JMA Podcast: Unlocking the Brain Using Neurofeedback with Cameron Center

Dr. Johnson (00:00:08) Good morning. I am Dr. Johnson with Johnson Medical Associates. I am the primary physician and owner, and it is my pleasure today to have with me Cameron Center. Cameron is head of our brain division at Johnson Medical Associates. At Johnson Medical Associates, we deal with many chronic disease problems. Those problems involve all parts of the body. The brain is affected by many of those. So if a person has allergies, it affects brain function. If they have a traumatic brain injury, if they have a toxic exposure, food reactions affect brain function. So it’s very important for us to understand the brain part of how we feel and then how actually it affects the rest of our body’s systems. It is the control part that controls not only our thought process, but our digestion, our movements, our breathing, our sleep patterns. So it is important we understand it. Over the years, it’s been my experience that we need to develop techniques to evaluate the different parts of the body, whether it’s pulmonary function for lungs, whether it’s stress test for heart, or diagnostic test that help us determine what the liver, the kidneys are doing. Measurement of toxins in the system to look at our body’s load of toxins, our genetics on how our body is handling what we’re exposed to, whether it’s exogenous toxins, or whether it’s medications. So today we’re going to discuss with Cameron the evaluation of the brain. There’s many ways to evaluate the brain. Most commonly, we see people have CAT scans or mris, the brain to look at brain structure. Then there’s different ways to look at brain function. And today we’re going to talk about brain function evaluation, which involves central nervous system evaluation, how good your memory is, what it looks like in short term, long term memory, as well as then how to help repair the brain. And so, Cameron, it is a pleasure to have you today with us. Cameron has a bachelor’s of science in psychology, business, and counseling.
Cameron Center (00:03:02) Correct.
Dr. Johnson (00:03:03) And then he also is board certified in neurofeedback. And it’s been my pleasure to work with him. And also prior to that, I worked with Cameron’s father, who’s in Fort Worth and is a PhD psychologist. So it’s been a family thing for you.
Cameron Center (00:03:21) Right.
Dr. Johnson (00:03:24) Could you tell us a little bit about your background and then exactly what neural feedback is and what it’s useful for and how it can help people to improve their sleep patterns or different functions of the brain that they may be struggling with?
Cameron Center (00:03:43) Absolutely. So there’s a lot to unpack there. Right. So we’ll start by how I kind of got into the field of neurofeedback and QEG assessment. So, as you alluded to, my father works in the field, and he started working in neurofeedback when he was finishing his counseling and psychology degrees and was working in mental health care hospitals. And he’d come home, never forget, he’d come home at 10:00 at night, be exhausted, way more exhausted than when he would come home from military service, spent 23 years in the Marine Corps, retired, and then got involved in counseling and psychology. And he would complain about how the system was sicker than the people that came in to get help. And so I just never forget him expressing that frustration with the fact that he wants to help people but doesn’t really know how to help people. And so he started working with Dr. Amon in the change your brain, change your life book, realizing that why is it that psychiatrists are the only doctors in the medical industry that don’t image the organ they work on? It doesn’t make any sense. If you broke your arm and you went into the hospital and they tried to put a cast on you without an x ray, you’d say, wait, we’re skipping a step here. But people who go into mental health facilities frequently don’t have their brain imaged or any other organ imaged to see what’s going on in terms of biological processes. So, long story short, my dad started getting EEG equipment so that he could kind of unpack and unravel what are ways to assess the brain to combine with other therapy modalities, like counseling? Or eventually what it led it into was neurofeedback. So my first experience was his guinea pig. In high school, I got hooked up to the EEG because my sisters didn’t want the gel in their hair, so I was voluntold. Right? And so that was my first experience just with the hookup process and seeing how the technology worked. And then I helped him set up his business just putting furniture together, and just saw him kind of grow from working in the mental health care hospitals into working specifically with patients using this technology. So when I went off to college, I went to go do my own thing. I was pre law and got the opportunity around my junior year of high school, or of college, rather, to work as an intern while I was finishing up my psychology degree. And so I gotten a call and said somebody was looking for some technical help who needed somebody to just set up computers and printers and all that kind of stuff. And so that was my first experience just working in a clinic. And it was with a social worker. It wasn’t even with a medical doctor. And what they were working with was specifically biofeedback, teaching people how to calm their heart rate through different breath exercises, and then also into the introduction into QEEG. So we kind of alluded to measuring brain function and using technology to assist in our assessments of brain health. And what we use is quantitative eeG. And quantitative eeg is similar to neuroquant, which is a quantitative MRI, where it takes the raw data of an electroencephalography and compares it to a normative database so that you can see, in a comparison to healthy brains, what areas of the brain may be overactive or underactive in terms of using too much energy or too little energy, talking too much or talking too little or going too fast or going too slow. And so that was kind of my intro was just getting thrown into it with my dad being involved in the field and then getting some hands on experience in college. And so when I started working as an intern, I was like, man, this is really cool work. People are getting a lot better when they’re training the brain instead of just talking about their issues or just taking medication to try to address their mental health symptoms. And so I finished my degree in, like you said, psychology, counseling, and business, and had wanted to go on for a higher education, but there really wasn’t anything available to me at the time. So I