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The Inconvenience of Science: When Evidence Challenges Enthusiasm

The Inconvenience of Science: When Evidence Challenges Enthusiasm

There have been extraordinary gains in understanding brain dynamics in the last decade. Quantitative EEG and FMRI connectivity studies have done much to better characterise the neural networks that underpin consciousness, as well as different psychopathological states. These demonstrated abnormalities encourage contemplation of the possible therapeutic interventions that may assist in normalising brain function. The literature about the positive benefits of intervention often is based on case series highlighting substantial improvement. However, high quality trials and even the meta analyses of the most investigated disorder, ADHD, have tended to fail to provide the necessary empirical support, for neurofeedback as an intervention.

A recent Institution of Medicine workshop also raised a number of cautions about using tDCS as an intervention. In the light of these controversies, the importance of careful objective investigation of individual patterns of neural activity prior to commencing interventions and tying these to the outcome data are critical steps. The area of neurostimulation is a field of medicine that has got most to gain from the personalised medicine approach. These issues will be highlighted and developed using a staged model disorder that highlights the interventions that may have therapeutic effects and are likely to be influenced by the duration of episodes of the disorder.