What is Neurofeedback ? Why isn't the NeurOptimal ?

To start, let's explain to my Grandma what neurofeedback is (because I know you read me Grandma).

First of all, neurofeedback is neuro-feedback. In scientific French, "feedback" means "retrocontrol", which should not speak to you. In common French, a "feedback" is a "return". For example, in my archery practice, my "return" is visual: it is the position of my arrow as a target. If she's to the left of the target, I know I have to aim to the right for the next one. As a result, "neuro-feedback" is a return of brain activity.

And for that, it is ultra-simple: we record the activity of your brain with electrodes placed on your skull (passive recording electrodes, we do not inject electricity, eh) and this activity is represented as a curve on the screen continuously and in real time.

If this activity is abnormally high, or abnormally low: the patient will see it on the screen to learn how to normalize it and will have a real-time feedback of this new activity on the screen, allowing him to correct himself. And an easy way to do that is to pause a video, for example, to warn you that this is not good. As soon as the video starts again, it's okay this time.

With practice, you won't even need the "return" to correct yourself, it will be automatic. In the same way as now, even with my eyes closed, I can shoot with a bow and arrow. After a lot (a lot) training, I no longer need visual feedback, my position is enough to know where the arrow will go (rarely where I want, let's be honest.....). BINGO! You are now an expert in Neurofeedback.

Almost. We do not quite record the activity of your brain, but the electric field emitted by your cortical neurons, and this is not a curve, but a frequency histogram after a Fourier transformation.... But, well, after all, it doesn't matter. Actually, what I like about neurofeedback is that this learning practice is based on a concept that I know well and that was part of my doctoral research topic: operant conditioning. Operant conditioning is very simple.

The operant conditioning is interested in the learning from which an action results and takes into account the consequences of the latter making more or less likely the reproduction of the said behaviour. (...) Human conduct is conditioned by the consequences of the behaviour, before it intervenes. Added to this is the subject's response, which is voluntary, because motivated to be rewarded.

There is a whole body of scientific literature on this operant conditioning (for example, it is it, which explains superstitions, fascinating, isn't it?). And for an effective conditioning to work, there are several key steps to put in place. I did it for years with mice, now I can do it on the Human (oops, an excess of curiosity...)!

First of all, we start with a shaping step: we will reinforce behaviours close to the target behaviour. For example, when my mouse approached the pedal, it was rewarded. Then one day, it will get so close, it will just happen to press it, and again BAM rewards! So I had broken down a complex action (getting close to the pedal and then pressing it) into two simple rewarded actions, so that the mouse remained motivated even if its behavior was not quite perfect. In neurofeedback, we do the same: we will play the video even if you are not perfect, because it is simpler at the beginning and little by little, you will improve.

Then, it's all very well that my mouse can press a pedal in a square box, but if the conditions change (for example when it will be in its Lamborghini), my mouse must learn to also press the pedal in this new box car. This is the generalization phase. And this is the bulk of the neurofeedback practitioner's work. Learning to control your brain in the office is easy, but little by little, we will have to be creative to mimic situations in your daily life - which pose problems - so that in these situations you can generalize your learning in the office.

So, as you can imagine, neurofeedback is about learning, active work and, in fact, it's a bit like the current debate about school. For a student to learn well, it is necessary:

• to be attentive: so manage to captivate and channel it. This could be a video he likes, for example.
• to be active: we learn a task better if we do it ourselves than if we are passive in listening to a teacher explain it to us.
• that he gets a return: a bit like in neurofeedback! ;-)
• that he has time to consolidate the acquis.

In education science, it is estimated that it is necessary to repeat at least 8 times information spaced at least 2 days apart, for this information to be acquired. And from my experience as a teacher, you're nice when you say 8 times....

And that's the NeurOptimal problem. The person is not asked to be attentive to the task. Or even be the engine of learning, just sit and wait. There is a return, but the scientific community does not know how it is given: "secret of manufacture", "private algorithm" and so on (this thing of which I do not know everything will go on my head, eh).... And the consolidation phase does not exist: NeurOptimal marketing is 8-10 sessions maximum. And the practitioner does nothing: he does not help generalization! Especially since in neurofeedback, we take the time to evaluate the patient (record all brain activity simultaneously with 19 electrodes, to discern the regions that need to work the most) and target specific regions for training (frontal, on the sides, at the back of the skull...), while NeurOptimal sticks two electrodes, always at the same place, for all patients.... Hello the customization of the treatment....

"But it works, NeurOptimal!", will tell me the fervent defenders of this commercial material. Let's be honest, yeah, it works. I will not deny that NeurOptimal has a beneficial effect in the short term. Except that it is not related to the training by the NeurOptimal, but to a nice placebo effect (this video of Mr Sam is brilliant of pedagogy to understand homeopathy): care, waiting of the patient, questioning, attention to new details of life.... In short, NeurOptimal is a bit like modern homeopathy. And homeopathy works well for a few days - the time the body heals itself - but if there is really a problem: it's time to switch to medical treatment (by the way, "medical treatment" = treatment that has more effect than the placebo effect alone, because the placebo effect is a real physiological process that has effect).

And in neurofeedback, I'm not going to lie to you: the first sessions, it's time for your placebo effect to fade. The real work starts once it gets boring, you're a little less in the discovery and excitement of the beginning. A little like a young couple doped with hormones in the first few months, who after a few years, when the hormones have fallen back, find themselves forced to do a job (concessions) so that the couple can hold on. Neurofeedback is waiting for the end of this placebo effect to start the real work and for your brain to start making concessions because you leave it no choice.

We know what neurofeedback is, but what's it for?

Well, it's useful for a lot of things, but it's not a miracle therapy. The longer the learning process, the greater the progress. By 2016 (two years ago, yes), neurofeedback was as effective (and more specific with fewer side effects) as chemical treatments for ADHD. Its effectiveness is not in doubt for anxiety, depressive disorders, headaches, hypertension, or erectile dysfunction (no kidding, huh).

What do they have in common? Everything is based on attention, emotional control or motor control.... Who are the targets of neurofeedback training. Other less square studies seem to give the interpretation that neurofeedback would also be effective for drug addiction problems, for autistic spectrum disorder (still a bit of my thesis!), insomnia, or improving sports performance (especially for concentration in Archers, there are beautiful studies!)... in short, it is a very vast field of research, more than 1,000 studies after Pubmed which is the bible for scientists (spolier : 0 study on NeurOptimal).

This article is already very long, in the next few days, I will tell you about a session, the group of neurofeedback practitioners that is being formed in Paris, the Francophone Association of Biofeedback and Neurofeedback that is being set up (and where I am on the board of directors), the material that I am developing (the time to find guinea pigs to refine the recording, because yes, I dig deeper into neurofeedback more than necessary to develop my own tools, validated according to my scientific requirements) and probably also into NeurOptimal's communication, because you know my passion for Zététique and the Critical Spirit (see my article just below) and you will see that between NeurOptimal and the fake news, there are not many differences.

So feel free to come back, comment if you see any typos, and come back soon! :-)