Neurofeedback

 

Neurofeedback is a form of learning (e.g. operant conditioning) employed to modify the electrical activity of the brain.The method is used to treat clinical conditions as well as to enhance performance. The first step is to perform a QEEG assessment to inform us of the areas of the brain and the connections between these areas that are over or underactive. A neurofeedback protocol is constructed from this assessment designed to reward the brain when the activity moves toward a desired state. The reward is typically an audio, visual or tactile signal. For example, when the brain is doing well, a movie is displayed in full size or full brightness on the screen; when the brain is performing poorly, the screen might darken or shrink.

What to Expect

You will be seated in a comfortable, upright chair facing a screen. An electro cap with 22 electrodes will be fitted to your head and the electrodes filled with a conductive gel. It can take about 5-10 minutes to set up and insure that the signals being collected by the computer are of a good quality. Sometimes, you may be asked to be aware of muscle tension in your forehead or neck that might be causing noise in the signal. During the hookup and immediately after the 30 minutes of training, we discuss your goals and your progress. Feedback rewards include movies, music, video games, and/or a BrainAvatar display.

 

We are making physiological changes, just like going to the gym. Consequently, it is best to train 2-3 times a week to make steady progress. Unfortunately, it is not possible to predict how many sessions will be required for you to reach your goals. We track symptoms every session and we run a progress QEEG after every 20 sessions.

Kinds of Neurofeedback

The Neurofeedback protocol is based on your QEEG assessment and symptoms.

  • Surface vs LORETA

For 40 years, neurofeedback was limited to training voltages on the surface of the scalp. Around 2000, a method was developed to determine the cortical current sources that generate EEG at the scalp using inverse modeling; this method was called LORETA (Low Resolution Electromagnetic Tomography) and the spatial localization was shown to compare favorably to the results obtained with fMRI. Most of the high-end neurofeedback systems now have the capability of using LORETA to train regions of interest in the brain, from Brodmann Areas to functional networks.

Higher resolution does not always mean faster results – there are a lot of factors in developing a protocol; importantly, we still tend to train diffuse dysregulations with surface protocols and focal dysregulations with LORETA.

  • Amplitude vs Z-Score

Another big change in neurofeedback training in the past decade is the use of normative databases to statistically normalize brain dysregulations. The program can look up what a “normal” measure might be for someone of a given age, and then provide rewards when that measure is within a certain standard deviation away from the average (technically, the software uses z-scores instead of standard deviations, but the concept is similar.)

On the other hand, who has an average brain? Consequently, we mix and match amplitude and z-score training when we move between difficult single targets and a systems approach.

  • Theta-Beta

This is a 2-electrode protocol that decreases the ratio of theta to beta activity along the frontal and central midline. It is a very well-researched protocol for ADHD, highly effective in those individuals for which this ratio impacts attention. (Attention issues can be caused by other dysregulations.)

  • ILF

Infra-Low Frequency training uses 2 to 4 electrodes to train frequencies below the Delta range (1 Hz). It is believed to work on the glial, rather than the neural, components of the cortex. We tend to use this protocol for brain injuries, chronic fatigue, anxiety, and some kinds of depression.

  • Alpha-Theta

This is a 1 channel protocol that balances the ratio of the alpha and theta bands over the parietal cortex. This is an “eyes closed” protocol during which the feedback primarily consists of two chimes, indicating the balance between the alpha and theta amplitudes. It creates a hypnogogic state – some place in between awake and asleep. It has been used for three applications:Trauma

• Trauma
• Enhanced Creativity
• Addictions

  • SMR

This is a 1 or 2 channel protocol that trains up the 13-15 Hz band over the center of the head (electrode positions C3, C4). It was the first neurofeedback protocol developed in the 1970s and has been studied for efficacy with attention, depression, and anxiety. SMR remains a valuable method to promote stillness, attention, and reduce anxiety.

We do not do LENS neurofeedback.

What it does to your Brain

Neurons that fire together, wire together. This was first suggested as a rule for learning by the psychologist Donald Hebb in 1949. In the 1980s, neuroscientists began demonstrating how these changes occur using electrophysiology and learning tasks in animals. More recently, neuroscientists have measured changes in functional connectivity of brain networks using fMRI after a 30-minute EEG-based neurofeedback session

Our Software Tools

We primarily use these tools for training (we use additional tools for QEEG analysis):

Neurofeedback is a form of learning (e.g. operant conditioning) employed to modify the electrical activity of the brain.The method is used to treat clinical conditions as well as to enhance performance. The first step is to perform a QEEG assessment to inform us of the areas of the brain and the connections between these areas that are over or underactive. A neurofeedback protocol is constructed from this assessment designed to reward the brain when the activity moves toward a desired state. The reward is typically an audio, visual or tactile signal. For example, when the brain is doing well, a movie is displayed in full size or full brightness on the screen; when the brain is performing poorly, the screen might darken or shrink.

What to Expect

You will be seated in a comfortable, upright chair facing a screen. An electro cap with 22 electrodes will be fitted to your head and the electrodes filled with a conductive gel. It can take about 5-10 minutes to set up and insure that the signals being collected by the computer are of a good quality. Sometimes, you may be asked to be aware of muscle tension in your forehead or neck that might be causing noise in the signal. During the hookup and immediately after the 30 minutes of training, we discuss your goals and your progress. Feedback rewards include movies, music, video games, and/or a BrainAvatar display.

