massage therapy, and homeopathy–can help patients feel better. But there is widespread skepticism that these treatments have lasting medical benefits. Most alternative therapies have not been studied rigorously, and the conditions they often treat–pain and nausea, for example–are ones where the placebo effect, or power of suggestion, can be potent. Doubtful doctors are one reason that alternative treatments are rarely an integral part of hospital care, even when offered at an affiliated center. For patients, perhaps the best advice is to be open to alternatives when they are available, but be careful to tell all your helathcare providers about any drugs or treatments you are getting or have tried. And be realistic in your expectations. Physicians say the beauty of complementary clinics is that they are run by doctors, who appreciate conventional as well as alternative remedies. Theri Raby, an internist and the director of the Center for Integrative Medicine in downtown Chicago, says education is part of her job, warning patients against ineffective, "quack" remedies and coordinating with standard treatments. "There's a lot out there that isn't right; part of my role is to stop people from wasting money on therapies that don't work," she says. Donald Novey, a family-practice physician who directs the Complementary Medicine Center, says he has a high success rate with alternative treatments. The center, which had about 700 patient visits in May, is located in what he calls an "average middle-aged, middle-class" suburb northwest of Chicago–not a place one would consider terribly New Age. Many of the patients were referred by their doctors after standard treatment failed. Some are in pain; others are seeking help with chronic conditions like arthritis or lupus. Novey notes which standard treatments and drugs have been tried and then meets with his staff, which includes a psychologist, acupuncturist, herbal medicine doctor, and homeopath, to choose other therapies. "I've learned that if you change a lot of parts of their life a little, you've changed their lives a lot," he says. What many patients gain from the treatments isn't a cure but an improved sense of well-being. Susan Bromstad, 55, has lupus, as well as thyroid and sinus problems. When the Park Ridge resident first came to the Complementary Medicine Center, she had very low energy. She first began receiving acupuncture treatments and then added Chinese herbs along with vitamins and nutritional counseling. She feels much more energetic. "I think it's everything together," she says of the treatment's success. Gwenn Lloyd, a 49-year-old floral designer and NCAA women's field hockey umpire from nearby Naperville, was referred to the center by her surgeon for help getting through a tough course of chemotherapy and radiation following her breast cancer diagnosis and lumpectomy. Psychological and nutritional counseling, heavy-duty doses of vitamins and antioxidants, and body work such as massage strengthened her for the invasive, often lonely, conventional therapy ahead, she says. "Here they healed my psyche and gave me the skills to move beyond the treatment." Resistance. But mainstream physicians and the hospital bureaucracy often resist making alternative medicine part of inpatient hospital care. Even though Chicago's Center for Integrative Medicine is affiliated with Northwestern Memorial Physicians Group, for example, it reports getting few referrals from hospital staff doctors and relies almost entirely on paying outpatients. That could change as teaching hospitals and universities add basic concepts of alternative medicine to their programs. A consortium of some of the nation's top medical schools–including Harvard, Duke, and Stanford–are teaching complementary medicine to first- and second-year medical students, stressing therapies like acupuncture and herbal medicine. Georgetown University, which received a $1.7 million National Institutes of Health grant, is teaching all first-year students basic concepts of alternative medicine, including mind-body techniques such as yoga. Why? Chances are, some of their future patients will seek these therapies. "It's not anymore a matter of an elective thing that you can teach, but it is our responsibility to teach," says Aviad Haramati, a Georgetown University professor leading the program.

