good evening everybody it's Monday the 18th of September you're here at neuro at night tonight Richard's going to be talking about some of the research she's done looking at asymmetry so this would be a well for me personally a very interesting topic um I I like that phase that part of the mapping system and looking at uh the asymmetries because it can oftentimes be very uh educational and tell us a lot about particular patients so that's the plan for tonight it will be recorded I understand and then posted so um I think are we going to keep Richard are you going to keep people on uh mutant and then unmute them towards the end or you want to ask questions as you go oh um I unmuted them but uh they can ask questions as we go if they have a burning question all right well then it's all yours take it away okay make sure I get people can see can you see that frontal Alpha asymmetry neurofeedback yada yada got it yeah it is yeah yeah they're Italian researchers but they did pretty good it was it's a little tough in spots but it's the English pretty good oh yeah in fact I find that sometimes foreign writers science writers are Rife better than the um uh Western writers because they they keep it simple because it's not their their primary language and they it's a lot it makes a lot more sense and all these people trying to do it make exotic inflated catech um verbiage you know to impress everyone yeah well we're I'm going to talk about asymmetry um uh since I'm updating the web course I have to do a total search of all research on topics uh all the different things disorders and so forth because we've got to have the latest in in the web course I mean relatively late it doesn't have to be the latest latest because uh it's you're learning the basics and a lot of the basics were set down 20 30 years ago um but uh people like to see the latest on the protocol section and it's really um worth it to keep track of the latest protocols particularly for us um because it's an incredibly supportive of what we do in new mind we do um asymmetry protocols and you all know that um that's what they are primarily and we there's a very specific reason we do them um because uh uh some time ago in the 90s um of everybody in neurofeedback took an interest in Rosenfeld and bears research about asymmetry and it was based on Research by Davidson done in the 80s starting with babies but he looked at affect and Alpha asymmetry and that was because um Alpha was considered a sign that the brain was idling and so it wasn't active whereas beta was active and and they thought well you know that's a good way to check on what areas are most active in the brain and the thought was that left hemisphere when it's active it's engaged in approach an external um activity and um the right hemisphere is less active in that state well when a baby withdraws and becomes less active there's more Alpha on the left and less beta and so the alpha asymmetry is reversed and that's a withdrawal state and Davidson related that to depression and so we have Rosenfeld and Bears um research and it wasn't big groups or anything like that but it was good research and they established that indeed it looked like if we have if we're just looking at Alpha asymmetry we can reduce depression by training the asymmetry Alpha asymmetry in the front of the brain around the same time the awesomers had developed protocols too you know and everybody had their set of protocols and their followers it's not much different than today and the authors were doing beta up which um stimulated the left hemisphere or SMR up to reduce the activity so you could do that on either side beta up or SMR up and left or on the right to speed up or slow down the brain that was kind of the way they thought about it it was the an arousal model and they trained on the left a certain amount on the right a certain amount depending on the symptoms and everything was done that way well everybody started to grow up with qeg and moved beyond that because that was the new um that was the new thing and it would solve all our problems you know there's always a new thing that's going to solve all your problems whether it's Loretta or z-score or network or God knows what else um and that's good we want people exploring new things but uh people tend to go overboard a lot of times I was talking to uh Elsa and Tom clora at uh isnr and ISR and we were having a discussion about the topic of asymmetry and a lot of other things and um Elsa had said well you know the protocol that um Rosenfeld came up with was um was patented and you had to pay and Bob craigo joined the conversation he's an oldie but a goodie from Tucson one of the most um pioneering people I know in the field he tried out everything um he said yeah that's kind of a bummer why would he do that now we can't explore it in the clinic we have to pay him every time we use it and Tom said well wait a second you know that's just log Alpha left I'm right minus all log um right divided by 2 and it's an equation and you know that's kind of tough anyways for your average clinician to figure out and uh Elsa said yeah it is definitely you don't have to do that you can just train Alpha down on the left and Alpha up on the right and she says you know come come to my workshop and you'll see so I went to the workshop and Elsa had a student a grad student who could make herself Cry by focusing on sad images and they had a big meter up on the stage and she made that needle go left or right on asymmetry just