What is EEG Biofeedback?

EEG Biofeedback is a learning strategy that enables persons to alter their brain waves. When information about a person's own brain wave characteristics is made available to him, he can learn to change them. You can think of it as exercise for the brain.

What is it used for?

EEG Biofeedback is used for many conditions and disabilities in which the brain is not working as well as it might. These include Attention Deficit Hyperactivity Disorder and more severe conduct problems, specific learning disabilities, and related issues such as sleep problems in children, teeth grinding, and chronic pain such as frequent headaches or stomach pain, or pediatric migraines.

The training is also helpful with the control of mood disorders such as anxiety and depression, as well as for more severe conditions such as medically uncontrolled seizures, minor traumatic brain injury, or cerebral palsy.

How is it done?

An initial interview is done to obtain a description of symptoms, and to get a picture of the health history and family history. Some testing may be done as well. And the person does the first EEG training session, at which time we get a look at the EEG. This all may take about two hours. (The details may differ among the various affiliate offices. In some offices a full brain map, or quantitative EEG, is routinely obtained, which may require a separate office visit. Or more extensive testing may be done.) Subsequent training sessions last about 40 minutes to an hour, and are conducted from one to five times per week. Some improvement is generally seen within ten sessions. Once learning is consolidated, the benefit appears to be permanent in most cases.

The EEG biofeedback training is a painless, non-invasive procedure. One or more sensors are placed on the scalp, and one to each ear. The brain waves are monitored by means of an amplifier and a computer-based instrument that processes the signal and provides the proper feedback. This is displayed to the trainee by means of a video game or other video display, along with audio signals. The trainee is asked to make the video game go with his brain. As activity in a desirable frequency band increases, the video game moves faster, or some other reward is given. As activity in an adverse band increases, the video game is inhibited. Gradually, the brain responds to the cues that it is being given, and a "learning" of new brain wave patterns takes place. The new pattern is one which is closer to what is normally observed in individuals without such disabilities.

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What therapeutic applications have clinical evidence?

There are clinical reports or case histories concerning the effectiveness of neurofeedback for the following therapeutic applications. See also Therapeutic Applications of Neurofeedback.

• Addiction
• Anxiety
• Attachment Disorder
• Attention Deficit Disorder
• Autoimmune Dysfunctions
• Chronic Fatigue Syndrome (CFS)
• Chronic Pain
• Conduct Disorder
• Depression
• Epilepsy
• Sleep Disorders
• Stroke/TBI
• Tourettes Syndrome

In the case of ADHD, impulsivity, distractibility, and hyperactivity may all respond to the training. This may lead to much more successful school performance. Cognitive function may improve as well. In several controlled studies, increases of 10 points in IQ score were found for a representative group of ADHD children. And in two clinical studies, an average increase of 19 and 23 points was demonstrated.

Behavior may improve in other ways as well: If the child has a lot of temper tantrums, is belligerent, and even violent or cruel, these aspects of behavior may come under the child's control.

In the case of depression, there can be a gradual recovery of "affect", or emotional responsiveness, and a reduction of effort fatigue. In the case of anxiety and panic attacks, there is gradual improvement in "regulation", with a dropoff in frequency and severity of anxiety episodes and panic attacks until the condition normalizes.

In the case of epilepsy, we observe a reduction in severity and incidence (frequency of occurrence) of seizures. In many cases the dosage of anticonvulsant medication may ultimately be reduced (if ordered by the referring neurologist), and side effects of such medication may diminish.

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Can a successful outcome be predicted?

It is not possible to predict with certainty that training will be successful for a particular condition. But for the more common conditions we see, a reasonable prediction of outcome is usually possible. More important, however, the effectiveness of the training can usually be assessed early in the course of training. For most conditions, there are no known adverse side effects of the training, provided that it is conducted under professional guidance.

Why does this training procedure work?

The brain is amazingly adaptable, and capable of learning. It can also learn to improve its own performance, if only it is given cues about what to change. By making information available to the brain about how it is functioning, and asking it to make adjustments, it can do so. When the mature brain is doing a good job of regulating itself, and the person is alert and attentive, the brain waves (EEG) show a particular pattern. We challenge the person to maintain this "high-performance", alert and attentive state. Gradually, the brain learns, just like it learns anything else. And like with other learning, the brain tends to retain the new skill.

We observe that if the EEG is not well-behaved under these circumstances, there may be adverse impacts on learning ability, on moods, on sleep, and on behavior. With training, these may be gradually brought under control, along with normalization of the EEG.

My doctor is skeptical about EEG Biofeedback. What can I do?

Your doctor may not know of this specific type of biofeedback. He or she will maintain a healthy skepticism about any new approach claiming numerous benefits. If your doctor is familiar with EEG biofeedback in general, he may still be thinking in terms of the more common early experiments with alpha wave training, rather than with the training we are dealing with here. Ask your doctor to examine the recent research on the effectiveness of EEG biofeedback in treating various disorders such as attention deficit disorder and epilepsy. The following references are a place where he or she can start:

• Duffy FH (2000). The state of EEG biofeedback therapy (EEG operant conditioning)in 2000: an editor's opinion Clinical Electroencephalography, 31, v-vii.

• Egner T, & Gruzelier JH (2004). The temporal dynamics of electroencephalographic responses to alpha/theta neurofeedback training in healthy subjects. Journal of Neurotherapy, 8, 43-57.

• Fernández T et al (2003). EEG and behavioral changes following neurofeedback treatment in learning disabled children Clinical Electroencephalography, 34, 145-52

• Hirshberg LM (2005). Emerging brain-based interventions for children and adolescents: overview and clinical perspective. Child and Adolescent Psychiatric Clinics of North America, 14, 1-19

• Lubar JF & Lubar JO (1999). Neurofeedback assessment and treatment for attention deficit/hyperactivity disorders (pp. 103-143). In JR Evans & A Abarbanel (Eds), Introduction to quantitative EEG and neurofeedback. San Diego: Academic Press.

• Rossiter T. (2004). The effectiveness of neurofeedback and stimulant drugs in treating AD/HD: Part I. Review of methodological issues. Applied Psychophysiology and Biofeedback, 29, 95-112; Part II, Replication. 29, 233-43.

• Sterman, M.B. (1996). Physiological origins and functional correlates of EEG rhythmic activities: Implications for self-regulation. Biofeedback and Self-Regulation, 21, 3-33.

• Trudeau DL (2005). Applicability of brain wave biofeedback to substance use disorder in adolescents. Child and Adolescent Psychiatric Clinics of North America, 14, 125-36

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