Flexyx Neurotherapy System in the Treatment of Traumatic Brain Injury: An Initial Evaluation. Schoenberger NE, Shif SC, Esty ML, Ochs L, Matheis RJ. Kessler Medical Rehabilitation Research and Education Corporation OBJECTIVE: To conduct an evaluation of the potential efficacy of Flexyx Neurotherapy System (FNS), an innovative electroencephalography (EEG)-based therapy used clinically in the treatment of traumatic brain injury (TBI). PARTICIPANTS: Twelve people aged 21 to 53 who had experienced mild to moderately severe closed head injury at least 12 months previously and who reported substantial cognitive difficulties after injury, which interfered with their functioning. DESIGN: Participants were randomly assigned to an immediate treatment group or a wait-list control group and received 25 sessions of FNS treatment. They were assessed at pretreatment, posttreatment, and follow-up with standardized neuropsychological and mood measures. RESULTS: Comparison of the two groups on outcome measures indicated improvement after treatment for participants' reports of depression, fatigue, and other problematic symptoms, as well as for some measures of cognitive functioning. Most participants experienced meaningful improvement in occupational and social functioning. CONCLUSION: On the basis of these results, FNS appears to be a promising therapy for TBI. Effects of Caffeine on Topographic Quantitative EEG. Siepmann M, Kirch W. Neuropsychobiology 2002 Despite the widespread use of caffeine as a central nervous stimulant, the central pharmacodynamic properties of the drug have not yet been conclusively evaluated in humans. The present study was undertaken to assess the acute effects of caffeine on measures of topographical quantitative electroencephalogram (EEG) in normal subjects. Ten healthy male volunteers (mean age +/- SD 25 +/- 4 years) received placebo and 200 mg of caffeine as powder with oral water solution (caffeine amount = 2 cups of coffee) under randomized, double-blind crossover conditions on two different occasions. Before administration and 30 min afterwards, a 17-channel quantitative EEG was recorded during relaxation with eyes open and closed (15 min each). Caffeine caused a significant reduction of total EEG power at fronto-parieto-occipital and central electrode positions of both hemispheres when the subjects kept their eyes open. Absolute power of the slow and fast alpha and slow beta activities was diminished in various regions of the brain (p < 0.05). The effect was more pronounced with the subjects keeping their eyes open than with eyes closed. It can be concluded that quantitative EEG is a sensitive method to assess the effects of psychostimulants on the human brain. Therefore, in pharmaco-EEG studies, environmental factors such as caffeine have to be excluded. The Clinical Role of Computerized EEG in the Evaluation and Treatment of Learning and Attention Disorders in Children and Adolescents. Chabot RJ, di Michele F, Prichep L, John ER. Department of Psychiatry, Brain Resarch Laboratories, New York University School of Medicine, NY, USA. Quantitative EEG (QEEG) can play an important role in the evaluation and treatment of children and adolescents with attention deficit and learning disorders. Children with learning disorders are a heterogeneous population with QEEG abnormality in 25% to 45% of reported cases. EEG slowing is the most common abnormal finding, and the nature of the QEEG abnormality may be related to future academic performance. Children with attention disorders are a more homogeneous population, with QEEG abnormalities in up to 80%. In this population, frontal/polar regions are most likely to show deviations from normal development, with the thalamocortical and/or septal-hippocampal pathways most likely to be disturbed. QEEG shows high sensitivity and specificity for distinguishing normal children and children with learning disorders and attention disorders from each other and may provide useful information for determining the likelihood that children with attention problems will respond to treatment with stimulant medication. A Comparison of EEG Biofeedback and Psychostimulants in Treating Attention Deficit/Hyperactivity Disorders Thomas R. Rossiter and Theodore J. La Vaque The study compared treatment programs with EEG biofeedback or stimulants as their primary components. An EEG group (EEG) was matched with a stimulant group (MED) by age, IQ, gender and diagnosis. The Test of Variables of Attention (TOVA) was administered pre and post treatment. EEG and MED groups improved (p < .05) on measures of inattention, impulsivity, information processing, and variability, but did not differ (p > 0.3) on TOVA change scores. The EEG biofeedback program is an effective alternative to stimulants and may be the treatment of choice when medication is ineffective, has side effects, or compliance is a problem. The purpose of the study was to examine the efficacy of 20 sessions of EEG biofeedback in reducing AD/HD symptoms and to compare the results with those obtained with psycho stimulant medication. Psychostimulants are the most widely used treatment for AD/HD (Barkley, 1990). In order to be a widely accepted alternative to medication, EEG biofeedback must be able to produce equivalent symptom reduction. Reports documenting the use of EEG biofeedback in the treatment of attention deficit hyperactivity disorder (AD/HD) began to appear in the literature in the mid 1970's (Lubar & Shouse, 1976). In recent years the use of this treatment has become more widespread and has received increasing attention from the professional community and the public. The increased professional interest may be due to a number of factors including the reported effectiveness of the treatment, the availability of relatively inexpensive, high quality, quantitative EEG equipment, an expanding