We have treated spsamodic torticollis, Writer's cramp and Dysphagia by EMG biofeedback therapy. Since 1977 we have treated 48 cases of spasmodic torticollis. These included twenty eight men and twenty women, whose ages ranged from 17 to 60 years with a mean age of 37.9±12.9 years. Follow up periods ranged from 3months to 8 years. The following were obtained: The therapeutic efficacy : seventeen patients showed marked improvement, nineteen moderate and tweleve did not. Among twenty six patients who had problems in their homes, jobs, human relationships and personal histories, tweleve patients showed marked improvement, nine moderate and five did not. Six cases needed psychiatric intervention. Most patients with spasmodic torticollis had problems in homes, jobs, human relationships or personal histories. Therefore we think that psychiatric problems might developed from spasmodictorticollis. In regards to writer's cramp we have treated five patients. Two patients are still continuing the therapy. One case says he feels relaxed while writing, and another says that now she cannot feel at home without training. In regard to dysphagia we have treated four patients. The patients train themselves to suck while watching surface Electromyograms of their orbicularis oris muscle and submental muscle. With sucking and aspiration, the pharynx of the patients go up. The patients can watch surface Electromyograms of sucking and aspiration. Sucking a piece of dry cuttlefish promotes saliva secretions and may makethe patients aspirate more easily. We experienced cases who reduced their saliva dribbling during sleep and improved aspiration disorder.

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The EMG is used most a lot as an index of feedback, and it is applied widely. In most of the cases the modality used heretofore in biofeedback therapy has been decided uniformly by disease unit based on its pathology. However, there are patients in whom this relationship proves ineffective and also many cases with psychosomatic disorder for whom decision cannot be readily be made on what modality should be used due to the presence of various symptoms. The authors have pointed out in their previous reports that the therapeutic effects of biofeedback therapy do not depend on diagnosis and disease type, and that biofeedback therapy is not effective unless the feedback indices accurately reflect the pathology of the patient and unless the case possesses not only sufficient margin for learning in the direction toward the desired goal but also physiological responsiveness. From these standpoints, the authors were made to feedback multiple physiological indices (multi-site and multi-modal feedback; e.g. plural EMGs/EMGs and skin temperature) at the same time. With the multi feedback system, it is possible for a patient to select a modality or modalities freely which s/he can easily control. When the patient feels difficulty to continue the practice with the response s/he chose, then s/he can try another modality and continues the practice. This flexibility might lessen the patient's burden due to the unsuccessful practice and might motivate her/him to continue the practice. This clinical benefit of the multi feedback was confirmed in previous study. This report introduces a practical use method and a therapeutic contrivance of EMG biofeedback as such a relaxation method.

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To effectively introduce electroencephalogram (EEG) and biofeedback (BF) therapy, this research compares effects between the use of BF therapy alone and that of both respiration and image therapies. The 215 cases for which BF therapy was done more than 20 times at the Department of Psychosomatic Medicine were divided into cases for which BF therapy alone was performed (Group A) and those for which both respiration and image therapies were conducted (Group B) to comparatively study trends in the α wave appearance rate and the correct prediction rate. In Group A, there were signs of a rise, albeit insignificant, in the α wave appearance rate and the correct prediction rate, whereas significant rises were observed in Group B. In a comparison before and after the concurrent use of respiration and image therapies, significant rises were observed in the α wave appearance rate and the correct prediction rate both before and after their concurrent use. This study suggests that EEG biofeedback therapy will be more effective with the concurrent use of the respiration method and image therapy.

