The Amen Clinics advertising is dangerous, disingenuous bullshit

I’ve written before about Daniel Amen and his network of Amen Clinics, that (amongst other things) give utterly unnecessary doses of radiation to children. To briefly recap, Amen is a psychiatrist, author, motivational speaker etc. who has built his reputation and fortune on performing brain scans and then wildly exaggerating their diagnostic and prognostic usefulness. His clinics use an imaging modality called SPECT, a largely obsolete technology with terrible spatial resolution that’s been superseded by PET and MRI for most clinical and research purposes. The only real advantage of SPECT is that it’s much, much cheaper to perform than either PET or MRI, which is, of course, precisely why he uses it. He’s been at this a while too. This article in Wired from 2008 contains some choice quotes:

“Let’s look at your scans.” He takes the images that he printed out this morning and puts them side by side on a large table. He points to several views of the surface of my brain. “What I see here is that activity in your prefrontal cortex is low at rest but becomes better when you concentrate, and your thalamus becomes more active, too. I think this means you have a predisposition to depression.”

I nod. Scrutinizing the scans some more, he says, “You need to be busy to be happy. Your brain is cool at rest. You need stuff in your life to feel alive, together, and connected.” He looks at another view, this one showing only the most active regions of my brain. “In this scan, you have increased activity in your thalamus, your two basal ganglia, and your cingulate cortex.” He picks up a pen and draws a line connecting these four regions to the right lateral temporal lobe. “I call this the diamond plus.’ It’s a pattern of angst, and we see it in people who have had significant trauma in their lives.”

And these are the scans that he’s supposedly looking at while making these judgements:

What?! You can’t diagnose conditions like depression in an individual subject from even the very best brain scans, and you certainly can’t see the effects of such nebulous existential concepts like ‘angst’. What the hell is ‘angst’ supposed to mean in this context anyway?! He might as well be saying “The connections between your Shatner’s Bassoon and the peri-sinovial labio-ventral cortex is unusually cromulent and this might predispose you to brilligness, and excessive slithy toveing.” So, yeah, he’s a colossal bullshitter, who must have to keep a fire extinguisher handy at all times to dampen down the constant spontaneous combustion happening in his pants. This is nowhere more true than in the adverts for his clinics. Here’s one from the clinics LinkedIn page:

Brains get significantly less lumpy-looking after treatment – good to know. But hang on – brains are lumpy-looking. They’re covered in ridges and bumps! These smooth-looking pretty-coloured brains that Amen seems to think are great actually resemble lissencephaly; a very serious condition where the developing brain lacks the normal cortical folds. In this case, I’m pretty sure that the smoothness of the images is produced by the fact that the SPECT imaging methods he uses are so poor that they simply can’t show that much detail of the cortical surface. Also, I’ve no idea what the pretty colour-washes are meant to signify, if anything. To show you how easy it is to create images like this, here are some I threw together in about five minutes using FSLView and a standard-space MRI template (the MNI152 1mm template, bundled with FSL), by varying the threshold of the 3D rendered surface:

(Clicky for bigness)

I’ve written before about why presenting brain images out of context in this way can be extremely misleading. Here’s another choice Amen-sponsored example:

As if it really needed saying; utterly meaningless nonsense. A Google image search brings up loads more examples, but I won’t sully your eyeballs with them unnecessarily. Amen’s use of SPECT images in this way is a gargantuan 20-year effort in energetic turd-polishing of a staggeringly disingenuous and despicable type, and I’m frankly amazed that he still seems to have an active licence to practice medicine.

Many thanks to @CousinAmygdala (and others) who first showed me these kinds of ads, and who also coined the most excellent term ‘neurofearmongering’.

The power of a well-chosen image; EEG measures of brain activity and exercise

This picture:

…occasionally does the rounds on Twitter, often spurred by tweets from the kind of evidence-phobic accounts that publish whole lists of mind-blowing ‘facts’, at least 50% of which are made up. This picture has also spurred about a billion blog posts (like here, here and here), somewhat unsurprisingly, written by the kind of people who like to get their scientific evidence from a single image on Twitter.

