Neurofeedback in ADHD: a single-blind randomized controlled trial

Neurofeedback treatment has been demonstrated to reduce inattention, impulsivity and hyperactivity in children with attention deficit/hyperactivity disorder (ADHD). However, previous studies did not adequately control confounding variables or did not employ a randomized reinforcer-controlled design. This study addresses those methodological shortcomings by comparing the effects of the following two matched biofeedback training variants on the primary symptoms of ADHD: EEG neurofeedback (NF) aiming at theta/beta ratio reduction and EMG biofeedback (BF) aiming at forehead muscle relaxation. Thirty-five children with ADHD (26 boys, 9 girls; 6–14 years old) were randomly assigned to either the therapy group (NF; n = 18) or the control group (BF; n = 17). Treatment for both groups consisted of 30 sessions. Pre- and post-treatment assessment consisted of psychophysiological measures, behavioural rating scales completed by parents and teachers, as well as psychometric measures. Training effectively reduced theta/beta ratios and EMG levels in the NF and BF groups, respectively. Parents reported significant reductions in primary ADHD symptoms, and inattention improvements in the NF group were higher compared to the control intervention (BF, d _corr = −.94). NF training also improved attention and reaction times on the psychometric measures. The results indicate that NF effectively reduced inattention symptoms on parent rating scales and reaction time in neuropsychological tests. However, regarding hyperactivity and impulsivity symptoms, the results imply that non-specific factors, such as behavioural contingencies, self-efficacy, structured learning environment and feed-forward processes, may also contribute to the positive behavioural effects induced by neurofeedback training.     

Slow cortical potential neurofeedback in attention deficit hyperactivity disorder: is there neurophysiological evidence for specific effects?

This study compared changes in quantitative EEG (QEEG) and CNV (contingent negative variation) of children suffering from ADHD treated by SCP (slow cortical potential) neurofeedback (NF) with the effects of group therapy (GT) to separate specific from non-specific neurophysiological effects of NF. Twenty-six children (age: 11.1 ± 1.15 years) diagnosed as having ADHD were assigned to NF (N = 14) or GT (N = 12) training groups. QEEG measures at rest, CNV and behavioral ratings were acquired before and after the trainings and statistically analyzed. For children with ADHD-combined type in the NF group, treatment effects indicated a tendency toward improvement of selected QEEG markers. We could not find the expected improvement of CNV, but CNV reduction was less pronounced in good NF performers. QEEG changes were associated with some behavioral scales. Analyses of subgroups suggested specific influences of SCP training on brain functions. To conclude, SCP neurofeedback improves only selected attentional brain functions as measurable with QEEG at rest or CNV mapping. Effects of neurofeedback including the advantage of NF over GT seem mediated by both specific and non-specific factors. M. Doehnert and D. Brandeis have contributed equally to this paper.     

Effects of Neurofeedback Training on Inhibitory Capacities in ADHD Children: A Single-Blind,Randomized, Placebo-Controlled Study

Introduction. Studies performed during the last decades suggest that neurofeedback (NF) training can effectively reduce symptomatology in children with Attention deficit hyperactivity disorder (ADHD). Yet questions remain concerning specific effects of NF training in ADHD children, because these studies did not use a randomized, placebo-controlled approach. To address this issue, such an approach was used in the present study to measure the impact of NF training on inhibitory capacities.

Method. Nine ADHD children (with no comorbidity), aged 8 to 13 years, were randomly assigned to either an experimental group (n = 5) or a placebo group (n = 4). For both groups, training protocols comprised 40 one-hr sessions (20 meetings of 2 sessions each). Sensorimotor rhythm/Theta training was used in the experimental group. Prerecorded sessions of the first author's EEG activity were used in the placebo group. Pre- and posttraining assessments consisted of the Conner's Parent Rating Scales (CPRS–R) and neuropsychological tests. A multiple case study strategy was applied for data analysis using a Reliable Change Index when applicable.