by focusing very intensely on sad thoughts and happy thoughts and they had somebody else doing that too that really amazed me that impressed me not only had the theory some research and I could see it happening um but but I had to reconcile that with beta and SMR and I went to um secret and I said you know what do you think about two channel training um valdine Brown's been proposing you're gonna do beta left SMR on right at the same time and maybe you one you could even involve asymmetry training in alpha or something like that and Siegfried I love the uh he said I love the idea that way you could see exactly what was going on in each image figure why you did it he said but I don't think we're going to go there we have this low this infolo thing that we're much more excited about and and he just said good luck with that asymmetry thing so I started experimenting in um my clinics I had five around the country in the United States in the 90s and I was running all of them and doing the brain mapping and interpreting them and we experimented with that a lot and we came up with a uh reading experiments for the clients and and I reported them at the meetings and um I came up with this more detailed Paradigm and um I called it uh uh by hemispheric compensatory model of neurofeedback training and I was really into this um and uh Tom was not interested because he was all excited about um uh s s Loretto a time we only had Loretta but and uh full cap training and he wanted to go there and and because he's an engineer and that was the most complicated way to do it and that excited him and he thought that must have tremendous power that's that'll be it the more places we can train the more powerful it would be well that was just a theory and it didn't necessarily jibe with my understanding of the brain so we had slightly different all of us had slightly different models in our head and he went off on that but I wrote it up and uh um it was a chapter in in a handbook of clinical qeg Neurotherapy edited by Tom clora and John Frederick who and it's a lot of my writing too he's great um and I'm I put down the basics for that model so you can go to that book and look at that chapter and you can see everything I'm about to tell you that these guys somewhat explored something like 20 years later now um a lot of the stuff we've already we take for granted and we do all the time if you're doing new mind but outside of us every a lot of every well the majority of people are still doing single Channel protocols and a small percentage are doing z-score which is really complex stuff and a lot of a lot of clinicians it doesn't really make a lot of sense them it's it's uh really technical um so a lot of people are interested in what we're doing because it's technical but not too Technical and it really works and basic um so this is this research not just this paper but all the papers in the last 10 years have been incredibly supportive and borne out this Theory of compensatory training and they even use the term some and some of the research you're using the terms reorganization and normalization I mean they're actually using the terminology and the concepts which make sense because they're researchers and that's what the neuroimaging people those are the terms they were using that's why I picked them up specifically from the researchers at Harvard because um I was excited about what they were doing again it was supportive of uh some of the theories I had about the brain and what's going on but I had the theory about asymmetry in my mind I liked it because the MRI showed activation and deactivation and they were doing a lot of amazing stuff with that and you could see it confirmed by this high-end highly funded research and EEG Alpha and beta were similar to activation and deactivation now everybody's made a mistake because if you look at the actual registration studies between qeg and fmri of the two in particular um Rosa at Al is one of the defendant one you can see that Delta and Theta compared to Alpha Delta and Alpha's active I mean beta is activating but it's Delta and Theta which are deactivating um pretty much now you can include Alpha but it really is a complex algorithm which we couldn't it couldn't be done right now with neurofeedback in the clinics but basically Delta and Theta is close enough and that's what it says uh that's what it's all about on your your when you train it says Delta and Theta is Activation so act the word activation means how much Delta and Theta compared to Beta uh and that's an algorithm which is very close to perfusion and glycogen utilization glucose and oxygen in the brain yeah and if I'm getting ahead of you just say so so when you're looking at a map if you had a map where you had dominant data on the right you know the anxiety if you will um and then you had dominant your Delta was dominant on the right would that be deactivating that data because that's what it does uh you would have a con you would have a conflict yeah you can have both at the same time some of the some of the um cell assemblies are um producing uh beta and some of them are producing excess Delta so you have a complex mix and it's really hard to figure out what's going on when that's happening but if you have normal levels of Delta and beta beta would be activating only but you could have a conflict okay thank you and that's not always obvious and it's hard to understand I remember running into that question and having to research it for years to get an