So what’s the problem here? What the image appears to suggest at face value is that brain activity is increased after a short bout of exercise (a 20-minute walk). Sounds reasonable, right? We know that exercise has various effects on brain function, and exercise in general is definitely a good thing, now that the Western world is suffering from massive rates of obesity, diabetes, etc. I really don’t have a problem with the message here, more in the way that it’s presented.

The brain images are clearly from an EEG, but beyond that, there’s very little information in the images about what it actually represents. There are lots and lots of different things you can measure with EEG technology, such as the P300, Error-Related Negativity, C1 and P1, or much slower neural oscillations across a wide range of frequency bands. We have no information about what particular measure this image is describing. Secondly, we have no information about what the colours mean. Heat-map colour scales on brain images like this often represent statistical values (usually t or z scores), which is a convenient way of representing a large amount of numerical data in a visual-friendly format. Here though, we have no colour-scale information, so we have no idea what the colours represent.

Here’s some brain images I just created from some MRI data I had laying around. Took about three minutes.

Big difference, right? Somewhat counter-intuitively, the left and right images above are actually the exact same functional brain data, all I did to create the right one was to lower the statistical threshold on the colour-overlay, to essentially say “Show me more results, I don’t care if they’re statistically reliable or not.” People who do this kind of work are very clued-in to these kinds of issues, and would always look for a colour-scale on these kinds of images in research papers. Clearly though the general public aren’t that conversant with statistical issues in brain imaging, because why would they be?

What we do have in the original image is an attribution to a guy called Chuck Hillman at the University of Illnois. Dr Hillman appears to be a perfectly respectable scientist, performing some perfectly respectable research focussing on the interaction between exercise and the brain. I have absolutely no problem with Dr Hillman or his obviously very worthwhile research. Looking through his articles, I can’t find an image which matches the one at the top of the post, although this paper  (PDF, Figure 2, page 548) does contain one that’s somewhat similar. That image shows the amplitude of the p300 wave during a particular task, after a period of reading and a period of exercise. Unfortunately the colour-scale here is in raw units of EEG signal (micro-volts) so it’s not totally clear if that represents a statistically-significant difference or not. If anyone can work out where the original image at the top comes from, please let me know in the comments!

As something of an aside, is an increase in brain activity necessarily a positive thing? Oxidative stress can potentially occur as the result of an increase in brain metabolism, and oxidative stress has been implicated as a potential causal factor in a huge variety of problems, from cancer to Alzheimer’s. One could even argue that lower brain activity is better because it indicates a more efficient use of cognitive resources; performing the same task, with less activity, equals greater efficiency. Although using the concept of ‘efficiency’ in this way is currently fairly controversial.

The essential point here is that when images like this are presented in academic papers or presentations, they come packaged with a whole host of caveats, qualifications, and additional information. Of course, scientists often try to make visually arresting images in order to present their results with maximum impact and clarity, and (as long as they don’t cheat in some way) that’s entirely appropriate, and indeed useful. The problem comes when someone else takes those images, strips them of this essential contextual information and presents them uncritically, often in order to further their own agenda or aims. Without the context, these images become pretty much meaningless. If this kind of thing happened to some result from my own research, I’d be pretty embarrassed about it. As ever, a critical approach to this kind of un-critically presented ‘evidence’ is crucial.

 

Transcranial direct-current stimulation – don’t try it at home

“Many Shubs and Zulls knew what it was to be roasted in the depths of the Sloar that day I can tell you.”

I’ve written before about tDCS and in particular the device produced by a company called foc.us; a company marketing a tDCS device to gamers. As a brief recap, tDCS involves passing a low-level electric current through your brain, and thereby attempting to stimulate particular regions of the cortex in order to enhance particular functions. Academics have been using this (and similar) method for a while now, and showing some interesting effects in all kinds of motor, sensory and cognitive domains (for a fairly broad review see here; PDF).

