The front, especially what is called the prefrontal cortex, acts a lot like a cruise control on a car. It keeps emotions in check. It regulates mental focus. It does lots of good things. In general, it overcomes the tendency for the brain to respond to emotional distress as if it represented real physical danger. When the brain is in “danger” mode, it turns down the prefrontal cortex and responds with a “fight or flight or freeze” mechanism. This is good for emergencies but not daily life. Training the prefrontal cortex to be dominant keeps people from responding to daily demands as if they were emergencies.”
More than twenty years ago, a clinical psychologist in New York named Dr. Jeffrey Carmen
was exploring ways to treat a pain disorder called RSD (Reflex Sympathetic Dystrophy) by training patients to control blood flow in the brain. Though the findings of his research were ultimately unsuccessful, he made some key discoveries that led to the development of an entirely new method for treating ailments such as migraine headaches, depression, anxiety, OCD, head injuries and other emotional disorders.
As with many scientific advancements, Dr. Carmen’s discoveries arose from a “serendipitous confluence of multiple events.”
“At that time, I was interested in the mechanisms involved with migraine headaches,” Dr. Carmen recalls. “I hypothesized that increasing brain activity in the prefrontal cortex might help with migraines. It was nothing more than an educated guess, but it turned out to be absolutely correct. If you train the prefrontal cortex to become dominant, migraines diminish. Along with that, concentration improves and all the other brain functions associated with the front of the brain improve. Depression improves, migraines improve, even some kinds of speech articulation problems improve.”
Utilizing advancements in infrared technology, Dr. Carmen devised a system in which he could visually monitor patients’ blood flow in prefrontal cortex and, more importantly, train patients to redirect blood flow to that area of the brain using biofeedback techniques. The treatment, called passive infrared hemoencephalography (pIR HEG), is now used by doctors and clinicians worldwide.
In a nutshell, pIR HEG training aims to increase the dominance of the prefrontal cortex, the section of the brain directly behind the forehead that regulates our response to stimuli. Certain thermal imaging cameras are able to detect subtle changes in surface temperature associated with blood flow to the PFC. Through a series of training techniques, patients learn to control blood flow in their brain and, as a result, control their response to stimuli that would normally trigger a negative response.
Thermal images of two patients in normal/healthy states show relatively balanced and even heat patterns in the area of the forehead directly associated with the prefrontal cortex
Thermal image of a femal patient during a migraine headache incident and a male patient with depression and focus problems
“Specifically, treating people using pIR HEG changes response patterns,” Dr. Carmen explains. “People with most brain-based and/or emotional disorders have the following characteristic: ‘excessive rate and magnitude of response to relatively benign stimuli.’ pIR HEG training quiets and normalizes this pattern. If you train the prefrontal cortex to become dominant, migraines diminish. Along with that, concentration improves, and other brain functions associated with the front of the brain improve.”
In one version of a pIR HEG session, patients watch a movie with a thermal imager monitoring their forehead. When the film evokes an emotional response, the PFC starts to shut off. The thermal imager detects a decrease in activity and pauses the movie, replacing it with a bar graph. During this “pause time,” the patient is taught to focus on the bar graph and re-engage their prefrontal cortex to restart the movie. Over time, the exercise trains patients to recognize a shift in their own brain activity and control their response to external triggers.
Tools of the trade: Dr. Carmen created a wearable headset for live monitoring during session and utlizes Sierra-Olympic's Viento 320 for precision for diagnosis and progress monitoring. The combination and accessible cost of entry of the two divices allows Dr. Carmen to help clinics around the world treat patients using pIR HEG.
The retraining of the brain in this way is a type of biofeedback- a therapy that has been used to treat many physical and mental ailments. Dr. Carmen is the first to combine it with thermal imaging technology to treat migraines and other disorders connected to the PFC.
Dr. Carmen’s work is on the frontier of brain research as psychologists recognize the critical role of the prefrontal cortex role in regulating important functions. The prefrontal cortex is connected to a large percentage of physical and mental disorders, and the role of thermal imaging to better understand it is significant. Dr. Carmen’s work is yet another example of the undiscovered potential for thermal imaging to enhance our understanding of the human body and improve lives.
“The really hot brain topic these days is the role the front of the brain plays in regulating all brain functions,” he explained. “I mean everything. It even has regulating functions that include the brainstem, which is pretty far removed from the front of the brain. The front, especially what is called the prefrontal cortex, acts a lot like a cruise control on a car. It keeps emotions in check. It regulates mental focus. It does lots of good things. In general, it overcomes the tendency for the brain to respond to emotional distress as if it represented real physical danger. When the brain is in “danger” mode, it turns down the prefrontal cortex and responds with a “fight or flight or freeze” mechanism. This is good for emergencies but not daily life. Training the prefrontal cortex to be dominant keeps people from responding to daily demands as if they were emergencies.”
The Technology: Sierra-Olympic’s Viento 320 Brings pIR HEG to More Patients
Dr. Carmen uses thermal imaging technology to scan a patient’s forehead and view patterns of infrared wave emission in the prefrontal cortex. More emission in this area correlates with increased brain activity and is marked with brighter red in the thermograms.
With the success of the pIR HEG system, Dr. Carmen set out to help other doctors collect infrared images. Among the different thermal systems he utilizes, Dr. Carmen enlists Sierra-Olympic’s Viento 320 LWIR camera to develop a complete system well suited for smaller practices.
“These offices run on a shoestring without much money available for equipment,” Dr. Carmen said. “The Viento represents a major price break. At the same time, it has one specific advantage over other cameras I have used. It is rock solid stable in terms of thermal drift. You can turn it on in the morning, leave it running all day, and the images will look exactly the same. In addition, there has been a willingness to customize almost every aspect of the camera with Sierra-Olympic. They have been a good company to work with.”