answer the main thing that it comes down to is um alphas and idling and it's not totally related to uh activation but it's enough so that it's uh it shows an effect when there's an asymmetry in the brain so um as it turns out when all is said and done how effective is this concept of alpha asymmetry um in you know did I chase uh a non-existent rabbit down the hall well no uh there are eight RCT studies on depression and 14 are CT studies on anxiety that involve asymmetry in the last 10 years that's almost 20 studies these are re uh random controlled designs um so people are randomly assigned to different um groups and uh and then they're usually trained with Sham and real neural feedback now there's all of them every design has every study has slightly different way of breaking the groups down but no matter what how they do it this is considered the highest quality design and all those Studies have um 25 to 75 some have a little bit more people in the studies that's a good study especially when you get up close to 70. the number of people if the sampling is done right is an approximate representative of the population and it's pretty close according to something called the central limit theorem in statistics so 20 studies and they and some of these are um the reliability is incredible because they're replicating in detail other studies and sometimes they're replicating but with variation to find out more so when you when you look at this and you think about um MRI studies and they find a group of 16 people or something and they do an MRI study and they find something really interesting it suddenly published you know in in all the journals and it hits the news and the farmer big Pharma goes after it and everybody's excited it's a gold rush that's on when you do it with the EEG it's like you know people yawn well we'll have to wait and see gotta have more studies we have in neural feedback over 20 studies in the last 10 years robust well done RCT studies that show efficacy for anxiety and depression reduction with asymmetry training now let that sink and that's about as good as it gets I mean you could do 200 people or 100 people would be perfect but some of these Studies have 70. I mean it's close enough and they're really really good studies so don't ever let somebody you know brow beat you about the efficacy of neurofeedback on anxiety and depression at least because it's there I mean it's ridiculous that anybody would challenge it and it's really solid and asymmetry is really good because you know what a lot of these Studies have as little as five sessions and show significant change in the EEG using pre-post cues back inventories Hamilton inventories and cortisol levels sometimes other things on blood samples I mean it's really good stuff I was impressed I had no idea and their International Studies of course that's how we got them because in the U.S you know it's where we invented neurofeedback it's uh well let's move on you know and everybody in the rest of the world saying like hold on this is amazing stuff so thank good for all the other countries whether it's Taiwan or Spain or Italy I mean they're doing great stuff for us in the field so that's cool now um this stuff this particular one by Manila at Al it was from 2017. and there's a uh 32 in this in the end size of the group and they only use five sessions uh to do uh Alpha um training they did asymmetry training like a lot of other people that um you know F4 minus F3 over 2 and it's usually log F3 and F4 so they're all doing that type of protocol and some people did other ones where they didn't but it's mostly all that and what's interesting is they this group used um asymmetry training to determine if they could reduce anxiety well traditionally it was all depression and there were eight studies done in RCT you know on depression so I found it amazing that 14 studies and this is the one of the latest well no not the least there's three later ones but it's one of the best ones because they said well we're doing asymmetry training but nobody's really checked out um the uh the fact that um what's happening specifically to Alpha and maybe even beta when you do asymmetry training does alpha in the left hemisphere go down or does it stay the same when you train the difference does alpha in the right hemisphere go up or does it just go up a little and left goes down I mean everybody's thinking asymmetry well left goes down a little right goes up that's probably how it works well they found that training on the equation that Alpha stayed the same on the left but it went up on the right and that they found very fascinating um and this is where they discussed um frontal Alpha power and where it came from the balance between activity left and right prefrontal um is associated and I just picked out some statements in here that are interesting five sessions of frontal Alpha neurofeedback using rewarding and non-rewarding tones okay kind of Clues you into what's going on they were concerned because previous studies observed modifications driven by changes in our power at right left and both frontal sites but they didn't check out specifically what the um Alpha was doing just that there was a difference in in the in the algorithm so they did bipolar Montage which it breaks from the traditional protocol and they um did Alpha F3 and reference it to CZ which which is the traditional reference for Alpha asymmetry although there are studies done with Alpha length years and uh Alpha 4 CC and then