Mary Lee Esty

Neurotherapy of Traumatic Brain Injury/Posttraumatic Stress Symptoms in OEF/OIF Veterans

The Flexyx Neurotherapy System (FNS), a novel variant of EEG biofeedback, was adapted for intervention with seven treatment-refractory Afghanistan/Iraq war veterans, and brought about significant decreases in bothersome neurobehavioral and posttraumatic stress symptoms. FNS may help ameliorate mixed trauma spectrum syndromes.

Neurotherapy of Fibromyalgia

OBJECTIVE To evaluate the efficacy of a novel variant of electroencephalograph biofeedback, the Low Energy Neurofeedback System (LENS), that utilizes minute pulses of electromagnetic stimulation to change brainwave activity for the amelioration of fibromyalgia (FM) symptoms. DESIGN Randomized, double-blind, placebo-controlled clinical trial. SETTING Tertiary referral academic medical center, outpatient. PATIENTS Thirty-four patients diagnosed with FM according to 1990 American College of Rheumatology classification criteria. INTERVENTIONS Active or sham LENS, depending on randomization, for 22 treatment sessions. OUTCOME MEASURES Primary outcome measure was the Fibromyalgia Impact Questionnaire total score. Secondary outcome measures included number of tender points (TPs) and pressure required to elicit TPs on physical examination, quantitative sensory testing heat pain threshold, and self-reported cognitive dysfunction, fatigue, sleep problems, global psychological distress, and depression obtained at baseline, immediate post-treatment, and 3- and 6-month follow-up. RESULTS Participants who received the active or sham interventions improved (Ps < 0.05) on the primary and a variety of secondary outcome measures, without statistically significant between group differences in evidence at post-treatment or 3- or 6-month follow-up. Individual session self-reported ratings of specific symptoms (cognitive dysfunction, fatigue, pain, and sleep, and overall activity level) over the course of the 22 intervention sessions indicated significant linear trends for improvement for the active intervention condition only (Ps < 0.05). CONCLUSION LENS cannot be recommended as a single modality treatment for FM. However, further study is warranted to investigate the potential of LENS to interact synergistically with other pharmacologic and nonpharmacologic therapies for improving symptoms in FM.

Neurotherapy for chronic headache following traumatic brain injury.

BackgroundChronic headache following traumatic brain injury (TBI) sustained in military service, while common, is highly challenging to treat with existing pharmacologic and non-pharmacologic interventions and may be complicated by co-morbid posttraumatic stress. Recently, a novel form of brainwave-based intervention known as the Flexyx Neurotherapy System (FNS) that involves minute pulses of electromagnetic energy stimulation of brainwave activity has been suggested as a means to address symptoms of TBI. This study reports on a clinical series of patients with chronic headache following service-connected TBI treated with FNS.MethodsNine veterans of the wars in Afghanistan and Iraq with moderate to severe chronic headaches following service-connected TBI and complicated by posttraumatic stress symptoms were treated in 20 individual FNS sessions at the Brain Wellness and Biofeedback Center of Washington (in Bethesda, Maryland, USA). They periodically completed measures including the Brief Pain Inventory-Headache (BPI-HA) past week worst and average pain ratings, the Posttraumatic Stress Disorder Checklist-Military version (PCL-M), and individual treatment session numerical rating scale (NRS) for degree of cognitive dysfunction. Data analyses included beginning to end of treatment t-test comparisons for the BPI-HA, PCL-M, and cognitive dysfunction NRS.ResultsAll beginning to end of treatment t-test comparisons for the BPI-HA, PCL-M, and cognitive dysfunction NRS indicated statistically significant decreases. All but one participant experienced reduction in headaches along with reductions in posttraumatic stress and perceived cognitive dysfunction, with a subset experiencing virtual elimination of headaches. One participant obtained modest headache relief but no improvement in posttraumatic stress or cognitive dysfunction.ConclusionsFNS may be a potentially efficacious treatment for chronic posttraumatic headache sustained in military service. Further research is needed to investigate the efficacy of FNS within a randomized, controlled clinical trial, to identify characteristics of those most likely to respond, and to explore underlying mechanisms that may contribute to improvement.

Neurotherapy of Traumatic Brain Injury/Post-Traumatic Stress Symptoms in Vietnam Veterans

Previous report suggested the beneficial effects of an adaptation of the Flexyx Neurotherapy System (FNS) for the amelioration of mixed traumatic brain injury/post-traumatic stress symptoms in veterans of the Afghanistan and Iraq wars. As a novel variant of electroencephalograph biofeedback, FNS falls within the bioenergy domain of complementary and alternative medicine. Rather than learning voluntary control over the production/inhibition of brain wave patterns, FNS involves offsetting stimulation of brain wave activity by means of an external energy source, specifically, the conduction of electromagnetic energy stimulation via the connecting electroencephalograph cables. Essentially, these procedures subliminally induce strategic distortion of ongoing brain wave activity to presumably facilitate resetting of more adaptive patterns of activity. Reported herein are two cases of Vietnam veterans with mixed traumatic brain injury/post-traumatic stress symptoms, each treated with FNS for 25 sessions. Comparisons of pre- and post-treatment questionnaire assessments revealed notable decreases for all symptoms, suggesting improvements across the broad domains of cognition, pain, sleep, fatigue, and mood/emotion, including post-traumatic stress symptoms, as well as for overall activity levels. Findings suggest FNS treatment may be of potential benefit for the partial amelioration of symptoms, even in some individuals for whom symptoms have been present for decades.