got my certification in neurofeedback, continued working at the clinic that I was interning at, but was now the lead neurofeedback technician. And then around 2020 was when I got a call from you saying that you were looking for somebody to come on to bring neurofeedback into the practice. Right. Because you were already doing some QEG assessments for your hyperbaric patients, for those people who were coming in either with history of head injury or toxicity that was causing neurological symptoms. And you were already doing those assessments for pre and post hyperbaric oxygen therapy, but you wanted to add neurofeedback in. Right? And so what is neurofeedback? Neurofeedback. I mentioned biofeedback earlier, where biofeedback is a process where you measure any biological measurement. So what? Heart rate, galvanic skin response, EEG. And you use that measurement and the education of what you’re measuring to change the function. So the easiest way to think about it is through heart rate. When we breathe at a certain pace, our heart rates will follow that breath pacer. And if you measure the heart rate and you measure the breath rate. You can actually see it on a screen in front of you, change as you change your heart rate. And so what neurofeedback does is it’s EEG biofeedback. We are informing the brain on what it is doing electrically to try to encourage a change via operant conditioning through a positive and negative reinforcement. So the way that looks or the way that works is you’ve got an EEG cap on your head while it’s measuring all the little squiggly brainwaves as they’re going on in real time. And there’s a lot of different ways to montage the EEG out. We use a 19 channel z score montage, which allows us to look at deeper structures in the brain, not just the cortical structures. And we measure the electrical efficiency in comparison to those databases. We see what areas are underactive, overactive, et cetera, like I was just explaining. And then we retrain the brain by encouraging it when it’s electrically efficient and by de habituating when it’s not. So the way that looks is you’re watching a tv screen, and when the brain is in that sweet spot of it’s doing what we want it to do, if we’re working on focus and attention, we want the fast wave activity to come out and the slow wave activity to calm down. And when that happens, the screen goes bright and the sound of whatever they’re watching goes up. And then as that slow wave activity comes back that is associated with the symptom of inattentiveness, the screen goes dim and the sound goes down. So through that positive and negative reinforcement, the brain can actually retrain itself how to be more efficient. So that’s kind of why we introduced it, or why you introduced it, rather, into your practice, as another modality of treatment for certain brain deficiencies, as well as the assessment tool of what’s going on and what’s changing in people’s brains as we go through treatment processes. I know that was kind of a long winded how I got into it and what we’re doing with it.
Dr. Johnson (00:11:42) Thanks so much. Very good explanation. So, basically, what you’re doing is looking at how to reinforce the good parts, decrease the negative input in the brain so that the brain can function and communicate within itself, connectivity wise, so that it is efficient in its function. So you aren’t using extra brain energy, but also optimizing the areas that need to be optimized for optimal brain function. And we see that many different people have problems with focus, with attention. And one of the things we were talking about earlier was people like with add focus problems, kids particularly have problems with it. What’s your experience with working with these type of individuals?
Cameron Center (00:12:39) Well, ADHD is, I think, the sweet spot of neurofeedback training because of the nature of having to pay attention in order to get the feedback response. So first of all, in terms of assessment for ADD, the DSM five is calling it ADHD. Now there’s ADd is no longer in that diagnostic category. But at the end of the day, we’re really not that interested in what the categories are labeled. Right. We want to see what is the function of a person’s central nervous system and why are they not able to pay attention. We see that the lack of ability to pay attention as a symptom and what’s causing that symptom. Right. So for your typical inattentive ADHD, the brain is stuck in a brainwave frequency called theta, which is one of the slower frequencies and it’s associated with daydreamy, restful, but not necessarily into sleep. And when we’re measuring their eeg and they’re sitting there in a resting state where a normal brain would be oscillating at nine to 10 hz, theirs are oscillating somewhere between six to 8. So there is a lack of fast wave activity for them to be able to push their attention towards something that they are intending. So the misnomer is that people with ADHD can’t pay attention and that’s not necessarily true. It’s they can’t choose what to pay attention to. Right. It’s the squirrel moment, right, where you just get pulled away from whatever it is that you’re wanting to keep your attention on. And so through the assessment process, we’re trying to see what are those brainwave frequencies and ratios looking like? Is there more theta activity in a resting state than alpha and beta? And if there is, then that person is going to struggle with those symptoms.
Dr. Johnson (00:14:38) Let’s back up just a bit so people can understand what we’re talking about. Because you have slow waves and then you have fast waves, right? So the slow waves are what you need for what type of activity and the fast waves are. Then what do you need?
Cameron Center (00:14:54) Just. Yeah, let’s simple term, I’ll take a step back and just go through all of them. So when we’re talking about waves, what we’re looking at is on an eeG, how often does the signal go up and down? Within a second. And however many times it goes up and down within a second is the hertz or the frequency. So one to four times per second is delta, a delta wave. And it looks something like that, where it’s slow and rhythmic. And that happens when we get into deep sleep, deep, restful sleep, especially into true deep sleep, not quite rim as the eyes are moving rapidly. But when we’re getting deep restorative sleep, our brains get into delta waves. Now that’s a healthy delta wave. We’ll see excess delta wave activity in aging populations. For people who are going through dementia type processes, Alzheimer’s and dementias, those are.
Dr. Johnson (00:15:55) The people that are older that are sleeping all the time, hard to arouse, right?
