About combining neurofeedback with photobiomodulation. An interview with a practitioner.

A creative and curious mind can be a beginning of something new, something important, 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. 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.

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.

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. Furthermore, 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.

You can read the full interview at: https://www.vielight.com/combining-neurofeedback-with-photobiomodulation, or by clicking on the image below.

Also, if you are interested in brain related research and its practical applications, join this LinkedIn group, Brain Research for Practical Applications and Noninvasive Neuromodulation: https://www.dhirubhai.net/groups/13983259/