What can be achieved by combining neurofeedback with photobiomodulation?

Penijean GracefireA creative and curious mind can be a beginning of something new, something important, even something big. This is as true in the field of arts as it is in the field of sciences. This article offers one more testament to these observations.

Penijean Gracefire is a licensed mental health counsellor (LMHC) in the state of Florida. She focuses on the applications of neurofeedback in her work with clients. Like many neurofeedback practitioners, she is excited by technology that can help her in her work. Unlike most, she is a techno geek, when it comes to her tools. Moreover, her interest in and fascination with technology helps her to discover new ways of helping her clients. She also happened to have an affinity for engineering and innovation, and pushes the frontier of her tools to the limits.

Thus, one day Penijean discovered trascranial photobiomodulation (tPBM) and Vielight’s tPBM devices. What happened when a talented neurofeedback practitioner with a curious mind decided on combining neurofeedback with photobiomodulation. Let’s find out the answer directly from Penijean Gracefire, LMHC.

How long have you been working with transcranial photobiomodulation (tPBM)?

Penijean: I’ve been interested in how light affects brains and bodies for as long as I can remember. Sometimes I joke that my interest in the therapeutic applications of light began when I was four years old. That is when I discovered that I could soothe a fussy younger sibling using a prism. Even as a child I noticed that my mood was affected by light and color, and I wanted to know why.

I picked up my first infrared light therapy device in 2005. Then I spent some years using tPBM for peripheral applications, such as relaxation and pain management.

What have brought you to tPBM initially and why did you stay with it?

Penijean: My initial experience using tPBM to stimulate the peripheral nervous system was informative and useful. However, I found that the applications were limited for my interests. Eventually I moved on to interventions that focused more on the central nervous system.

In 2017, I met Dr. Lew Lim at a neurofeedback conference. Our discussion of his Vielight Neuro device reignited my interest in tPBM. At that time I had been sitting on ideas for integrating infrared stim (stimulation) into a closed loop neuromodulation design. Dr. Lim was willing to allow me to use the Vielight platform to start creating new techniques. My design concept incorporated both the tPBM and the neurofeedback protocols.

The early results from the prototype designs were very promising. Thus, tPBM has become a much more central element in my protocol design process. I found it to be an excellent and naturally fitting complement to neurofeedback.

Where do you see synergies between tPBM and neurofeedback?

Penijean: Research indicates that tPBM has potential to support synaptogenesis – the creation of new synapses. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4870908/

Neurofeedback relies on brain plasticity (https://en.wikipedia.org/wiki/Neuroplasticity) to help individuals learn new ways to process information and regulate stress responses. Injury or illness can reduce neural capacity to adapt in real time to the changing demands of our environment. Brains need healthy and flexible neural networks to be able to prioritize and shift attention. Furthermore, they need to have the capacity to signal the central nervous system to wind down and relax. For example, this would be useful when a busy day is over.

Helping brains develop new connections, which support better function, is an important part of neurofeedback training. In my view, tPBM can potentially support the growth of those new pathways.

Combining tPBM with Neurofeedback, have you noticed anything new that could have a strong potential for helping your clients?

Penijean: The “feedback” part of neurofeedback means that we are giving the brain information based on its own behavioral changes. Typically, this feedback consists of musical sounds or visual data displays or, perhaps, an object that physically vibrates. For the feedback to work, it needs to be sufficiently novel and stimulating to recruit the brain’s attention.

After experimenting with and designing a number of innovative feedback techniques, I created the first EEG-modulated pEMF designs. While pEMF stands for pulsed electromagnetic field therapy, EEG stands for electroencephalogram. This protocol design has tremendous therapeutic potential. At the same time, these new integrated training protocols were yielding very exciting results. However, I work with many populations that are medically fragile and have compromised systems. Therefore, not all cases were suitable for the information-dense combination of neurofeedback and pEMF.

Combining Neurofeedback and Photobiomodulation

For some individuals, integrated tPBM and neurofeedback offers the perfect balance. Thus, on the one hand, this combination provides not so much feedback that their system feels overwhelmed. On the other hand, it provides not too little feedback that would fail to effectively recruit the brain’s attention.

I adapted my designs and created the first closed loop EEG-modulated pNIR (pulsed near-infrared light) protocols. This means that the individual not only simultaneously receives both the tPBM and the neurofeedback, but the NIR pulses themselves are changing in real time based on live EEG.

The combination of neurofeedback and tPBM is like a conversation with a wise friend while sitting in the afternoon sun. You receive both, the benefits of learning new helpful things about yourself and the benefits of absorbing natural light.

TPBM is the light source that supports your brain energetically, as it builds new connections. When this happens, the neurofeedback takes advantage of this optimized learning state to help your brain develop better cognitive function.

Can you provide some examples of how you employ tPBM in your neurofeedback practice?

Penijean: The practical flexibility of tPBM in a clinical setting is one of its strengths. Whether I use tPBM as a standalone therapeutic approach or combine it with other modalities often depends on individual needs.