Alpha FZ to CZ so they have three bipolar montages they're training up Alpha on the right and I mean I'm not well let me amend that they take F3 CZ and f4zc CZ compute the difference and then give you an image on the screen and a tone so you can focus on changing both and then they had another group where they did only FC Alpha up and for control group and that was their comparison group so um they did five minutes and what's different about these thing is they do trials five minute um I believe it's five minutes and everybody does different length of Trials and they rest them for a minute and they do another and they do 30 minutes of it or 50 minutes of it um this is what the researchers are doing because a lot of them um want to be very specific and that's you know how are they doing in the first part of the trial of the session versus the second trellis session third they like to break it down to controllable segments so they can compare everything it's just what researchers do um and the difference uh was left to right to left F4 minus F3 they had visual feedback and um uh the FC people had visual feedback to the same visual feedback only it was Alpha increasing um let's see if we can find that they should they tell they sell F 3 and F4 are log transfer formed uh so it's still that traditional method um and they find that uh it was effective that with back inventories they looked at the difference they also um some of these studies do um uh computerized performance tests cognitive tests to see if cognition is changed by Alpha asymmetry training and what they find is cognition is incredibly improved by symmetry training and that supports our our stance that cognitive functions are dependent upon stable affect because it's the last stage in evolution in humans the emotional brain is older and if it's not working right then the cognitive brain is working right it's kind of like that statement if my if the mama ain't happy ain't nobody happy the emotional brain ain't right then the thinking brain ain't right and um it gives us a good reason to always do uh affect train training anxiety and depression getting that out of the way to really determine how much they actually need cognitive training it also sheds light on the fact that that um all these people are saying oh add is a cognitive issue when really a lot of it's emotional anxiety and depression and that was my experience when I measured kids and adults and the clinic I was in um you really have to go over the emotional stuff you have to get that balance out before you know what really is the deficit because that will destabilize the whole cortical function um and they they they looked at it and they said um they talked about Davidson there and they said all participants who underwent frontal Alpha acmg training showed both a decrease in right frontal activity and a parallel reduction in subjective measures of negative affect and anxiety so there was an increase in right but there wasn't a decrease in um uh the left side and they noted that and they thought it was very interesting um and they said maybe you should just train the alpha down on the left side since it doesn't go down because there was no improvement in positive affect you know we didn't get a positive Improvement in affect and they thought that was because the alpha didn't go down in the left now remember that because we're going to talk about that in a minute what what do you do should you get that Alpha down which doesn't go down and how should you do it should train Alpha down or what maybe beta up well researchers thought about that and other ones said anxiety symptoms have been found to be associated with increased right to left frontal activity as measured in Alpha asymmetry also this cortical pattern has been related to heightened negative affect with withdrawal tendencies um that's an interesting statement so um there's a problem here in that some some of the past Studies have found that you can get some negativity out of this you know even though it calms people down and we've noticed that um when you do asymmetry people do get kind of negative for a while and that's an interesting statement too and the other studies shed light on that as well we have hypothesize that in order to impact on clinical depression neurofeedback should be aimed at increasing left compared to right frontal activity thus stimulating approach and avoidance so they're saying oh well maybe also we could do beta up or something like that to increase activity to get rid of depression this was a new idea for them meanwhile you've been doing this in new mine for 15 years if you've been around that long with us at the same time the possibility that clinically depressed patients would benefit from alpha asymmetry cannot be rolled out well that's an odd statement they're so impressed by what anxiety has happened and how little affected depression because the alpha didn't go down and they're saying well if you if you increased it on the left the activity and did this then maybe you could have the best of both worlds for instance in depressed individuals the same training could decrease Alpha at the left and right sides in contrast from the pattern observed in our sample thus being beneficial in this regard my computer just blanked out come back ah it's back am I can you hear me Rob yeah we hear you and uh oh your slide was up and then you said you're it blacked out it just went out for a minute and now we're back I can hear you yeah my whole my