You're sitting on a sofa facing a screen. You're playing a game. On your head, there's a headset, and an electrode is attached to your scalp. The headset communicates with software on a mobile device programmed to respond to your brain's activity.
From an observer's perspective, you may appear to be simply relaxing and playing video games, but your brain is actually doing hard work. Based on your brain activity, you may be doing well at the game or, alternatively, your player may be struggling.
You’re doing EEG-based neurofeedback, typically referred to as simply neurofeedback, which is a non-invasive methodology that measures your brainwave activity and trains your brain using visual and auditory cues.
But what exactly does this mean? Let's break it down.
EEG-based neurofeedback has been offered in clinical settings for decades and for many different purposes. It's a form of biofeedback that uses EEG technology to read your brainwaves in real time and show visual or auditory feedback based on protocols determined by your doctor.
Here are the basics of neurofeedback as well as the benefits of neurofeedback in alleviating symptoms of various brain disorders:
Neurofeedback can help you perform at the top of your game in an increasingly challenging environment. It's at the cutting edge of mental health care. And by helping people worldwide to achieve optimal performance, little by little, neuron by neuron, this type of brain training is changing the world.
Visit our research overview article for a comprehensive summary of neurofeedback research in multiple conditions, with supporting scientific references.
Neurofeedback is a technique that leverages modern technology and scientific knowledge to train brainwaves. It is one of a broader group of biofeedback therapies relying on the principle that if a person can access information about their bodily functions in real time, they can learn to control them.
Biofeedback can be applied to a variety of bodily processes such as muscle tension, body temperature, or blood pressure, and a variety of conditions, including anxiety, migraines, and chronic pain.
Neurofeedback is a form of biofeedback based on a learning method called operant conditioning, which involves rewards and punishments for behavior. Through operant conditioning, an association is made between a behavior and a consequence (whether negative or positive).
The goal of neurofeedback is to train the brain to regulate itself and help you understand when your brain is in the desired state. Eventually, your brain may be able to maintain a more balanced state even when it's not receiving feedback. For example, you may not be aware when your brain is in a focused state or notice when your mind is wandering. During neurofeedback training, visual and/or auditory feedback clue you in on exactly when your mind is wandering in real time, and you learn how to restore your focus to the activity at hand.
Brainwaves are patterns of electrical activity occurring in the brain. They are related to many crucial aspects of brain function, like thoughts, emotions, and behaviors.
Try to think of them as musical notes: the low-frequency waves are like a deep drum beat, while the higher frequency brainwaves are more like a subtle, high-pitched flute. As a symphony, the higher and lower frequencies link and cohere with each other through harmonics.
Depending on what you're doing at the time, a particular brainwave may be dominant over the others. And if your brainwaves are not balanced properly, you may experience both emotional and neuro-physical health concerns. For example, if the slower brainwaves are dominant, you may feel tired, sluggish, or dreamy. The higher frequencies are dominant when you feel focused or hyper-alert.
The brainwaves recorded by the EEG are measured in frequency (speed of the waves expressed in hertz: number of waves per second) and in amplitude (height of the waves expressed in microvolts). In general, the amplitude decreases as the frequency increases.
Brainwaves are divided into frequency bands as follows:
Beta brainwaves can be subdivided into three categories:
We cycle in and out of different brainwave states throughout the day and night. Even though all brainwave states are essential, they should be experienced appropriately — when engaged in certain activities, at certain times of day and for particular durations of time.
Neurofeedback teaches your brain to regulate your brainwaves so that you can achieve the desired brainwave state.
For example, alpha waves occur when you are relaxed. Beta waves are associated with alertness, but when maintained for too long, they may lead to fear and anxiety.
So, if you are anxious, learning how to increase alpha waves while reducing beta wave activity might be your goal.
Neurofeedback was pioneered in the 1960s by two researchers: Dr. Joseph Kamiya at the University of Chicago and Dr. Barry Sterman at UCLA.
Dr. Kamiya found that by using a simple reward system, people could control their brainwaves. He trained people to achieve an alpha state by rewarding them with the sound of a bell. This marked the first time that real-time feedback was provided to humans based on EEG monitoring – the first instance of neurofeedback training.
