Mental Health and Neurofeedback: Expert Insights from Live Q&A
This article captures key insights from a live expert panel discussion on mental health and neurofeedback, featuring clinical perspectives on brain training approaches and their real-world applications.
The Brain-Gut Connection: When Seizures Affect Digestion
One of the most striking discussions centered on the relationship between brain activity and gastrointestinal problems, particularly in autism and epilepsy cases.
Abdominal Epilepsy: A Hidden Phenomenon
Dr. Jay Gunkelman explained a fascinating clinical pattern: approximately 70% of individuals with autism experience GI problems, and this isn't coincidental. The culprit often lies in the posterior insula—a brain region that regulates gastrointestinal motility through smooth muscle control.
"As you drop down the homunculus from the feet on the top down to the hands and then to the face... as you get further in, the posterior insula is all of your gastrointestinal motility," Gunkelman noted. When seizure activity occurs in this region, it doesn't produce the typical muscle convulsions we associate with epilepsy. Instead, it creates painful intestinal spasms.
This explains why some individuals experience chronic digestive issues that don't respond to traditional gastroenterology treatments. The problem isn't in the gut—it's in the brain circuits controlling the gut.
A Case Study in Success
Gunkelman shared the case of Isabella, whose seizures began in the left insula and spread across both hemispheres. Her aura manifested as internal distress—a clue that pointed to the insula as the seizure focus. Neurosurgeons were preparing to remove part of her right temporal lobe when neurofeedback training targeted the actual source.
The results: Isabella has been seizure-free for over seven years, graduated with honors from Baylor on a tennis scholarship, and is now pursuing her master's degree. She specifically requested her name be included in the published case study because she wants to advocate for neurofeedback in epilepsy treatment.
Clinical Implications
This brain-gut connection has practical implications for practitioners:
- GI Specialists are Making New Referrals: According to the panel, some gastroenterologists now refer patients for brain assessment when scoping reveals no structural problems
- The Insula Shows Up in QEEG: Clinicians report finding insula abnormalities in children presenting with both attention problems and constipation
- Simple Solutions First: Before jumping to complex explanations, rule out basics like magnesium deficiency or anxiety-related somatic symptoms
Migraine and Epilepsy: Shared Mechanisms
The discussion revealed important connections between migraines and epileptiform activity. A high percentage of migraine sufferers show paroxysmal discharges in EEG recordings, which explains why anticonvulsants like Topiramate (Topamax) are commonly prescribed for migraine prevention.
This overlap suggests that some migraines may be better understood as seizure-related phenomena rather than purely vascular events. The implications for treatment are significant—targeting the underlying electrical activity might be more effective than focusing solely on blood vessel dilation.
The Complexity of Modern Mental Health
The conversation touched on broader challenges facing mental health treatment today. The panelists noted how various environmental and social factors complicate traditional approaches:
Insurance and Access Issues
Real-world barriers emerged in the discussion, from insurance companies withdrawing coverage from high-risk areas (whether for natural disasters or treatment challenges) to the practical difficulties of accessing specialized care. These systemic issues affect who can receive advanced treatments like neurofeedback.
The Need for Precision
The experts emphasized moving beyond one-size-fits-all approaches. Whether dealing with constipation in a child with attention problems or seizures mislocalized by traditional imaging, the message was clear: look at the actual brain patterns, not just the presenting symptoms.
Practical Takeaways for Clinicians
Several key principles emerged from the expert discussion:
1. Start Simple, Then Escalate
Before investigating complex neurological explanations, rule out basic factors like nutritional deficiencies or anxiety-related symptoms. Magnesium deficiency, for instance, can cause constipation that might be mistaken for neurological dysfunction.
2. Look Beyond Traditional Boundaries
The brain-gut connection exemplifies how neurological problems can manifest in unexpected ways. Practitioners should consider neurological factors in persistent GI complaints, just as they should consider GI factors in neurological conditions.
3. Use Precise Terminology
The experts were careful to distinguish between descriptive terms (like "paroxysmal" for sudden-onset, sudden-stop electrical events) and diagnostic labels (like "epileptiform"). This precision helps maintain appropriate scope of practice while communicating effectively with medical colleagues.
4. Consider Individual Mechanisms
Understanding why a specific intervention works for a particular person matters more than applying generic protocols. Isabella's case succeeded because the training specifically targeted her seizure focus, not because neurofeedback generically "helps epilepsy."
Looking Forward
The panel discussion highlighted how neurofeedback and related approaches are finding new applications as our understanding of brain-body connections deepens. From GI specialists making neurofeedback referrals to successful outcomes in complex seizure cases, the field continues evolving beyond traditional boundaries.
The key insight: many problems that seem purely physical or psychological may have specific, trainable neural mechanisms underlying them. Success comes from identifying those mechanisms precisely and targeting them directly, rather than treating surface symptoms.
This precision approach—whether for seizures, migraines, or attention problems—represents a shift toward truly personalized brain training based on individual neural patterns rather than diagnostic categories alone.
This article synthesizes insights from a live expert panel discussion. Individual cases mentioned were shared with appropriate permissions for educational purposes.