Neurofeedback for Concussions II

charles barkley

By Siegfried Othmer, PhD

charles barkleyBasketball phenom Charles Barkley urged parents years ago not to let their children play football. The hazard of injury was too great. Now Dr. Bennet Omalu has issued the same caution. He delivers an even stronger message: Children should not be allowed to play high-impact contact sports until they are old enough to make their own decisions—the age of maturity in each state.

For the time being, however, parents are still confronted with children who insist on playing the game, and it’s not yet against the law to allow them to do so. What is to be done? In the following, we’ll scope the problem and suggest a remedy. First of all, the issue is not Chronic Traumatic Encephalopathy (CTE). The main issue to be concerned about is subtle functional loss that comes with repeated minor brain insults. Fortunately, the brain recovers from these minor insults nicely if it has the opportunity to do so. If the insults pile up in short succession, on the other hand, the subtle injury compounds and full recovery may be inhibited.

The best that can be done for someone at risk is to break the chain of compound injury. One must either allow for recovery to occur naturally after minor brain insults, or one must arrange for recovery to be accelerated—-with neurofeedback. The functional loss can initially be quite subtle, however. How does one know? That requires testing.

A child at risk of a football injury should have his performance benchmarked before exposure to risk, and he should be tested again prior to resuming play after even minor injury. A suitable test is what is known as a Continuous Performance Test (CPT). This is a choice reaction time test done under time pressure. The testee is supposed to respond as rapidly as possible. We use the QIKtest for this purpose, which offers up-to-date norms. The test requires less than half an hour.

Since our concern is mainly about compound injury, we also know to ask about the quality of brain function in the child that is being sent out onto the playing field for the first time. Did that child suffer brain trauma at birth, for example? Did he suffer minor head injuries in the early years? That matters a great deal because there may well be a latent vulnerability in such a child. So what we should really be focusing on is what can be done ahead of time to minimize the chance of injury in the first place. A child going out for sports should think not only about training in the skills of the sport but also about training the brain toward higher performance and greater resilience. This holds particularly for high-impact sports. We are persuaded that we know how to buffer the brain against injury with neurofeedback. We do so by resolving the consequences of prior injuries.

In the real world, people often do not recall their own history of minor head traumas. They are forgotten, or were never registered as such in the first place. Realistically, it is best to assume that most children experienced such events even if they did not suffer from them or even remember them. So it is prudent to give every child involved in sports, and particularly those involved in high-impact sports, the opportunity to first train their brains before they place them at additional risk.

We are headed for a time in sports where competitors would not think about competing without having done some brain exercise ahead of time. Musicians are already there, effectively, because the very act of practicing one’s musical skills is also a kind of brain training at the same time. That doesn’t cover all the bases, but it helps. Sports people need to do something different. They need to train their brains explicitly with neurofeedback. And in the case of high-impact sports, the training should be done routinely. It should be considered to be part of sports training. In the real world, one is not likely to notice subtle deficits that might result from hits to the head. But more than that, most participants in sports don’t even want to notice! They are not wimps, after all. They don’t want to dwell on the knocks that they are taking. They’re tough.

So when it comes to risk management for minor head injury, this is certainly going to be much more of a concern for the parents than for the child. The child likely still thinks he’s immortal. The appeal of neurofeedback for the child is the opportunity to improve function rather than the chance to avoid the consequences of an injury. And that’s fine. What’s drawing interest in neurofeedback among sports people is the chance to take one’s skills to another level. Raising the bar against brain insults is just a fringe benefit. And just as the musician never ceases to gain from further practice, the athlete will continue to gain from doing neurofeedback. So neurofeedback exercise should come to be regarded as a routine part of sports training.

Interestingly, what happens in neurofeedback training is that the brain actually gets better at it over time. Initially neurofeedback is a novel experience for the brain as much as for the person involved, and it has to do some learning as well. The neurofeedback can therefore be thought of as skill learning on two levels. The brain is learning better self-regulation while it is also learning how to do neurofeedback.

Siegfried Othmer, PhD

P.S. After a more serious brain injury that involves lingering deficits, there is really no alternative to neurofeedback as an aid in the recovery of function, as we have said before.

In that regard, see the following:

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