During the same period, Dr. Sterman found that cats in his lab could be trained to increase their brainwaves at a certain frequency when rewarded with food. Dr. Sterman called this frequency, which was in the low beta range (Beta1; 12-15 Hz; see above) and recorded over the middle part of the brain (sensorimotor strip), “sensorimotor rhythm”, or “SMR”.
A few years later, Dr. Sterman was doing an experiment for NASA on whether rocket fuel caused seizures, and he used the same cats as experimental subjects. During this study, he found that the cats who had undergone SMR training were significantly less likely to experience seizures than other cats. Dr. Sterman then applied this technique to humans who have epilepsy and found that 60% of the participants were able to reduce their epileptic seizures by 20-100% and that the results were enduring.
In the 1970s, Dr. Joel Lubar began to run controlled studies applying neurofeedback training to children, adolescents, and ultimately adults, to treat Attention Deficit Hyperactivity Disorder (ADHD).
Since then, a significant body of research on the efficacy of neurofeedback therapy for treating ADHD has emerged, with many studies showing significant and long-term improvements after neurofeedback therapy.
Neurofeedback has been around for more than 50 years! Its origins are fascinating, and there are hundreds of research studies in the scientific literature supporting its efficacy. In the past, neurofeedback was only available in specialized clinics, but today you can use it from the comfort of your home.
Inhibiting certain brainwave frequencies and enhancing others is usually done by placing electrodes on the scalp and then providing immediate feedback about the brain's activity. This awareness makes it possible to gradually recondition brain activity.
Let's say you're training for attention. EEG helps in detecting alertness in real time. So, each time you're in a mental state reflecting focus, you may get a visual or auditory reward, encouraging your brain to remain/enter this state more often. And that's how the brain self-regulates; it learns from positive or negative feedback.
Over time, the ability to regulate brainwaves can be applied in real-world situations. For example, you may find it easier to stay focused in stressful situations, like on a job interview or during an exam.
Attention-deficit/hyperactivity disorder (ADHD) is a neuro-behavioral disorder characterized by an ongoing pattern of inattention and/or hyperactivity/impulsivity.
People with ADHD have different brainwave patterns from those who don't have the disorder. They often have more theta (slow, mind-wandering waves) activity than usual, and less beta (fast, focused, problem-solving) activity than other people. Thus, neurofeedback therapy for ADHD often aims to increase beta waves and diminish theta waves.
For ADHD, the usual recommendation for a full course of neurofeedback is 20–40 sessions twice or three times a week, with a session duration of 20–30 minutes.
People with ADHD may start to see results after 8–10 sessions, but the full course of sessions is recommended to ensure that results are long-lasting.
ADHD is the most well-studied condition in neurofeedback research. Based on meta-analyses and large multicenter randomized controlled trials (RCTs), two frequency neurofeedback protocols researched for more than 40 years have been shown efficacious and specific for ADHD:
A series of meta-analyses have shown that the standard TBR and SMR protocols improve ADHD symptoms, especially inattention.
Notably, RCTs suggest that 30–40 sessions of TBR neurofeedback are as effective as methylphenidate (a central nervous system stimulant) in alleviating inattentive and hyperactivity symptoms and are even associated with superior post-treatment academic performance (studies by Duric and colleagues, Meisel and colleagues).
Frequency neurofeedback for ADHD received a grade 1 (‘‘best support’’) rating from the American Academy of Pediatrics in 2013.
Anxiety is a feeling of fear and distress. It's a normal physical response when you are faced with severe stress or danger. However, it becomes a disorder if it’s prevalent almost all the time or if it becomes so intense that it interferes with your life.
“Anxiety disorders” is an umbrella term that includes generalized anxiety disorder (GAD), panic disorder, phobias, social anxiety disorder, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD).
Prolonged symptom duration typically classifies anxiety as a chronic disorder, and in many cases these symptoms are frequent panic attacks, obsessive thoughts, a paralyzing phobia, or unrelenting worries.
Anxiety changes the brain by weakening the connections between the amygdala (a brain structure associated with emotional processes) and the ventrolateral prefrontal cortex (a region of the frontal lobes associated with response inhibition and goal-appropriate response selection).
In healthy brains, the ventrolateral prefrontal cortex and the amygdala work together to analyze and respond to social and environmental cues.
