What is Neuromodulation?
Neuromodulation refers to the psychophysiological and therapeutic processes of influencing neural activity through targeted assessments and interventions. These interventions can involve the use of electrical, electromagnetic, photic, chemical, sensory, or other types of signals to modify the functioning of neural circuits or networks within the central and peripheral nervous systems, either directly, or passively.
The goal of neuromodulation is to bring about specific changes in neural activity patterns, which can have a wide range of effects on various bodily functions and behaviors. All neuromodulation interventions are preceded by assessments of the target variable(s) of interest by instruments (tests, assessments, psychophysiological measures (e.g., Electroencephalogram (EEG), electromyogram (EMG), temperature, galvanic skin response, cardiac measures), and appropriate assays of blood, urine, and saliva).
While neuromodulation interventions are given, the same assessment tools are used to measure progress and effects on the target variable(s) of interest.
Neuromodulation techniques are often used to treat many of the same disorders as neurofeedback including but not limited to: neurological, psychiatric, and disorders of self-regulation and stress management, such as chronic pain, epilepsy, depression, traumatic brain injuries, posttraumatic stress disorder, autism spectrum disorder, attention deficit/ hyperactivity disorder, and Parkinson’s disease, among others.
These techniques may include:
1. Electrical Neuromodulation
This involves the use of electrical or electromagnetic currents to stimulate or inhibit nerve activity. Techniques like deep brain stimulation (DBS), spinal cord stimulation (SCS), transcranial magnetic stimulation (TMS), pulsed electromagnetic fields (pEMF), transcranial direct current stimulation (tDCS), transcranial alternating current stimulation (tACS), transcranial picowatt stimulation (there are several proprietary systems that use this technology), surface electromyography with stimulation (i.e., pelvic muscle dysfunction training), and transcutaneous vagal nerve stimulation, are examples of technologies that fall in this category. These technologies do not employ operant conditioning nor instrumental learning, so they are separate and distinct from all forms of biofeedback. Use of these technologies may be limited based on license type, and scope of practice rules, which differ from country to country, and between states.
2. Chemical Neuromodulation
Chemical substances and dietary supplements, such as precursors to neurotransmitters, amino acids, or medications, which are used to alter neural activity. For instance, medications that affect neurotransmitter levels can modulate brain function and treat various disorders, or Omega 3 fatty acids can be used for someone with behavioral symptoms of neuroinflammation. Use of medications is limited to medical providers (except in remote areas of the US where some behavioral health providers have prescribing authority), license type, and scope of practice rules, which differ from country to country, and between states. The use of dietary supplements in clinical practice may also be limited based on licensure and scope of practice.
3. Photobiomodulation
This is a more recent technique that involves application of red light, near infrared, far infrared, and low-level laser light, to accelerate wound healing and tissue regeneration, increase circulation, reduce acute inflammation, reduce acute and chronic pain, and help restore normal cellular function and mitochondrial DNA activity.
4. Biofeedback
Biofeedback employs physiologic sensors and instrumentation to assess, measure, and monitor over time, one of the body’s many systems that produce an electrical field or other measurable byproduct (epiphenomenon) of physiological activity (i.e., galvanic skin response, temperature, blood volume pulse, etc.) and by means of feedback (auditory, visual, tactile, or a combination) under the guidance of an appropriately trained person, can teach the trainee to take voluntary control over the measured system. The ability to self-regulate has been demonstrated to help people to increase self-efficacy, decrease the frequency, severity, and duration of chronic pain, headaches, migraines, and in recovery from physical and psychological trauma, among many other conditions. Neurofeedback (EEG biofeedback) is also a form of biofeedback.
The field of neuromodulation continues to evolve as researchers develop a deeper understanding of neural circuitry and its role in various psychophysiological and pathological processes. The techniques mentioned above have shown promise in providing new avenues for understanding and treating neurological and psychiatric conditions.
