Neurofeedback Could Fight Depression–or Just Empty Your Wallet

Some brain-training companies are overselling the data behind EEG analysis.

Neurocores brain-training stations.

Courtesy Neurocore

Things went sideways in the brain room.

Neurocore LLC’s newest office, housed in a strip mall in Palm Beach Gardens, Fla., looks like an Apple Store crossed with an outpatient clinic. The company, owned in part by U.S. Education Secretary Betsy DeVos, is one of the nation’s largest providers of “neurofeedback,” part of the fast-growing $2 billion brain-training market. Neurocore says technicians at its nine offices in Florida and Michigan can analyze the electrical impulses in your head to improve cognitive performance, diagnose attention deficit hyperactivity disorder, and provide a “lasting solution” for depression with a series of 40-minute training sessions (30 for $2,200). For what it’s worth, my $250 initial assessment had at least one big glitch.

In a carpeted exam room, a technician stretched a blue cap over my head and attached 19 electrodes capable of recording an electroencephalogram (EEG), essentially a map of brain activity. With my skull coated in a cool gel, I concentrated on being calm (eyes closed), then focused (staring at a fixed point), as directed by a second technician. About a half-hour later, a clinical specialist presented the EEG results and said the assessment had revealed certain “excesses” and “deficiencies” compared with the average 35-year-old. “During the day, you’re a little drowsy,” she said, referring to a pool of blue in one region of the brain. Elsewhere, bright blotches of red and orange meant trouble focusing.

Then we went to the brain room, a cylindrical space lit dimly in blue, where clients watch DVDs while wired to brain- and heart-scanning equipment. There, another clinician burst in to apologize: Her colleague had shown me the wrong brain map. “You look a little bit more normal,” the first technician amended after reviewing my actual results. “Attention and focus is still a problem for you.” She suggested I’d still see benefits from training sessions, in which I could try to tune up my brain activity by watching DVDs while concentrating on my focus and breathing. But the mixup left me wondering if the data could be interpreted to mean anything.

Ordinarily, Neurocore and its rivals say, neurofeedback offers cognitive benefits well beyond crossword puzzles and classical music. The basic science is credible: Different brain patterns, like those reflecting arousal and attentiveness, can be monitored via EEG. It’s much less clear whether neurofeedback can truly train people to focus or be happier—or whether it has any real long-term effects besides a lighter wallet. A paper published last year in the journal Psychological Science in the Public Interest found little to back up claims of lasting benefits from such sessions.

“There’s simply not good evidence,” says Zach Hambrick, a cognitive psychologist at Michigan State University who co-authored the paper. “People get better at the task itself,” he says, but that doesn’t necessarily translate to everyday life. Neurofeedback companies’ marketing claims tend to remain imprecise enough to be considered “acceptable puffery,” he adds.

Neurocore says it stands by its claims that it can “help people optimize their brains” with exercises designed to treat ADHD, anxiety, depression, migraines, sleep disorders, stress, and the symptoms of autism. In March the company published a study of 163 clients with reduced symptoms of anxiety and depression after two to six months of training. The study, however, lacked a control group, and all its authors were affiliated with Neurocore.

“You would get laughed out of the ballpark if you tried to propose a medical treatment with evidence like this,” says Russ Poldrack, a psychologist and the director of the Stanford Center for Reproducible Neuroscience. “The lack of a control group basically makes the paper useless from the start.” Neurocore acknowledges that the study had no control group.

Neurocore, originally called Hope 139, was co-founded in 2004 by Tim Royer, a psychologist. Royer has performed EEG assessments on children enrolled at private Christian schools, according to the Grand Rapids Press, and continues to work with professional athletes. Neurocore’s website says the U.S. Food and Drug Administration “has cleared brainwave testing for ADHD,” and Rob Trube, vice president for marketing, says, “We wouldn’t be posting it if we didn’t feel like it was valid.”

But even some EEG device makers and neurofeedback advocates say Neurocore is overselling its treatment based on narrowly positive results. “Their marketing is more aggressive than what the science can support,” says Howard Merry, president of device maker Neba Health LLC, which has the only FDA-approved EEG assessment aid for diagnosing ADHD. He says he’s never sold equipment to Neurocore. Leslie Sherlin, president-elect of the International Society for Neurofeedback and Research, says the field has a wide range of behavioral and mental health applications, but the medical standards must be implemented by trained professionals. “When we’re just out there, you know, reading it like a horoscope, then that sets everyone up for failure,” he says.

Despite the lack of rigorous scientific evidence, many people want to believe cognitive enhancement is possible. Alvaro Fernandez, chief executive officer of SharpBrains, a market-research firm in San Francisco, says the largest slice of last year’s growth in the brain-training market came from companies specializing in consumer gadgets. “It gives people hope,” says Michigan State’s Hambrick.

Some are convinced by their own experiences with neurofeedback. Jeff Clark says his son, Sam, whom doctors diagnosed with autism, benefited greatly from training with $6,000 in EEG equipment. (He didn’t use Neurocore.) In 2008, Sam spent two months training daily with the gear at home for about an hour at a time, honing his focus by watching videos that only played when the EEG indicated he was calm. Afterward, he stopped taking Ritalin and Prozac and began to regularly interact with his family for the first time in years.

His father says this was the first step toward greater self-sufficiency. Sam, now 23, drives himself to his maintenance job at the same regional hospital where Jeff works. “I don’t think this is the perfect solution, and I know it’s not the solution for everybody, but we got our son back,” the elder Clark says.

Stanford’s Poldrack says it’s tough to say whether people like the Clarks are isolated examples, because “we don’t even really know what the placebo effect looks like for these types of training.” While neurofeedback may have its uses, he says, overzealous claims “end up polluting the world with treatments that don’t actually have a basis in science.”

The bottom line: There’s some scientific basis for neurofeedback training, but evidence for its benefits in treating ADHD or depression is mixed.

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