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Dynamic Neural Retraining System
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Annie Hopper created the '''Dynamic Neural Retraining System''' or '''DNRS''' in 2008, and states this is based on her recovery from "severe Multiple Chemical Sensitivity, Fibromyalgia and Electric Hypersensitivity Syndrome".<ref name="team">{{Cite web | url=https://retrainingthebrain.com/meet-the-dnrs-team/ | title = Meet the DNRS™ Team | last = Tozer | first = James|website=Dynamic Neural Retraining System|language=en-CA|access-date=2020-09-23}}</ref> Hopper is not a doctor or a scientist.<ref name="team" /><ref name="Tuller2Sep2020">{{Cite web | date = 2012-09-02| url = https://www.virology.ws/2020/09/02/trial-by-error-what-is-the-dynamic-neural-retraining-system/| title = Trial By Error: What Is the Dynamic Neural Retraining System?|website=[[Virology blog]] | last = Tuller | first =David | authorlink = David Tuller}}</ref> ==Theory == DNRS's website states that [[trauma]] is the cause of brain changes, and that trauma causes a "maladaptive stress response" which then causes certain physical symptoms, which the website lists.<ref name="about" /> However, the symptoms listed have many possible causes and DNRS is not an approved trauma recovery program.<ref name="about">{{Cite web | url=https://retrainingthebrain.com/how-the-program-works/ | title = How The Program Works | last = Tozer | first = James | authorlink = | date = | website = Dynamic Neural Retraining System|language=en-CA| archive-url = | archive-date = |url-status = | access-date=2020-09-23}}</ref> Various scientific claims on the website about the long term effects of trauma and about how the program physically alters the brain do not have scientific references, including the claim that the program will help you create "new, healthy neural pathways".<ref name="about" /> ==Components == The program is a psychologically based self-help approach that states it involves *[[cognitive behavioral therapy]] *[[mindfulness]] based cognitive restructuring *emotional restructuring therapy *[[neural linguistic programming]] (NLP) *incremental training (a form of neural shaping) *behaviour modification therapy *cognitive-behaviour therapy<ref name="about" /> The program states it takes 14hrs to complete the training, with 4 days suggested for this, followed by regular practice. It can be done online or by DVD. You are expected to commit to 6 months of practice, at a minimum of one hour per day.<ref name="about" /> ==ME/CFS == The DNRS website claims it can "rewire chronic illness disease patterns in the brain" and that "the program is an effective treatment for [[Multiple chemical sensitivity|chemical sensitivities]], [[chronic fatigue syndrome]], [[fibromyalgia]] and many other chronic illnesses". No brain scans or brain imaging studies support this "rewiring the brain" claim, no other evidence is given to support this claim, and there is no evidence that brain-only dysfunction is the sole cause of any of these illnesses.<ref name="about" /> DNRS does not suggest any benefits that could lead to improvement in [[Mitochondrion|mitochondria]] or [[immune system]] functioning, or any change in [[dorsal root ganglia]] inflammation,<ref name="about" /> all of which research has found to be involved in ME/CFS. Peripheral nerve changes, the [[autonomic nervous system]] changes, and POTS are not mentioned.<ref name="about" /> The only scientific support is not published in full and not peer-reviewed, and appears as a graph and basic summary of some aspects of a preliminary report based on questionnaires from a group who tried DNRS. Only some results are reported, and it shows a high drop-out rate, and unsurprisingly shows that those who did not drop-out did improve to a degree.<ref name="Guenter2019" /> There is no information about whether participants had been professionally diagnosed, the results of the patients self-reporting CFS are not given, and full results are not reported, which is an indicator of [[research bias in ME/CFS|bias]]. ME/CFS is a neurological disease which is also multisystemic; symptoms include immune system dysfunction including altered [[cytokine]] expression, digestive / gastrointestinal symptoms that in some cases become severe enough to need tube feeding or even cause death from [[Sophia Mirza|kidney failure]], [[mitochondria dysfunction]], hormonal changes caused by the endocrine system, multiple types of pain, new intolerances to certain foods or sensory intolerances, alterations in the shape of [[erythrocyte|red blood cells]], changes in the circulatory system for example [[postural orthostatic tachycardia syndrome]] (POTS), and significant [[cognitive dysfunction]].