Results. One experimental participant was a dropout, and one placebo participant had to be discontinued due to adverse effects. The latter participant accepted to undergo posttraining evaluations; hence an Intention-to-Treat analysis was performed on this participant's data. Remaining participants showed significant improvements on the CPRS–R. Improvements were measured on the Variability measure of the CPT–II consistently across the placebo group and on the Inhibition Condition of the Stroop Task for all but one placebo participant. The same trend was found for the Inhibition/Switching Condition (Stroop Task) across the experimental group (n = 4).

Conclusion. The small sample size precludes from evaluating specific neurofeedback effects. Still, the presence of placebo responses suggests that other factors, such as motivation or expectations, might contribute to the outcome of NF training in children with ADHD.     

NEUROFEEDBACK TRAINING IN A CASE OF ATTENTION DEFICIT HYPERACTIVITY DISORDER

Abstract

Electroencephalographic biofeedback, also known as neurofeedback, has been used to improve attention in children with Attention Deficit Hyperactivity Disorder (ADHD). In the present case study, a ten-year-old boy completed 37 sessions of neurofeedback training over a six-month period on-site in a school setting. Beta brainwave training was applied for sessions 1 – 22 and replaced by sensorimotor rhythm training for sessions 23 – 37. A review of his national achievement test scores for four years revealed he improved performance the year he received neurofeedback and the gain was lost the year after treatment was completed. The participant had been receiving methylphenidate for the previous two years and remained on the medication throughout neurofeedback and for the year after neurofeedback treatment. Findings are suggestive of the advantages of incorporating neurofeedback training as part of a multimodal treatment program in a school setting for children with ADHD.     

Schizophrenia and the efficacy of qEEG-guided neurofeedback treatment: a clinical case series

Schizophrenia is sometimes considered one of the most devastating of mental illnesses because its onset is early in a patient's life and its symptoms can be destructive to the patient, the family, and friends. Schizophrenia affects 1 in 100 people at some point during their lives, and while there is no cure, it is treatable with antipsychotic medications. According to the Clinical Antipsychotic Trials for Interventions Effectiveness (CATIE), about 74% of the patients who have discontinued the first medication prescribed within a year will have a relapse afterward. This shows an enormous need for developing better treatment methods and better ways to manage the disease, since current therapies do not have sufficient impact on negative symptoms, cognitive dysfunction, and compliance to treatment. In this clinical case series, we investigate the efficacy of quantitative electroencephalography (qEEG)-guided neurofeedback (NF) treatment in this population, and whether this method has an effect on concurrent medical treatment and on the patients. Fifty-one participants (25 males and 26 females) ranging from 17 to 54 years of age (mean: 28.82 years and SD: 7.94 years) were included. Signed consent was received from all patients. Most of the participants were previously diagnosed with chronic schizophrenia, and their symptoms did not improve with medication. All 51 patients were evaluated using qEEG, which was recorded at baseline and following treatment. Before recording the qEEG, participants were washed out for up to 7 half-lives of the medication. After Food and Drug Administration (FDA)-approved Nx-Link Neurometric analysis, qEEGs suggested a diagnosis of chronic schizophrenia for all participants. This was consistent with the clinical judgment of the authors. The participants' symptoms were assessed by means of the Positive and Negative Syndrome Scale (PANSS). Besides the PANSS, 33 out of 51 participants were also evaluated by the Minnesota Multiphasic Personality Inventory (MMPI) and the Test of Variables of Attention (TOVA), both at baseline and following treatment. Each participant was prescribed an NF treatment protocol based on the results of their qEEG neurometric analysis. Each session was 60 minutes in duration, with 1 to 2 sessions per day. When 2 sessions were administered during a single day, a 30-minute rest was given between the sessions. Changes in the PANSS, MMPI, and TOVA were analyzed to evaluate the effectiveness of NF treatment. The mean number of sessions completed by the participants was 58.5 sessions within 24 to 91 days. Three dropped out of treatment between 30 and 40 sessions of NF, and one did not show any response. Of the remaining 48 participants 47 showed clinical improvement after NF treatment, based on changes in their PANSS scores. The participants who were able to take the MMPI and the TOVA showed significant improvements in these measures as well. Forty were followed up for more than 22 months, 2 for 1 year, 1 for 9 months, and 3 for between 1 and 3 months after completion of NF. Overall NF was shown to be effective. This study provides the first evidence for positive effects of NF in schizophrenia.     

