BFE 18th Annual Meeting in Rome

As spring comes to a start, we at the BFE mark the end of our annual BFE Meeting which this year was held in Rome, Italy. Months of preparation came to fruition with clinicians and clinical leaders from all over Europe and the world converging over 5-days to learn about the latest methods and practices in biofeedback. We are extremely pleased with the results of the event, and we would like to thank all attendees, workshop presenters, scientific day speakers, and poster presenters for making the conference a success. Below, Jon Bale, the BFE's research manager, shares his perceptions of the Rome conference, as well as what the event means for the BFE's online education and software for the next year.

The BFE conference is always such a hurricane of events, with rarely a moment to sit down. There are so many interesting workshops and scientific presentations to check out, as well as people for me to engage  to learn about the exciting work they are doing in the field. Aside from the little hiccups that accompany all live, multi-day events, I'm extremely proud of everyone that helped coordinate the event and grateful to all of those who attended. It has always been a goal of ours to provide clinicians of all skill levels and students the opportunity to learn directly from the expert in their fields, and I definitely believe that standard was maintained this year.

My conversation with attendees left me with several positive, stand-out impressions of  the meeting. Amongst these highlights are:

Linda Walker, MHR, LPC presented two workshops, one on "Pratical Tips for Getting the Most out of Biofeedback"and the other on "Z-Score Neurofeedback: Tips and Methods for Effective Integration in Practice". Her name has long been cemented as the BFE's most popular online instructor, and it was confirmed by participants that her hands-on approach to learning, with calm and clear explanations, made her a winner here as well.

Mari K. Swingle, Ph.D., daughter of well-known psychologist and author Dr. Paul Swingle,  presented three times during scientific day on the neurofeedback assessment and training of digital technology and internet addictions. Due to the fascinating (and even frightening) nature of this topic of internet addiction, i-technology and youth, the BFE has invited her to present a webinar on this timely topic. Keep your eyes open for that. (You might say to yourself: "Yes, but Dr. Swingle already has spoken on that...". Well, from whom did you think he learned this?)

Biofeedback and sports fans received quite the treat: 2-days from Dr. Lindsay Thornton, 2-days from Dr. Penny Werthner, and a scientific day presentation where heavy hitters of the field Dr. Bruno Demichelis and Tim Harkness of Chelsea F.C. converged for a talk on the "Unique Peak Performance Database". Attendees of the scientific day got to witness quite the passionate discussion.

 Those that are interested in sleep issues will be happy to hear that the BFE has asked Lothar Niepoth, head of the German Biofeedback Society, to present his 1-day workshop on "Biofeedback in the Treatment of Insomnia" as full online class.

Dr. Steven Baskin received quite glowing reviews for his 2-day workshop on "Biobehavioral Considerations in the Diagnosis and Treatment of Primary Headache Disorders". Participants enjoyed his hands-on approach and ease of interaction. If the BFE is lucky, we may also be able to share some video of his workshop.

Who doesn't love a conference room that's reminiscent of some type of United Nations round-table discussion? Attendees of Drs. Lynda and Michael Thompson's workshop certainly enjoyed it.

Although I was left a bit exhausted by the end of the conference I thoroughly enjoyed the opportunity to meet with and learn from, I look forward to the next meeting and I hope to reencounter the many new colleagues and friends made this year. From my all my online work during the year, I very much enjoy finally putting faces to the voices with whom I teach and speak to.

The BFE would like to thank everyone who attended our Rome meeting. We hope that the conference provided you with the opportunity to make new friends, connect with colleagues and share knowledge and expertise with participants from around the world. We were fortunate to welcome workshop presenters who are leaders in their respective fields, along with a diverse group of speakers and poster presenters who addressed a wide variety of biofeedback topics as part of the scientific program.

We would also like to thank our host, the Salesian Pontifical University in Rome, for providing a location for our meeting. Special thanks go out to our sponsors – without their support the conference would not be possible.

It is indeed a pleasure when so many members of the biofeedback community come together to share ideas. Thank you again for being a part of BFE 2015.

Introduction to Slow Cortical Potentials (SCPs)

Among the many questions I fielded at the BFE Meeting in Venice, a large number came from individuals looking to know more about slow cortical potentials. Much of this was due to Dr. Ute Strehl's 2-day workshop on slow cortical potentials. If anyone ever has the chance to sit in on a talk by Dr. Strehl, I would highly recommend them to do so.

Slow cortical potentials (SCPs) are not particularly a topic for novice clinicians.  Making sense of the underlying source of SCPs can be a little difficult. In terms of their functional measurement, it's an additional hurdle to overcome for collecting a clean signal and timing the training with the client correctly. We at the BFE have had several clinicians new to neurofeedback embark on the journey of SCPs for research at their university or clinical application in their private practice. I'm happy to report that each group that has reached out to us for guidance through our online class has attained their goals for using SCPs.

