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22/Oct/2021

What is headache?

Headaches (migraines) are one of the most common disorders of the nervous system. They are primary painful disorders as migraine or, tension headaches and cluster headaches. It can also be caused by many other conditions, such as excessive consumption of analgesics.

It is estimated that the worldwide prevalence of headache (at least once in the last year) in adults is 47 per cent. Between half and three-quarters of adults aged from 18 to 65 years have suffered a headache in the last year, and more than 10 per cent of this group has suffered migraine. The headache that occurs each 15 days or each month affects from 1.7 per cent to 4 per cent of the adult population in the world. Despite regional variations, headaches are a global problem that affects people of all ages, races, income levels and geographic areas.
Headache is not only painful but also debilitating. In the Study of Global Burden of Disease, updated in 2004, migraine represented 1.3 per cent of years lost due to disability.

Headaches also impose personal burden in the form of intense suffering, impairment of quality of life and economic costs. Frequent headaches and constant fear about the next episode damage family life, social relationships and work. A prolonged effort to deal with a chronic headache may also predispose to the occurrence of other diseases; for example, depression, which is three times more common in people suffering from migraine or severe headaches than in healthy.

Causes

Migraine is within what are called central sensitization syndromes. Central sensitization is a process that affects the central nervous system, reducing the pain threshold and leading to its distorted perception. People who suffer this syndrome are much more sensitive to stimuli that are normally not so painful, not having this pain an adaptive and “notice” purpose.

Types and symptoms

Migraine, tension headache and the caused by an excessive consumption of analgesics (rebound headache) are important to public health since they cause severe disability and morbidity in the population.

Migraine (headache)

Es una cefalea primaria.
Suele aparecer en la pubertad y afecta principalmente al grupo entre los 35 y los 45 años de edad.
Está causada por la activación de un mecanismo encefálico que conduce a la liberación de sustancias inflamatorias y causantes de dolor alrededor de los nervios y vasos sanguíneos de la cabeza.
La migraña es recurrente, a menudo dura toda la vida y se caracteriza por presentarse episódicamente

It is a primary headache. It usually occurs in puberty and mostly affects the group between 35 and 45 years old.
It is caused by the activation of a mechanism that leads to release of inflammatory and pain-causing substances around the nerves and blood vessels of the head.
Migraine is a recurring headache, often lasts lifelong and is characterized by occur episodically.

These episodes are characterized by:

– Moderate and severe headache.
– Nausea (the most characteristic symptom).
– Pain on one side of the head, sometimes pulsatile.
– Worsens with ordinary physical activity.
– It can last from a few hours to 2 or 3 days.
– Episodes occur with a frequency that varies between one year and one week.
– In children, the episodes usually last less and abdominal symptoms are more prominent.

Tension Type Headache

It is the most common primary headache.
Episodic Tension Type Headache (TTH) is observed in more than 70 per cent of certain population groups.
It often begins in adolescence and affects more women than men in a ratio of 3:2.
It may be related to stress or musculoskeletal problems of the neck.
When it is episodic, the episodes usually last a few hours, but may persist for several days.
Chronic tension headaches may be constant and much more disabling than episodic.
The patient describes this headache as a kind of pressure or tightness band around the head, which sometimes radiates to the neck or from this.

Cluster Headache

It is a primary headache.
It is relatively rare; It is suffered by less than 1 in 1,000 adults; It is more common in men than in women, with a ratio of 6: 1.
It usually occurs from mid-twenties.
It is characterized by recurrent and frequent, brief but extremely painful episodes of headache and pain around one eye. It provokes tears and reddening; accompanied by nasal discharge or blockage of the nostril on the affected side, and eyelid may be down.
It can be episodic or chronic.

Headache due to overuse of analgesics (rebound headache)

It is caused by chronic and excessive consumption of drugs to combat headaches.
It is the most common form of secondary headache.
It can affect up to 5 per cent of certain population groups, more women than men.
It is an oppressive and persistent headache which usually is worsen on waking.

burnoutTreatment

A large number of people who suffer migraines are not diagnosed or treated. To treat headaches it is important that health professionals are well trained, the diagnosis of the disorder is accurate and appropriate treatment is provided.

It is very common that people do not consider headaches as a serious disease since they usually occurs episodically, are not fatal and do not spread. It is estimated that 50 per cent of people with headache are treat by themselves.

In many cases, the authorities intended to limit the costs of health care and do not recognize that headaches impose a considerable economic burden on the state – Direct costs of treatment of headaches are minimal when compared to indirect costs (for example, days off work).