Cameron Center (00:15:59) And when you put an eeg on them and they’re awake in your office, but their brains are making excess delta activity, that’s usually no good. And if you think about it just from a physics standpoint, if things are moving slowly, then you’re not going to be able to have fast excitatory processes. And so when a person’s brain is in delta, they’re usually resting, they’re sleeping. Now, when we see a lack of delta activity, it’s usually evidence that that person has not been getting enough deep, restful, quality sleep. So that’s one to 4 hz delta associated with sleep and rest. Five to 8 hz is considered theta, which I mentioned earlier. And theta in a healthy brain is associated with inattentive daydreamy, not focused and paying attention or mindful, but internally focused. So when you meditate, your brain goes into a deep theta state. In fact, when they do eegs on the tibetan monks, when they go into deep meditation, it’s incredible how much their brains completely go into a theta state. It’s like they’re not on this planet anymore. They’re completely in their own heads. And the experience of the meditator would tell you that that makes sense. We see that again, excess theta activity, though, in people who’ve had history of head injury or have had a recent concussion, the thought is that as the brain is injured, it goes into those slow wave functions for healing, resting and repairing. And so when you have a hit to the head, oftentimes the brain will get stuck in a theta state where you’re inattentive and daydreaming, not really focused on what’s going on around you, but more internally focused. A reduction in theta can oftentimes be seen as restlessness. You’re not able to get into those meditative, calm, relaxed states. Nine to 12. Next frequency range is alpha. And it’s called alpha because when they first started putting eegs on people’s heads. That was the first brainwave frequency that was picked up. And alpha is kind of the gatekeeper between focus and concentration and rest and relaxation. So it’s like neutral in your car. If you can’t idle an alpha, you’re going to have a hard time speeding up or slowing down. We see too much alpha, especially in the frontal lobes. With adults, it can be indicative of depression symptoms where the executive functioning network and that frontal lobe functions are idling too much can be an issue. And a reduction of alpha can be similar to the same thing as a reduction in theta, where you’ve got the inability to be focused and relaxed. And then as we move on in frequencies, we get into the different beta ranges. And the reason why I say beta ranges is because beta is the brain in action. So the first range is that twelve to 15 hz, where we see that, especially over the sensor of motor rhythm, the SMR frequency, which is awake, alert and ready for action. So if you imagine, like your shortstop, who’s still. But as soon as that ball is hit, they’re going to react to it and they’re ready to move. Their brains are resting in a little bit faster state than what we are just sitting here, right. We see a lot of different things pop up in beta, especially when I first started working for you, we noticed that a lot of those people who were dealing with mold toxicity had this interesting pattern of high beta activity right on the top of the skull. And as we did our research, we realized that that’s actually an inflammation biomarker. And so we started to see that that inflammation biomarker went down when people were being treated with hyperbaric, which was really interesting. We can talk about that in a minute. So beta is the brain in action, right. And the faster you get, the more energy that’s being spent as the fast frequencies use a lot of energy, even though they’re small in terms of their voltage. So healthy beta brain function in terms of processing information, learning, doing any sort of high order thinking, if you have too much beta, it can be indicative of anxiety or stress, the overrumination of the brain or hyper vigilance. And then a reduction of beta is similar to an excess of theta, where you don’t really have all of the energy necessary to have all your mental faculties about you. So if you have a reduction in beta, you’re going to find it hard to focus and concentrate, to learn new things, to have areas of the brain connect that don’t normally connect, that you need to connect in terms of learning. Right. And so, for our ADHD population that we alluded to, we see excess theta and reduced beta, and we look at that ratio of what the theta to beta looks like. If a person is complaining about those symptoms, I can’t focus, I can’t concentrate. I’m having a hard time. I feel like I’ve got brain fog all the time. And we’ve obviously done all the panels of what could be causing these symptoms. And at the end, there’s nothing that we see, but they’ve got a genetic history. Mom and dad have a hard time focusing, paying attention. They’ve been diagnosed with ADHD and been put on ADHD medication at times before, but it’ll work for a little bit, and then it stopped working. And so a lot of adults who were given the ADHD label and have been dealing with medication on and off, oftentimes find that the meds aren’t doing their job as they were at the beginning. And so if they’ve got these biomarkers that we can track and then train, we can address those symptoms through retraining the brain. So my job, when I’m working with folks like that, I’m a trainer, I’m showing them what their brain is doing. I am informing them on tips and techniques and tricks in order to bring their focus to the forefront of their attention. And then the feedback process of using the EEG to inform the person that, yes, you’re on it, you’re focused, or you’re attentive, allows them to go through that training process in the same way that you would go to the gym and lift weights until your muscles get bigger. Right. It’s the person sitting in the chair who’s doing the work themselves in order to retrain their brain based on the biomarkers that we measure that correlate to those symptoms that they’re dealing with. So that kind of gives you a brief explanation of the brainwave frequencies and how they’re important, both in terms of a healthy brain and also what we expect to see in people who are dealing with symptoms. And so the QEG assessment helps us to analyze and find those areas of deficit, and then the neurofeedback process allows us to use those measurements to then retrain the brain to address symptoms.
Dr. Johnson (00:23:32) Excellent explanation.
Cameron Center (00:23:33) Thank you.
Dr. Johnson (00:23:33) Thank you so much. It is important, as we go through and evaluate patients with chronic type problems, as you have been describing, that we understand what the brain is doing. The brain is the control mechanism. If the brain is not functioning right, then it’s hard for the person to feel good and to function well in the environment. And as you pointed out, anxiety is a big issue today, and it’s part of what could be ADHD. It can be just part of our constant exposure to stressful situations in our daily living, with all the input we have from social media, from people around us, from stressful situations. So that that plays a part in trying to help people to feel better, to cope with their environment. At Johnson Medical Associates, we see there’s many environmental factors that affect the person’s individual function. And it can be foods, it can be the environment around you, which is pollens, dust, molds, exposure. It can be indoor mold exposure, toxins, as you talked about, which affects the brain, and it can be prior head injuries. And this is one of the things we see fairly frequently. If you do not take a full history and ask them about prior head injuries, it does not show up, but it is picked up very easily with a QEG. And we see people that have fallen as kids, were dropped as babies, even sports injuries, people that play soccer, that head the ball frequently.
Cameron Center (00:25:25) They don’t think about it, do they? They don’t think about those as head injuries.