When academics perform this procedure on their experimental subjects for the purposes of research they have to get clearance from an ethical review board first, and they observe strict limits in order to ensure the safety of their participants, both in terms of the time they stimulate for, and the amount of electrical current they use. However, there is a community of amateur tDCS enthusiasts, who build their own equipment and zap their brains at home. If this sounds like a spectacularly bad idea, you’d be dead right. These guys (and let’s face it, it’s usually guys) naturally aren’t bound by the same safety rules; the only limit is their own stupidity.

TDCS appears to be becoming more mainstream, with commercial products like the foc.us headset and positive write-ups in media outlets (like this one and this one) helping to raise the profile of what has been up until now, a pretty niche activity. This BBC report focuses on the military applications of the technology and proclaims that the US military are ‘very interested in its potential’. Yeah, well… the US military also ran a 20-year research program into remote viewing and other psychic phenomena (only discontinued in 1995!) so let’s not put too much faith in their ability to spot obvious bollocks.

The point I want to get across here is that DIY-tDCS is not only pretty unlikely to actually do anything useful, but can also be potentially extremely dangerous. I know, right? Who’d have thought that passing electric currents through your brain might be a problem? The tDCS sub-reddit page is full of horror-stories ranging from people suffering electrode burns (like this guy) to this story of a user suffering crippling anxiety, panic attacks and depression for more than a year after tDCS. Whether the tDCS actually caused these fairly extreme symptoms in this particular case is somewhat debatable, and probably unknowable, but the point is that relatively severe adverse events can, and do happen with these devices. Most worryingly of all, there’s a report here on the electrical safety of the commercial foc.us device, which suggests that it doesn’t perform in the manner it specifies in terms of regulating the voltage, and can cause skin burns. This user claims to have suffered severe migraine-like pain after a session with the foc.us device.

To sum up:

Do not pass electrical currents through your head! It is a bloody stupid thing to do.

Seriously, if you want to give yourself some kind of an ‘edge’ in gaming, or studying, or whatever, just have a quadruple espresso – much safer and more effective.

Thanks to @neuroconscience for pointing out the tDCS horror-stories on Reddit.

 

You keep using this word ‘neuroplasticity’. I do not think it means what you think it means.

So, I wanted to write a post about how the word ‘neuroplasticity’ is  the current neuro-bullshitter’s favourite big sciencey-sounding word to throw around these days. I was going to explain how it was actually such a broad umbrella term as to be pretty meaningless, and talk about some things like LTP and synaptogenesis in the hippocampus which (in contrast) are precise, well-defined terms, and fascinating processes, and how your brain is changing in a ‘plastic’ manner even as you read these words. It was really going to be a great post.

Unfortunately (as so often seems to happen), it turns out that the mighty Vaughan Bell beat me to it by a scant three years with this typically outstanding post on mindhacks.com. So. I guess you should all just go and read that instead, and I’ll have to be content with my standard operating procedure and take the piss out of some quacks instead.

The ‘About the Science’ section of the Brain Balance Centers main website has some awesomely meaningless language, that manages to work in some other big sciencey-sounding word too:

“It was once thought that the brain was static, unable to grow or change. But extensive research and in depth study of epigenetics has shown that it’s remarkably adaptable, able to create new neural pathways in response to stimulus in the environment, a branch of science called neuroplasticity.”

Ooh – epigenetics, and neural pathways. Fans of meaningless brain cartoons should definitely check out that site too, their disconnected vs. connected diagram is fabulous.

The Lumosity website (a brain-training company) has some pretty choice language too:

“But when neuroplasticity’s potential is thoughtfully and methodically explored, this physical reorganization can make your brain faster and more efficient at performing all manner of tasks.”

There are lots of other examples I could paste in here. I spend a fair amount of time looking at these companies’ sites and I’ve come to the conclusion that any mention of the word ‘neuroplasticity’ is basically a massive red-flag. People are very fond of using it to promote these things, but mostly their arguments boil down to “Because: neuroplasticity!”, which as Vaughan explained so eloquently, doesn’t mean anything at all without a whole additional layer of explanation, refinement and qualification.

So – a top tip, when you see the word ‘neuroplasticity’ think ‘bollocks’ instead.  99% of the time you’ll be absolutely dead-on.

