EEG Biofeedback Neurofeedback

Brain Wave Activity  Delta – sleep state (1-3 Hz)  Theta – between sleep and awake (4-7 Hz)  Alpha – relaxed state (8-12 Hz)  Low Beta – focused concentration (SMR-Sensory Motor Rhythms) (12-15 Hz)  Mid-range Beta – alert state (15-18 Hz)  High Beta – very alert, vigilant (Above 18)  Gamma – Hyper vigilant (Above 40)

Attentional Shifting  Ability to produce the right states associated with focus and attention  Poor concentration: lack of sufficient levels of SMR  Attentional deficits: excessive amounts of slow brain wave activity (Theta waves) Neurofeedback: electroencephalograph (EEG) recording system and training software trains an individual to concentrate while receiving visual and auditory feedback from a computer.

Literature Review  95% of learning disabled children could be correctly identified strictly on the basis of the EEG (Lubar, 1989)  Possible to control seizure susceptibility and hyperactivity with EEG training that attempted to "train down" the low frequency activity at the same time that certain higher- frequency activity is promoted (12-18 Hz) (Sterman, 1978)  Study of both attention and learning problems using EEG biofeedback was performed, specific learning disabilities were often characterized by elevated low-frequency (Theta waves) activity in the EEG (Lubar, 1984).

Literature Review  First of many studies in which improvements in IQ score were documented for EEG training (Tansey, 1983)  24 subjects with learning disorders (Tansey 1990), an average improvement in Wechsler full-scale IQ score of 19 points was demonstrated  “Significant improvements in cognitive skills, academic performance and behavior are found, and confirmed in follow up. Average improvement in WISC-R Full Scale IQ was 23 points.” (Othmer, 1992)  Neurofeedback may be an effective supplement to special education in improving IQ and reading performance (Orlando, 2004)

Procedure NDB: 1. To assess the neurological status of the patient and to determine to what extent there is a neurological basis of the patient’s complaints 2. To identify possible strengths and weaknesses in the organization and electrophysiological status of the patient’s brain so as to aid in the efficient and optimal design of Neurotherapy 3. To increase efficiency and to objectively evaluate the efficacy of treatment by comparing the patient’s EEG before, during and after treatment.

Procedure  After initial interview: the first EEG training session (two hours)  Sometimes a full brain map, or quantitative EEG (QEEG) is obtained  The first six sessions are completed as quickly as possible and then the frequency of training reduces to two or three times per week.  sessions (depending on the severity of the disorder and other comorbid symptoms present)  Approximately minutes for each session (approximately 4-6 months)

Procedure  Electrodes are placed on the scalp and to the earlobes  Series of tasks (reading, listening to stories, etc.) are presented  EEG waves are recorded as a spectrum of frequencies  Rewarded by changes in the game when certain level of beta wave activity is produced  Changes on the screen occur milliseconds after they occur in the brain, computer tones are then heard to signal the change the moment goal is achieved. Video

Outcomes  Possibility of improvement in capability, rather than simply adjustment and coping strategies  Some improvement is generally seen within ten sessions and permanent in most cases.  Children show no resistance to biofeedback.  In between 40 and 60 sessions, the individual is able to produce more SMR at will  Improvements in behaviour (control of temper tantrums, violence, cruelty)  Recovery of "affect", or emotional responsiveness (depression)  No known adverse side effects of the training, provided that it is conducted under professional guidance  Increased openness to change and responsiveness to psychotherapy

Limitations  Cost of treatment (typically, $3000 and up), many medical and psychological insurance plans cover biofeedback for various conditions  Performed only by a qualified practitioner in a clinical setting  There is only a small number of EEG normative reference databases adequate to meet the minimal standards necessary for responsible and ethical uses of a NDB in the field of EEG Biofeedback. Improvements are expected in the future.  Not as quick acting as medications

Limitations of Previous Research  Lack of appropriate control conditions  Small clinical practices and extremely small sample sizes  Case studies  More research necessary to distinguish which learning problems improve with EEG biofeedback training, ex. dyslexia

Final Comments  Guidelines for researchers in the area of EEG biofeedback were recently published to aid future studies (La Vaque, et al., 2002), and the quality of research is expected to improve  Clear evidence that EEG biofeedback procedures do produce predictable and lasting changes in the EEG (e.g., Strawson & Gruzelier, 2002), and that characteristics of the EEG are correlated with important psychological conditions (John, Pricep, Friedman, & Easton, 1988)