number of opportunities for training in the use of EEG biofeedback, and the emergence of scientific interest groups that have facilitated the promulgation of information in this area. The study demonstrated that a treatment program with EEG biofeedback as the major component led to significant reduction in both cognitive and behavioral symptoms of AD/HD after 20 treatment sessions completed over a period of four to seven weeks. The EEG group manifested significant improvement in attention, impulse control, speed of information processing and consistency of attention on the TOVA. BASC questionnaires completed by mothers confirmed the reduction in AD/HD symptoms and also indicated a decline in internalizing and externalizing psychopathology. In every case where parents and/or teachers reported significant improvement in behavior or school performance, corresponding improvement in the TOVA performance was observed. This confirms that improvement was not limited to TOVA test scores, but had generalized beyond the clinic and was observed as symptom reduction in the patients' daily lives. More importantly, the EEG biofeedback program led to improvement on all four TOVA outcome variables that was equivalent to that obtained with the medication pro-ram. The EEG program is an effective treatment for AD/HD and a viable alternative to the use of psychostimulant medication. The results indicating significant reduction of AD/HD symptoms with EEG biofeedback are consistent with those reported by Lubar (1991), S. F. Othmer and S. Othmer (1992), Linden, Habib & Radcjevic (in press), Cartozzo, Jacobs & Gevirtz (1995) and Scheinbaum, Zecker, Newton & Rosenfeld (1995). Moreover, the improvement was evident in far fewer than the 40-80 sessions sometimes cited as the expected course of treatment (Barkley, 1992). This allows for conservation of health care resources by identifying patients who are not responding to treatment earlier in the treatment process. The EEG biofeedback program is an effective treatment for AD/HD and may be the treatment of choice in cases where medication is ineffective, only partially effective, has unacceptable side effects, or where compliance with taking medication is low. In addition, 60-70% of children with AD/HD continue to have symptoms of the disorder into their adolescent and adult years (Weiss & Hechtman, 1994). Since psychostimulants do not result in any lasting reduction of AD/HD symptoms, their use must be continued indefinitely if the symptoms are to be controlled. By the time many children reach adolescence, they are no longer willing to take psychostimulants whether they had responded favorably in the past or not. For this reason, there is a substantial population of AD/HD adolescents and young adults for whom medication is not an acceptable treatment option. The EEG biofeedback program provides an alternative for this group of patients. Among patients who have a good response to medication, the choice between EEG biofeedback and medication is not as clear cut. The EEG program is more expensive in the short run than the medication program. However, the cost differential may be declining due to better pretreatment assessment and more efficient treatment protocols . S. Othmer (1994) reports that training is successfully completed in 20 sessions for at least 30% of AD/HD patients. The EEG biofeedback program is a cost effective alternative to the long term use of medication if it results in lasting symptom reduction, particularly if the patient is one of the 60-70% who will not "outgrow" the disorder. One to ten year follow-up of successfully treated patients suggests that EEG biofeedback leads to long term symptom reduction (Othmer, S., Othmer, S. F., & Marks, 1991; Lubar, 1995; Tansey, 1993). These reports are encouraging but need to be confirmed by systematic follow-up studies with larger samples of patients using objective assessment procedures such as the TOVA, standardized academic achievement tests, etc. Complete article can be found at http://www.snr-jnt.org/JournalNT/JNT(1-1)7.html

NIACIN TREATS DIGESTIVE PROBLEMS TORONTO, CANADA. Many digestive problems such as bloating, abdominal distention or pain, heartburn and belching are caused by a lack of stomach acid (hypochlorhydria). An adequate output of stomach acid is required in order to prevent fungal and bacterial overgrowth in the small intestine (candidiasis and Helicobacter pylori) and to facilitate the flow of bile and pancreatic enzymes. Dr. Jonathan Prousky of the Canadian College of Naturopathic Medicine believes that many cases of hypochlorhydria can be traced to a relative lack of vitamin B3 (niacin, niacinamide). Some people, it appears, have a much higher than normal need for vitamin B3 especially when under stress. If this need is not met then digestive problems arise. Dr. Prousky cites the cases of two patients with abdominal bloating and other digestion-related problems whose condition improved very significantly after starting to supplement with 1-3 grams/day of niacin (in divided doses). One of the patients also suffered from gastroesophageal reflux (GERD); his symptoms completely disappeared after beginning niacin supplementation. Dr. Prousky suggests that patients who suffer the symptoms of low stomach acid production can markedly improve their condition by supplementing with 200-500 mg of niacinamide with every meal. For more severe cases betaine hydrochloride and 500-1000 mg of niacin per meal may be required. This regimen may also help to eradicate a Helicobacter pylori infection. NOTE: High doses of niacin should only be taken under the supervision of a physician. Prousky, Jonathan E. Is vitamin B3 dependency a causal factor in the development of hypochlorhydria and achlorhydria? Journal of Orthomolecular Medicine, Vol. 16, No. 4, 4th quarter 2001, pp. 225-37 [74 references] HIGH