The worst neurobollocks infographics on the web

Regardless what you think of infographics (and personally, I think they’re largely a pustulent, suppurating boil on the bloated arse of the internet) there are some good, useful ones out there. However, these are vastly outweighed by the thousands of utterly ghastly, misleading, poorly-referenced and pointless ones.

Because I’ve been on holiday for the last week, my levels of rage and misanthropy have dropped somewhat from their usual DEFCON-1-global-thermonuclear-war-the-only-winning-move-is-not-to-play levels, so I thought trying to find the absolute worst neuroscience-related infographics on the web might be a good way to top the vital bile reserves back up again. And oh boy, was I right. There are some doozies.

First up is this purple and blue monstrosity titled ’15 things you didn’t know about the brain.’ Here we learn (amongst other howlers) that the capacity of the brain is 4 terabytes, men process information on the left side while women use both sides, and:

Women are more emotional because they have a bigger limbic system? Are you fucking kidding me? Also, it turns out that ‘Exploding head syndrome’ (also mentioned above) is a real thing, well… kind-of a real thing. Well, actually not really a real thing at all.

Moving swiftly on then, this one titled ‘The neurology of gaming’ is perhaps less laughable, but more dangerous in that it makes a lot of assertions without much to back them up. Nearly all the content here is currently pretty contentious and while some of it might possibly be correct, it’s all presented as fact, with no nuance at all, and only the most cursory attempt at referencing. It also has this brilliantly awful graphic at the bottom:

What are those little coloured blocks supposed to represent, exactly? Numbers of male and female gamers? Activated brain voxels? Absolutely fucking nothing at all?

The best (by which I mean, worst, naturally) brain-related infographics though, are related to the bullshit left/right-brain myth. This is the idea that some people are more ‘left-brained’ and others are ‘right-brained’, and this has some relationship to their personality, preferences etc., or the idea that some types of information are processed by one hemisphere alone. This is an absolute beauty, which manages (extra points!) to mix up some learning-styles nonsense in there as well for good measure. Amongst many other obviously made-up bits of foolish drivel, it claims that the right-brain is psychic(!), the left likes classical music while the right prefers rock, and the left likes dogs, while the right likes cats.

However, the top prize goes to this pitiful effort, which is chock-full of steaming great turds, but probably the best (worst) bit is reproduced below:

So, you can see which-side-brained you are by which nostril happens to be more blocked up, and men only have brain activity in the left hemisphere. Whoever wrote this deserves to be first up against the wall with a blindfold on when the neuro-revolution comes.

Just to finish on a positive note, while I was scouring the darkest pits of the interwebz to find these, I came across this lovely, helpful little comic about brain development, which manages to be informative, accurate and entertaining. Turns out good ones do exist after all, but infographics (like pretty much everything else) most definitely appear to obey Sturgeon’s Law. 

Paging Susan Greenfield: South Korea has made up a new problem – ‘Digital Dementia’

A slew of bullshit news pieces has hit the interwebz in the last couple of days, driven by a couple of articles in the usual rigour-phobic press sources. They focus on a South Korean report which claims to identify a syndrome known as ‘Digital Dementia’ in some young people. This syndrome, it’s claimed, is characterised by a deterioration in cognitive abilities brought about by over-use of digital devices.

The Telegraph reports on it here, the Daily Fail here, and Fox News have a video report here.

The fact that ‘Digital Dementia’ seems to be a condition that’s just been made-up for the purposes of the report, and no-one actually seems able to describe what it is in any precise terms doesn’t dim the enthusiasm of these news sources at all, naturally.

As if that wasn’t bad enough, a widely-circulated quote from Dr Byun Gi-won, (of the Balance Brain Centre in Seoul), goes:

“Over-use of smartphones and game devices hampers the balanced development of the brain. Heavy users are likely to develop the left side of their brains, leaving the right side untapped or underdeveloped,”

Players of Neurobollocks-bingo can put a big cross on the ‘Left/Right brain neuromyth’ section of their score-card, then.