We thought it might be useful to review the basic concepts related to the nature of SCPs, for anyone that might be considering adding this EEG technique to their clinic. For those that are looking for more in-debt explanations, feel free to look up articles by Dr. Ute Strehl and Dr. Niels Birbaumer. Recommended articles have been added to the end of this post. 

What are slow cortical potentials?

Slow cortical potentials are slow event-related, direct-current shifts in the EEG, originating from the large cell assemblies in the upper cortical layer. Let's break that previous, information-dense sentence down. SCPS are:

• Slow. In terms of speed, they can occur from 300 milliseconds to over several seconds. Compared to most EEG activity that is monitored for neurofeedback, that is a very long time. Equipment for measurement of SCPs must be specialized to collect these longer changes, and needs to average the activity from many trials to gain an overall trend of the EEG activity. 

Example of SCP average of activation and inhibition. Note - this image is generated by a subject that is not yet used to SCP training.

• Event-related potentials. This means there are changes in EEG activity based on responses to events. If an image or sound is presented to an individual, the presentation of the stimulus will cause  a change in the brain's potential, as a reaction to the stimuli. Interestingly, this change in potential can be of exogenous origins (reaction to a presented external stimulus) or endogenous origins (reaction to expectation of stimuli). The brain reacting to the expectation of a stimulus, without actually being presented the stimulus, means the change in event related potential can be consciously generated at will. If it can be generated at will, it can be trained.
• Direct current shifts in EEG. SCPS are general measures of electrical activity. The vast majority of neurofeedback is based on measuring subsets of the EEG activity, divided into bandwidth frequencies (such as Theta, Alpha, Beta). The SCP signal however is general electrical activity in amplitude. These changes are weak shifts so it is necessary to run many trials to get an overall trend in activity.
• Originate from large cell assemblies in the upper cortical layers. The thalamo-cortical system acting as a "neuronal pacemaker" triggers the general activation of these cell assemblies, which then expands outward via cortico-cortical connections of inhibition and excitation. The degree of activation/depolarization of these cell assemblies is the focus of SCP training.

Studies show that changes in SCPs leading to increased negativity reflect greater depolarization of the large cell assemblies, which in turn lowers the threshold of excitement of neurons in the brain, leading to increased neuronal activity. 

Inversely, changes in SCPs leading to increased positivity reflect less depolarization of the cell assemblies, which in turn increases the threshold of excitement of neurons in the brain (greater inhibition making it more difficult for neurons to activate), leading to less neuronal activity.

The clinical implications of slow cortical potentials and their training are reflected in epileptics, individuals with ADD and those suffering from migraines. 

• Increased SCP negativity is observed in epileptics a few seconds before a seizure. Increased SCP positivity occur immediately after a seizure is finished. Training for increased positivity (less activity/greater inhibition) with SCPs has shown to decrease the frequency of seizures.
• Training for increased negativity with SCPs, reflecting greater activation of the cortical networks, has been shown to improve attention in individuals with ADHD.
• Migraine sufferers that pursue similar training as epileptics have shown decreases in the frequency of episodes and other headache parameters.

Slow Cortical Potentials Software Suite

Following Dr. Strehl and Dr. Birbaurmer's protocol, initial training starts with the subject taking turns practicing both to activate/excite and deactivate/inhibit their brain activity. Whether the subject is correctly activating or inhibiting their brain activity, the BFE's SCP Suite displays feedback to either show success in terms of each 0.5-second period of the 8-second trial or as a continuous single feedback output for the trial, depending on what the clinician and subject prefer. After training progresses past the first transfer trial session (training without feedback to see if the subject can generalize the training), the protocol then increases the focus on activating/exciting or deactivating/inhibiting brain activity, depending on the client's circumstance. For example, an ADHD child would now train to activate/excite their brain, such that they would focus on an activation to inhibition trial ratio of 2-to-1 (twice as many attempts to activate the brain than to inhibit the brain).

Example of activation trial with feedback from 0.5-second periods. Subject had initial difficulty activating, but then persevered through the trial.

Recommended reading:  

Self-regulation of Slow Cortical Potentials: Strehl, U., Birbaumer, N. A New Treatment for Children With Attention-Deficit/Hyperactivity Disorder Pediatrics November 1, 2006 118: e1530-e1540.

Thought Technology Slow Cortical Potentials Software Suite

Slow Cortical Potentials Online Class - Linda Walker, MHR, LPC

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BFE 2011 Annual Conference

We have just confirmed the dates for our 2012 Annual Conference. This year the conference will be held September 11-15, 2012 in Rzeszów, Poland.

For more information, as well as submissions of workshop proposals, submissions for the scientific program (symposia, lectures, papers, posters, short courses) and questions about industrial exhibition please contact:
Monika Fuhs, Program Chair: editor@bfe.org,
or visit our homepage www.bfe.org

Submission deadlines:
March 1, 2012 workshops and short courses, invited talks
April 15, 2012 symposia and paper session
May 1, 2012 posters and oral presentations

We look forward to seeing you there!