Neurofeedback Effects on Evoked and Induced EEG Gamma Band Reactivity to Drug-Related Cues in Cocaine Addiction

Introduction. Preoccupation with drug and drug-related items is a typical characteristic of cocaine addicted individuals. It has been shown in multiple accounts that prolonged drug use has a profound effect on the EEG recordings of drug addicts when compared to controls during cue reactivity tests. Cue reactivity refers to a phenomenon in which individuals with a history of drug abuse exhibit excessive psychophysiological responses to cues associated with their drug of choice. One of the aims of this pilot study was to determine the presence of an attentional bias to preferentially process drug-related cues using evoked and induced gamma reactivity measures in cocaine addicts before and after biobehavioral treatment based on neurofeedback. Another aim was to show that central sensorimotor rhythm (SMR) amplitude increase and frontal theta control is possible in an experimental outpatient drug users group over 12 neurofeedback sessions.

Method. Ten current cocaine abusers participated in this pilot research study using neurofeedback combined with Motivational Interviewing sessions. Eight of them completed all planned pre- and postneurofeedback cue reactivity tests with event-related EEG recording and clinical evaluations. Cue reactivity test represented a visual oddball task with images from the International Affective Picture System and drug-related pictures. Evoked and induced gamma responses to target and nontarget drug cues were analyzed using wavelet analysis.

Results. Outpatient participants with cocaine addiction completed the biobehavioral intervention and successfully increased SMR while keeping theta practically unchanged in 12 sessions of neurofeedback training. The addition of Motivational Interviewing helped retain patients in the study. Clinical evaluations immediately after completion of the treatment showed decreased self-reports on depression and stress scores, and urine tests collaborated reports of decreased use of cocaine and marijuana. Effects of neurofeedback resulted in a lower EEG gamma reactivity to drug-related images in a postneurofeedback cue reactivity test. In particular, evoked gamma showed decreases in power to nontarget and to a lesser extent target drug-related cues at all topographies (left, right, frontal, parietal, medial, inferior), whereas induced gamma power decreased globally to both target and nontarget drug cues. Our findings supported our hypothesis that gamma band cue reactivity measures are sufficiently sensitive functional outcomes of neurofeedback treatment. Both evoked and induced gamma measures were found capable to detect changes in responsiveness to both target and nontarget drug cues.

Conclusion. Our study emphasizes the utility of cognitive neuroscience methods based on EEG gamma band measures for the assessment of the functional outcomes of neurofeedback-based biobehavioral interventions for cocaine use disorders. This approach may have significant potential for identifying both physiological and clinical markers of treatment progress. The results confirmed our prediction that EEG changes achieved with neurofeedback training will be accompanied by positive EEG outcomes in a cue reactivity and clinical improvements.     

Real-Time Changes in Connectivities During Neurofeedback

Introduction. Changes in quantitative EEG during and in response to neurofeedback (NF) training was explored in patients with traumatic brain injury (TBI). Data from 19 adults with a TBI of moderate mechanical nature, non-drug-related, and without severe posttraumatic stress disorder or seizure disorder were analyzed (14 male and 5 female).

Methods. EEG was evaluated before, during, and after ROSHI NF training. Data were collected as duplicate samples of 6 min each during eyes open and eyes closed conditions, but only the eyes closed condition was analyzed.

Results. Significant changes in connectivity occurred during and in response to NF training.