Dr. Johnson (00:25:28) No, they don’t, but they do show up. And what is significant when we run a QEG. So if people are having cognitive function or dysfunction, trouble with focus, with concentration, headaches, sleep problems, QEEG is very helpful in defining what actually is going on, and then a definitive treatment can be formulated for them, whether it’s neural feedback. What we have found in doing our studies with and in conjunction with hyperbaric is that you were telling me the response that the patients have if they’re doing hyperbaric with neurofeedback is much more rapid.
Cameron Center (00:26:24) They’re definitely synergistic. Yeah, there’s no doubt about it. Where when I first started working for Dr. Johnson, I had worked at a clinic previously that just did neurofeedback and biofeedback. So I had some experience on what I expected for response time for people when we’re doing neurofeedback training. And I started getting a handful of patients who had already completed 20 to 40 hours of hyperbaric, and they were doing five to ten sessions of neurofeedback before they would go off to school or whatnot. We had a lot of college students that come in because dorm rooms are notoriously moldy. And, yeah, we saw them train really well and really quickly towards. We call it towards z equals zero, because we’re looking at standard deviations. We always want those most deviant measurements to work their way towards the norm. And I was noticing that, yeah, after people were doing hyperbaric oxygen, that movement towards the norm was happening at an accelerated pace. And after doing some research into hyperbaric, that makes a ton of sense because, well, you get a lot of accelerated paces with the hyperbaric oxygen, particularly in the way that it affects cellular function. And at the end of the day, when we’re encouraging certain brain function, those things are happening at the cellular level. And so if you can increase cell function by eating well, sleeping right, and getting good exercise or doing other treatment modalities like hyperbaric, then the system is going to work a whole lot better. And I wanted to mention, as you were explaining different things that we’ve used before with head injury. Oftentimes, as I’m training people using these technologies, I’m also teaching them about their own the things that we do on our everyday life that affect our brain function and our physical health, which are these three, diet, sleep, and exercise. And it’s incredible how many people come to us and are complaining about symptoms, and no one has ever talked to them about those three things. They don’t talk to them about what they are putting in their body and what they’re eating. People don’t ask enough questions about sleep and sleep hygiene. You mentioned about how much of our environment can affect our brain function and our health. So much of the environmental issues are self administered. We have our phones on too long at night. We stay up watching tv for far too long. We don’t drink enough water. We drink too much sugary beverages. We all like to put tons of sugar and milk into our coffee in the morning. We’re highly caffeinated, which is not necessarily a problem. But if you’re not sleeping and you’re using caffeine to get your focus in the day, you’re working up a creek without a paddle. The best thing you can do for focus is get good sleep. And when people are saying, oh, I sleep 8 hours a day, and you’re like, well, what time are you sleeping for 8 hours from 04:00 a.m. To noon, it’s like, but that’s not good sleep. Yeah, you may be getting 8 hours, but you want to sleep when the sun is down. So much of our hormone system and the way that our brains and bodies function is based on what’s going up in the sky. And so if you’re avoiding the first early morning sunlight, and then you’re like, well, I can’t focus. It’s like, well, try being up when the sun is up, right. And so a lot of what we try to do, and one of the reasons why I was so excited to start working with you a few years ago was the idea of actual, true functional medicine and holistic care. Right. Where we’re not just looking at one test, and we’re not just looking at one thing, but taking into consideration not only an extensive history, but also explaining and teaching people what they can be doing on their own. So they’re not just looking to you, the doc, to fix them.
Dr. Johnson (00:30:27) Right, exactly. So many patients I see come in and say, well, this medicine is not working. That medicine is not working well. It’s not a medicine that’s causing the problem, and the medicine is only trying to alter some sort of function in our body. Medicines are important. Don’t get me wrong. They really help a lot of things. But when we’re trying to look at optimal health, how to take care of yourself, and how to fix a lot of these chronic, ongoing problems, you have to look at underlying factors, and one of them, like you say, is sleep. And you have to have good sleep for your brain to function well, and the rest well. And I see people coming in all the time saying they’re fatigued and they’ve never had a sleep study done or monitoring overnight whether they are hypoxic. There’s a simple device that I give my patients that fits on your finger measures your oxygen saturation. People are much more familiar with them since COVID because everybody has an oximeter. I have them in the office where they monitor overnight your oxygen saturation. And I’m surprised at the number of people that desaturate during the night. They have apnea type episodes. If you have those episodes, you do not sleep well, you do not get restful sleep. So that’s an important issue. So Cameron and I work together to help people improve their overall health, their brain function. And in order to do that, as you were explaining, you have to have a good diet. People that have food reactions causes brain dysfunction. It also causes stimulation. One of the old, old techniques to measure food reaction was to eat one food at a time and measure your pulse before and after eating those foods. If your pulse increased ten to 15 times more emitted from before to after eating, that was a stimulatory food to you, and would be implied that maybe omitting that food would help decrease your anxiety, help your focus. And from that point, people work. Then forward. Now we do different blood tests to help define food sensitivities, we do skin tests to define it. And then we put people on healthy diets, omitting the foods that they are reactive to or stimulatory to help with this, to calm their brain down. We see that a lot with hyperactive kids, that different foods will affect them. We see it with adults frequently. We see people that are dairy intolerant, people that are gluten intolerant, and then people that react to different spices, like garlic and onion, oftentimes cause problems with people. So as we work together, if people are having problems, we look at diet. Cameron then works with them with helping to normalize their brain function through the neurofeedback. And then there’s some other techniques that you use. Also, there’s different devices that work with the vagus nerve, different devices that work with the alpha waves. Can you explain some of what those devices are? There’s even light devices, right?