Some people are sufficiently responsive. Thus, for them, 5-10 minutes of tPBM by itself is enough to produce a noticeable impact. Other people are a little more resilient. For those, I may do multiple things in a session, but in a sequence instead of simultaneously.

TPBM can be an effective primer at the beginning of a session before introducing sensory grounding techniques, or heart rate variability training. By applying tPBM to the head, we can help stimulate neural activity immediately prior to a neurofeedback session.

When combining tPBM with other modalities, you are only limited by your own creativity. Therefore, I try to be as creative as appropriate. For example, I may have someone wear a pair of violet eye lenses while receiving a 40hz tPBM stimulation. This helps to create a shift in gamma activity. I can also have someone wear a pair of dark amber or orange lenses, when receiving a 10hz stimulation. This can help to support slowing down into a more alpha-wave friendly state.

I noticed that layering other inputs over tPBM can also help with state flexibility and integration. Thus, utilizing inputs like binaural beats, vibrating sensory aids, or progressive relaxation audio can be helpful.

What benefits do you see tPBM on its own and in combination with neurofeedback can provide at this stage?

Penijean: A helpful way to think about these modalities is in terms of how much of a resource demand they place on a nervous system. This can be in terms of demand on attention, arousal, processing and integration. Each technique is a different way of asking the brain to prioritize and learn from specific types of sensory information. Penijean Gracefire with Vielight tPBM devicesFurthermore, different brains may respond differently to the stimuli.

Some brains learn more easily when we present information to them in simpler ways. Those people make quicker, more noticeable progress, if they receive tPBM and neurofeedback separately. This separation can be done either during different sessions, or at different times during a session.

Other brains have more capacity for integrating complex information. They seem to benefit more from the combination of neurofeedback and tPBM. Often such individuals are less medically fragile and have more physical resources to help them process more dense cognitive tasks.

Both of these approaches are beneficial. Usually, we start with the simpler approach and build up over time to more complex feedback designs.

What benefits do your clients report during and following your protocols that include tPBM?

Penijean: Clients report results across a wide spectrum. Some improvements are expected, such as better sleep, more functional attention and cognitive flexibility, and less anxiety. However, I am pleasantly surprised by how frequently clients report unanticipated benefits.

For example, one elderly woman recovered her ability to remember music that she thought she lost years ago. An executive who came to reduce his anxiety around work was very happy to discover his golf game improved significantly. Children, brought in by parents concerned about academic performance, have noticed improved visual integration, better frontal lobe inhibition, and increased social awareness. As you can see, there is a lot to learn.

As you are aware, Vielight has developed and will be launching a unique new tPBM device, the Neuro Pro. What do you think the applications of the Neuro Pro can be for neurofedback practitioners and their patients specifically?

Penijean: Being both a health and wellness practitioner and a designer of innovative ways to interact with the brain, I am limited only by two things. These things are my own creativity, and the capabilities of my tools. I am someone who tends to push devices to their limits. Therefore, I am always looking for user interfaces that allow as much customization and choice as the platform can support.

The Neuro Pro is the type of device, which will allow to design and build tPBM sessions specifically tailored to a specific individual. The capacity for programming a series of pulses based on a person’s unique EEG signatures will be unprecedented.

While not every practitioner will want to design their own protocols, the Neuro Pro will still provide the platform for all practitioners to run the protocols developed by researchers.

New Brain Modulation Techniques

When new effective brain modulation techniques emerge, they can only spread as widely as the availability of the technology. Neuro Pro will support the innovation of new tPBM protocols. At the same time it will provide the devices by which these protocols can be implemented and used.

This means that neurofeedback providers will be able to pair up more precise tPBM protocols with the customized EEG biofeedback. Techniques that have not been possible before, such as cross frequency coupling feedback timed synced with near infrared pulses, to improve neural networks, or ramping frequency delivery protocols that help the brain learn state flexibility, may become much more accessible.

What could be the applications of this device for researchers and health and wellness practitioners dealing with human brains?

ISNR 2021 Vielight AdPenijean: One of the critical principles of interacting with the brain in effective ways is being able to observe and, to a degree, mimic some of the complex dynamics, which make up flexible neural states. The brain habituates quickly to repetitive stimuli, because so it can prioritize its limited resources.

The Neuro Pro offers the possibility of building more sophisticated and precise tPBM protocols. These protocols could not only capture the brain’s attention better, but also could produce informational sequences, which more closely match neural patterns. Thus, this Vielight device opens potential for advanced stimulation designs that can target network behaviors with more nuance and specificity.

What else would you like to add in conclusion?

Penijean: In an increasingly tech savvy society, as we are suffering from the habitual overexposure to specific light frequencies from heavy screen use, it seems poetic to me that we may be able to help rewire these brains using other types of light. The light is information. Our bodies rely on light sources to help us regulate various systems and functions. Thus, regulating circadian rhythms, affecting our sleep cycles, our immune systems, our metabolism, and our mental health are some possibilities.

Wavelengths of light are a language. The more we learn, the better we can speak to our body in ways, which it recognizes as familiar and healing. Transcranial photobiomodulation could be an invaluable mechanism in our pursuit of improving brain’s function and wellbeing.