There are different types of treatment, with or without medicaments

No medications: To identify and avoid triggers of migraine is an example of treatment without medication, writing a migraine diary to track your symptoms and identify your triggers (food, cold, heat, light, sleep, etc.), technical relaxation, acupuncture, neurofeedback and biofeedback.

With medication: analgesics, anticonvulsants and prophylactic products.

Data and numbers

Headaches are one of the most common disorders of the nervous system.
Overall, it is estimated that 47 per cent of adults have experienced at least one headache in the past year.
The headaches are accompanied by personal and social problems such as pain, disability, impaired quality of life and economic losses.
Worldwide, only a minority of people suffering headaches receive a proper diagnosis made by a health professional.
Globally, headaches have been underestimated, poorly known and do not receive adequate treatment.

Neurofeedback application in headaches cases

Neurofeedback is a neuropsychological technique that allows self-regulation of the central nervous system. Its application will reduce and / or disappear migraine symptoms, decrease anticipatory fear and stabilize the physiological activity improving sensitivity and increasing of pain threshold.

Neurofeedback different investigations in cases of headaches show the high degree of effectiveness of this therapy for treatment.

According to the study carried out by Dr. Jonathan E. Walker in Dallas, and published in 2011 in which participated 71 patients who often suffered migraines, they were obtained the next data:

Neurofeedback group (46 patients) Pharmacological group (25 patients)
No migraines 54 per cent 4 per cent
Decreasing of migraines >50 per cent 39 per cent 8 per cent
Decreasing of migraines <50 per cent 4 per cent 20 per cent
No changes 1 patient 68 per cent

 


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22/Oct/2021

When did it start talking about autism?

The word autism was first used by psychiatrist Eugene Bleuler Swiss in 1912. The medical classification of autism was given in 1943 by Dr. Leo Kanner. At one time, an Austrian scientist, Dr. Hans Asperger, coincidentally used the term autistic psychopathy in children who exhibited similar characteristics. Dr. Asperger’s work, however, was not recognized until 1981, probably because it was written in German.

The DSM (Diagnostic Manual of Mental Disorders) in its version published in 1994, DSM-IV defined autism and his associates as “pervasive developmental disorders”. In the latest DSM-V, this definition has been replaced by the term “autism spectrum disorders” (ASDs), which have been included in turn within a broader “neurodevelopmental disorders” category.

What are the Autism Spectrum Disorders?

The concept of Autism covers a range of disorders that affect communication skills, socialization and empathy of the person.
People with this disorder have difficulties in relating to others, to communicate, to express how they feel. The manifestation of these disorders varies greatly of one person to another. These behaviours not only make life more difficult for people with autism, but also seriously affect their families and people around them as tutors or teachers. It is also associated with routines and (stereotypies) repetitive behaviours, such as obsessively arranging objects or the repetition of very specific habits and customs. In short, autism is a psychological disorder characterized by intense concentration of a person in his own inner world and the loss of contact with the outside world.
According to the British psychiatrist Lorna Wing, people who have autism spectrum have the following characteristics:

– Disorder in capabilities of social recognition.
– Disorder in capabilities of social communication.
– Repetitive patterns of activity, tendency to routine and difficulties in social imagination.

Detection of Autism Spectrum Disorder

Parents of a child with autism are the first ones to notice unusual behaviour. Although it is a fact that for parents can be enormously difficult and painful to label as “autistic” to their child, an early diagnosis is important. Currently, there is no cure for autism. However, research shows that early intervention in an appropriate educational and family environment produces significant improvements for many young children with autism spectrum disorders. As soon as autism is diagnosed, early intervention should begin focusing on developing of communication skills, socialization and cognitive treatments.
Currently, they are diagnosed with autism 1 of every 68 individuals and 1 of every 42 boys; being four times more common in boys than in girls. Autism spectrum disorders are often formally diagnosed at the age of 3 years, but new research allow to obtain a diagnosis about 6 months.

Origin
What cause the autism spectrum disorder is not known. Research suggests that both genes and environmental factors play an important role. The diagnosis of autism spectrum disorders (ASDs), currently, is based on the observed behavioural characteristics, without the help of biomarkers.

n7asTreatments

Currently there is no an effective way to prevent autism spectrum disorder, effective treatment or cure.

