There is a lot of effort being made in the area of treatment for conditions like post traumatic stress disorder. The Start-up company, GrayMatters Health is looking at ways to treat this disorder using two different neuroscience techniques. GrayMatters Health is an offshoot from the Tel Aviv University, Israel and made it to the top eight in line for The Spinoff Prize in 2021.
The virtual test: “Tension builds in the crowded emergency department. Voices grow louder. A baby cries. People rise from their seats and march up to the receptionist’s desk. The scene grows more intense, and the person controlling it – a soldier about to leave for a war zone – isn’t in the room.”
This scene is a virtual environment being watched from a seat in a laboratory. It is enabled by an assortment of electrodes being placed on the head of the soldier who is then able to reflect on their own emotional state. They are able to practice regulating their emotions and able to control their neural activity. In this way they are able to quiet down the virtual waiting room. People start to sit-down, the noise level is reduced and the situation becomes calmer.
At this point they are much more in control, even able to do other things including going for some fun with no deposit codes Fair Go.
In a study, soldiers in training were subjected to experiences like this, in order to examine whether it was possible that the virtual environment could assist them in regulating their actions in combat. Talma Hendler, a psychiatrist at Tel Aviv University, together with her colleagues noted that the trainees showed more emotional resilience than control groups. This could help make them less susceptible to developing post traumatic stress disorder following combat.
Training the brain in this way is referred to as neurofeedback and has been used for some time in treating conditions like post traumatic stress disorder, PTSD. However, the brain doesn’t give us sound or visual signals for emotions and therefore it is difficult to actually control the brain’s response, other than by chance as it is impossible to know exactly which “buttons” are the ones that need neutralizing or cancelling out. Oded Kraft, the co-founder of GrayMatters Health says that “People can struggle to control their emotional reactions, and this system sort of places a mirror in front of the brain”.
The goal of GrayMatters Health is to create a situation where people will never develop PTSD. However, it is currently using the technology to help with those suffering with PTSD and persistent depression. 250 million people in the world are suffering with one of these conditions. It could well be that this number will increase after Covid-19 with many doctors, nurses and other medical practitioners being at risk of developing some form of mental health problem or even PTSD.
In spite of the fact that there is a growing need, treatments have remained unchanged for near on 40 years. According to I-Wei Shu, a psychiatry researcher at the University of California “These treatments (drugs and psychotherapy) save the lives of some patients, but most don’t get as much out of them as we’d like.”
He goes on to say that “30-60% of people with a mental health condition, both are less than ideal: drugs cause unwanted side effects, and psychotherapy frequently requires people to relive traumatic experiences, such as sexual violence, making it a tough metaphorical pill to swallow.” Therefore, he says “It’s important that we mobilize resources to create the next generation of treatments.”
One such treatment began being developed some 10 years ago by Hendler, who is not only a psychiatrist but the chief medical scientist at GrayMatters Health. It involves combining two techniques: electroencephalography (EEG) which measures brain activity and functional magnetic resonance imaging (fMRI) which searches for brain activity via blood flow.
fMRI has literally transformed neuroscience by revealing deep rooted brain regions, making them visible, such as the amygdala, which is so important to emotions like anxiety and fear. However, MRI equipment is expensive and is usually set up in hospitals and health centers.
A significant connection
A machine learning algorithm which connected EEG signals to fMRI data was devised by Hendler and her team in 2016. They first started by measuring EEG and fMRI data simultaneously in a group of healthy people. By pooling the data together, the researchers were able to see the changes that occurred in blood flow in the amygdala calculated by the fMRI and also electrical signals on the head.
The algorithm looked at both types of data in order to create an electrical ‘fingerprint’. It showed a relationship with spikes and troughs in the goings on of the amygdala. The fingerprint is measured only using EEG but does act as a stand-in for fMRI activities of the amygdala.
Following on from this the team looked to validate the fingerprint. They wanted to know if an EEG, combined with fMRI data would be better than the regular EEG that measured superficial brain regions. Having the fingerprint on hand, meant that they no longer needed to use fMRI on every person.
Those participating in the study were asked to use mental strategies to reduce the volume of a sound clip they were listening to. An assortment of electrodes tracked the electrical fingerprint simultaneously of their amygdala activity. They were not given exact instructions on how to do this. They wanted each person to devise their own strategy that would work for them, like using visualization or deep breathing.
At the same time, a control group did the exact same exercise but were given feedback relating only to the surface EEG signs and not about the activity and response of their amygdala. They found that those participants that received feedback about the response of their amygdala were more able to reduce the volume than those that were in the control group.
The product developed by GrayMatters Health does not need an fMRI reading. A person’s EEG fingerprint relates to the innermost workings of their brain and is accessed by a single surface electrode positioned on the scalp.
EEG based neurofeedback therapy is readily available but it does rely mostly on neuroscience research done in the 1970s and not on more recent, fMRI- based understandings of neural activity. Shu says that Hendler and her team “found a way to connect EEG signals with current models of brain function.” He goes onto say that “It was unclear how to do this analytically – that’s where they succeeded and others have stalled.”
Hendler and her team also tested their method as a means of managing chronic pain in patients suffering with fibromyalgia. Their study involved 34 participants who received neurofeedback training on a biweekly basis over 5 weeks. Those who received sessions based on the amygdala fingerprint said they slept better and felt less pain compared with participants in the control group. Hendler said “That was out first demonstration of clinical applications.”
In February 2020 the company gained its first funding. Almost a year later its machines were being tested at Israeli and American universities. In the United the product is categorized as an investigational medical device. This means that it has not been approved by the US Food and Drug Administration and is only available as an addition to regular treatments used for PTSD and depression.
Both Kraft and Hendler ultimately see wider uses. They feel that by looking at different brain regions, they may be able to identify electronic fingerprints that link with other mental health disorders.
Kymberly Young, a neuroscientist at the University of Pittsburgh and is involved with the company says that this technology could well be affordable and made available to small clinics and not just to large hospitals.
However, future trials will need to compare this method of neurofeedback to other treatments, including drugs and psychotherapy, that are involved in training the brain to control emotions.
Young does stress however, that medical insurance coverage for treatment might be a difficult obstacle to clear, even if the method of neurofeedback is as effective as prescription medication. However, Young is optimistic about the possibilities that the technology can bring. “It overcomes a lot of barriers to treatment for mental health, like taking a pill every day or talking to a stranger about your mother. The greatest challenge might be getting people to accept it as an intervention”.