Treatment for Brain Fog After Chemotherapy
Research finds that 20%-40% of persons who go through chemotherapy or radiation treatment for cancer develop chemotherapy-induced cognitive dysfunction, popularly known as chemo brain or chemo fog. Chemobrain symptoms commonly include mental cloudiness, problems concentrating, trouble being able to multi-task, and forgetfulness. The memory problems can include trouble remembering common words, names and details. People frequently report being more disorganized and taking longer to finish tasks. Learning new skills can be more difficult. The brain often simply does not work as quickly as it used to, causing problems at work and at home.
Naturally such symptoms can be a distressing source of worry and can become depressing. It has been found that sometimes chemo brain symptoms improve over the course of a few months or after a few years. In other cases this mental cloudiness and cognitive decline seems more enduring, and has even found to last for 10 or more years. Neuroimaging studies have shown that in some patients the areas of the brain involved in memory, planning ahead, inhibiting impulses, and translating thoughts into action have become smaller after chemotherapy.
Research on chemo brain is limited and treatments that are suggested have typically been to use antioxidants and some of the stimulant medications that are used to help ADD/ADHD.
TREATMENTS
However, a recent research study found that neurofeedback (EEG or brainwave biofeedback) has significant potential in improving chemo fog. In this study cancer survivors who had received chemotherapy from 6 months to 5 years previously were treated with 20 sessions of neurofeedback training. Objective measures done before and after neurofeedback evaluated cognitive function, degree of impairment, quality of life, fatigue, and levels of depression. Following neurofeedback 91% of patients reported very statistically significant improvements. These findings are encouraging, although more research is needed.
Even though chemo fog is a new area of application, neurofeedback has been extensively applied and researched in treating many other conditions involving slowed brainwave activity. These problems include ADD/ADHD, head injuries, uncontrolled epilepsy, and learning disabilities. This research, which has included randomized and placebo controlled studies conducted over the past 30 years, has documented that neurofeedback has effectively produced significant improvements about 80% of the time. Research with “normal” people has also documented the ability of neurofeedback to produce significant improvements in memory, concentration and athletic performance. Thus it is also being used for “brain brightening,” to counter the cognitive decline associated with aging.
More than a decade ago, Frank H. Duffy, M.D., a Professor and Neurologist at Harvard Medical School, wrote in the professional journal Clinical Electroencephalography that scholarly literature now suggests that neurofeedback “should play a major therapeutic role in many difficult areas. In my opinion, if any medication had demonstrated such a wide spectrum of efficacy it would be universally accepted and widely used.” He said, “It is a field to be taken seriously by all.”
Neurofeedback training is brainwave biofeedback. During training, an electrode is placed on the scalp that samples your brainwave activity over 1,000 times a second. This high tech electronic equipment then provides you with real-time, instantaneous feedback about your brainwave activity. This process works through operant conditioning, seeking to recondition and retrain the brain into healthier brainwave patterns. Ordinarily, we cannot reliably influence our brainwave patterns because we lack awareness of them. However, our current technological advancements provide us with the opportunity to retrain and rehabilitate the brain in ways not previously possible–-much like sophisticated physical therapy for the brain.
In the most thorough approach to doing neurofeedback it is also ideal to do a quantitative EEG (QEEG or brain map) as an initial assessment. It
consists of placing a swim-type cap on your head with 20 electrodes. We then measure your brainwave patterns, much like the way a physician listens to your heart from the surface of your skin. No electric current is put into your brain. Your brainwave patterns are then relayed to a computer and recorded. Then we do statistical comparisons of your pattern of brain functioning compared to that of healthy normal persons of your age. This is done with a sophisticated, FDA registered normative database. This scientifically objective data can then guide the neurofeedback process, allowing us to individualize the treatment to you.
Below you will find an example of a portion of a quantitative EEG brain map on a person who has an excess of abnormally slow and inefficient brainwave activity. Normal activity for a person of this age is represented by a deep green color. The bright yellow, orange and red colors indicate an increasing level of excess in the amplitude of the brainwave activity at various frequencies. The blue colors indicate a deficiency. You can see that this person has a significant excess in 4-8 Hz activity, which is in the theta brainwave range. In addition to this excess of slow activity you can also see that there is a deficiency in more efficient activity in the alpha and beta brainwave frequencies from 10 Hz upward. With this scientifically objective information, neurofeedback can now be focused on inhibiting the 4-8 Hz inefficient activity, while simultaneously reinforcing the efficient activity to produce a more optimally functioning brain. Usually within 5-6 sessions patients begin to notice improvements that are beginning to occur.
This Cutting Edge Technology is Available
Neurofeedback and brain mapping services are available at the offices of Dr. Barbara Paul-Blume, Ph.D., BCIA. She is board certified in EEG Neurofeedback, and a licensed Clinical Psychologist in California (PSY 10174). Dr. Blume has used neurofeedback to work with many problems including head injuries and concussions, ADD/ADHD, learning disabilities, depression, insomnia, restless legs, OCD, anxiety and panic disorder, post-traumatic stress disorder, stroke, alcoholism, drug abuse and damage resulting from substance abuse, autism, Asperger’s, following neurosurgery, for problems with physical balance, to counter effects of aging on the brain, with chronic fatigue, fibromyalgia, and uncontrolled epilepsy.