What is Neurofeedback?
Neurofeedback, often referred to as EEG biofeedback or brain wave training, is a type of biofeedback in which individuals are trained to improve their brain function.
Neurofeedback (NF), or EEG biofeedback is a type of biofeedback that involves learning to control and optimize brain function. Neurofeedback may or may not include the use of a direct stimulus or task when teaching the brain new ways of performing.
Neurofeedback has been practiced for well over four decades. Hundreds of thousands of individuals and families impacted by various mental health and/or neurological conditions have benefited greatly from this powerful, effective, established, and proven intervention.
Like other forms of biofeedback, Neurofeedback Training (NFT) uses monitoring devices to provide moment-to-moment information to an individual on the state of their physiological functioning. The characteristic that distinguishes NFT from other biofeedback is a focus on the central nervous system and the brain. Neurofeedback Training (NFT) has its foundations in basic and applied neuroscience as well as data-based clinical practice. It takes into account behavioral, cognitive, and subjective aspects as well as brain activity.
Watch this short video to learn the basic points of neurofeedback.
What is Neurofeedback training?
Neurofeedback training (NFT) is preceded by an objective assessment of brain activity and psychological status. During training, sensors are placed on the scalp and then connected to sensitive electronics and computer software that detect, amplify, and record specific brain activity.
Resulting information is fed back to the trainee virtually instantaneously with the conceptual understanding that changes in the feedback signal indicate whether or not the trainee’s brain activity is within the designated range.
Based on this feedback, various principles of learning, and practitioner guidance, changes in brain patterns occur and are associated with positive changes in physical, emotional, and cognitive states.
Often the trainee is not consciously aware of the mechanisms by which such changes are accomplished although people routinely acquire a “felt sense” of these positive changes and often are able to access these states outside the feedback session.
NFT does not involve either surgery or medication and is neither painful nor embarassing. When provided by a licensed professional with appropriate training, generally trainees do not experience negative side-effects.
Typically trainees find NFT to be an interesting experience. Neurofeedback operates at a brain functional level and transcends the need to classify using existing diagnostic categories. It modulates the brain activity at the level of the neuronal dynamics of excitation and inhibition which underly the characteristic effects that are reported.
Research demonstrates that neurofeedback is an effective intervention for ADHD and Epilepsy. Ongoing research is investigating the effectiveness of neurofeedback for other disorders such as Autism, headaches, insomnia, anxiety, substance abuse, TBI and other pain disorders, and is promising.
Being a self-regulation method, NFT differs from other accepted research-consistent neuro-modulatory approaches such as audio-visual entrainment (AVE) and repetitive transcranial magnetic stimulation (rTMS) that provoke an automatic brain response by presenting a specific signal. Nor is NFT based on deliberate changes in breathing patterns such as respiratory sinus arrhythmia (RSA) that can result in changes in brain waves. At a neuronal level, NFT teaches the brain to modulate excitatory and inhibitory patterns of specific neuronal assemblies and pathways based upon the details of the sensor placement and the feedback algorithms used thereby increasing flexibility and self-regulation of relaxation and activation patterns.
The International Society for Neurofeedback and Research (see www.isnr.org) is the largest group of licensed professionals involved in the practice, teaching, and research of NFT. Some members of ISNR have sought and received certification by the Biofeedback Certification Institute of America (see www.bcia.org). Members of ISNR subscribe to a code of ethics providing an added measure of accountability to the standards of their profession. Additionally, ISNR is committed to supporting new developments by publishing a professional journal and newsmagazine, by producing a well-attended annual conference, and by encouraging large studies of NFT through the ISNR Research Foundation.
This definition was ratified by the ISNR Board of Directors on January 10, 2009 and edited on June 11, 2010
Read a peer-reviewed article, written by D. Corydon Hammond in 2011, entitled "What is Neurofeedback - An Update".
How does Neurofeedback therapy work?
The process of Neurofeedback Therapy may include sensors placed on the scalp to measure the brain’s electrical activity. Other methods of monitoring brain activity may be used, such as, but not limited to Functional Magnetic Resonance Imaging (fMRI) or Hemoencaphalography (HEG).
After this neural information (data) is sent to a computer to be processed, the data is sent back to the brain. The brain then learns to make changes to itself based on this real time data. In Neurofeedback sessions, changes within the brain can be accomplished by either talking directly to the brain electrically, or through stimuli presented to the brain in audio, visual, electrical, magnetic, or tactile form.
These changes can positively impact our everyday lives by improving and enhancing our thoughts, feelings, behavior, and performance.
While this is not a complete list, Neurofeedback can include games, activities, or tasks that teach the body flexibility and adaptability in regulating our attention, cognition, executive functioning, processing speed, memory, stress responses, emotional regulation, trauma, traumatic brain injury, seizure, autism, reading, mood, and sleep.