Brain Health Northwest - Neurofeedback Loop

We are making physiological changes, just like going to the gym. Consequently, it is best to train 2-3 times a week to make steady progress. Unfortunately, it is not possible to predict how many sessions will be required for you to reach your goals. We track symptoms every session and we run a progress QEEG after every 20 sessions.

Kinds of Neurofeedback

The Neurofeedback protocol is based on your QEEG assessment and symptoms.

  • Surface vs LORETA

For 40 years, neurofeedback was limited to training voltages on the surface of the scalp. Around 2000, a method was developed to determine the cortical current sources that generate EEG at the scalp using inverse modeling; this method was called LORETA (Low Resolution Electromagnetic Tomography) and the spatial localization was shown to compare favorably to the results obtained with fMRI. Most of the high-end neurofeedback systems now have the capability of using LORETA to train regions of interest in the brain, from Brodmann Areas to functional networks.

Higher resolution does not always mean faster results – there are a lot of factors in developing a protocol; importantly, we still tend to train diffuse dysregulations with surface protocols and focal dysregulations with LORETA.

  • Amplitude vs Z-Score

Another big change in neurofeedback training in the past decade is the use of normative databases to statistically normalize brain dysregulations. The program can look up what a “normal” measure might be for someone of a given age, and then provide rewards when that measure is within a certain standard deviation away from the average (technically, the software uses z-scores instead of standard deviations, but the concept is similar.)

On the other hand, who has an average brain? Consequently, we mix and match amplitude and z-score training when we move between difficult single targets and a systems approach.

  • Theta-Beta

This is a 2-electrode protocol that decreases the ratio of theta to beta activity along the frontal and central midline. It is a very well-researched protocol for ADHD, highly effective in those individuals for which this ratio impacts attention. (Attention issues can be caused by other dysregulations.)

  • ILF

Infra-Low Frequency training uses 2 to 4 electrodes to train frequencies below the Delta range (1 Hz). It is believed to work on the glial, rather than the neural, components of the cortex. We tend to use this protocol for brain injuries, chronic fatigue, anxiety, and some kinds of depression.

  • Alpha-Theta

This is a 1 channel protocol that balances the ratio of the alpha and theta bands over the parietal cortex. This is an “eyes closed” protocol during which the feedback primarily consists of two chimes, indicating the balance between the alpha and theta amplitudes. It creates a hypnogogic state – some place in between awake and asleep. It has been used for three applications:Trauma

• Trauma
• Enhanced Creativity
• Addictions

  • SMR

This is a 1 or 2 channel protocol that trains up the 13-15 Hz band over the center of the head (electrode positions C3, C4). It was the first neurofeedback protocol developed in the 1970s and has been studied for efficacy with attention, depression, and anxiety. SMR remains a valuable method to promote stillness, attention, and reduce anxiety.

We do not do LENS neurofeedback.

What it does to your Brain

Neurons that fire together, wire together. This was first suggested as a rule for learning by the psychologist Donald Hebb in 1949. In the 1980s, neuroscientists began demonstrating how these changes occur using electrophysiology and learning tasks in animals. More recently, neuroscientists have measured changes in functional connectivity of brain networks using fMRI after a 30-minute EEG-based neurofeedback session

Our Software Tools

We primarily use these tools for training (we use additional tools for QEEG analysis):

Additional Reading

Budzynski, T. H., Budzynski, H. K., Evans, J. R., & Abarbanel, A. (Eds.). (2009). Introduction to quantitative EEG and neurofeedback: Advanced theory and applications. Academic Press.

Cantor, D. S., & Evans, J. R. (Eds.). (2013). Clinical neurotherapy: application of techniques for treatment. Academic Press.

Collura, T. F. (2014). Technical foundations of neurofeedback. Routledge.

Collura, T. F., Thatcher, R. W., Smith, M. L., Lambos, W. A., & Stark, C. A. (2009). EEG biofeedback training using live Z-scores and a normative database. Introduction to quantitative EEG and neurofeedback,, 103-141.

Demos, J. N. (2005). Getting started with neurofeedback. WW Norton & Company.

Ros, T., Théberge, J., Frewen, P. A., Kluetsch, R., Densmore, M., Calhoun, V. D., & Lanius, R. A. (2013). Mind over chatter: plastic up-regulation of the fMRI salience network directly after EEG neurofeedback. Neuroimage, 65, 324-335.

Soutar, R. G., & Longo, R. E. (2011). Doing neurofeedback: An introduction (pp. 121-140). ISNR Research Foundation.

Thatcher, R. W. (1998). Normative EEG databases and EEG biofeedback. Journal of Neurotherapy, 2(4), 8-39.

Thompson, M., & Thompson, L. (2015). The neurofeedback book. Wheat Ridge, CO: Association for Applied Psychophysiology and Biofeedback.

Yucha, C., & Montgomery, D. (2008). Evidence-based practice in biofeedback and neurofeedback. Wheat Ridge, CO: AAPB.