Cameron Center (00:34:07) Yeah, the light devices. Yeah, they’re cool. So we break down different techniques. So we got neurofeedback and biofeedback as training techniques, and then we’ve got what we call neuromodulation, which is anything that is going to encourage the brain to do something different, or the central nervous system to do something different than what it’s doing before using stimulation anywhere from small electrical pulses, using transcranial alternating current system or stimulation, a transcranial direct current stimulation. Pink noise and random noise, which have an influence on the way that the brain responds to that. Used to, like, even 1015 years ago, we thought hitting the brain with random noise confuses it. What we realized now is that the brain is the most random noise generator in the known universe. Our brains are more complex than what we understand universes as. Like, star systems are. So it’s way bigger than what we expect it to be. And so the way it responds in modulation, oftentimes is it actually will reset itself when it’s given random noises to play with or different types of random noise stimulation. So there’s white noise, what we know as background noise. That’s just really, truly random pink noise, which is an inverse solution of a random noise generator that causes the brain to reset. In a way, it’s a very broad description of what’s happening in that. And then a little less intense stimulations in the electrical side of things is a PEMF. So we work with some practitioners that use the large magnetic coils, like Dr. Miller, using the mert and magnetic resonance therapy. We have PEMF in our office, pulsed electromagnetic field stimulation, which uses coils to create a very small, about five volt magnetic frequency field that will increase blood flow. So when you put a coil of Pemf on a shoulder, knee, head, anywhere, it’s going to increase blood flow in that area. You’re going to have an activation of glial cells, which are all the non neuronal cells within the central nervous system, all the supporting figures, and then you can modulate to stimulate at certain frequencies. And because the brain is an energy efficient organ, which is both to our benefit and demise, part of the reason why things like depression, anxiety, and ADHD become cyclical cycles, or rather cyclical experiences of the brain, is because the brain is an energy efficient organ, and those are defense mechanisms. Anxiety is a defense mechanism. Something happened that’s causing me to be on high alert and stay on high alert so that nothing bad happens again. Right. And so the energy efficiency part of that needs to be worked on. You have to show the brain, hey, it’s actually more efficient. Now you’re out of that situation. If it was an experiment or environmental issue or if it’s genetic, you have to show it, hey, it’s better to function like this than like that. So when we’re using PEMF at specific frequencies, you can encourage the brain. So if you’re working on ADHD, you can encourage it to hit it with an alpha Hertz frequency so that resting state isn’t quite in the theta and the brain will follow it. You’re showing it what to do, but it doesn’t, not always stick in the same way that medication doesn’t stick. Those are stimulation techniques that can be helpful in the immediate future for symptom relief. And we’ll use it to kind of show the brain what we want it to do. And then we’ll go through the neurofeedback process and actually have it do it on its own, reward it with positive reinforcement when it’s doing what you want it to do and then deabituating when it doesn’t. So that’s pemf. Then you’ve got vagal nerve stimulators, which has really become our favorite. Right, because so many deficits that people are dealing with is affecting their vagus nerve. And so really quickly, for those of you who don’t know what the vagus nerve is, it’s one of the longest nerves in the body, starts at the brain stem. It works all its way down. It innervates in the neck, it attaches to the heart, it attaches to the diaphragm and then it goes and attaches to the colon. The vagus nerve comes from the latin word vagabond, which means to wander. And when you see that nerve in the body, it looks like a tree branch that’s wandering up the body and even wanders up the neck and then attaches at the brain stem. And it’s in charge of the parasympathetic side of our central nervous systems. So we’ve got sympathetic rest, our fight or flight parasympathetic rest and digest. And the vagus nerve modulates when we go into rest and digest. We saw that people with long call Covid were having a lot of issues in vagal tone and their vagal nerve function, where their digestion was off, their sleep was off. All the things related to the parasympathetic nervous system function were dysregulated. And there’s a couple of different ways to stimulate that nerve. The easiest and cheapest way is through diaphragmatic breath, because that nerve attaches to the diaphragm. So when we teach people HRV techniques, we’re teaching them how to stimulate the vagus nerve.
Dr. Johnson (00:39:46) Explain HRV technique.
Cameron Center (00:39:47) Yeah, so I mentioned it earlier where we’re measuring the heart rate, and then you’re showing the person a breath pattern to follow. So if we are in a resting state and you’re using your diaphragm to breathe, your heart rate should follow a pattern of your breath rate, so that when you breathe in, the heart rate goes up, and as you breathe out, the heart rate goes down. And what you’re measuring is the variability of the beat to beat interval. So how high does the heart rate go and how low does it go in the middle of the breath? And the greater that variability of the upbeat and the downbeat, the healthier or the more resilient the heart. This is why we see runners have really low resting heart rates, but they can also have a high heart rate for an extended period of time, and their heart be pumping efficiently. Well, we also want our hearts to be pumping efficiently when we’re resting. Right. And so oftentimes we see people with anxiety, especially, or some of these other food related symptoms, that their heart rates are elevated. They’re in a sympathetic fight or flight mode when they’re not supposed to be what we would consider a dysregulated sympathetic nervous system response. And if you teach them how to calm their nervous systems down on their own, well, then they don’t need to pop that Xanax so that breathing looks.
Dr. Johnson (00:41:22) Like Watt, when you are teaching somebody.
