Neurofeedback is a training procedure which improves the efficiency of brain function. The targets of intervention for this training include virtually all aspects of brain activity; thought, emotion, and behavior. Brain activity is monitored and desired changes are rewarded similar to a videogame. A more detailed explanation is provided below.
Prior to beginning neurofeedback training an assessment is conducted to examine presenting problems, client history, contributing factors, and other relevant information. Interviews, symptom checklists, computer based continuous performance tasks, review of relevant documentation, and a quantitative
EEG (QEEG) are common components of the assessment.
After reviewing the data gathered during the assessment a training plan or protocol is developed. The protocols identify which areas of the brain are to be trained as well as the frequencies of brain cell activity to be changed. This process is discussed with the client to ensure understanding as well as prepare the client for monitoring treatment response.
Once the training is initiated, the client’s response to treatment is the primary consideration with regard to any modifications to the training protocol. Treatment response is monitored by report of the client and other observers (teachers, family, and caretakers). Early in training monitoring forms are used to assist the client.
A neurofeedback session is typically 30-60 minutes. Training
takes place 1-2 times, for a total of at least one hour of training per week. In the session the client’s brain activity is monitored and measured by an EEG electrode placed on the predetermined area of the scalp.
The EEG signal is processed by a computer and
the relevant frequencies are filtered from the signal. The program is adjusted to reward the client when appropriate changes occur in the target frequencies. The process appears similar to a simple video game where points are scored and stimulating sounds and images are provided to signify success.
Length of training
Duration of training is typically predicted by severity and duration of initial symptom presentation. The average amount
of training ranges from 20-30 hours of training (40-60 half hour sessions). Initial response to training should be observed in subtle but significant changes in function occurring within the first 2-5 sessions.
Completion of treatment
When positive treatment response is established training will continue with ongoing monitoring and modification of training
as necessary to enhance benefit. When sufficient improvement
in function is established and maintained, termination of training is discussed. The decision to terminate is at the discretion of the client.
More Information Than You Might Want to Know
EEG and Brain Function
The neurofeedback process utilizes data provided by electroencephalography or EEG. EEG is a widely used medical procedure that measures the bioelectrical activity generated by
the brain. This bioelectrical activity is most evident at the moment a brain cell releases chemicals called neurotransmitters. Neurotransmitters are one means by which brain cells (neurons) communicate with each other. The release of neurotransmitters
is called neuron ‘firing’. The frequency at which neurons fire is measured in hertz (cycles per second). Frequencies range from rates of less than 1hz (less than one time per second) up to 100+hz (over 100 times per second). Most neurons fire between 1 and 40 times per second.
When the human EEG is measured during a conscious alert state the EEG signal is comprised of a mixture of all frequencies. In each small area of the brain monitored by an EEG electrode
there are hundreds of thousands of neurons firing at different rates. In order for the brain to work effectively and manage the broad range of daily challenges it must be able to spontaneously and consistently change patterns of this activity and then maintain those patterns as long as the situation demands. It is somewhat analogous to a symphony orchestra that requires a balance of instruments, volume, and timing to perform well.
This process is not typically controlled or significantly influenced by effort or will power. It is a process of self-regulation that occurs outside of an individual’s awareness. There are no sensory mechanisms within the brain that provide information about
the frequencies of neuron firing.
Analyzing the frequency distribution of neuronal activity in the EEG reveals characteristics about the efficiency of the area of the brain being monitored. It has been demonstrated that inefficiency in brain activity is often associated with an imbalance in the distribution of neuronal activity across the frequency range.
For example, there might be areas of the brain where there is an excess of neurons firing slowly during tasks requiring concentration or consistent productivity. This is often the case with attention disorders. Typically the EEG of a person with Attention Deficit/Hyperactivity Disorder (AD/HD) will reveal excess slow wave activity, particularly in the frontal areas of the brain.
Neurofeedback has demonstrated the capacity to improve the brain’s efficiency. By training the brain to more effectively
change and maintain the appropriate balance of frequencies
the individual becomes more capable of responding to daily challenges. The benefits of this process are manifested in the enduring reduction of symptoms of a broad range of issues including anxiety/depression, impulsivity, attention issues, learning disabilities and head injury.
History of Neurofeedback
of Medicine, was instrumental in revealing
the ability of the brain to alter the frequency
of cellular activity via a rudimentary neurofeedback process. Using a group of laboratory animals Dr. Sterman’s research team was able to promote an increase in specific frequencies (more brain cells firing at those frequencies) by providing food as an immediate reward. In later research those animals exhibited a significant improvement in stability when exposed to a toxic vapor observed to evoke seizure activity in animals that had not received the training.
Dr. Sterman adapted his technique to work with human volunteers. His first human research population were individuals experiencing epileptic seizures that were not responsive to medication. Many of this group experienced multiple seizures per day and were disabled. The training was successful in reducing seizures in the majority of the participants and in some cases
the seizures were eliminated. Further, the benefits of the training were enduring.
Dr. Sterman’s procedure was replicated in the early 1970’s by
Dr. Joel Lubar of the University of Tennessee who used the same training to reduce the symptoms exhibited by ‘hyperkinetic’ children. This population would now be diagnosed with Attention Deficit/ Hyperactivity Disorder (AD/HD). Those early investigations of Drs. Sterman and Lubar established the foundation for the
procedure as it is used today.
In the early 1990’s the development of personalized computers and complex software allowed the training process to be manageable, both technically and financially, for treatment providers in small clinics.
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