Conclusion. Results showed significant changes in real-time QEEG connectivity. An evaluation of a larger subject population will clarify gender differences in connectivity responses to NF training.     

UNCONSCIOUS OPERANT CONDITIONING IN THE PARADIGM OF BRAIN-COMPUTER INTERFACE BASED ON COLOR PERCEPTION

This study investigate the mutual fine-tuning of ongoing EEG rhythmic features with RGB values controlling color shades of computer screen during neuro-feedback training. Fifteen participants had not been informed about the existence of neurofeedback loop (NF), but were guided only to look at the computer screen. It was found that during such unconscious NF training, a variety of color shades on the screen gradually changed from rather various types to the main one within the framework of color palette specified for each individual. This phenomenon was not observed in control experiments with simulated neuro-feedback. Individual color patterns induced on the screen during NF did not depend on the schema of connection between of EEG rhythms and RGB controller. It is suggested that the basic neurophysiological mechanism of described NF training consists of the directed selection of EEG patterns reinforced by comfortable color shades without conscious control.     

Unconscious operant conditioning in the paradigm of brain-computer interface based on color perception

This study investigate the mutual fine-tuning of ongoing EEG rhythmic features with RGB values controlling color shades of computer screen during neuro-feedback training. Fifteen participants had not been informed about the existence of neurofeedback loop (NF), but were guided only to look at the computer screen. It was found that during such unconscious NF training, a variety of color shades on the screen gradually changed from rather various types to the main one within the framework of color palette specified for each individual. This phenomenon was not observed in control experiments with simulated neuro-feedback. Individual color patterns induced on the screen during NF did not depend on the schema of connection between of EEG rhythms and RGB controller. It is suggested that the basic neurophysiological mechanism of described NF training consists of the directed selection of EEG patterns reinforced by comfortable color shades without conscious control.     

Neurofeedback with Juvenile Offenders: A Pilot Study in the Use of QEEG-Based and Analog-Based Remedial Neurofeedback Training

SUMMARY

Introduction. Atypical EEG and neuropsychological indicators have been observed among offenders. Dangerous offenders treated with a combined program that included neurofeedback (EEG biofeedback) and galvanic skin response (GSR) biofeedback demonstrated reduction in recidivism (Quirk, 1995). This study was designed to further evaluate the EEG findings of youth offenders and to provide an initial report on the effectiveness of a task-oriented analog/QEEG-based remedial neurofeedback training approach.

Method. Five offenders with significant psychopathology were referred for treatment. The group was evaluated with attentional testing and analog/QEEG assessment prior to and following neurotherapy. Treatment consisted of 20 or 40 sessions of a task-activated analog/QEEG-based approach. Another group of thirteen offenders were assessed with attentional testing and provided with neurotherapy following QEEG assessment.

Results. For all of the youth trained, in the analog/QEEG group, pre- vs. post-audio and visual attention testing demonstrated significant improvement within 20 remedial sessions. Three of the five youth showed rapid advancement in a residential grading system. Staff observational ratings suggested behavioral improvement in the QEEG group who in general were in training for a longer period of time.

Conclusion. EEG abnormalities and deficits in neuropsychological testing were found among offenders. Neurotherapy as an adjunctive treatment appears to hold promise for improvement in cognitive performance as well as recidivism. It is anticipated that different neurofeedback protocols may enhance outcomes.     

Golf Performance Enhancement and Real-Life Neurofeedback Training Using Personalized Event-Locked EEG Profiles

Background. This study reports on a new method for golf performance enhancement employing personalized real-life neurofeedback during golf putting.