Cameron Center (00:41:24) So you got a heart rate monitor going, they can see their heart rate on screen in front of them, and you show them a breath pattern, and the breath pattern will go sinusoidal. One of the easiest ways to do it is on your Apple Watch. Your Apple Watch mindfulness app has this. I don’t know if I can get that on the screen, but if you go to the mindfulness and you go to your breathe app, it’s measuring the heart rate through the little electrode on the bottom, and it tells you when to breathe in and when to breathe out. And it will tell you what your heart rate is at the end of the exercise. So people can take their apple watches, measure their heart rate, do a little breathing exercise, watch their heart rate go down. Congratulations. You’ve just done biofeedback, the most basic form of biofeedback, and I would argue the most helpful. I think everybody needs to know how to do diaphragmatic breathing exercises.
Dr. Johnson (00:42:11) And so when you do that, what’s the ratio of breathing in to breathing out?
Cameron Center (00:42:15) Good question.
Dr. Johnson (00:42:16) And then some people work with holding their breath in between.
Cameron Center (00:42:20) There’s a lot of different techniques. The military teaches box breathing, which is a way where you inhale for four, hold for four, exhale for four, hold for four. They call it a box because it looks like a box. Right. And that helps with holding the gun steady as you’re aiming. The technique I tend to teach is a sinusoidal breath. And what I mean by that is an even breath rate in and an even exhale ratio out, about a twelve second breath. So five breaths per minute. When you’re setting them up on these devices, that’s how they get set up. So it’s a five second InHale, a 1 second hold, five second exhale, and a 1 second hold. And I have people put one hand on your belly, one hand on your chest, and make sure that it’s your belly hand that’s rising and falling and that your chest cavity is staying still. If you breathe with your chest, that’s no good. Your lungs actually want to expand down into the end of the abdomen, and that’s how the vagus nerve actually gets stimulated in that.
Dr. Johnson (00:43:26) Actually, when you breathe, there’s different muscles that are part of your whole breathing mechanism, right? You have chest muscles, but the main muscle is the diaphragm muscle, right? And the diaphragm looks like a big dome sitting here under your ribs. And it goes up and down.
Cameron Center (00:43:45) Right.
Dr. Johnson (00:43:45) And that’s why singers, runners, everyone, that has efficient breathing is mainly from the diaphragm, but then the chest has to be free to move so it can expand to its optimal breathing capacity. And a lot of times I see patients come in and they don’t know how to breathe.
Cameron Center (00:44:03) Right.
Dr. Johnson (00:44:04) And you try to do a pulmonary function test on them to see whether they have asthma or not, and you have to explain to them how to breathe first. So you get an accurate pulmonary function test.
Cameron Center (00:44:14) Yeah. It’s interesting, isn’t it?
Dr. Johnson (00:44:16) Yeah, it really is.
Cameron Center (00:44:18) So through doing HRV, that’s the first way to do vagal nerve stimulation. We’re still on the vagal nerve, right. And there’s a lot of different, because that nerve is so long, and it goes so many different places. There’s a lot of different ways that you can hit it. One of the first places I ever used when I was working in the other clinic, you put two little electrodes on the mastoid bone right here behind the ear, and you stimulate. There are different frequency protocols. The one that we tended to use was fairly simple. It would cycle through about three or four different frequencies as a delta theta, an alpha wave, kind of going through the whole gambit. But it was just stimulating back there and hitting that vagus nerve. While I was having people do breathing exercises at the same time. And it’s funny, every time you’d hit somebody who was anxious with it, the first thing is like, man, I feel like I’m in a hammock rocking a little bit. It’s because you’re hitting that vagus nerve, and then this is kind of nice, and you’ll see them, they’ll get a little smile out of their face, and then they’ll start breathing. And then after a while, because I’m measuring the eeg the whole time. And one of the things that really is the biggest enemy of good neurofeedback training is muscle tension. If people are carrying tension in their jaws or their forehead, then I can’t pick up what’s coming off of the brain. It’s all what’s going from the muscles. And so one of the first things that happens when you see people go into a relaxation mode is the tension releases. And so we get the tension released, and then now, all of a sudden, we can do really good biofeedback training and neurofeedback training, rather, because we’re not just training what’s going on with the muscles around the face. So we’ve got different devices, one of them that we rent out to people or we check out it’s called a gamma core, and it stimulates using two electrodes that go right here on the neck, and it’s on both sides. And that device is specifically indicated for migraines and headaches. Because migraines and headaches are vagal in nature, the vagus nerve modulates the activity that can cause a migraine or cause a headache. And so we get people that device, they’ll hit themselves with it. A couple of times we’ve had some people who’ve had some digestion issues. Their GI tract is just inflamed and unhappy. Their gut doesn’t want to accept anything. Stimulate the vagus nerve, do a little breathing exercises. All of a sudden, the gut has calmed down a little bit, and those symptoms are relieved.
Dr. Johnson (00:46:53) Well, one of the things with the vagus nerve is in all nerves, all cranial nerves, is there’s afferent and eferent. I mean, outgo and input.
Cameron Center (00:47:04) Right.
Dr. Johnson (00:47:04) And the vagus nerve has a lot of feedback from the parts it innervates.
Cameron Center (00:47:09) Right. We talk about the gut brain connection. Right. And that’s that connection.
Dr. Johnson (00:47:14) Exactly. And so you’re not only working with what the brain is telling the end organ, but also what the brain is receiving back. And that whole system has to be in balance for you to feel good.
Cameron Center (00:47:29) Absolutely. And that’s part of the reason why HRV is so helpful, because our brain can tell our body, hey, something’s not right. You need to be anxious. It’s like your eyes see the lion and it tells your heart, pump faster. It’s time to run. Right?
Dr. Johnson (00:47:45) Right.