whole screen and computer goes out I've got to get a new one yeah I've never seen that happen it only happens with go to meaning in particularly in a number of study supportive motion that the notion that Alpha and beta bands are inversely correlated with activation of the underlying neural structure as a measure as measured by functional resonance imaging both at rest they're saying well they might be inverse you train Alpha up on the left Alpha down on the right Alpha down on the left Alpha up hey that might work we should try that and get experiments on it and I'm sitting here thinking like we should try that we've been doing that for 15 years with with thousands of over a hundred thousand people and their new mind is trained using that protocol nurses saying hey we got an idea from this research we could do it this way which is interesting so they're proposing what we've what we've done now real quick this time is passing I just want to look at this other piece of research and um Wang at L and this is from 2019 and he had 87 subjects yes so um 87 and that's a realistic significant sample I mean you're going to get good statistical quality out of that if it's done right and it's an RCT training and they did log F4 minus log F3 in one group but they had another group and they did P3 P4 High beta down and these both were done linked ears not reference to CZ and he had significant results again using things like the back I think he used the Beck and Hamilton's too and this I don't recall exactly I've got 20 of these floating around my head they swirl together at a certain point but yeah it was a bit significant greases on depression and anxiety scores so he found Alpha asymmetry with linked ears got anxiety and depression were the less that you just saw CZ referenced only got improvements and anxiety that's a very interesting situation and deserves more thought and research but Wang is even closer to what we're doing so um linkediers is valid and in fact Richie Davidson in his original research piece said that he had done some linked ears and it was effective too you know and it was like two lines in the research paper and everybody seemed to ignore that those lines but I didn't and Tom didn't um so uh this is uh the same thing but they did the beta down in one of the control groups and guess what they found data down High beta down at p3p4 reduced depression and anxiety what what we used to do alpha up training and beta down training at pz and P4 all the time and when Rob came in we were doing protocols like that when Rob and I first got together it's around 2005 2006. these were among the many protocols that people were using and we were getting good results in foreign we just kind of went for the asymmetry because it was it got so many factors in one shot it did so much like they found in this research F4 and F3 with Alpha on both and linkediers and you could get Alpha you could get anxiety and depression at the same time that was incredible and uh what if you did beta up on the left and uh something down on the right you could you could add more things happening at once you're doing multiple protocols at once what you're doing is you're controlling the activation by controlling Alpha and beta you're controlling enough of the activation in the hemisphere and a fine in A fine grain level that you can get amazing results with anxiety and depression and add another protocol or two in on top of it depending on on how you construct them so you can see why I went um uh anterior posterior because this is posterior beta and the alpha anterior Alpha you can see y i did asymmetry all anterior posterior and use quadrant Theory to develop these protocols and the research is incredibly supportive and not 10 sessions you know five sessions on these things there was one guy who did one session and found significant I have a problem with that but it was just post session it wasn't you know pre-post a long series of sessions like for um 20 sessions or 30 sessions so this is this is all pretty neat stuff that it comes down to um make it even more complicated Lou at L 2022 uh and uh found that with 33 subjects he could train SMR c c at C3 for six sessions over three weeks and get relief from anxiety so SMR is similar to Alpha you train it on the left and it doesn't produce excess Alpha but just reduces activation enough um relieve anxiety on the left side so SMR has a very interesting way of controlling arousal too and so the optimers were right and he proved it that beta up on the left SMR off on the right or vice versa you are controlling the level of arousal but you are also controlling the level of pers perfusion and activation in the brain and that's kind of neat um another group of Cheon at Al in 2016 did beta up at F3 I think so beta up and F3 and this time activating beta in people who were depressed at and he did that to correct for isometry he just did made up La he said well if I just activate the left side the right should follow and this is all getting at Dynamics in a brain system and these people are thinking the same same thing sometimes and he also trained Alpha down at PC get that well we know Alpha down with traumatized people um calms them down so if you have people who are depressed because of trauma and they didn't test for that it would be it would work but in a sense he's doing two protocols at the same time he's doing beta up at F3 like we heard and he's doing um Alpha down and pz that's like Nicholson and that's probably where he