Method. Participants (n = 6) received an assessment and three real-life neurofeedback training sessions. In the assessment, a personal event-locked electroencephalographic (EEG) profile at FPz was determined for successful versus unsuccessful putts. Target frequency bands and amplitudes marking optimal prefrontal brain state were derived from the profile by two raters. The training sessions consisted of four series of 80 putts in an ABAB design. The feedback in the second and fourth series was administered in the form of a continuous NoGo tone, whereas in the first and third series no feedback was provided. This tone was terminated only when the participants EEG met the assessment-defined criteria. In the feedback series, participants were instructed to perform the putt only after the NoGo tone had ceased.

Results. From the personalized event-locked EEG profiles, individual training protocols were established. The interrater reliability was 91%. The overall percentage of successful putts was significantly larger in the second and fourth series (feedback) of training compared to the first and third series (no feedback). Furthermore, most participants improved their performance with feedback on their personalized EEG profile, with 25% on average.

Conclusions. This study demonstrates that the “zone” or the optimal mental state for golf putting shows clear recognizable personalized patterns. The learning effects suggest that this real-life approach to neurofeedback improves learning speed, probably by tapping into learning associated with contextual conditioning rather than operant conditioning, indicating perspectives for clinical applications.     

Neurofeedback for children with ADHD: a comparison of SCP- and theta/beta-protocols

Research groups have consistently reported on behavioral and cognitive improvements of children with ADHD after neurofeedback. However, neurofeedback has not been commonly accepted as a treatment for ADHD. This is due, in part, to several methodological limitations. The neurofeedback literature is further complicated by having several different training protocols. Differences between the clinical efficacy of such protocols have not been examined. This study addresses previous methodological shortcomings while comparing the training of theta-beta-frequencies (theta-beta-group) with the training of slow cortical potentials (SCP-group). Each group comprised of 19 children with ADHD that were blind to group assignment. The training procedure consisted of 30 sessions and a six months follow-up training. Pre-/post measures at pretest, the end of the training and the follow-up included tests of attention, intelligence and behavioral variables. After having already reported intermediate data (Strehl et al. 2004), this paper gives account on final results: Both groups are able to voluntarily regulate cortical activity, with the extent of learned self-regulation depending on task and condition. Both groups improve in attention and IQ. Parents and teachers report significant behavioral and cognitive improvements. Clinical effects for both groups remain stable six months after training. Groups do not differ in behavioral or cognitive outcome variables.     

“Native Americans,Neurofeedback, and Substance Abuse Theory”. Three Year Outcome of Alpha/theta Neurofeedback Training in the Treatment of Problem Drinking among Dine' (Navajo) People

Abstract

This three year follow-up study presents the treatment outcomes of 19 Dine' (Navajo) clients who completed a culturally sensitive, alpha/theta neurofeedback training program. In an attempt to both replicate the earlier positive studies of Peniston (1989) and to determine if neurofeedback skills would significantly decrease both alcohol consumption and other behavioral indicators of substance abuse, these participants received an average of 40 culturally modified neurofeedback training sessions. This training was adjunctive to their normal 33 day residential treatment.

According to DSM-IV criteria for substance abuse, 4 (21%) participants now meet criteria for “sustained full remission”, 12 (63%) for “sustained partial remission”, and 3 (16%) still remain “dependent” (American Psychiatric Association, 1994). The majority of participants also showed a significant increase in “level of functioning” as measured by the DSM-IV Axis V GAF.

Subjective reports from participants indicated that their original neurofeedback training had been both enjoyable and self-empowering; an experience generally different from their usual treatment routine of talk-therapy and education. This internal training also appeared to naturally stimulate significant, but subtle, spiritual experiences and to be naturally compatible with traditional Navajo cultural and medicine-ways. At the three-year follow-up interview, participants typically voiced that these experiences, and their corresponding insights, had been helpful both in their ability to cope and in their sobriety. From an outside perspective, experienced nurses also reported unexpected behavioral improvements during the participant's initial training. Additionally, administrators and physicians generally found the objective feedback and verification quality of neurofeedback protocols compatible with their own beliefs.

An attempt has also been made to conceptualize the outcome analysis of this study within both a culturally specific and universal socio/bio/ environmental context.     