So, when you experience a potential threat, the amygdala sends signals throughout the brain, activating the ventrolateral prefrontal cortex, which helps your brain respond to the situation appropriately. Anxiety weakens the connection between the ventrolateral prefrontal cortex and the amygdala, making you less likely to respond to the threat rationally.
Research has shown that neurofeedback may help strengthen the connection between these parts of the brain. With the connection restored, the ventrolateral prefrontal cortex can effectively provide an appropriate response to potential threats, reducing the impulsive, hyperactive reactions commonly associated with anxiety.
In a study of highly-talented musicians performing under stressful conditions, only musicians who received alpha-theta (enhancement) neurofeedback training yielded enhanced musical performance under stress. In another study, adolescents with self-reported attention and anxiety symptoms found enhanced alpha and SMR along with improved symptoms (by visual analog scales) after neurofeedback training of alpha, theta, and SMR twice a week for five weeks.
Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called “major depressive disorder” or “clinical depression”, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems.
There are different types of depressive disorders, and their symptoms can range from relatively minor (but still disabling) to very severe.
Neurofeedback for depression is based on well-established EEG research indicating that the left frontal area is more associated with positive affect, while the right frontal area is more involved with negative emotion.
A biological predisposition for depression exists when there is an asymmetry in brainwave activity, such that there is excessive left frontal alpha (8–12 Hz) reflecting less activation and failure to suppress the subcortical structures that mediate depression.
Research has shown that when the left frontal region is “stuck” in an alpha idling rhythm, there is both reduced positive affect and more withdrawal behavior.
And when there is increased left frontal beta (15–18 Hz), there is more activation and a greater sense of well-being.
In a recent study of major depressive disorder (MDD), most participants who received a 1-hour/week neurofeedback protocol were able to regulate their alpha asymmetry and show improvement in depressive symptoms after 6 weeks.
Studies have also shown that enhancing beta and inhibiting theta or alpha may reduce depressive symptoms.
PTSD (post-traumatic stress disorder) is an anxiety disorder caused by exposure to a traumatic event, often appearing after the event and characterized by feelings like guilt, isolation, irritability, difficulty sleeping, and difficulty concentrating.
Neurofeedback training for PTSD often starts with a training protocol to calm the patient physically and mentally. Neurofeedback experts then move on to "alpha-theta training," which encourages patients to enter a very relaxed state (see ‘5 Types of Brainwaves’ above).
This study, published in 1991, compared two groups of Vietnam veteran PTSD sufferers – one group received neurofeedback and the other didn't.
The neurofeedback group showed a significantly greater reduction in symptoms. Two-and-a-half years after the training, PTSD symptoms had returned in only 20% of the neurofeedback group, compared with 100% of the control group.
A recent systematic review and meta-analysis pooled data across four randomized controlled trials (RCTs) in PTSD and revealed a very large effect size for improvement in PTSD symptoms. The studies consistently favored neurofeedback in terms of symptom severity and number of patients achieving remission.
Specifically, PTSD symptoms were reduced by 34-66% in the neurofeedback group, but ranged from a reduction of 15% to an increase of 13% in the control groups.
The follow-up study reported a 46% symptom reduction posttreatment and 51% symptom reduction at the one-month follow-up (compared with reductions of 13% posttreatment and 14% at one-month follow-up in the control). At 1-month follow-up, 58% (11/19) of neurofeedback patients achieved remission as compared with only 11% (2/19) of controls.
Neurofeedback can also help with acquired brain injuries (ABI) or deterioration in brain function over time. These injuries can be:
Neurofeedback cannot repair physical damage to the brain's structure, but it can strengthen and help generate new neural pathways to restore brain function.
In one study, 12 participants who experienced impairments of attention due to closed head injury engaged in ten neurofeedback sessions aimed at increasing beta activity over two weeks, while 9 participants trained with computer-based attention training.
All participants were tested before and after treatment with a set of attention tests.
Participants in the neurofeedback group improved significantly more on the attention tests than participants in the control group.
Neurofeedback provides tools to improve brain efficiency and train neural networks in the same way you would build a muscle.
By strengthening specific neural connections and improving the brain's efficiency, less extraneous mental energy is expended maintaining composure or overanalyzing, for example.
Neurofeedback can also be used to promote stress recovery and improve sleep quality, which are essential to optimal brain performance and resilience.
Peak performance neurofeedback protocols aim to control arousal, attention, and motivation. The main goal of training is for you to complete a specific function or task with fewer errors and greater efficiency.
