America's ongoing opioid epidemic has mired thousands of communities in a fight against addiction. The battle has been long and daunting, but a new project at the University of Dayton shows promise for people addicted to opioids by retraining their brains.
This potential recovery tool emerged in 2017 as part of The Ohio Opioid Technology Challenge. The competition called for innovative solutions to the opioid crisis. “Even if you’re not personally affected by the epidemic, you know people who are,” says Kelly Cashion Beigh, a software engineering researcher at the University of Dayton Research Institute who witnessed the effects of the epidemic and was inspired to enter the contest.
Her proposal: a neurofeedback system that would help those with addictions conquer their cravings by addressing core imbalances in the brain. Her idea was one of five to win a $10,000 prize in the first round of this competition. (The contest has three rounds and concludes in 2019.) We spoke to Cashion Beigh about her project and how biofeedback might be part of the solution sought by so many.
Shifting from software engineering to thinking about addiction and neurotherapy is quite a leap. How did that happen?
I was working on my master’s degree in electrical engineering, and as part of it I was doing a research project on brain machine interfacing, using [electroencephalograms] to read brain activity. Someone wearing the EEG could use the electrical impulses from their own brain to control a robotic arm, which could move down, pick up a pencil, turn and put it down somewhere else. It was pretty basic, but it was amazing to see what the brain could do. That’s how I knew I wanted to keep pursuing opportunities to work in neuroscience engineering.
When did it strike you that neurotherapy could be used as a tool for addiction recovery?
Within the brain, addiction looks like a lot of imbalances in the electrical signals between two main regions of the brain: the prefrontal cortex and the cingulate cortex. The prefrontal cortex area is a control center in the front of the brain with reasoning centers that are able to say, “No, I shouldn’t do this.”
The cingulate is in the center of the brain, and it handles emotions like fear, responses to basic needs and pleasure. When someone is addicted to drugs, the cingulate cortex gets too much control. Basically, that’s part of the imbalance that occurs.
When I read the initial request for ideas for the Opioid Technology Challenge I thought, maybe neurofeedback fits here. I looked into all the different applications of neurofeedback, and I found research on how it’s used to treat nicotine addiction. So I thought this could be a really helpful recovery tool for opioid addiction, too.
‘It’s pretty incredible, and it means that over time you can train the brain to be more balanced and resilient, and the changes seem to be permanent.’
Can you explain how a neurofeedback system works?
A neurofeedback system uses an electrode headset to read imbalances in brain activity and display them through a feedback mechanism. The mechanism could be a visual display or an audio track that lets the person get immediate feedback about how their brain is performing.
For example, to treat A.D.H.D., the display is usually a video. When a brain imbalance causes the person to lose focus, the video fades out. When the user starts to focus again, it comes back into full color.
One of the best analogies that explains how neurofeedback works is that when you look in a mirror you stand a little straighter. Because you have that immediate feedback, you can adjust your posture to present yourself better. When a person can see their own brain activity — immediately — they can make adjustments they couldn’t make without that kind of feedback.
Can you explain the different approaches you’re exploring?
The first uses a more traditional approach to neurofeedback. It involves having a trainer who does an analysis of the whole brain and then tries to pick out imbalances in brain activity that could be causing susceptibility to addiction. The trainer decides which wavelengths need to be balanced out and which areas to target for training. The trainer then comes up with a plan for the individual to train their brain to balance out.
The second approach is designed to be a lot more accessible to the user. It shows your brain activity and provides small interruptions to, say, a soundtrack, to indicate when your brain is getting off track. This approach also involves a trainer, but it really leaves the changes up to the person. This system would be easier for people at clinics to use.
‘When a person can see their own brain activity — immediately — they can make adjustments they couldn’t make without that kind of feedback.’
How do you see your program being used in the future?
We don’t think the training would work very well while someone is still on the drugs. But after they’ve been in a recovery clinic and gone through some of the processes to get sober, you can add in neurofeedback.
We expect it to take at least 30 sessions, minimum, to see a permanent change. We’d like to start using this program locally, and then expand it. As soon as we demonstrate the system’s effectiveness, we can take it to any recovery clinic in any county or state.
One of the psychologists we’re working with treated 20 people with opioid addiction as part of a study using neurofeedback. About 18 of them didn’t relapse. It’s pretty incredible, and it means that over time you can train the brain to be more balanced and resilient, and the changes seem to be permanent.
WORKING WITH THE UNIVERSITY OF DAYTON
The University of Dayton is committed to many ongoing community initiatives, and it has been able to offer generous support to Cashion Beigh throughout the research and development of her neurotherapy product. When she won the $10,000 prize for her proposal, the university provided ancillary program support, so the money she won could be channeled directly into product development for the second phase of the challenge. The winners, who will be announced in September, will receive $200,000 for further development. Those who make it to the final phase will get $1 million.
There’s still a lot of ground to cover, but Cashion Beigh says she feels optimistic about the potential for bringing her neurotherapy product to market — and saving lives. “I think our story’s strong because there’s a lot of support for treating addiction in Ohio,” she says. “And we believe the technology we want to apply has a lot of potential to make a big difference.”