n e u r o f e e d b a c k

What Is Neurofeedback?
Neurofeedback, also known as neurotherapy or EEG biofeedback, is a type of treatment that uses electronic equipment to measure brain wave activity and teach you how to change abnormal brain wave patterns. It is a painless, non-invasive technique that has been used by psychologists, physicians and other health care providers since the early 1970’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 alertness and external focus. They are prominent when you are involved in activies that require your brain to process information such as reading or having a conversation. 
Alpha wave (8-13 Hz) activity increases, 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 likely to occur during 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). 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 adults who have Attention Deficit/Hyperactivity Disorder (ADHD) have an excess of theta wave activity and not enough beta activity. In other words, their brains have an excess of waves associated with internal focus and drowsiness and not enough waves associated with external focus and alertness. It is common to see an increase in theta activity when ADHD children are working on a task that is uninteresting or repetitive. Neurofeedback for this type of ADHD would involve training to reduce the excess theta that the brain is producing.

Some people with ADHD have high levels of beta (fast wave) activity. Their attention problems are caused by a brain that is running too fast rather than too slowly. Neurofeedback treatment would consist of learning how to reduce the amount of beta waves that the brain is producing.

Other conditions that are treated with neurofeedback include anxiety disorders, drug and alcohol abuse, autistic spectrum disorders, depression, learning disabilities, traumatic brain injury and epilepsy.

A Typical Neurofeedback Session
A neurofeedback training session begins with placement of one or more sensors on your scalp and one on each ear. 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 me create a neurofeedback treatment plan that is specifically designed to meet your needs. More information on the can be found on the QEEG/rEEG page

How Many Neurofeedback Sessions Will Be Needed?
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. Many people experience significant improvement after 40 to 50 training sessions. Progress is faster if you have more than one session per week. It is best to have at least two neurofeedback sessions per week.

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.

Want to know more about Neurofeedback?
The International Society for Neurofeedback and Research website is an excellent resource for information on neurofeedback research and clinical applications.

© 2003 Aharon Shulimson Ph.D.