What the Heck Is Neurofeedback Technology, Betsy DeVos’s Pet Project?

Conflicts of interest have been a major theme for President Donald Trump's administration and Trump's pick to head the Department of Education, wealthy investor and private education advocate Betsy DeVos, is no exception.

DeVos and her husband are major investors in Neurocore, a Michigan-based company that specializes in a drug-free, brain-training treatment called neurofeedback. It's used to treat everything from ADHD to depression and anxiety, DeVos has promoted it as a way to help students perform better in school. According to filings with the Office of Government Ethics, DeVos has agreed to step down from the Neurocore board, but refuses to divest her estimated $5 million to $25 million stake in the company.

While the questions around conflict of interest remain open, there's another question lingering in the air: what exactly is neurofeedback technology?

Biofeedback is the process of measuring certain functions in our body, from our heart rate to our brain waves, and using that data to adjust those functions when things go awry. Neurofeedback specifically refers to using brainwaves, measured by an electroencephalogram or EEG, to gain insight and provide treatment for everything from ADHD, to depression, to addiction, or even just sharpen focus. Elite athletes, business leaders, or artists sometimes use neurofeedback to excel in their field.

It's been touted as an effective treatment for a wide range of conditions, including autism, but the scientific community is conflicted over whether there's enough evidence to make such claims. There are lots of promising studies showing success with neurofeedback for treating conditions like ADHD and depression. But systematic reviews of the research are less concrete, showing some flaws in the data and big differences in methodology between studies.

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Here's how the treatment works. The first step is to get a quantitative EEG: a map of your resting brain waves that is compared to a huge database of other typical brainwaves. From there, a neuroscientist can analyze this pattern and identify anything that's different from the norm.

"If you see an excess of theta brain waves, for example, that's a classic indicator of hyperactive or compulsive ADHD," said Andrew Hill, a cognitive neuroscientist and the CEO of the Peak Brain Institute, a biofeedback treatment center. "Then we try to decide if the patterns that show up match the person's experience."

Once a pattern associated with the patient's symptoms has been identified, they use specialized software to "train" the brain to alter these patterns: so, someone with excess theta activity associated with ADHD will be trying to dial those theta wave down. During a 30-minute session, electrodes attached to the scalp measure the brain's activity in real time. The software uses this information to run a game that rewards the desired brain activity.

"When something we want to change moves in 'right' direction, we make something happen on a screen: so the spaceship flies faster, or music gets louder, maybe an animation unfolds," Hill explained. "When the brain moves in the 'wrong' direction, the game stops. The brain finds that kind of annoying. Over several days, the brain starts to learn to produce activity that was rewarded by the increase in stimulation."

Neurocore offers two types of treatments in particular, each lasting 45 minutes: One is biofeedback training, which involves watching your heart rate and respiratory rate on a monitor and learning to breath to achieve consistency in these rates. The other is neurofeedback, and for Neurocore's version, this involves watching movies that pause when your brainwaves are not in your pre-determined "therapeutic range."

Hill told me patients typically require between 30 to 40 sessions, a few times a week, but that they start to see results within just a few weeks. Few insurance companies cover this kind of treatment, and sessions cost upwards of $100 each. Hill told me he's seen some incredible success stories, but the science is not perfect.

Hill said part of the problem with research is that because neurofeedback treatment is highly personalized and relies on EEG data, it makes it much more challenging to do a classic, double-blind, placebo-controlled study. He has worked with software developers to create blinded versions of the software and said there is more rigorous research happening at the moment, but that it's tough to get funding for a massive, gold-standard study.

"It's profoundly effective on many things that there's a lot of money behind," Hill said. "Big Pharma isn't able to patent or control neurofeedback in such a way that it makes sense to spend the $5 million it would take to run a clinical study."

There's still mixed opinions among the scientific community on the effectiveness of neurofeedback. But clearly, Betsy DeVos is convinced.

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