The latest research confirms that early intervention in an appropriate educational environment can obtain significant improvements. As soon as the diagnosis is made must begin with effective intervention programs to emotional stability and development of communication, socialization and cognitive skills.
The main treatments are as follows:

– Neurofeedback: a neuropsychological technique which trains and exercises the brain. This training increases brain functionality and ability to regulate itself. To do this, neurofeedback uses registration and automatic analysis of brain electrical activity by an electroencephalograph. In recent years, there is growing evidence that people with ASD can present alterations in neuronal connectivity. In his article, “Neurorehabilitation of social dysfunctions: a model-based neurofeedback approach for low and high-functioning autism” Jaime Pineda says the effectiveness of neurofeedback as a treatment for autism, combined with behavioural treatment, results in a significant improvement of symptoms presented.

– Educational behavioural interventions: It is advisable to perform them in both the individual diagnosed with autism and their family environment. This therapy consists of a series of sessions with a goal: obtaining capabilities which develop social and language skills on subjects. It is usually used behavioural therapy ABA (Applied Behavior Analysis) which is based on the behaviourist model of learning. This therapy teaches skills through reinforcers and aversives. The therapy also includes instructions to the people in the subject’s environment (parents, siblings, etc.) and their goal is the acquisition of communicative skills by both sides, to improve the relationship between the person diagnosed and their environment, increasing the level welfare and happiness.

– Emotional and psychological interventions: it has as purpose acquisition and development of emotional skills, developing empathy. As educational social interventions, this therapy includes the immediate social circle of autistic subject working the expression of their feelings, frustrations, impressions, etc. Here also we would include music therapy and animal therapies.

– Specific diets,  as free caffeine or gluten and rich in certain vitamins.

– Medications: there are no specific medication for treating autistic disorder. In consequence, it is used palliative therapy of symptoms developed by the subject. The most common drugs administered to these patients are anxiolytics, antidepressants and those ones used for treatment of obsessive-compulsive disorder.

The education of a child is a task that requires a lot of involvement and energy, this investment of effort is much higher in the case of children with autism spectrum symptoms. Before, we have summarized different types of treatment, but we must remember that all programs must incorporate the child’s interests, tastes, habits, preferences etc. Since the more comfortable the child with treatment, the easier it will be to follow it.

Benefits of application of Neurofeedback in Autism

– Grater social awareness.
– Increase in social and communication skills.
– Improvement of eye contact.
– Reduction of stereotypies.
– Reduction or elimination of tics and self-harm.
– Development and strengthening of preverbal language and verbal.
– Decline and disappearance of absences, epileptic attacks if any.
– Empowerment of psychomotor coordination.


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22/Oct/2021

Application of Neurofeedback to Fibromyalgia cases.

What is fibromyalgia?

Fibromyalgia is a syndrome that causes suffering and loss of quality of life for whom suffer it without a demonstrable organic disorder. Fibromyalgia generates a variety of symptoms, being the most characteristic generalized pain which is necessary to diagnose the disorder. It affects between 2 and 4 per cent of the population and is more prevalent in women than in men. In addition to the pain, people with fibromyalgia manifest symptoms such as fatigue or tiredness. For a person with fibromyalgia any movement can cause pain what might leads to a progressive loss of muscle mass. Pain, fatigue suffered by the person produces mood changes and sleep problems … which can also trigger episodes of stress, migraines, loss of short-term memory, sadness, anxiety and a lot of frustration, among others.

In short: a person with fibromyalgia is in a loop of discomfort, not only physically but also emotionally.
At the moment there is no universally accepted explanation for fibromyalgia, but there are pharmacological and non-pharmacological treatments that have been proven effective. In 1992 fibromyalgia was recognized as a disease by the WHO (World Health Organization) and listed under the heading of rheumatism.

What is the relationship between fibromyalgia and nervous system?

Fibromyalgia syndrome can be classified as central sensitization. This is a pathological process that affects the central nervous system consisting of decreasing of pain threshold which leads to an altered perception of normally non-painful stimuli.

The person who suffers it feels hyper-excitability of neurons in the central nervous system after a peripheral stimulus. This generate a heightened painful response without any adaptive purpose as well as a perception of pain to stimuli that normally are not painful.

This process is a common feature of several diseases characterized by chronic pain, such as fibromyalgia, chronic fatigue syndrome, migraines, restless legs syndrome etc.

Treatments for Fibromyalgia

There are several treatments for this syndrome. The most common drugs are usually antidepressants, some antiepileptic and finally, if patients do not respond to any other medication, benzodiazepines (anxiolytics) are used. These drugs are effective, but side effects they produce are significant.

One of the newest alternative in the treatment of fibromyalgia is Neurofeedback as non-invasive and effective therapy.

