Neurofeedback Frequently Asked Questions

WHAT IS NEUROFEEDBACK GOOD FOR?
Neurofeedback addresses problems of brain disregulation. These happen to be numerous. They include the anxiety-depression spectrum, attention deficits, behavior disorders, various sleep disorders, headaches and migraines, PMS, emotional disturbances. It is also useful for organic brain conditions such as seizures, the autism spectrum, and cerebral palsy.

MAY THIS BE CONSIDERED A CURE FOR SOME OF THESE CONDITIONS?
In the case of organic brain disorders, it can only be a matter of getting the brain to function better rather than of curing the condition. When it comes to problems of disregulation, we would say that there is not a disease to be cured. Where disregulation is the problem, self-regulation may very well be the remedy. But again the word cure would not apply.

BUT THE SYPMTOMS MAY GO AWAY, SO IT'S ALL THE SAME IN THE END?
Indeed, with neurofeedback the symptoms may be entirely suppressed. A person with diagnosed Attention Deficit Disorder may be able to train the brain to pay attention, so that condition will no longer be diagnosable. A person coming in with migraines may no longer have them. (However, that person may still have a greater "vulnerability" to migraines than the average person on the street.) A person with epilepsy may no longer have seizures. (Although that person still retains a vulnerability to seizures.) A child with severe rages and temper tantrums may not have them again.

HOW IS THIS DONE?
We apply electrodes to the scalp to listen in on brainwave activity. We process the signal by computer, and we extract information about certain key brainwave frequencies. (All brainwave frequencies are equal, but some or more equal than others….) We show the ebb and flow of this activity back to the person, who attempts to change the activity level. Some frequencies we wish to promote. Others we wish to diminish. We present this information to the person in the form of a video game. The person is effectively playing the video game with his or her brain. Eventually the brainwave activity is "shaped" toward more desirable, more regulated performance. The frequencies we target, and the specific locations on the scalp where we listen in on the brain, are specific to the conditions we are trying to address, and specific to the individual.

HOW DO YOU KNOW HOW TO TRAIN A PARTICULAR BRAIN?
Over the years, certain training protocols have been developed that are helpful with certain classes of problems such as attention, anxiety and depression, seizures and migraines, as well as cognitive function. There are a number of assessment tools we use to help us decide which protocols to use. These are simple neurodiagnostic and neuropsychological tests.

WHAT IS NEURODIAGNOSTIC AND NEUROPHYSIOLOGICAL TESTING?
Neurofeedback addresses issues of brain function, and hence assessment likewise is aimed at measuring function: We employ a continuous performance test called the IVA ® (Integrated Visual and Auditory Continuous Performance Test) in order to characterize impulsivity and attention. We do screenings for certain visual problems that are ordinarily overlooked. Also, we do the Vanderbilt Assessment ADD/ADHD Assessment Scale and the DASS, the Depression, Anxiety and Stress Scale.

NEUROFEEDBACK SOUNDS LIKE A REAL BREAKTHROUGH, IS IT?
And should I be hopeful for my child? Yes, and yes again. The most significant scientific frontier in health care at this time is to understand how our brain functions. We are beginning to learn the brain's "operating system," and these findings are not without clinical implications. We have already learned how to make almost any functioning brain function better. But we can promise only progress, not perfection. The parent's first role in this is to resist the message "there is nothing more that can be done for your child," and to move forward to experience what neurofeedback may offer.

ARE THE EFFECTS LASTING?
Yes, if you do enough training. As with any kind of learning, when the brain is exposed to repeat training the result is a permanent learned skill. It will not be forgotten unless there is an ongoing disease process or an unrelenting stress that undermines the training.

HOW LONG IS A NEUROFEEDBACK SESSION?
Typically a session runs from 20-30 minutes at least once per week.

HOW MANY SESSIONS ARE REQUIRED?
Studies have shown that individuals with ADHD tend to see a significant, measurable impact after about 30-40 sessions. Remember, this brain exercise is not “one size fits all” – it is determined by the specific needs of each client. That is why a thorough assessment is made prior to beginning a program.

DOES NEUROFEEDBACK HAVE SIDE-EFFECTS?
One of the advantages of neurofeedback is that side-effects are very rare. You may find that learning to control your brain waves is a frustrating process, especially at the beginning of treatment. Patients sometimes feel tired at the end of a session. Patients with sensitive skin have had reactions to the products that are used to clean the skin or hold the sensors in place on the scalp or ears.

MY DOCTOR TAKES A DIM VIEW OF BIOFEEDBACK. WHAT CAN I TELL HER?
Your doctor may not know of this specific type of biofeedback. He or she will maintain a healthy skepticism about any new approach claiming numerous benefits. If your doctor is familiar with EEG biofeedback in general, he may still be thinking in terms of the more common early experiments with alpha wave training, rather than with the training we are dealing with here. Ask your doctor to examine the recent research on the effectiveness of EEG biofeedback in treating various disorders such as attention deficit disorder and epilepsy. The following references are a place where he or she can start:

-Lubar, J.F. and Bahler, W.W. (1976). Behavioral management of epileptic seizures following biofeedback training of the sensorimotor rhythm. Biofeedback and Self-Regulation, 1, pp.77-104.
-Lubar, J.F. and Shouse, M.N.. (1976). EEG and behavioral changes in a hyperactive child concurrent training of the sensorimotor rhythm (SMR): A preliminary report. Biofeedback and Self-Regulation, 1, pp.293-306.
-Lubar, J.O. and Lubar, J.F. (1984). Electroencephalographic biofeedback of SMR and beta for treatment of attention deficit disorder in a clinical setting. Biofeedback and Self-Regulation, 9, pp.1-23.
-Shouse, M.N. and Lubar, J.F. (1979). Operant conditioning of EEG rhythms and Ritalin in the treatment of hyperkinesis. Biofeedback and Self-Regulation,4, pp.301-312