Limbic self-neuromodulation as a novel treatment option for emotional dysregulation in premenstrual dysphoric disorder (PMDD); a proof-of-concept study

Aim

To assess the efficacy of a novel neurofeedback (NF) method, targeting limbic activity, to treat emotional dysregulation related to premenstrual dysphoric disorder (PMDD).

Methods

We applied a NF probe targeting limbic activity using a functional magnetic resonance imaging-inspired electroencephalogram model (termed Amyg-EFP-NF) in a double-blind randomized controlled trial. A frontal alpha asymmetry probe (AAS-NF), served as active control. Twenty-seven participants diagnosed with PMDD (mean age = 33.57 years, SD = 5.67) were randomly assigned to Amyg-EFP-NF or AAS-NF interventions with a 2:1 ratio, respectively. The treatment protocol consisted of 11 NF sessions through three menstrual cycles, and a follow-up assessment 3 months thereafter. The primary outcome measure was improvement in the Revised Observer Version of the Premenstrual Tension Syndrome Rating Scale (PMTS-OR).

Results

A significant group by time effect was observed for the core symptom subscale of the PMTS-OR, with significant improvement observed at follow-up for the Amyg-EFP group compared with the AAS group [F(1, 15)=4.968, P = 0.042]. This finding was specifically robust for reduction in anger [F(1, 15) = 22.254, P < 0.001]. A significant correlation was found between learning scores and overall improvement in core symptoms (r = 0.514, P = 0.042) suggesting an association between mechanism of change and clinical improvement.

Conclusion

Our preliminary findings suggest that Amyg-EFP-NF may serve as an affordable and accessible non-invasive treatment option for emotional dysregulation in women suffering from PMDD. Our main limitations were the relatively small number of participants and the lack of a sham-NF placebo arm.     

Neurofeedback for Adult Attention-Deficit/Hyperactivity Disorder: Investigation of Slow Cortical Potential Neurofeedback—Preliminary Results

Attention deficit/hyperactivity disorder (ADHD) is characterized by symptoms of inattention, impulsivity, and hyperactivity. Compared to ADHD in children, only a few studies have investigated ADHD in an adult population, and even less have investigated new forms of treatment such as neurofeedback. Neurofeedback has been applied effectively in various areas, especially in the treatment of children with ADHD, and symptom improvements were associated with increased amplitude of the contingent negative variation (CNV). This study investigated if any behavioral and electrophysiological changes reflected in the CNV can be observed after 15 sessions of SCP neurofeedback training. Furthermore, a comparison of CNV amplitude in adults with ADHD and a healthy control group was conducted. Continuous 22-channel EEG was acquired from 10 adults who met DSM–IV criteria for ADHD and 8 matched healthy controls. EEG recordings were collected pre/midtreatment and included resting EEG, P300, and CNV tasks as well as ADHD behavioral questionnaires. The adult ADHD group received 15 sessions of SCP training at Cz (referenced to A1, ground A2). The control group only underwent the EEG recording. After 15 sessions of SCP-training a significant improvement in self-ratings of ADHD symptoms was reported. In addition, a trend in increasing CNV mean amplitude was observed after training. A significant difference in baseline CNV between the adult ADHD group and the healthy control group was observed. These results give a promising outlook to the outcome after the completion of 30 sessions of SCP training. The differences in CNV amplitude between the ADHD group and healthy controls are in line with other studies about adult ADHD and CNV. This supports the idea of impaired self-regulation in adult ADHD. The behavioral improvements and increase in CNV after SCP training suggests that SCP training has a positive effect on adult ADHD symptoms and their origin.     

Neurofeedback Treatment of Depression with the Roshi

Abstract

Introduction. A patient with severe, medication resistant depression was found to have the frontal alpha asymmetry described in Davidson's (1998a) research as demonstrating a predisposition to depression.