Neurofeedback is a neuropsychological training technique for our brain, is a safe, passive and non-invasive method that helps to stabilize the central nervous system. It aims to increase the functionality of our brain and its ability to self-regulation. To get this, Neurofeedback uses registration and automatic analysis of brain electrical activity by an electroencephalograph. This activity represents certain psychological processes that usually are handled outside our conscious control.

It is a learning process in which we monitor brain electrical signals and show them to the patient, thus, giving feedback on its implementation and reinforcing the frequency that we have established as goal. The individual thereby receives feedback from the activity of his own brain who is taught and rewarded. This gradual learning improves his functions and gets welfare patterns and effectiveness desired.

The main benefits of Neurofeedback application in cases of Fibromyalgia are:

– Better body-mind awareness.
– Physical and mental calm down.
– Decreasing of pains.
– More emotional stability.
– Increasing of motivation
– Improvement of self-esteem.
– More motor control
– Stabilization of sleep cycles


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22/Oct/2021

Neurofeedback aplication in ADHD cases: an effective treatment without side effects.

 What is ADHD?

ADHD is a behavioural disorder characterized by a moderated to severe distraction, brief attention periods, motor restlessness, emotional instability and impulsive conducts.

This disorder was firstly identified in childhood. However, over time, it was recognized its chronic character since it persists and manifests beyond adolescence. The long-terms monitoring studies have demonstrated that between 60 and 75 per cent of the children with ADHD manifests the symptoms until adulthood.

ADHD is typically diagnosed when children are 7 years old, although in some cases, this diagnose  can be done earlier. It appears as an increasing in physical activity, impulsiveness and difficulty keeping attention in an activity during a continued time. In addition,  many children develop self-esteem issues linked to ADHD symptoms which are not typically associated with this disorder by parents.

Also, ADHD may be associated frequently with other problems, and its consequences are seen in different environments of the child’s life, not only the school. It also affects their interpersonal relationships, with family, with other children and with their teachers, being all these ones key relationships in child development.

According to the North American classification  of  psychiatric diseases DSM-IV, not all people with ADHD have the same clinical features. In some of them,  they predominate the inattention symptoms, in others hyperactivity and impulsiveness, and in others there are both attentional and hyperactivity and impulsiveness problems (what is known as ADHD combined or mixed). Therefore, ADHD can be divided into several subtypes, depending on which group of symptoms predominate. These variants are known as “ADHD subtypes”. Of all these variants the most common is the combined, followed by the predominantly hyperactive-impulsive. The inattentive subtype is the least common of them and is more common in girls than in boys. This contrasts with the other medical conditions that are found more in boys. In consequence, as the inattentive symptoms are more subtle, are detected less and cause the diagnosis of ADHD in girls / adolescents take longer and, in many cases, go unnoticed.

Population affected by ADHD

Who are more likely to have ADHD, boys or girls?

In the pediatric population, ADHD is identified more in men than in women. Most experts believe that the much lower ADHD incidence in girls and young women is due to girls tend to suffer the subtype predominantly inattentive. In contrast, the hyperactive subtype, more frequent in boys, attracts the attention of adults precipitating the patient evaluation.  Therefore, in general population, the ratio of boys vs. girls diagnosed of ADHD is about 4:1.

In adults, it is estimated that 4 per cent of population suffers the disorder, but just a few of them are detected. In general, hyperactivity disappears leaving a restlessness, a continuous feeling of needing something. The impulsiveness and inattention do not appear as in childhood.

Evolution of TDAH in adults

Overall, patients with ADHD achieve an academic training less compared to the control groups, even with similar levels of intelligence. Only 5 per cent of patients with ADHD achieve their access to college. Studies report that people with ADHD have a worse work adaptation. In addition, it is demonstrated that labour discontinuity in patients with ADHD is caused by lack of social skills. For example, some symptoms, as hyperactivity, impulse control or lability can leads them to see monotone and boring their jobs. This emotional and labour instability also affects to their families and the couple. There are publications where they are described these relationship difficulties as well as social adaptation issues which can persist in adults with ADHD.

Neurofeedback application in ADHD cases

    • – Improvement in body awareness and the environment.
    • – Developement of social skills.
    • – Enhancement of emotional management.
    • – Increase of communication skills.
    • – Improvement of impulse control: rage and anger.
    • Development of the capacity for analysis and decision making.
    • – Benefits concentration and attention.

 

 

Neurofeedback: recommeded treatment for the American Academy of Pediatrics

The American Academy of Pediatrics (world leader in this area) for the treatment of ADD and ADHD puts the effectiveness of Neurofeedback on the same level as medication, but without the side effects.
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