Application of Neurofeedback

Application of Neurofeedback

Neurofeedback allows for the development of self-control over one’s own brain activity. Electrical signals from the brain are received through Electroencephalographic (EEG) technology. A computer almost instantly analyzes specific brainwave data and lets the patient know, through changing screen displays and auditory sounds (games), when his/her brain is producing desirable patterns consistent with attention and alertness. Likewise, the computer lets the patient know when his/her brain is producing patterns consistent with excess low frequencies and heightened muscle tension. In letting a patient know instantly when they are more attentive, focused and less mentally open, neurofeedback makes learned self-control possible. The game-like program responds only to the desired mental and physical criteria demanded by the computer. Properly calibrated by the doctor to the very edge of the patient's abilities, the computer “game” continues to challenge the patient into longer and longer trains of attention and focus. Over time, the duration of the moments of focus and alertness may increase twenty and thirty fold as higher and higher thresholds of achievement are reached and maintained.

Neurofeedback and AD/HD

While most of us may sometimes desire a little more alertness and perhaps sharper focus, some of us have an exceptionally difficult time focusing, concentrating, and being still. When these problems begin to interfere with our daily lives or with the lives of those around us, this “condition” may qualify as a disorder known as Attention Deficit Hyperactivity Disorder (ADHD), or Attention Deficit Disorder (ADD). This is predominantly a genetic, neuro-physiological condition generally present in the frontal lobes of the brain. ADD/ADHD is characterized by the excessive outward symptoms of distractibility, impulsivity and, in some cases, hyperactivity. It is suspected that these symptoms, most visibly hyperactivity, are the result of the mind and body compensating for a very under aroused central nervous system. Often those with the disorder struggle with additional complexities such as anger, moods, depression, low self-esteem or self-image, oppositional defiance, disrespect for authority and other related issues. These typically are the logical outgrowth of the labeling or marginalizing that may go on within themselves, within schools and social settings, as well as the home or workplace.
The symptoms of Attention Deficit Disorder can have far reaching implications. Adults and children are likely to be seen as underachievers, having great potential but consistently performing below their abilities. They may appear disrespectful or non-caring by not listening when they should or by losing interest easily. They may seem forgetful or uncooperative. They may appear to lack judgment in social situations by interrupting, speaking their mind or failing to consider the needs and social conventions of others. Commonly, academic problems are pronounced. They are likely to have poor reading comprehension, poor writing mechanics and bad spelling. They may show difficulties in completing tasks or not turn in completed works on time, or at all. Even with tutoring or coaching they may seem to lack the discipline required for improving organizational skills or for developing good study habits.

Low Frequency (Drowsy) Brain Activity

ADHD occurring in both males and females with or without hyperactivity is understood to be a disorder of relative “under arousal”. Such individuals show lower and/or slower than average physiological reactions to stimuli. Excessive levels of “low frequency” (drowsy) patterns appear in the brain’s electrical activity. This excess in low frequency brainwave activity is often most pronounced during reading, listening or other non-stimulus tasks, and can look much like Stage 2 sleep. Stimulant medications such as Ritalin, Adderall and others are currently the most commonly recommended and prescribed treatment for ADHD by psychiatrists, psychologists and general practitioners across the United States and Canada. This is because with the introduction of stimulant medication into the body, the patient’s brain activity is pharmaceutically elevated out of a low frequency, under aroused state. Adequate levels of stimulants seem to allow for some measure of focus and attention. One may observe that when we first get hyperactive children to sit or be still, they rapidly drop off into a drowsy state. These folks seem to live at the edge of sleep, much like a driver who is getting tired and involuntarily drops off, even while fighting it. If the tired driver could just get up, move around or just do something different he would become more alert. Hyperactivity in the same way is thought to be the body’s way of attempting to maintain normal arousal in an effort to prevent drowsiness. This is why amphetamine medications (speed) create the so-called “paradoxical” effect of calming down ADHD behavior.
Although excessive levels of low frequency brainwave patterns mark ADHD, their neurology shows brief periods of activation in the raw EEG data during a patient’s performance of a task. These brief “operants” of focus and alertness are spontaneous periods when the brain becomes more activated and are the moments that neurofeedback therapy reinforces.

Empirical Support

Neurofeedback therapy is a relatively new approach to ADD/ADHD. The earliest reports of success were published in the mid and late 1970’s. Until recently, only a few, controlled, clinical research studies had been done, currently there are at least two double-blind studies in press. Past studies have been very impressive. One of the crucial pioneers of neurofeedback was a professor of neurology and biobehavioral psychiatry at the UCLA School of Medicine, Dr. Barry Sterman. Dr. Sterman was among the first to experiment with a kind of Beta (high frequency) brainwave and was able to favorably treat epilepsy, showing a 60% reduction in seizures in 60% of his subjects. Numerous other experiments at more than a dozen other institutes have demonstrated even higher success rates. Today, the treatment of epilepsy is the most established of the protocols for Neurofeedback. One of Sterman’s research colleagues, Dr. Joel Lubar of the University of Tennessee at Knoxville, noticed that hyperactivity decreased in patients treated for epilepsy and, based on this, developed the protocols now used for the treatment of ADHD. Lubar showed that training for decreased theta (low frequency brainwaves) reduced or eliminated the symptoms of ADHD in his subjects. Reverse training (training for increased theta) on non-ADHD subjects produced ADHD like symptoms. Over the past eight years, a growing collection of numerous studies have been published and presented at national and international conferences, which continue to clinically support the efficacy of the treatment of ADHD through Neurofeedback. All of the studies are publicly available and can be requested through treatment centers or found on the Internet. To date, not one study exists that adversely denotes the substantial gains and claims of Neurofeedback provided to ADHD subjects.

* Two organizations have formed to provide a professional forum for discussion, presentation of papers and teaching. These are the International Society for Neuronal Regulation, and the EEG Section of the Association for Applied Psychophysiology and Biofeedback.

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