Twenty-three controlled studies reviewed here have shown neurofeedback-related gains in:
You’ve probably heard the myth that once you hit your 20’s, you only need about 6 hours of sleep to function properly. You’ve probably even heard that most people have the ability to function on less than that.
Quite frankly, that isn’t true. In fact, 7-8 hours is the recommended amount of sleep you should be getting every night. A sufficient amount of sleep is imperative to keep your brain healthy and functioning to its full capacity.
So, while you might be inclined to check that email or scroll through your phone before calling it a night, that time could be better spent preparing your brain for the day ahead.
First and foremost, sleep helps you stay focused and keeps your brain sharp. This allows you to recall information more quickly and enhance your problem-solving skills.
Sleeping not only helps you process information better when you’re awake, but it even helps when you’re sleeping. Research finds that during sleep, information you learned during the day is reactivated (consolidated), making it easier for you to remember it later on.
Moreover, getting the proper amount of sleep boosts your creativity! Dreaming takes place during the REM stage of your sleep, and this stage is vital in contributing to your ability to come up with new ideas. Without it, you will spend your day feeling disinclined to be creative because you will be too focused on getting home, crawling under the covers, and laying your mind to rest.
During sleep, your brain puts in the work to clear out harmful toxins. By ridding your body of harmful molecules that build up throughout the day, your brain will be better equipped to fight off neurodegenerative diseases in the future, such as Alzheimer’s and Parkinson’s.
This is what happens with your brainwaves during NREM and REM stages of sleep:
Stage 1: Throughout this stage of your sleep cycle, both alpha and theta brainwaves are amplified. Initially, in the early portion of stage 1 sleep, alpha waves are produced. These are relatively low frequency (8–12Hz), high amplitude patterns of brainwave activity. In general, alpha brainwaves are amplified during periods of wakefulness and relaxation and are dominant when you tuck yourself in and mentally prepare for a night of rest. If you train using EEG neurofeedback, you may recognize this as the state you aim for in the closed-eyes relaxation training exercise.
In the later part of stage 1 sleep, there is an increase in theta brainwave activity. Theta brainwaves are lower frequency (4–7 Hz) and higher amplitude brainwaves than alpha. Additionally, theta brainwaves are associated with dreaminess – both daydreaming and night dreaming – when your thoughts are free-flowing and detached.
Stage 2: In the transition to stage 2 of the sleep cycle, the body goes into a state of deep relaxation. Theta brainwaves dominate brain activity during this stage, but they are interrupted by “brief bursts of activity” known as sleep spindles. These rapid bursts of higher frequency brainwaves are believed to be important for learning and memory. Intriguingly, neurofeedback that enhances 12-15 Hz sensorimotor (SMR) activity has been shown to increase sleep spindles and lead to better sleep and improved memory. Dr. Arango's sleep improvement protocol is based on this research.
Stages 3-4: Delta brainwaves rule supreme when it comes to these stages of deep sleep. Delta brainwaves are low frequency (up to 4 Hz), high amplitude waves that are evident during the deepest meditative states and during these stages of dreamless sleep. In these stages, heart rate and respiration slow dramatically, and it becomes increasingly more difficult to wake someone from their slumber.
REM Sleep: REM, which stands for rapid eye movement, is a stage of sleep during which brainwaves are very similar to those observed when a person is awake. During REM sleep, dreaming occurs, and there is no voluntary muscle movement – with the exception of those muscles responsible for circulation and respiration, of course.
Now that we’ve established the importance of sleep and the brainwaves that occur during downtime, here are the things you can do to ensure you’re catching enough Z’s on a nightly basis:
These statements have not been evaluated by the FDA and are not intended to diagnose, treat, cure, or prevent any illness. The contents of this website are for informational purposes only and are not intended to be a substitute for medical advice, diagnosis, or treatment. Never disregard professional medical advice or delay seeking treatment due to information contained herein. Copyright © 2022 Clínica Reverdecer - All Rights Reserved
Powered by God
Neurofeedback is a form of neurotherapy that uses EEG technology to train brainwaves to achieve a healthier state – kind of like exercise, but for the brain! EEG neurofeedback measures brainwave activity and gives you feedback on your child's performance in real time, through visual and/or auditory cues from videos or games.