Role of your Temporal Lobes

temporal lobe btne kittery

Clients often ask  me for more detailed descriptions of the lobes of the brain and their functions. For the next few Monday posts I’ll detail the different segments.

The temporal lobe is one of the four sections, or lobes, that make up the cerebral cortex of the brain. Located on the lower regions of both the left and right sides of the cortex (above and around the ears) , the temporal lobe is essential in processing sensory stimuli received from both the eyes and ears. It assists in coordinating speech and spatial navigation and contains the brain structures responsible for long-term memory. This is why when someone has a stroke over their left ear they often lose the power of language expression. Or a bonk to that area might have affected your memory or language processing.

Auditory Processing

  • The temporal lobe contains a section of the brain known as the primary auditory cortex. This region of the cortex is responsible for receiving and interpreting the information transmitted to it by auditory receptors (your hearing) . This part of the temporal lobe assists the brain in determining the location of a sound. While parts of other lobes in the brain play a role in auditory processing, the temporal lobe is the most important.

Speech

  • The temporal lobe located on the left side of the cerebral cortex is essential for speech. This left temporal lobe contains Wernicke’s area, a portion of the brain that is largely responsible for controlling the mental processing needed for speech, including comprehension and verbal memory.

Visual processing

  • The lowest portions of the temporal lobe are responsible for processing and interpreting information from the visual system, especially the most advanced types of visual memory. This portion of the temporal lobe contains the neural networks required for an individual to perceive and remember objects, faces and detailed settings and scenery.

Memory

  • The hippocampus is located in the temporal lobe; this structure is one of the most crucial parts of the cortex involved in long-term memory retention. The hippocampus is found not on the outer region of the cerebrum but within the actual lobe, and it allows an individual to retain new memories while storing older ones. These memories can be anything from facts learned by rote or memories of events that occurred in the past.

Spatial navigation

  • Portions of the temporal lobe, particularly the hippocampus, also play a large role in the ability of an individual to navigate spatially and to physically “remember” a place that the person has been before. People with a damaged hippocampus often get lost because their brains are unable to process, spatially, where they have been and where they are going.

Stay tuned to next week when I will write about the Parietal lobes.  Interesting stuff.  To get my weekly blog to your inbox, just press the follow this blog button.

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Brain Waves Basic

Four simple periodic rhythms recorded in the EEG are alpha, beta, delta, and theta. These rhythms are identified by frequency (Hz or cycles/sec) and amplitude. The amplitudes recorded by scalp electrodes are in the range of microvolts (μV or 1/1,000,000 of a volt).

rhythm Freq (Hz) Amp(μV)
alpha 8-13 20-200
beta 13-30 5-10
delta 1-5 20-200
theta 4-8 10

Alpha: The four basic rhythms have been associated with various states. In general, the alpha rhythm is the prominent EEG wave pattern of an adult who is awake but relaxed with eyes closed. Each region of the brain had a characteristic alpha rhythm but alpha waves of the greatest amplitude are recorded from the occipital and parietal regions of the cerebral cortex. In general, amplitudes of alpha waves diminish when subjects open their eyes and are attentive to external stimuli although some subjects trained in relaxation techniques can maintain high alpha amplitudes even with their eyes open.

Beta: Beta rhythms occur in individuals who are alert and attentive to external stimuli or exert specific mental effort, or paradoxically, beta rhythms also occur during deep sleep, REM (Rapid Eye Movement) sleep when the eyes switch back and forth. This does not mean that there is less electrical activity, rather that the “positive” and “negative” activities are starting to counterbalance so that the sum of the electrical activity is less. Thus, instead of getting the wave-like synchronized pattern of alpha waves, desynchronization or alpha block occurs. So, the beta wave represents arousal of the cortex to a higher state of alertness or tension. It may also be associated with “remembering” or retrieving memories.

Delta and Theta: Delta and theta rhythms are low-frequency EEG patterns that increase during sleep in the normal adult.   As people move from lighter to deeper stages of sleep (prior to REM sleep), the occurrence of alpha waves diminish and is gradually replaced by the lower frequency theta and then delta frequency rhythms.

Although delta and theta rhythms are generally prominent during sleep, there are cases when delta and theta rhythms are recorded from individuals who are awake. For example, theta waves will occur for brief intervals during emotional responses to frustrating events or situations.   Delta waves may increase during difficult mental activities requiring concentration. In general, the occurrence and amplitudes of delta and theta rhythms are highly variable within and between individuals.

Neurofeedback & Mental Health

Neurofeedback: a viable treatment for mental health issues?

hirshberg-cover-3.16

PHOTO BY TOM CROKE
Lawrence M. Hirshberg, Ph.D., BCN, said neurofeedback is almost never the first treatment for mental health problems. Hirschberg is director of the NeuroDevelopment Center in Cambridge, Mass. and Providence, R.I., and a Brown University faculty member.

The brain could be considered the communication center of the body, sending messages to every cell and keeping all systems running properly. But psychological or physical trauma can disrupt those signals. Researchers are finding that neurofeedback can repair broken connections and help restore functioning.

A traumatic brain injury involves the tearing of white matter connections in the brain that cause the whole system to be “out of whack,” according to Diane Roberts-Stoler, Ed.D., owner of Dr. Diane Brain Health in North Andover, Massachusetts.