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Hardiness is known as a personality trait of people with good health under stressful situations. This study examined the effects of hardiness on cardiovascular response to stressful conditions. Twenty-two female university students underwent two stressful conditions : mental arithmetic (MA) and cold pressure (CP) in a counter-balanced order. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean blood pressure (MBP) were measured. Participants were asked to fill out the questionnaire about hardiness and personality using the hardiness scale and the NEO Five Factor Inventory (NEO-FFI), respectively. They were divided into low and high hardiness groups by the median split. Results indicated that the high hardiness participants scored significantly higher on the NEO-FFI on openness, marginally higher on conscientiousness, and lower on neuroticism. SBP, DBP and MBP significantly increased in both conditions. HR increased in MA condition, but it decreased in CP condition. The high hardiness participants showed a significant DBP increase in MA condition. These results implied that the positive cognition of hardiness had some effects on the physiological responses to active coping stressors.

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Physiological and psychological evaluations are both necessary in order to judge the effects of aromatic substances. We measured the both changes in autonomic nervous system parameters (i.e. heart rate R-R intervals data and skin temperature) and mood scores (i.e. pleasantness, relaxation and anxiety) following drinking chamomile tea (or hot water of same volume and temperature as chamomile tea) after 45 min Kraepelin test. Scores of relaxation increased after drinking chamomile tea. Decrease of heart rate and LF/HF ratio, an indicator of sympathetic nervous activity, were greater after drinking chamomile tea than hot water. Elevation of peripheral skin temperature was higher after drinking chamomile tea than hot water. Significant correlation was observed between changes in relax scores and autonomic nervous system parameters after drinking chamomile tea. From the results, it became obvious that the objective physiological parameters fully correlated with the psychological indices reported subjectively using the standardized questionnaire.

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Alzheimer's disease is a kind of neural degenerating diseases with progressive memory dysfunction and orientation impairments as the main symptoms. In the present study, we aimed at developing a painless and non-invasive rehabilitation method of dementia of Alzheimer's type (DAT) using transcutaneous electrical nerve stimulation (TENS) as exterior stimulation to activate the central neural system. In our previous Studies, DAT patients were treated with TENS on the middle of the forehead. After the treatment, not only their cognitive function, but also the eye reflection movement to light, which is considered to be an index of the activity of acetylcholine, has also been improved. However, the patients received stimulation passively and the whole process was thought boring. To make the procedure more effective and more interesting, biofeedback training was combined with the pupil's pictures as its feedback information. The subjects (9 DAT patients) were treated with TENS as same as usual while a pair of glasses with a built-in-camera was put on simultaneously. As the pictures of their own eyes were shown on a screen monitor, the subjects were told to open their eyes as widely as possible. The training trial has been carried out for 30min every other day for 10 Sets completely. Immediately after the training, the parameters of eye reflection to light were improved and the performance of the cognitive scales was increased. Therefore, it is suggested that the method combined TENS with biofeedback training is effective on improving the eye reflection to light, which is considered relate to memory, as well as intelligence. However, there is no direct evidence that the brain has been activated and the probable mechanism is discussed in this paper.

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We have been developing a new rehabilitation system by light-stimulation for senile dementia. If the lost synaptic and dead neuronal cells, which lead to dementia, can be reactivated with any stimulation, the dementia will be rehabilitated. Results in our other study lead to a hope that dementia may be rehabilitated by Biofeedback (BF) training with the light-stimuli. The pulse-wave light-stimuli was bestowed on patient of senile dementia 5 times in 1 min (1 sec stimulus at intervals of 10 sec) as one set of BF training. Patient was given 3 sets of training in one day (1 set of training at intervals of 30 min), and continued for 3 days. Patient was instructed to be looking closely at the pupil image taken on video of himself, trying to make it as circular and big as possible, in order to win BF effect efficiently. The HDS-R (the Revised version of Hasegawa's Dementia Scale) scores were recorded before and after the training to estimate the training effect. Twenty patients of senile dementia (five Cerebrovascular dementia patients and fifteen Alzheimer's disease patients, mean age 79.3 years, SD 6.5) were trained. From the fact that not only the HDS-R scores (p<0.01) but also the parameters of pupillary light reflex of dementia patients such as time of latency (p<0.05) were significantly improved by training, we could conclude that the training with light stimulation may be beneficial to the rehabilitation of dementia patients. On the other hand, the pupil image showed the usefulness as a BF index.

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