What Is Neurofeedback?
Neurofeedback, also known as neurotherapy or EEG biofeedback, is a type of treatment that uses electronic equipment and computer software to measure brain wave activity and teach you how to change abnormal brain wave patterns that are associated with various medical or psychiatric conditions. It is a painless, non-invasive technique that has been in existence since the late 1960's.
Introduction to Brain Waves
Brain waves are the electrical activity
that is produced by neurons (brain cells). There are four main brain wave
bands that are measured in Hertz (Hz), which is the number of waves that
occur per second.
| Beta waves (13 Hz and higher) are associated with external focus and concentration. They are prominent when you are focusing on an external activity such as a conversation or while reading. |
| Alpha waves (8-13 Hz) become more prominent, especially in the back of the brain, when you close your eyes and become calm and relaxed. |
| Theta waves (4-8 Hz) are associated with an internally focused state at the upper end of the band (6-8 Hz) and drowsiness at the lower end (4-6 Hz). |
| Delta waves (0-4 Hz) are most prominent during sleep. All of these waves are continuously present in your brain. Keep in mind, however, that the brain tends to slow down as you move from focus on external activities to relaxation to internal focus/drowsiness and finally to sleep. |
How Does Neurofeedback Work?
Our daily lives are filled with
times when we use feedback to help us improve performance of a task. Consider,
for example, how much easier it is to control the speed of a car when you
can look at the visual feedback provided by the speedometer. You also get
clues about your speed from the sound of the engine (auditory feedback).
Shaving in the morning is a lot easier (and safer!) with the visual feedback
provided by one's reflection in the bathroom mirror. Neurofeedback works
by giving you instant real-time information about your brain waves. You
can then use that information to control brain wave activity.
What Is Neurofeedback Used For?
There are many psychiatric and medical
disorders that are associated with abnormal patterns of brain wave activity.
For example, many children and teenagers who have Attention Deficit/Hyperactivity
Disorder (ADHD) have an excess of theta wave activity and not enough beta
activity. In other words, their brains are working too slowly to effectively
perform externally focused activities. It is common to see the brains of
ADHD kids slow down when they open their eyes, which is exactly the opposite
of what should be happening. Neurofeedback treatment for this type of ADHD
would involve first learning how to reduce the excess theta, followed by
training to increase the amount of beta.
Some ADHD children and adults have an excess amount of alpha activity. High amplitude alpha that occurs when the eyes are open is associated with inattention and distractibility. As with excess theta activity, having too much alpha means that your brain is not running at its optimal speed. Treatment would consist of learning how to reduce the amount of eyes-open alpha to a normal level.
Other conditions that have abnormal brain wave patterns and respond to treatment with neurofeedback include anxiety disorders (typically excess beta), drug abuse (not enough theta and/or alpha), learning disabilities (amplitude asymmetry), and traumatic brain injury (excess theta, elevated coherence). Neurofeedback is also used to treat intractable epileptic seizures by increasing activity in the sensorimotor rhythm band (12-15 Hz), which has been shown to reduce the occurrence of seizures.
A Typical Neurofeedback Session
A neurofeedback training session
begins with placement of one or more sensors on your scalp and ears. The
sensors are connected to the neurofeedback equipment, which amplifies your
brain waves and sends them to a computer. You sit in front of a computer
monitor and watch a display that changes as your brain waves change. For
example, you may be trying to make a circle get smaller by reducing theta
waves or make a jet plane go higher on the screen by producing more beta
waves. A typical neurofeedback session lasts for 45 to 50 minutes.
How Do You Know Which Part of
the Brain Needs Training?
Before neurofeedback therapy is
started, a test called a quantitative EEG (QEEG)
is performed. The QEEG is a test of brain wave activity that helps Dr.
Shulimson create a neurofeedback treatment plan that is specifically designed
to meet your needs. More information on the QEEG can be found in Dr. Shulimson's
QEEG FAQ.
How Long Does Neurofeedback Take?
Learning to control your brain waves
takes a long time because we have very little natural feeling for what
our brain waves are doing. In contrast, we have very good ability to know
where our arms and legs are positioned. Try closing your eyes and touching
your nose with your finger. The length of time needed to complete neurofeedback
therapy depends on the needs of each individual. A typical child or teen
with the high theta/low beta form of ADHD probably will require approximately
40 to 50 training sessions. It is best to have at least two neurofeedback
sessions per week. Having three or four weekly sessions speeds up the learning
process.
How Successful is Neurofeedback?
As with all forms of medical and
psychiatric treatment, a successful outcome cannot be guaranteed. However,
over thirty years of research and clinical experience have demonstrated
that neurofeedback can be an effective treatment for ADHD and other conditions.
One recent study with ADHD children found that over 80% of those who were
given neurofeedback therapy had significant improvements in performance
on a test of attention. Another study showed that neurofeedback produced
an average increase of 10 IQ test points and a significant decrease in
inattentiveness in ADHD subjects. Multiple research studies have demonstrated
that neurofeedback training can reduce the frequency of seizures.
Neurofeedback and Medications
Neurofeedback therapy can be done
at the same time that you are taking prescription medications. It is strongly
advised that you continue taking your medication(s) while doing neurofeedback.
When your course of neurofeedback therapy is finished it may be possible
to reduce or eliminate some medications, though there is no guarantee of
being able to do so.
Does Neurofeedback Have Side-Effects?
One of the advantages of neurofeedback
is that side-effects are very rare. You may find that learning to control
your brain waves is a frustrating process, especially at the beginning
of treatment. Patients sometimes feel tired at the end of a session. Patients
with sensitive skin have had reactions to the products that are used to
clean the skin or hold the sensors in place on the scalp or ears. There
have also been rare instances when neurofeedback training has gone too
far and produced unwanted side-effects. This can be easily corrected by
some training in the other direction, such as down-training excess beta
that is producing irritability.
Does Insurance Pay For Neurofeedback?
Coverage for neurofeedback depends
on your particular insurance policy. To obtain information from your insurance
company, use Dr. Shulimson's handout titled "Obtaining
Insurance Payment For QEEG and Neurofeedback."