How long will Neurofeedback therapy take?
As with most forms of treatment, Neurofeedback results will vary with each individual. Neurofeedback training may require 20-40 sessions or more, depending upon the age of the client and the severity of his or her condition.
An introduction to the equipment and process
Neurofeedback involves several steps and pieces of equipment, including hardware, software, and feedback
1a. Electrodes or Sensors
Sensors, such as the example, are stuck to the scalp using a conductive paste. Often, they are referred to as “electrodes” but in most forms of neurofeedback, no current is sent into the brain. Instead, the sensors receive cortical activity and send it through and amplifier to the computer.
1b. A cap with multiple electrodes
In some cases, for assessments or forms of neurofeedback where a lot of sensors are used, a cap with electrodes placed in it may be used to ensure the proper placement of the sensors.
The system used is usually the International 10-20 System.
There are lots of amplifiers out there, so the one your neurofeedback provider uses might be similar to this one, or it might look very different, but regardless of the type of amplifier used, the purpose of it is the same: The box receives the signals from the sensors and amplifies them so that the computer can analyze and display them. It will connect to both the sensors and the computer via either a cord or a wireless connection.
3. Computer Software
Like the amplifiers, there is a wide variety of software available to your neurofeedback provider. The software is responsible for 3 basic things:
- Trace the EEG onto a graph so that the neurofeedback provider can see it.
- Allowing the provider to input a desired condition (called a threshold) or goal.
- Control an auditory and visual display which gives you information about what and how your brain is functioning.
4. Repetition Makes a Habit
As the electrical patterns are repeated, they become a habit for the brain, so the pattern holds for longer periods of time. After a while, the feedback is no longer needed for the brain to repeat the state it was taught.
5. Brain Change
Because the feedback you are getting is happening almost as soon as your brain produces the signal, your brain will repeat patterns that produce the reward (usually a sound and/or a video or game working). If it repeats it enough, it learns the pattern and the change becomes long lasting.
Who might benefit from Neurofeedback therapy?
Neurofeedback therapy has shown improvements in treating disorders like ADHD, anxiety, depression, autism spectrum disorder and learning disabilities.
A great benefit from Neurofeedback is that it is relatively non-invasive and creates lasting results in stark contrast from the outcomes derived from pharmaceutical treatment for a wide variety of conditions.
We estimate over 15,000 clinicians, world-wide are using this technology. The represented professions are inclusive of: psychology, counseling, social work, marriage and family therapy, nursing, neurology, pediatrics, rehabilitation medicine, physical therapy, occupational therapy, naturopathic medicine, speech and language pathology, chiropractic, psychiatry, child and adolescent psychiatry, and family medicine.
What are the benefits of Neurofeedback?
The benefits are usually experienced as improved focus, enhanced concentration, increased energy, higher quality sleep, decreased moodiness, diminished agitation, and reduction in anxiety, as well as reductions in other physical symptoms typically related to stress such as headaches.
What are the risks of Neurofeedback therapy?
Neurofeedback integrates clinical expertise with the best available research to address behavioral, cognitive, and subjective functions related to brain activity and therefore is considered an evidence-based intervention.
Neurofeedback is non-invasive, does not involve surgery or medication, is neither painful nor embarrassing, and has long-lasting effects.
The FDA recognizes that all interventions pose risks and benefits. Typically, the benefits of neurofeedback far outweigh the risks, although on occasion, it can result in non-serious adverse events as a form of biofeedback, it falls under the category of other low risk activities such as progressive relaxation, hypnosis, breathing exercises, meditation, yoga and massage.
Training with neurofeedback can occasionally result in adverse response(s) that temporarily increases symptoms which are typically associated with relaxation and calming of the central nervous system such as fatigue, headaches, lightheadedness, dizziness, irritability, moodiness, weeping, insomnia, agitation, and difficulties with focus and anxiety. These reactions, if they occur, are temporary and typically only last 24-48 hours. Once clients/patients become more relaxed and aware, they tend to integrate past emotional issues and these symptoms subside.
How effective is Neurofeedback?
Promising ongoing research shows the effectiveness of Neurofeedback for disorders such as autism, insomnia, anxiety, depression, substance abuse, traumatic brain injury (TBI), and chronic pain.
In addition, neurofeedback is showing promising outcomes with: cognitive and learning deficits, epilepsy and seizures disorders, fibromyalgia, tinnitus, Parkinson’s, migraine headaches, Tourette’s and Tic Disorders, Post Chemotherapy Symptoms, etc.
Can neurofeedback help the average person?
Neurofeedback has also been used to enhance learning and cognitive function in normal clients. Results show improved attention in college students and adults, and increased thinking speed and executive self-control in the elderly.