From Our 2012 Archives
Brain Biofeedback May Help Bedwetting
By Brenda Goodman, MA
Reviewed by Louise Chang, MD
Oct. 11, 2012 -- Biofeedback may help children and adults who wet the bed at night, a small new study shows.
The study of 11 children and adults treated at the same clinic in Texas found that all had reduced brain activity in a region that's thought to relate to bladder control.
When they were trained to speed up their brain activity by playing a special video game, the nighttime bedwetting stopped.
Several important cautions apply. The study was very small and needs to be repeated by other researchers before biofeedback can be considered a valid treatment.
But the research does suggest that some bedwetting problems may be rooted and solved in the brain.
"The brain is a learning machine. If you tell it what it needs to do to be normal and you give it a reward for doing it, it will make more fast activity and less slow activity," says researcher Jonathan E. Walker, MD, a neurologist in private practice in Dallas, Texas.
When Kids Don't Stay Dry at Night
Up to 9% of children older than age 5 continue to wet the bed at night, according to the National Association for Continence.
It's not clear why kids continue to wet the bed in every case. For some, studies show that problems with nighttime bladder control are genetic. In others, sleep problems are thought to play a role. And some kids wet the bed because of problems with chronic constipation.
Whatever the reason, some children don't outgrow the problem. Therapies used to treat bedwetting include medications that decrease urine production, alarms that wake people as they start to pee at night, and laxatives to treat constipation.
For the neurofeedback therapy, Walker hooked each subject up to a machine that translated electrical activity in the mid-occipital region, which is at the back of the brain, into a video game.
When brain waves moved slowly, so did a Pac-Man-like character on the screen. By speeding up their brain waves, people in the study made the Pac-Man move more quickly around a game board.
After five to seven 20-minute sessions, which got progressively harder, each person in the study saw their bedwetting stop. The relief has lasted for more than a year.
Patients in the study ranged in age from 4 to 70. Most were children, but a few were adults who had searched their whole lives for help with the problem.
"They were very happy about it," Walker says.
The study is published in the journal Biofeedback.
More Research Is Needed
Independent experts who reviewed the study for WebMD said they were skeptical.
The study was very small and didn't include a control group of untreated patients for comparison.
"If the study was repeated in another center with more patients, I'd be surprised if the benefits would be the same," says Steve J. Hodges, MD, an associate professor of urology at Wake Forest Baptist Medical Center in Winston-Salem, N.C.
He says there's also nothing in the study to explain why retraining this brain region may help.
"I didn't really get the feel for how this therapy would work. I'd love to see other data on it," says Hodges, who has also written a book on bedwetting called It's No Accident.
SOURCES: Walker, J. Biofeedback, Fall 2012. National Association For Continence: "Statistics on nighttime enuresis." Jonathan E. Walker, MD, neurologist, Neurotherapy Center of Dallas, Dallas, Texas. Steve J. Hodges, MD, associate professor, department of urology, Wake Forest Baptist Medical Center, Winston-Salem, N.C.; author, It's No Accident, Lyons Press, 2012. Cedron, M. American Family Physician, March 1, 1999.
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