How is neurofeedback used clinically?

Common Situations Commonly Reported as Clinically Responsive to Neurofeedback:
  • ADD/ADHD, Attention Problems
  • Conduct Disorders, Oppositional Behavior
  • Behavior Disorders
  • Depression, Mood Regulation
  • Affect Regulation Disorders
  • Bipolar Disorder
  • Anxiety Disorders
  • Panic Attacks
  • PTSD
  • Insomnia, Frequent Waking, Other Sleep Disorders
  • Restless Leg Syndrome
  • Bruxism
  • Migraines and Headaches
  • Chronic Pain
  • Seizures
  • Learning Disabilities
  • Pervasive Developmental Disorder
  • Autism, Asperger’s
  • Obsessive Compulsive, Rumination
  • Traumatic Brain Injury (TBI)
  • Stroke
  • Tourette’s Syndrome
  • Peak Performance
  • Anger, Rage
  • Substance Abuse, Addiction

Think Central Nervous System problem. There are clearly others not listed which have responded well to neurofeedback, though in much smaller numbers, including Schizophrenia and Parkinson’s.

Neurofeedback doesn’t target a disorder. It’s used to change timing and activation patterns in the brain and helps create changes in the brain’s feedback loops and pathways. This creates improvement in brain regulation, which improves a variety of symptoms.

Different symptoms may require different training targets. As examples, many clinicians report that depression may involve frontal lobe training, and anxiety may involve some parietal training.

Just as there are different ways to exercise the body, there are different approaches to training or exercising the brain.

Like with anything, neurofeedback doesn’t work for everyone. Clinicians typically estimate that 75%-80% of their clients are helped with neurofeedback.

Some commentary on neurofeedback regarding each disorder:

ADD/ADHD

More kids and adults with ADD/ADHD are using neurofeedback than any other problem. Experienced clinicians estimate they have significant impact with 80-85% of patients who complete 30-40 training sessions. Is it the most commonly treated because it’s the easiest problem to deal with? Not really. ADD/ADHD is often many different symptoms rolled into one diagnosis. These must be sorted out as part of doing neurofeedback. There are some practical reasons that ADD /ADHD is the most common use for neurofeedback:

  1. Parents are often more motivated to help their children to succeed than to help themselves.
  2. There are increasing concerns that putting a child on medications for years is not a good thing. Parents want an alternative that works.
  3. For many kids, medications don’t work very well. They have side effects, make the kid feel less normal, or create more problems.
  4. There are thousands of neurofeedback success stories around the country – many related to ADD and ADHD. More clinicians are adding neurofeedback because patients are asking for it or talking about it.
  5. Significant, solid, published research exists on ADD/ADHD and neurofeedback.
  6. There is increased awareness of the role of the brain in ADD and ADHD (as well as other disorders). In the last 5 years, every magazine seems to have had a brain imaging picture on its cover. As a result, neurofeedback as a brain-based intervention doesn’t seem so foreign, and there is much more openness towards the concept.
Anxiety

Most clinicians say generalized anxiety is one of the first symptoms to start to respond to training after sleep. Significant improvements are typically estimated at 80-90% of those being trained. However, success also very much depends on other existing comorbidities. More complex cases that have multiple symptoms may take more expertise and time to respond. We still expect that these more complex cases will respond to neurofeedback; however, they take more time and expertise, along with clinical skills. That means not every clinician will achieve good results.

Depression

Even for long-term, non-responsive depression cases, neurofeedback often helps.  From depression to dysthymia, neurofeedback can be used to help alleviate symptoms an lessen medication. This is not to say that it’s easy. Clinical skills are important. There are a variety of protocol options depending on the comorbidities associated with the client.

Learning Disabilities

Over the last few years, several professionals have published data about new training techniques they are using to target learning disabilities with a qEEG. This was really big news for the field of neurofeedback. It’s common for reading, math, and other problems to improve with neurofeedback. Some clients still could have deficits regardless of neurofeedback training, even after some improvement. By adding in a newer technique (“coherence training”, which is a fairly sophisticated component of training), several professionals report more consistent improvements in dyslexia, reading and math deficits, and visual and auditory processing problems.

Bipolar Disorder

Clinical reports from psychiatrists, psychologists, and therapists indicate that neurofeedback helps bipolar patients become more stable and better able to reduce medications.

Cognitive Impairment, Traumatic Brain Injury, Concussion, and Stroke

Neuropsychologists have reported that improvement in patients with a traumatic brain injury, concussion, or stroke, often occurs even many years after the injury – that neural plasticity still exists and is greatly enhanced with neurofeedback. Emotional and behavioral improvements are significant for this group.

Migraines and Headaches

Therapists and physicians report that the frequency and intensity of migraines are often reduced, and sometimes eliminated.

Chronic Pain

For chronic pain sufferers, neurofeedback can help reduce pain or perhaps how the brain manages pain, even in severe cases.

Sleep Dysregulation

The first changes clients typically observe after neurofeedback relate to sleep. These can include improvement in insomnia, bruxism, poor sleep quality, difficulty waking, frequent waking, and nightmares.

Autism & PDD Reactive Attachment Disorder

Autism, PDD, and RAD are among the fastest growing areas of neurofeedback. The calming effects of neurofeedback produce noticeable results quickly in these severely-affected populations.

Substance Abuse

In one study, neurofeedback was compared with a successful 12-step program for crack, cocaine, methamphetamine, and heroin users. Sustained abstinence was significantly greater (2 times or more) with the group that also received neurofeedback training. Previous published studies show similar results for alcoholics. Substance abuse is an obvious form of poor self-regulation and self-medication that can be helped with neurofeedback.

Epilepsy

Multiple peer-reviewed studies show a reduction in seizures that are non-responsive to medications, and that the effects from brain training hold. This compelling literature is published in respected journals, and clinical reports consistently reflect improvement. But for several reasons, including a lack of funding to educate doctors, the research is not well known.