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Neurofeedback (NF) also known as EEG Biofeedback was first recognized as a treatment intervention in the 1960's for epilepsy and attention deficit disorder. The intervention is non invasive and there have only been rare adverse outcomes reported in research studies or by clinicians. There are two professional societies or associations in the United States: the International Society For Neurofeedback & Research (isnr.org) and the Association for Applied Psychophysiology and Biofeedback (aapb.org).

Aside from the usual health care provider assessment, there are two major components in the provision of NF treatment. The first is the Quantitative EEG (QEEG), sometimes referred to as brain mapping. QEEG is the measurement of electrical patterns or brainwaves at the surface of the scalp using digital technology so the information can be quantified. Brainwaves occur at various frequencies. Some are fast and some are quite slow. The classic names of these EEG bands are delta, theta, alpha, and beta. The second major component of NF treatment is the actual training in the form of biofeedback.

Neurofeedback training is done through the use of a sensitive electronic instrument called an electroencephalograph (EEG) that measures the frequency and strength of an individual's brain electrical activity and immediately sends this information to a high-speed computer. Almost instantly, these brainwave signals are processed by the computer and presented to the individual in the form of both visual and auditory feedback.

Using sophisticated computerized programs, the neurofeedback clinician can then assist the patient in learning how to use this "neurofeedback" to both recognize and better regulate his or her brainwave patterns. With children, the computer programs sometimes take the form of games. With continuing feedback, coaching, and practice, the patient learns to produce the desired brainwave patterns.

Different disease states or symptoms demonstrate particular brain wave patterns. Persons with stroke, ADD, ADHD, learning disabilities, head injuries, Tourette's syndrome, epilepsy, and often post-polio syndrome, chronic fatigue syndrome and fibromyalgia tend to have excessive slow waves (usually theta and sometimes excess alpha) present. When an excessive amount of slow waves is present in the executive (frontal) parts of the brain, it becomes difficult to control attention, behavior, and/or emotions. Such persons generally have problems with concentration, memory, impulse control, moodiness and hyperactivity. They cannot focus very well and exhibit diminished intellectual efficiency. When there is an excessive amount of slow wave in the parietal or occipital areas of the brain, language or communication problems are common.

Efficacy has been demonstrated with a range of anxiety disorders (Moore, 2000) and, seizure disorders in particular where 82% of trainees achieved significant improvement (Sterman, 2000). Although there are remarkable reports of clinical success in the treatment of many disorders, it should be acknowledged that the use of neurofeedback with many problems such as head injury, effects of stroke, chronic fatigue syndrome, fibromyalgia, depression, alcoholism and drug abuse, sleep disorders, PTSD, post-polio syndrome, effects of aging, PMS, sleep disorders, Parkinson's, dyslexia, Tourette's, physical balance, developmental disorders, anoxia, and obsessive-compulsive disorder, while appearing promising, must still be regarded as an exploratory treatment given the absence of large, carefully controlled studies. In many ways this is similar to the "off-label" prescribing of medication that is often done in psychiatry.

The area of neurofeedback is ripe with opportunity for research due to the noninvasive nature of the intervention. Also the new brain sciences appear to be continuing to develop in directions that support the efficacy of neurofeedback and even to enhance the intervention with additional information that can be provided to the brain through feedback.


Richard C. Davis, PhD is now a certified Global Neurofeedback Initiative Instructor! Please check back for upcoming workshop information.