What Is Neurofeedback?


Neurofeedback (also called EEG biofeedback) involves the measurement and "feedback" of brainwave activity for the purpose of allowing an individual to increase their ability to manage their central nervous system. The brain is an electro-chemical network system that communicates through chemically derived electrical signals. These signals are measurable at the scalp surface. Years of research have demonstrated that there are certain brainwave patterns that reflect pathology in the brain. Through neurofeedback, these brainwave patterns can be consciously altered by systematically exercising the regulatory centers in the brain. This exercise results in a more efficient use of the brains resources (similar to how physical exercise enhances the body’s strength and flexibility). Improvements in attention, impulse control, mood, sleep and cognitive functioning are routinely observed following the training. Often times these improvements are quite dramatic.

How is Neurofeedback Done?

The actual treatment involves applying sensors at the scalp surface for the purpose of measuring the changes in potential (voltage) occurring in the cortex. This is not an invasive treatment involving a breaking of the skin or the introduction of electrical current to the brain. It is strictly the brain’s electrical “output” that is of interest in neurofeedback. The signal is then sent to a computer for processing and then mapped into a video game for display to the trainee. When the EEG activity moves in the desired direction, the person is rewarded with a “beep” or some visual indication that his brain is performing the task correctly. It is essentially, a video game without a hand controller. The feedback provides visual, audiory and even tactile (tracking) of the subtle altering of brainwave patterns.

Do the effects of Neurofeedback training last?

Neurofeedback is a learning strategy, not a medicine. Brain disregulation is an issue of timing and sequencing within the neural networks. It is similar to the timing chain on a car's ignition system. For example: If one were to take the pristine engine in a high performance car and turn the distributor so that the timing is off –just slightly, it will run like a 72 Pinto. The damage is not structural but rather functional. The same is true with the brain. When neuronal timing in the brain is not properly managed, inefficiency is the result. Even when there is structural damage to the brain, there is also much “functional” damage that manifests broadly in the timing domain. The neurofeedback “exercise” appears to push the restorative capabilities of the brain into action and it’s overall efficiency improves. Since the training is a learning process and all information and experience is retained by the brain, it is not surprising that the effects of neurofeedback tend to be permanent. Unfortunately, it is a somewhat different story when we are dealing with degenerative conditions like Parkinson's or the dementias, where the training is working against a deteriorating neural network. In such cases the training needs to be continued at some level over time.

How do we know the positive effects are not due to the Placebo Effect?


Neurofeedback training effect is cumulative and tends to not disappear over time, as is common with placebos. Placebo effect tends to reach maximum quickly and then fall off. And so, if neurofeedback's effectiveness were to be explained in terms of the placebo effect, one would have to account for the “dose dependent” nature of the training that is often observed. Also, training effects tend to be consistent with localization of function within the brain. Many times practitioners will see improvements in areas of function that the client or the parent were not expecting. It is also common to receive reports of improved performance from independent observers who are unaware of the person’s treatment –such as teachers, coaches, employers and even spouses. In addition, the initial discoveries of neurofeedback’s effectiveness in eliminating seizure activity were made in connection with animal research (Sterman 1976) . It is therefore highly unlikely that feline seizure activity was resolved due to the cat’s strong faith in Dr Sterman.

What is a QEEG?

A Quantitative Electroencephalogram (QEEG), also known as a Brain map, is a diagnostic technique that measures specific aspects of the human EEG. It requires that 19 or more sensors be placed on the head so that the brainwave activity can be recorded and measured. Like neurofeedback, it is non-invasive -i.e. the procedure doesn’t involve breaking the skin. Brainwaves are recorded with eyes open while the person is passive and again while performing certain tasks such as math problems or diaphragmatic breathing. It is recorded again in the eyes closed condition. The idea is to measure how the brain’s response to challenges and different conditions plays out in the EEG activity. This data is then compared to normative databases –of which there are several. The data are mapped into a series of graphs which reveal the areas of the brain that are abnormal as well as the severity of abnormality.  The QEEG can provide useful information regarding determining neurofeedback protocols. However, many providers of neurofeedback find that symptom determined approaches are more effective. When QEEG driven protocols are in opposition to those suggested by the persons symptoms, the latter will generally prevail. The neurofeedback field is somewhat split with regard to the usefulness of the QEEG as applied to EEG training. There are those whose training is strictly symptom based and those who train to the QEEG without any regard to symptoms at all. Other clinicians use some combination of the two. The marriage between the QEEG community and the neurofeedback community is relatively new and (as with all marriages) is one that will likely require patience, flexibility and (of course) more data. The QEEG will likely offer more refinement to neurofeedback protocol approaches when its relevance to the field becomes more clear.