She speaks from first-hand experience. In 1990, she suffered a stroke while driving, resulting in a head-on collision; fourteen years later she had a mini-stroke. Subsequently, two other separate accidents left her with concussions and traumatic brain injuries. During routine CAT scans and MRIs, doctors discovered a brain tumor and diagnosed permanent brain damage.

Today, thanks to neurofeedback, Roberts-Stoler has proliferated in her work as a psychologist, speaker and author who focuses on brain, health, sports and performing arts psychology.

“During a neurofeedback session, the clinician maps 19 points on the brain,” she explained. “The waves give the clinician a snapshot of the asymmetry, phase and cohesion in the brain. Neuroplasticity in the brain allows us to make new connections.”

In her practice, Roberts-Stoler uses different types of neurofeedback, including a Low Energy Neurofeedback System (LENS) and quantitative electroencephalogram (QEEG) to confirm a diagnosis and then attempts to find the cause of the “disconnect.”

Laurence M. Hirshberg, Ph.D., BCN, director of the NeuroDevelopment Center, located in Cambridge, Mass. and Providence, R.I., and faculty in the department of psychiatry and human behavior at Brown University, explained that neurofeedback records changes in brain function shown through EEG and functional magnetic resonance imaging (fMRI).

When a patient presents, Hirshberg reviews previous therapies, because in most cases, neurofeedback is almost never the first approach to a mental health problem.

“Ninety percent of patients have experienced multiple treatment failures/insufficiencies. Neurofeedback is only the first treatment in kids with ADHD whose parents choose not to use medication,” he said.

Prior to initiating treatment, Hirshberg evaluates the patient’s diagnosis, existing research on how to achieve an effective pattern of functioning for the diagnosis and conducts a QEEG that he compares to a database showing normal brain activity to establish a baseline. He solicits the patient’s observations both before and after a session, which help to fine-tune the settings.

According to Hirshberg, the neurofeedback protocol comprises two components: where to acquire the EEG signal, i.e., where to place the electrodes and what frequency to use.
Before beginning treatment, Hirshberg instructs the client to be calm and patient.

“There will be moments when the brain is not getting it. Those moments are as important as when things are happening,” he said. “It’s not volitional or intentional. It’s a different kind of learning.”

He noted that the patient views a grid on the computer screen. Recordings are taken every half-second; when a goal is met one section of the grid fills in. “When targets are met, a version of thumbs up is given to the patient. Think of it as behavior reinforcement,” he added.

Hirshberg reported that follow-up studies show neurofeedback to be effective across a spectrum of mental illnesses, including ADHD; PTSD; depression; generalized anxiety disorder; traumatic brain injuries and concussions; autism; sleep difficulties; attachment disorder; chronic fatigue and pain; and bipolar disorder.

However results are unique to each patient. “When treating a patient, there are individual outcomes. In some cases, we might reduce sessions from two times a week to once per week to see if the symptoms decrease in between. Some patients come back for a booster if they have severe trouble. Some patients train at home,” he said.

Neurofeedback causes no lasting adverse effects, according to Hirshberg, although there may be short-term issues. “For instance, in children with ADHD, neurofeedback can lead to difficulty falling asleep the night of the session. In such a case, we would adjust the dose and activation,” he said.

“One other side effect has been tics when training for ADHD. We had to stop treatment for a couple of patients.”

On its own neurofeedback can be helpful, but in some cases, patients engage in other therapies simultaneously.

“We like to initiate neurofeedback with a level playing ground. We ask the patient if he intends to do another therapy or take medications,” Hirshberg said. “We don’t want too many variables starting at the same time. Approximately 60 percent are on medication during neurofeedback.”

Mark Gapen, Ph.D., BCN, internship director at Community Services Institute, Inc. in Springfield, Mass., equates neurofeedback to “gym for the brain.” He sees the therapy as a way to access unconscious processes that are difficult to address through talk therapy. He pointed out though that “psychotherapy synergistically interacts with neurofeedback.”

Training to use neurofeedback involves four days of didactic instruction as well as firsthand experience, Gapen reported.

“As part of the certification process, you have to demonstrate that you have done 10 sessions on yourself,” he said. “I advise clinicians to start practicing right after completing the training. You will never master it, but you don’t want to lose what you’ve learned.”

Unfortunately, insurers currently don’t reimburse specifically for neurofeedback, said Gapen. “I would like to see insurance companies reimburse on an integrated psychotherapy and biofeedback CPT code at a decent level. This would allow more clinicians to accept insurance for this work,” he said.

Gapen also advocates for more neurofeedback-related education in professional psychology schools.

“We won’t expand neurofeedback unless we integrate it into the curriculum. Few graduate programs provide training in neurofeedback. We need more institutional presence and younger clinicians in the field,” he said.

Hirshberg reported that although some studies have demonstrated positive outcomes, a lot of work remains to be done. “There have been lots of claims of what neurofeedback can help, which are not always substantiated,” he said.

Hirshberg designed and coordinated a study funded by the National Institute of Mental Health, which should provide more solid information on whether changes are connected to the EEG feedback procedure.

By Phyllis Hanlon