Cameron Center (00:47:46) Well, the opposite is true. The heart can be in that mode of function, whether it’s because you’re not breathing right or it’s because you’re eating stuff you shouldn’t be, you’re not sleeping. But if the heart rate is pumping fast, it can then go up and tell the brain, hey, we’re anxious. And then now all of a sudden, we’ve got these anxiety symptoms. And so it’s shocking. You mentioned earlier how often people with ADHD are also dealing with anxiety and vice versa. And they’re going in to get help, and they’re getting help via medications that don’t truly break those vicious cycles. And oftentimes we see that people have attention issues because they are anxious. But the only thing they realize is, I’m not as successful in school or at work as I used to be. My focus is gone. I can’t pay attention. And you start to do a little deep dive analysis, and you’re asking, well, why can’t you pay attention? Because they’re chronically anxious. They don’t rest, they don’t eat right, they don’t exercise. And so in order to help them with their attention, you’ve got to help them with their anxiety. And so if you just give them an adderall to help, because that’s the symptom that they’re expressing to the professional that they’re struggling with, well, you’re just going to make them the problem worse, then.
Dr. Johnson (00:49:04) Exactly. And I see patients all the time that come into the office that says, I saw my family practice, I saw my psychiatrist, and I started on some antianxiety medicines or antidepressant medicines, and they say they are working. They worked a little bit at first, but they aren’t working now. And a lot of the Medications used now are ssris, where there are serotonin reuptake inhibitors. And there is a test we do in the office that looks at your neurotransmitters and how well your body is able to produce those. We often see that the body is incapable or not producing enough of those neurotransmitters. So you have low serotonin, and you wonder why the antidepressant is not working. So one of the areas we look at is, in conjunction with what Cameron’s been talking about, is doing that specific urine test for the neurotransmitters to see whether you have enough of serotonin or norepinephrine, dopamine, gaba pea, that helps with focus or helps with calm, calming you down, whether the serotonin is sufficient to help have adequate sleep. If not, then we use precursors, which are natural substances that help you make serotonin, like tryptophan, five Htp, or precursor to serotonin.
Cameron Center (00:50:35) Right.
Dr. Johnson (00:50:36) And so that helps. And then Cameron’s able to evaluate and help retrain the brain, but you have to make sure that it has adequate hormones to work with.
Cameron Center (00:50:49) Right. Yeah, you’ve got to have the resources.
Dr. Johnson (00:50:51) Exactly.
Cameron Center (00:50:52) Or you’re just working up creek without a paddle. So one of the things, too, that I find is interesting is taking histories and asking people multiple questions because we talked about head injury. It’s one of the things that we see a lot of, because people are interested in hyperbaric for it. But oftentimes people will come in, they’re complaining about depression, anxiety, focus and attention. You ask them, do you have any history of head injury? No, I don’t have any history of head injury. And then you. Okay, have you ever had any car accidents? Oh, well, I’ve been in like three or four car accidents. Never hit my head, but I’ve always had whiplash. Whiplash is a head injury.
Dr. Johnson (00:51:33) Exactly.
Cameron Center (00:51:33) Your brain is a really soft, squishy tissue floating in fluid like an oil, the same density as motor oil in a sharp skull. Well, as soon as your head whiplashes forward, that really soft object is being forced into that really sharp object. You’re going to get head injuries. I’ll never forget this one time I was asking somebody about their history of head injury, and they’re like, no, I’ve never really had a history. I did have one time where my little brother hit me in the back of the head with baseball bat and I blacked out for five minutes. And I thought to myself, how did you at first think that that wasn’t a head injury? But oftentimes we’ve got to ask a lot of questions. We’ve got to ask a lot of family history questions because we know that there is a huge genetic component to what’s going on with people’s symptoms. We talk about the precursor to those resources for the brain to have what it needs in order to get the job done efficiently. That’s all food, that’s all diet, right? And we can supplement with those things if there is a deficit and it needs to be addressed. But at the end of the day, part of what our jobs is as healthcare providers is to teach people how to eat and how to eat appropriately so that they don’t have these things happen. It’s interesting, we go to a conference, we’ve gone a couple of times in the last few years, the change, life and destiny conference, which is a group of medical professionals that are focused on not treating diseases, but preventing diseases through education and healthy lifestyle tips and tricks, as well as healthcare practices, and having the information about yourself on what does your brain function look like? What do your neurotransmitters look like? All of this information that we have access to, that never had access to before. It’s important to know, even if you are feeling good, so that if one day you do, unfortunately ever get into a car accident, you have a reference to where my normal is. And so oftentimes I encourage people who are healthy, but I like to play hockey. So all my hockey buddies, I try to encourage, hey, you should come in, get a brain scan so that you know what your brain looks like normally. So that if, God forbid, anything ever happened on the ice, you’ve got good information to make informed decisions about how to address your brain. We do this for a lot of other organs in our body, but we don’t think about that with brain health, and that’s arguably, and I think very easily arguably, the most important part of our biological functioning.
Dr. Johnson (00:54:31) Yeah, exactly.
Cameron Center (00:54:32) That.
Dr. Johnson (00:54:33) Brain health is so important because this controls your whole being. And if your brain’s not working well, you’re not getting good sleep, your mental processes are not following through, where you can relax, think in a logical manner, decrease your anxiety, then it makes sense to look at what are the underlying factors. And Cameron’s been so helpful with the techniques that he’s described, looking at a QEEG, which looks at those brainwaves, have you been describing? And part of that is that it analyzes for, as you’re talking about post or past concussions, past traumatic brain injuries that hinder the brain’s function, even though it may occur years and years ago, and maybe the underlying cause for headaches, chronic migraines, that type of thing, even seizure activity. And so it’s important to look at those, figure out. So if you have problems that are ongoing as an individual, my whole goal at Johnson Medical Associates is to look at the underlying causes, the triggering factors, what’s gone on and what continues to go on, and then look at specific treatments for that. If you don’t have an accurate diagnosis, whether it’s brain, as we’ve been talking about, or some other part of the body, and then you can’t have a focused treatment program.