I can’t find any further mention on the internet of a) Dr Byun Gi-Won, b) this Balance Brain centre in Seoul, or c) the actual report that these news stories are based on. I might be missing something, so if any readers do manage to track down any information related to any of those things, please let me know in the comments. In the meantime, just file this one under ‘bullshit irresponsible scaremongering, with a laughably transparent veneer of made-up neuroscience’ and move on.

Brain stimulation hits the mainstream – commercial tDCS device available soon for $249

Transcranial Direct-Current Stimulation is a technique that involves passing low-level electrical currents through parts of the brain. The effects of this are various, depending somewhat on the area being zapped, but it appears to change the baseline level of cortical excitability, and the effects can persist for several hours (or perhaps days) after a standard 20-minute session. People have been zapping themselves in the head pretty much since electricity was discovered, but tDCS in its modern form is a relatively new technique, and is thought to have potential for treating depression, stroke-recovery, and other clinical issues. It can also apparently lead to enhancements of normal functions (visual, motor, working memory, etc.) in healthy participants. The Guardian published an article this week on the effects of tDCS on maths ability, based on research which has been fairly widely criticised on Twitter.

This potential cognitive-enhancing effect is what’s caught the eye of a company called Foc.us, who are now offering a commercial tDCS system, for use by anyone at home, for $249 (or £179 in the UK). Here it is:

The foc.us tDCS headset

So, it’s a small band with a battery at the back, and four electrodes at the front that sit over the forehead. Foc.us are marketing this as a device for gamers to “Excite your prefrontal cortex and get the edge in online gaming.”

So – does it work? Possibly… But it almost certainly doesn’t do what the company says it does. For a start, if you want to “get the edge in online gaming” wouldn’t you want to stimulate your motor cortex (at the top of the head) and/or the visual cortex (at the back)? It’s unclear how stimulating the prefrontal cortex (behind the forehead) would give you an advantage in games. In fact, (as this article explains) placement of the electrodes over the dorsolateral prefrontal cortex is most often used for treatment of depression and chronic pain, so potentially these devices might have more of an effect on mood or emotions than any useful gaming-related functions. There is no information about effectiveness or effects on the  company website; the standard protocol of 1mA stimulation for five minutes is unlikely to do much beyond delivering a mild sensation on the scalp. The device can be configured to deliver up to 2mA (through a smartphone app), which may be enough to affect the brain.

Furthermore, there are important safety considerations for this kind of device. In fact, tDCS is such a recent technique that researchers are still in the process of working out what the safe limits actually are (in terms of both power delivered, and duration/frequency of stimulation). This article highlights the possibility that the electrodes can cause skin lesions, and tDCS can even potentially cause lesions in the brain  (admittedly in rats, and with currents a couple of orders of magnitude higher than used in humans). Still, potentially people could be using these systems repeatedly for long periods, and we have very little idea about what the effects of that might be.

If you’re still really intent on zapping your own brain to see if you can become an intellectual giant, or give yourself telekinetic powers or X-ray vision (hint: you won’t) then you could also build your own tDCS device using a 9V battery, some wire, a resistor and a couple of sponges, as described here. Total cost: about $5.

ABSOLUTELY DO NOT DO THIS. IT’S A FUCKING STUPID THING TO DO TO YOURSELF.

Passing electrical currents through the body can be fantastically dangerous. A (alternating) current as low as 10 MICRO-Amps can be enough to cause ventricular fibrillation and cardiac arrest, if passed directly across the heart,  current in the 10-20mA range causes severe muscular contractions, while 60-70 mA is usually fatal (source: Wikipedia).  Seriously, let’s leave passing electric currents through the body to the professionals, eh?

Many thanks to tDCS researcher Nick Davis for helpful discussions on Twitter related to this article.

Feminist-inspired neurobollocks from Daniel Amen

Not strictly relevant – I just like it.

I’ve written before about Dr Daniel Amen, the owner of a network of private clinics which perform completely unnecessary brain scans using SPECT (a cheap alternative to PET that involves dosing people with gamma radiation) in order to make spurious diagnoses of everything from ADHD to ‘marital problems’. Unsurprisingly, Dr Amen is also a regular contributor to the Huffington Post; the news source second only to the Daily Fail in its tendency towards rigour-phobic science coverage. A couple of articles he’s posted up there in the last few weeks have caught my eye because of their general dreadfulness, but also because of their particular dreadfulness about women.