<ref name="ICC2011primer" /> The theory of ME/CFS as a long-term consequence of [[trauma]] lacks evidence and has significant evidence against it, with many patients having no trauma history and most reporting that the onset if the disease was linked to a [[viral onset hypothesis|virus]], other [[infection]], or physical injury.<ref name="ICC2011primer" /> A study of military veterans by Murphy et al. (2003) could not find a link between [[Post-traumatic stress disorder]] and CFS-like symptoms.<ref name="veterans2003">{{Cite journal | last = Murphy | first = Frances M. | authorlink = Frances Murphy | last2 = Lee | first2 = Kyung Y. | authorlink2 = Kyung Lee | last3 = Mahan | first3 = Clare M. | author-link3 = Clare Mahan | last4 = Natelson | first4 = Benjamin H. | author-link4 = Benjamin Natelson | last5 = Kang | first5 = Han K. | author-link5 = Han Kang | date = 2003-01-15 | title = Post-Traumatic Stress Disorder and Chronic Fatigue Syndrome-like Illness among Gulf War Veterans: A Population-based Survey of 30,000 Veterans |url =https://academic.oup.com/aje/article/157/2/141/90101|journal=American Journal of Epidemiology|language=en|volume=157|issue=2 | pages = 141–148|doi=10.1093/aje/kwf187|issn=0002-9262|quote=|via=}}</ref> Heins et al. (2011) found no relationship between childhood maltreatment and response to [[Cognitive behavioral therapy|CBT]] therapy for CFS.<ref name="Heins2011">{{Cite journal | last = Heins | first = Marianne J. | authorlink = Marianne Heins | last2 = Knoop | first2 = Hans | authorlink2 = Hans Knoop | last3 = Lobbestael | first3 = Jill | authorlink3 = Jill Lobbestael | last4 = Bleijenberg | first4 = Gijs | authorlink4 = Gijs Bleijenberg | authorlink5 = | date = Dec 2011 | title = Childhood maltreatment and the response to cognitive behavior therapy for chronic fatigue syndrome | url =https://www.ncbi.nlm.nih.gov/m/pubmed/22118383/|journal=Journal of Psychosomatic Research|volume=71|issue=6 | pages = 404–410|doi=10.1016/j.jpsychores.2011.05.005|issn=1879-1360|pmid=22118383|quote=|via=}}</ref><ref name="Clark, 2018">{{Citation | last = Clark | first1 = James E. | author-link1 = James Clark | last2 =Davidson | first2 = Sean L. | authorlink2 = Sean Davidson | last3 = Maclachlan | first3 = Laura| authorlink3 = Laura Maclachlan | last4 = Newton | first4 = Julia| authorlink4 = Julia Newton | last5 = Watson | first5 = Stuart | authorlink5 = Stuart Watson | title = Rethinking childhood adversity in chronic fatigue syndrome | journal = Fatigue: Biomedicine, Health & Behavior | volume = | issue = | page = | date = 2017 | pmid = | doi = 10.1080/21641846.2018.1384095 }}</ref><ref name="Morris2019">{{Cite journal | last = Morris | first = Gerwyn | authorlink = Gerwyn Morris | last2 = Berk | first2 = Michael | authorlink2 = Michael Berk | last3 = Maes | first3 = Michael | authorlink3 = Michael Maes | last4 = Carvalho | first4 = André F. | author-link4 = André Carvalho | last5 = Puri | first5 = Basant K. | author-link5 = Basant Puri | date = 2019-01-26 | title = Socioeconomic Deprivation, Adverse Childhood Experiences and Medical Disorders in Adulthood: Mechanisms and Associations |url =https://doi.org/10.1007/s12035-019-1498-1|journal=Molecular Neurobiology|language=en|volume=|issue= | pages = 1-25|doi=10.1007/s12035-019-1498-1|issn=1559-1182|quote=|via=}}</ref> {{See also|Trauma}} ==Risks and safety == There is no scientific evidence that DNRS has positive benefits or that it is a safe treatment, no clinical trials have been conducted, and DNRS was not developed by a medical professional or scientist.<ref name="about" /><ref name="Guenter2019" /> The hallmark symptom of ME/CFS is [[post-exertional malaise]] which can be triggered by too much cognitive effort; in [[severe and very severe ME]] watching too much TV or listening to audio may cause post-exertional malaise or permanent deterioration, which may mean the commitment and work needed by DNRS is both impossible and very harmful.