Cameron Center (00:56:14) Right.
Dr. Johnson (00:56:15) And I see many, many people come in that have seen 1015 different doctors. They’ve described the symptoms to the physicians. They’ve been given the medicine for the symptom, but it missed the whole underlying reason for the problem. And once you’re able to find out what the underlying reason is, the underlying cause, and look at addressing that directly, then you can get a good therapeutic response, typically from that type of treatment. And that’s where the neurofeedback comes in. But assessment has to be done first. Absolutely. So you know specifically what you’re dealing with. And just as you’re doing your neurofeedback, there’s many different techniques that you use during neural feedback to help normalize that brain function, that stimulatory or calming type.
Cameron Center (00:57:14) You know, there’s. There’s ways to address that. Know other organs like the know, we like to follow that process that Eamonn talks about in that change your brain, change your life, to assess, address, and then reassess so that we’re not relying on the patient to give an accurate depiction of what’s going on in their everyday function, because a lot of times people don’t know. They’re aware there’s a problem, but they don’t know the severity of the problem or how to quantify it. And that’s why it’s helpful to use these assessment tools. But also the assessment tools are embedded in the training tools. And I say training specifically and not treatment, because what you do on your side is treatment with medication and the things that you do as a doctor, but as a neurofeedback practitioner and again, trainer, I’m more like somebody who you go to at a gym that helps teach and train people how to take agency over their health. And I think at the end of the day, holistic treatment in the medical field, you have a level of responsibility to educate patients on how to take care of themselves. Otherwise, everybody’s coming to you, running to you for a problem.
Dr. Johnson (00:58:46) Exactly. And as we go through and look at these different patients that have chronic eye problems and have ongoing difficulty with their central nervous system, it is important then to define what are the specific areas that’s going to give you the best results with it. And so one of the ways that we look at it is, as we’ve talked about, do an assessment. We do a cognitive assessment to look at the memory, how much anxiety, depression, stress is actually in that person’s life. Look at the brain waves to determine exactly what is going on with the different brainwave patterns. And then that gives us a baseline for working up a treatment program, whether it’s neurofeedback, whether it’s hyperbaric, whether there’s underlying food reactions, underlying environmental toxins that the person is dealing with, right? And as we described, this can be from childhood, whether it’s the baseball bat from your brother, or whether it’s genetics, such as gluten intolerance, or whether there’s been ongoing reactive processes that occurred. We see that different genetic patterns can be expressed with a stressful situation.
Cameron Center (01:00:34) Right?
Dr. Johnson (01:00:35) And so that genetic pattern can be turned on. It’s just like with COVID We’ve seen so many people that Covid was a very, very stressful situation, but it stimulated the sympathetic nervous system tremendously. People couldn’t sleep. They were very anxious, they were short of breath, which was a constant stress factor, adrenaline producing situation. An individual’s endogenous epinephrine, the epinephrine that you make, is much more stimulatory than what we can give you from external sources. And so that can keep your heart rate up. It can keep your mind fuzzy. Difficulty in focusing all those different areas. So looking at the mind, evaluating the whole central nervous system process with the QEG is essential. And then, as he was mentioning, is when we deal with people that have had strokes, traumatic brain injuries, encephalitis, all those different things that can affect brain function, which we treat with hyperbaric to help heal the brain tissue, then we can measure that process and healing process with.
Cameron Center (01:02:06) And so as a list of what are the things that we use QEG for, or what are the list of symptoms or areas of deficit that we would like to assess with a QEG. This is depression and anxiety. ADHD, your big three in a psychiatric PTSD history of head injury. Like we’ve said, environmental toxicity or anything else that might be causing central nervous system inflammation, autism. We’ve got folks who are doing peak performance training, people who are like, I’m functioning to a high level, but I want to see how much better can I be? People go and do brain training just like they go to the gym to do training. They just want to be the best versions of themselves possible. And so there’s a lot of different things that we can work with. And you don’t always have to have a problem in order to work on these things and take care of your brain and take care of your body.
Dr. Johnson (01:03:13) Well, you’re talking about peak performance. And we see a group of athletes that we work with. Some of them have had injuries like concussions or head injuries. Others want to figure out their peak performance, how to get better rest, how to recover quicker. Hyperbaric helps with recovering help. Hyperbaric helps heal traumatic brain injuries that they’ve had, whether they’ve been playing football, soccer, or we see a group of hockey players that have head injuries. It helps heal that brain. You can measure then the healing factors by QEG and then help the brain recover with treating the connectivity defects or the brainwave dysfunction that has occurred due to this trauma.
Cameron Center (01:04:11) Right.
Dr. Johnson (01:04:13) So thank you so much, Cameron, for.
Cameron Center (01:04:15) Being with us, for having me on.
Dr. Johnson (01:04:16) Yeah, you’re welcome. We appreciate your valuable asset to Johnson Medical associates and have provided great wealth of information today. I hope it’s helpful to those that are listening, those that listen to this program. If you have questions, do not hesitate to call Johnson medical Associates at 972-4790 400, or you go to our website, Johnson Medical associates, and it describes what we’ve been talking about today. There are other podcasts on the website to help you understand further some of the things that we’ve been talking about, but not addressed in great detail today. Thanks again. Appreciate you.
Cameron Center (01:05:06) Thank you. Thank you.
Dr. Johnson (01:05:07) You’re welcome.