The first one is titled ‘Is it time to let women take the wheel?’, in which Dr Amen argues that the world would be a better place if more women were in positions of power and influence. This is a pretty well-worn argument, and intuitively it seems like there might well be some value in it, but Dr Amen claims to have some new evidence:

“the inner CEO (the prefrontal cortex) of women is much more active than men. This area of the brain governs things like judgment, forethought, organization, planning, empathy, impulse control and learning from the mistakes you make. These are the very qualities needed to successfully manage a company, lead a nation, mediate crisis, and get people working together toward a common goal.”

A little bit of a leap there, don’t you think Dr Amen? To my utter shock and amazement the data he’s talking about come from an unpublished analysis of data collected in his clinics.

A couple of weeks later, he’s at it again, jumping on the Lean in bandwagon with another piece: ‘Lean in, and why women’s brains are wired for leadership’:

“women are actually wired for success. The “CEO part of the brain” — the prefrontal cortex, which controls judgment, organization, impulse control, and planning — is more active in women, suggesting that women are wired to hold positions of power and run the world.”

Both these articles are pretty transparent attempts to plug his new book Unleash the power of the female brain. The broad thrust of the articles (that we need more women in positions of influence, and that they have a lot to contribute in such positions) is unarguable, however suggesting women are ‘wired for success’ because of differences in cerebral blood flow is patently ridiculous, and a massive generalisation. Clearly some women make excellent leaders, and some do not (just like men).  It’s been known for some time that women’s brains do show somewhat higher blood flow than men’s, however the most likely explanation is that it simply reflects underlying gender differences in Cardiac Index (a body-size normalised measure of cardiac output), which is generally higher in women. In other words, the blood-flow differences in the brain might be a cardiac effect and have very little functional role at all.  There is a very interesting discussion to be had about sex differences in brain function and what they might mean, however the differences are generally fairly subtle and nuanced, and the chain of logic connecting them to (group, or population-level) behaviour is insubstantial.

Making bullshit claims about women based on dodgy science and cherry-picked brain data doesn’t advance the feminist cause one little bit. Furthermore, this approach completely ignores the very real and often highly disturbing social challenges that women face on a daily basis. ‘Neurofeminism‘ is apparently a thing now (haven’t read that book, can’t really comment), but these articles make no useful contribution to that discourse whatsoever.

Another irrelevant, picture; just because I really fucking detest Twilight.

‘Brain Power Miracle’ will make you an Einstein-level genius

There’s a hell of a lot of bullshit self-help brain-training, memory-boosting, whatever products out there and most of them I don’t even bother looking at in any detail, because I value my emotional stability and life’s just too short. Brain Power Miracle  though is worth a mention, purely because of the hilarity of their claims.

The start off with the old canard that we only use a part of our brain – but they go one better than the normal jokers – they say we may only use 2% (but that it ‘isn’t conclusive’). Then:

“Just think about it: what if you could turn your brain into an unstoppable success machine—bringing you all the wealth, success and happiness that you had previously never thought possible?”

And if that wasn’t enough:

“We will show you how to become a genius like Einstein, Mozart, Da Vinci…”

It’s a shame they didn’t employ one of their genius-level users to copy-edit their webpage and remove all the spelling mistakes.

And to finish off, some nice sciencey-looking pictures of frequency spectra:

Only $37.95 for seven CDs full of white-noise and synthesised dying-whale-noises! What are you waiting for people?! Go get it!

Interactive metronome treatment for ADHD/ADD; swing your arms about, cure your brain

Ian Dury. Because… any excuse.

One of the best things about starting this blog was several e-mails I got from like-minded people saying nice things, and often, pointing me towards interesting bits of neurobollocks that I wasn’t aware of. Such was a series of e-mails from Deborah Budding and Michael Thaut (who must be one of only a few people in the world who holds posts as Professor of Music, and Professor of Neuroscience – cool) about the ‘interactive metronome’ technique. Michael’s research (unsurprisingly) focuses on the interplay between the brain and music, and in particular, the processing of temporal information as it relates to rhythmicity, so it’s probably fair to say he certainly knows his way around a metronome.