PROTEIN DIET BENEFITS DIABETICS ADELAIDE, AUSTRALIA. The optimum diet for type 2 diabetes patients has long been a subject of considerable controversy. Some researchers advocate a diet high in complex carbohydrates while others contend that a diet high in protein is superior. Researchers at the Commonwealth Scientific and Industrial Research Organization have just released the results of a study, which shows that a high protein diet is superior to a high carbohydrate diet. The study involved 54 obese men and women with type 2 diabetes who were fed either a high protein (HP) or a low protein (LP) diet for eight weeks. The HP diet provided 30 per cent of energy from protein, 40 per cent from carbohydrates, and the remainder from fat. The LP diet provided 15 per cent of energy from protein and 60 per cent from carbohydrates. The fat portion consisted of 8 per cent saturated fatty acids, 12 per cent monounsaturated fatty acids, and 5 per cent polyunsaturated fatty acids. The diet was energy restricted (1600 kcal/day) for the first eight weeks and balanced for the following four weeks. At the end of the trial, participants had lost an average of 5.2 kg (11 lbs). Women on the HP diet lost significantly more fat (5.3 versus 2.8 kg) than did women on the LP diet and the fat loss was particularly pronounced in the abdominal area. Both men and women experienced a 5.7 per cent (average) reduction in LDL ("bad") cholesterol on the HP diet as compared to only a 2.7 per cent reduction on the LP diet. Total cholesterol levels also declined significantly more in the HP group than in the LP group. Both groups also saw a significant drop in fasting and 2-hour insulin concentrations. The researchers conclude that the high protein diet is a valid choice for patients with type 2 diabetes and may actually reduce their risk of cardiovascular disease by 10 per cent. Parker, Barbara, et al. Effect of a high-protein, high-monounsaturated fat weight loss diet on glycemic control and lipid levels in type 2 diabetes. Diabetes Care, Vol. 25, March 2002, pp. 425-30 IRRITABLE BOWEL SYNDROME AND CELIAC DISEASE SHEFFIELD, UNITED KINGDOM. It is estimated that as many as 15 per cent of all people in Western societies suffer from irritable bowel syndrome (IBS). IBS is characterized by abdominal pain, altered bowel movements (constipation or diarrhea) and abdominal bloating, fullness or swelling. Researchers at the University of Sheffield Medical School have found that the prevalence of celiac disease (a condition in which the small intestine fails to digest and absorb food) is seven times higher among IBS patients than among controls. Their study involved 300 patients newly diagnosed with IBS and 300 healthy controls. They found that about 75 per cent of the patients had been correctly diagnosed as having IBS; the remainder had either celiac disease (6 per cent) or some other organic abnormality such as diverticulosis (13 per cent). The researchers recommend that IBS patients be routinely checked for the presence of celiac disease. Sanders, David S, et al. Association of adult celiac disease with irritable bowel syndrome: a case-control study in patients fulfilling ROME II criteria referred to secondary care. The Lancet, Vol. 358, November 3, 2001, pp. 1504-08

"The Schwarzbein Principle" by Diana Schwarzbein, M.D. Dr. Schwarzbein takes a factual and scientific look at fad diets including the low-fat diets and low-no carb diets. From low-fat diets creating Type II Diabetics or resulting in weight gain to no-carb diets creating excessive ketones which damages metabolism, Dr. Schwarzbein takes a look at why the body reacts the way it does to the food we put in it or don't put in it. This is a practical and moderate "non fad" approach to food and eating and worth reading for those interested in why proper metabolism and hormones are integral to our well-being. Examples: Claim: Eating fat and cholesterol adversely affects your cholesterol profile and puts you at risk for heart attacks. Fact: Eating a low-fat diet causes heart attacks. High insulin levels produced by a low-fat, high carbohydrate diet result in plaqueing of the arteries, because insulin directs all the biochemical processes that lead to plaque formation in arteries. ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Claim: A low-fat, high-carbohydrate diet, which is the current "standard of care" treatment for diabetes, makes patients healthier. Fact: Long-term low fat, high carbohydrate dieting leads to insulin resistance and if continued, results in Types II diabetes. This same diet makes diabetics sicker. ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Claim: Eating fat causes cancer. Low-fat diets prevent cancer. Fact: Low fat diets high in carbohydrates cause insulin levels to rise too high which is a major player in cancer-cell replication. Dietary fat lowers insulin levels. Dietary fat is also essential for hormone production, which in turn is essential for a healthy immune system. In other words, dietary fat provides the immune system with key components that fight the growth of cancer cells. ––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– "The fad diet that requires a drastic reduction in carbohydrate and an equally extreme increase in proteins and fat causes excessive ketones (a breakdown product of fat metabolism). This diet is extremely dangerous because your body is breaking down healthy tissues and causing imbalances within your system. There is no "fast-and-healthy" way to lose body fat. Body fat is lost when your metabolism uses your stored fat tissue as energy. If you want to lose body fat you must first heal your metabolism. As your metabolism heals, it becomes more efficient at burning fat." The Schwarzbein Principle will take you step by step how this can be acheived.

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