<ref name="ICC2011primer">{{citation | last1 = Carruthers | first1 = BM | author-link1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas | last5 = Broderick | first5 = G | authorlink5 = Gordon Broderick | last6 = Mitchell | first6 = T | author-link6 = Terry Mitchell | last7 = Staines | first7 = D | author-link8 = Donald Staines | last8 = Powles | first8 = ACP | author-link8 = A C Peter Powles | last9 = Speight | first9 = N | author-link9 = Nigel Speight | last10 = Vallings | first10 = R | author-link10 = Rosamund Vallings | last11 = Bateman | first11 = L | author-link11 = Lucinda Bateman | last12 = Bell | first12 = DS | author-link12 = David Bell | last13 = Carlo-Stella | first13 = N | author-link13 = Nicoletta Carlo-Stella | last14 = Chia | first14 = J | author-link14 = John Chia | last15 = Darragh | first15 = A | author-link15 = Austin Darragh | last16 = Gerken | first16 = A | author-link16 = Anne Gerken | last17 = Jo | first17 = D | author-link17 = Daehyun Jo | last18 = Lewis | first18 = DP | author-link18 = Donald Lewis | last19 = Light | first19 = AR | author-link19 = Alan Light | last20 = Light | first20 = KC | authorlink20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 = S | authorlink21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 = J | authorlink22 = John McLaren-Howard | last23 = Mena | first23 = I | authorlink23 = Ismael Mena | last24 = Miwa | first24 = K | authorlink24 = Kunihisa Miwa | last25 = Murovska | first25 = M | authorlink25= Modra Murovska | last26 = Stevens | first26 = SR | authorlink26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012 | isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf }}</ref> Some components of the program such as [[cognitive behavioral therapy]], mindfulness and stress management techniques have not been shown to be effective in the majority of ME/CFS, and some have resulted in substantial rates of harm. If used as a trauma recovery or stress management program, it is not known how this compares with well-established, proven treatments. ==Evidence == No clinical trials have been conducted to show the effectiveness or potential risks of DNRS, and there is no evidence that the brain is "rewired" or "retrained" or that neural networks within the brain are altered by the treatment.<ref name="about" /> Evidence consists of an unpublished presentation, which has not been peer reviewed, part of which can be found on the DNRS website, and a number of claims by coaches or facilitators who stated they recovered from multiple illnesses using it.<ref name="ResearchSep2020">{{Cite web | url=https://retrainingthebrain.com/research-3/ | title = Research | last = Tozer | first = James | authorlink = | date = n.d.|website=Dynamic Neural Retraining System|language=en-CA| archive-url = | archive-date = |url-status = | access-date=2020-09-23}}</ref> According to the presentation, brain imaging or brain function tests were not used to assess neuroplasticity after the DNRS course, and all results were based on patient questionnaires.<ref name="Guenter2019">{{Citation|vauthors=Guenter et al | first = | title = Neuroplasticity-based treatment for fibromyalgia, chronic fatigue and multiple chemical sensitivity: feasibility and outcomes| publisher = | date = 2019 | url=|volume=|issue=| pages=|chapter=|edition= | last2 = | first2 = }}</ref> The presentation on the website does not provide results separately for patients with ME/CFS, although some patients reported having it.<ref name="Guenter2019" /> ==Learn more == *[https://www.virology.ws/2020/09/02/trial-by-error-what-is-the-dynamic-neural-retraining-system/ Trial By Error: What Is the Dynamic Neural Retraining System?] - [[Virology blog]] *[https://paradigmchange.me/wp/retraining/ Some Comments on So-Called “Brain Retraining” Programs] - Psychologist Lisa Petrison comments on the unproven scientific claims and potential harm - Paradigmchange.me *[https://retrainingthebrain.com/how-the-program-works/ How the program works - DNRS] ==See also == *[[Brain training]] ==References == {{Reflist}} [[Category:Brain training]] [[Category:Potential treatments]] [[Category:Psychological and behavioral therapies]]
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