But what’s this interactive metronome business? Well, as you can see in this video on the hypochondriac’s website of choice (WebMD), it’s basically waving your arms about and moving your feet in time to a regular beat. So, it’s basically dancing then, but much more boring.

Surprisingly, given it appears to be such a simple technique, some people are claiming that it can have profound effects, and assist with various disorders such as ADHD, Parkinson’s, MS and even post-brain injury and stroke. The usual bunch of jokers with slickly-designed websites have sprung up offering treatment for all these things and more. The ‘How it works’ section of that website claims that the underlying deficit in a variety of disorders, claiming that the underlying dysfunction in ADHD, autism, dyslexia, Parkinson’s and others is just a ‘neural timing deficit’. The exercises used in IM correct the timing deficit, and therefore (supposedly) treat the disorder.

To say this is startlingly simplistic would be a massive understatement; it’s just plain wrong. The precise neurological issues in many of these disorders are difficult to pin down and are the subject of active investigation but, to take a simple example, we know exactly what the problem is in Parkinson’s; neuronal depletion in the substantia nigra. To claim that it’s some vague neural ‘timing’ issue goes well beyond disingenuousness and into the realm of outright deception.

There’s even a home-based version of IM therapy, that can be run on any computer – however the basic equipment (wiresless button boxes, tap mats for the feet etc.) and the software licence cost $800.

A PubMed search for ‘interactive metronome adhd’ actually produces five hits! However, on closer inspection, all five articles are seriously compromised in some way – studies with no control group, or with very low numbers. Interestingly, one of the papers that pops up is one I’ve discussed before in reference to Brain Balance Centers. So, IM appears to form a cornerstone of what the Brain Balance guys (chiropractic, with a thin layer of neuro-woo laid on top) are pushing too. The IM guys have gone to a lot of trouble to make their approach appear scientific – there’s a well-populated ‘Science’ section on the website, that contains links to lots of articles, however, many of them are ‘white papers’ of uncertain provenance, and the rest are articles from obscure journals, or on barely relevant topics.

Another problem with IM is that it gets conflated with serious interventions. There’s a large field of study focussed on the use and effectiveness of musical-type interventions for a variety of neurological disorders (broadly, called Neurologic Music Therapy, or NMT) that has some solid research behind it. The slick marketing of IM seeks to conflate their approach with much more high-standard music-based therapy approaches.

In Prof. Thaut’s words (my emphases added):

First, where is the research? Studies that back up the clinical effect of IM directly, are very rare or nonexistent. A small study from 2001 is one that comes up repeatedly. One small study does not build clinical evidence. IM seems in general a well marketed but unresearched application. From a research point I see no evidence for the therapeutic benefit of IM.

Second, brain mechanisms in therapy work differently. Possibly to fill the research void IM generously includes ‘borrowed’ research that has nothing to do with their device. Since I am one of the authors they use I have to clearly  state that my brain research in music and rhythm does not address IM and our results do not support IM applications, neither with patients nor physiologically in explanatory brain mechanisms. The only forms of therapy in brain rehabilitation that work are active and specific exercises based on functional learning and training paradigms, not machine tapping. 

Last, rhythm has its own life. The claim that tapping to a metronome improves timing in patients which in turn transfers to all kinds of cognitive and motor improvements is not only unsupported by research but seems based on a misunderstanding. Rhythmic synchronization is a very complex process that fluctuates continuously on a millisecond level and is inherently unstable and variable. This time flexibility is the actual hallmark of functional entrainment. Therefore the IM definitions and measurements of what constitutes rhythmic improvement seem physiologically and functionally meaningless.

So, there you have it. If you’re concerned about your child’s sense of rhythm (for some reason?) you’d probably be much better off signing them up for dance classes, or piano lessons. It’ll almost certainly be cheaper, and they’ll likely have a lot more fun too.