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Neurofeedback Training
What is EEG Biofeedback?
EEG Biofeedback is a learning strategy that enables persons to alter their brain waves. When information about a person's own brain wave characteristics is made available to him, he can learn to change them. You can think of it as exercise for the brain.
What is it used for?
EEG Biofeedback is used for many conditions and disabilities in which the brain is not working as well as it might. These include Attention Deficit Hyperactivity Disorder and more severe conduct problems, specific learning disabilities, and related issues such as sleep problems in children, teeth grinding, and chronic pain such as frequent headaches or stomach pain, or pediatric migraines. The training is also helpful with the control of mood disorders such as anxiety and depression, as well as for more severe conditions such as medically uncontrolled seizures, minor traumatic brain injury, or cerebral palsy.
How is it done?
An initial interview is done to obtain a description of symptoms, and to get a picture of the health history and family history. Some testing may be done as well. And the person does the first EEG training session, at which time we get a look at the EEG. This all may take about two hours. Subsequent training sessions last about 40 minutes to an hour, and are conducted from one to five times per week. Some improvement is generally seen within ten sessions. Once learning is consolidated, the benefit appears to be permanent in most cases.
The EEG biofeedback training is a painless, non-invasive procedure. One or more sensors are placed on the scalp, and one to each ear. The brain waves are monitored by means of an amplifier and a computer-based instrument that processes the signal and provides the proper feedback. This is displayed to the trainee by means of a video game or other video display, along with audio signals. The trainee is asked to make the video game go with his brain. As activity in a desirable frequency band increases, the video game moves faster, or some other reward is given. As activity in an adverse band increases, the video game is inhibited. Gradually, the brain responds to the cues that it is being given, and a "learning" of new brain wave patterns takes place. The new pattern is one which is closer to what is normally observed in individuals without such disabilities.
What disorders have been treated with neuro feedback?
All of the following disorders have clinical reports or case histories for EEG biofeedback; many have scientific reports: Alcoholism, Attention Deficit Disorder, Anxiety, Autoimmune Dysfunctions, Conduct Disorder, Chronic Fatigue Syndrome (CFS), Chronic Pain, Depression, Epilepsy, Sleep Disorders, Stroke/TBI, Tourette Syndrome
What results do we obtain?
In the case of ADHD, impulsivity, distractibility, and hyperactivity may all respond to the training. This may lead to much more successful school performance. Cognitive function may improve as well. In several controlled studies, increases of 10 points in IQ score were found for a representative group of ADHD children. And in two clinical studies, an average increase of 19 and 23 points was demonstrated.
Behavior may improve in other ways as well: If the child has a lot of temper tantrums, is belligerent, and even violent or cruel, these aspects of behavior may come under the child's control.
In the case of depression, there can be a gradual recovery of "affect", or emotional responsiveness, and a reduction of effort fatigue. In the case of anxiety and panic attacks, there is gradual improvement in "regulation", with a dropoff in frequency and severity of anxiety episodes and panic attacks until the condition normalizes.
In the case of epilepsy, we observe a reduction in severity and incidence (frequency of occurrence) of seizures. In many cases the dosage of anticonvulsant medication may ultimately be reduced (if ordered by the referring neurologist), and side effects of such medication may diminish.
Can a successful outcome be predicted?
It is not possible to predict with certainty that training will be successful for a particular condition. But for the more common conditions we see, a reasonable prediction of outcome is usually possible. More important, however, the effectiveness of the training can usually be assessed early in the course of training. For most conditions, there are no known adverse side effects of the training, provided that it is conducted under professional guidance.
Why does the training procedure work?
The brain is amazingly adaptable, and capable of learning. It can also learn to improve its own performance, if only it is given cues about what to change. By making information available to the brain about how it is functioning, and asking it to make adjustments, it can do so. When the mature brain is doing a good job of regulating itself, and the person is alert and attentive, the brain waves (EEG) show a particular pattern. We challenge the person to maintain this "high-performance", alert and attentive state. Gradually, the brain learns, just like it learns anything else. And like with other learning, the brain tends to retain the new skill.
We observe that if the EEG is not well-behaved under these circumstances, there may be adverse impacts on learning ability, on moods, on sleep, and on behavior. With training, these may be gradually brought under control, along with normalization of the EEG.
What does EEG Biofeedback look like?
The therapist computer is usually positioned behind the patient. This enables the therapist to monitor the patient's EEG at any time during the session without disturbing the biofeedback. A single electrode is placed on the scalp (above the motor strip, typically) using gel or paste and two other electrodes are attached to the earlobes. Most patients recline during training. The game computer is placed a few feet away, directly in front of the patient. The patient interacts (only using her EEG) with the game computer for the next 30 minutes. Each display contains four EEG data streams (below each stream are text and average data values). The top line, slightly squiggly, is the person's entire EEG recorded from the scalp by the single active electrode.
The three wavy lines below show activity in three separate EEG frequency bands or rhythms -- here, theta, SMR, and high beta bands. The patient's goal is to increase certain EEG frequency bands (e.g., SMR) while decreasing others (e.g., theta & high beta). The patient monitors his/her EEG frequency band activity not as wavy lines on the therapist machine, but as elements of a game on the game computer. For example, during the 30 minute session, she will work to keep purple and yellow boxes small and make the blue box large as long as possible. For every half second that her brainwaves stay in the desired state or "zone", she scores another point, an additional seagull appears in the sky (top of screen, barely visible), a new stripe segment is drawn on the highway (middle of screen), and a beep sounds to announce it all. If or when she attains 500 points, the volcano (middle left) will erupt!
How long does the training take?
EEG training is a learning process, and therefore results are seen gradually over time. For most conditions, initial progress can be seen within about ten sessions. Initial training goals may be met by twenty sessions, at which time the initial retests are usually performed. In the case of hyperactivity and attention deficit disorder, training is expected to take about forty sessions, or even more in severe cases. Teeth grinding usually responds in twenty sessions. Some symptoms of head injury often respond in less than twenty sessions (quality of sleep; fatigue; chronic pain), whereas others may require longer training before they show an initial response (memory function, for example).
Read about Bio Feedback
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