got the idea because I don't know anybody else who turned Alpha down at PC oh well I do no that's not true uh they were training SMR up at PC to reduce rental Alpha according to Jake gunkelman and getting good results but we haven't seen Alpha down except for Ross at Al which is around earlier than this and Nicholson later on 21 22 23 on Alpha down and he demonstrated clearly with MRI that that works when you use EEG so he was kind of a fortunate mix but you can do two protocols at once so you begin to see how simple this can be or also how complex with asymmetry and all doing variations on Alpha beta and SMR left versus right and if you look at the new mind protocol that's all they're about and they're done by um it it decides what to do with the protocol you know which protocol to do where by looking at the statistical abnormality in five neurometric dimensions of each pair of homologous sites in the brain so these people have been validating everything we've been doing but of course we were just following the MRI research from the beginning anyways and following the research on networks and following the research on non-linear systems in the brain and again while Dean Brown played into this to a certain degree this is what valdene Brown's doing but he's only doing it C3 C4 we're telling you you've got to move around more and he's using a more complex algorithm to do it we're just doing you know one thing one side down one side up with different frequencies to control for symmetry so you uh the linked ears works beta up left or Alpha down activates the left hemisphere beta down or Alpha up columns down the right any combination should work but it is important what exactly the combination is that's determined statistic by the quadrant rule and it's important uh to have statistical analysis to determine where's the weakest homologous site where this is going to make the biggest difference because you can do it front or back so that's basically my presentation it's kind of loose but um because I'm learning this stuff from the research of the past 10 years this is pretty recent for me um and I haven't totally digested it in terms of what's the next step or the implications you know for new mind and what we're doing but it's certainly uh pairs out that we're doing is extremely well validated extremely robust which I'm I believe based on the research but I'm relieved to see so much supporting it um that's why the protocols works so well so I thought you all might find all those things interesting I don't know I found them stunning and um opened up two doors think of two protocols at once and different things you could do and there's many more these pieces I just highlighted some of them and went through two and one in particular in detail anybody have a comment or question my comment would be really supports a lot of the uh my biases after working for years with asymmetry protocols it's one of the reasons when I'm working with anxiety for example I love working in the back and using asymmetry protocols because they tend to work and I tend to go five sessions you know with each protocol and then if I'm mentoring somebody say look it if something works really well stay the course and do 10 of them you know yeah but working p3p4 is great or 102 is great for depression F3 F4 and I even like fp1 fp2 because of the mood regulation stuff um so uh and when I combine those you know a 102 p3p4 into the four Channel they're highly effective if I combine F3 F4 F1 and P2 together into a four Channel with depression they're highly effective I've had great Visions that's new I mean that's relatively Innovative and um and that you're probably right based on what we've seen you know and you've you experience it as really effective and probably yeah I've had people who were never left the house and were Cutters using that protocol for depression and among the exact opposite started driving their car went to visit family in another town clean the house out clean the garage out put the vacuum when they start cleaning up with things you know or you're creating order within creates order without yeah yeah they clean up the Messes in your life so I enjoyed it simply because it really reinforces a lot of the way I'd like to work with those disorders and um fits for me very well yeah and this gives you an overview a quick overview this all of this stuff will be in the updated web course so you don't have to go anywhere you get you all have taken the web course more or most of you have and these updates and all this information will be in the updated version when it comes out so you get to read it all again find all the latest stuff that's a good thing about it every four or five years we updated some of it may be uh not clear to you but we'll be going over and over in Lynch and learns going forward bringing it up yeah if you have a question throw it out on the list serve or bring it to a lunch and learn and we'll definitely try to get those questions answered because I mean when you think about the work we do I mean and as much as we've talked about things even like uh ADD and ADHD and other disorders you get people sleeping better and get that anxiety down and their lives begin to improve in a variety of ways okay well it's 7 59. yep all right everybody we'll see you uh Wednesday uh we have a uh no uh set agenda for Wednesday so if you have a particular topic throw it along if you have a map shoot it along and we'll see you Wednesday okay see all then bye everybody