Treatment. Initial sessions of EEG neurofeedback using Rosenfeld's (1997) protocol for correcting the alpha asymmetry were discouraging, actually producing slight negative change. Therefore, treatment shifted to using the Roshi, a two channel unit combining neurofeedback and photic stimulation, doing primarily left hemisphere beta training.

Results. The very first Roshi session produced positive changes, and within five sessions the patient reported feeling less depressed and more energetic. At the conclusion of thirty training sessions, objective testing documented dramatic reductions in depression, somatic symptoms, overemotionality, anxiety, rumination, and fatigue.

Discussion. In support of Henriques and Davidson's (1991) belief that hypoactivation of the left hemisphere results in an “approach deficit” and more withdrawal behavior, post-testing and interview data also documented that the patient had become less withdrawn, more active, sociable, and less distrustful. Eight and one-half month follow-up documented maintenance of changes. Continued exploration of left hemisphere beta protocols in treating depression, and of the combined use of neurofeedback with photic stimulation are encouraged.     

Infrared Imaging and Neurofeedback: Initial Reliability and Validity

Introduction. The neurological correlates underlying positive treatment outcomes for neurofeedback have been either unavailable or difficult to demonstrate. Assessment of brain-related changes associated with neurofeedback is needed to further establish its empirical basis. Infrared (IR) imaging is a noninvasive assessment of brain activity with high spatial and temporal resolution.

Method. Study 1, a reliability study, assessed the test-retest stability of IR imaging. In Validity Study 2 and 3, IR imaging assessed brain-related changes prior to and following neurofeedback and passive infrared hemoencephalography (pir HEG) training, respectively.

Results. In Study 1, high correlations occurred in pre-post comparisons for IR measures unrelated to treatment. Lower correlation between measures of IR imaging indicated changes in brain activation associated with thermoregulation following neurofeedback training. In Study 2, changes in thermal regulation occurred both within and across sessions. The change in metabolic regulation was enduring and associated with a reduction in core Autistic Spectrum Disorder symptomatology and improved cerebral connectivity. In Study 3, a significant percentage of patients with Traumatic Brain Injury increased thermal readings following pir HEG training and the change in thermal readings was associated with EEG connectivity.

Conclusion. Findings indicated that IR imaging may be a reliable and valid measure of treatment outcomes with clinical utility and sensitivity.     

Neuromodulatory Approaches for Chronic Pain Management: Research Findings and Clinical Implications

Two lines of evidence provide preliminary support for the role that brain state, measured via electroencephalogram (EEG), may play in chronic pain. First, research has identified a link between brain EEG activity and the experience of pain. Second, there are a number of published studies documenting the beneficial effects of interventions that impact the cortical activity associated with chronic pain. These interventions include neurobehavioral treatments such as neurofeedback and hypnosis as well as invasive and non-invasive brain stimulation. Preliminary data showing the efficacy of neuromodulatory strategies for treating pain provides compelling reason to examine how cortical activity (as measured by EEG) may underlie the experience of pain. Existing data already suggest specific approaches that neurofeedback clinicians might consider when treating patients with chronic pain. Reciprocally, observations by neurofeedback practitioners could provide important case data that could foster the design of more definitive randomized clinical trials using such strategies for the treatment of chronic pain.     

Visual-motor Integration and its Relation to EEG Neurofeedback Brain Wave Patterns,Reading, Spelling,and Arithmetic Achievement in Attention Deficit Disordered and Learning Disabled Students

Abstract

Studies examining EEG neurofeedback treatment for Attention Deficit Disorders (ADD) and Learning Disabilities (LD) have shown relationships between Theta/Beta ratios (TBR's) and enhanced attention, and measures of cognitive functioning including visual-motor integration. Thirty-eight children, ages 8 to 18, received neurofeedback where Beta was rewarded while Theta and EMG were inhibited and demonstrated significant reductions in TBR's after an average of 46 sessions. They also demonstrated significant improvements in measures of visual-motor integration, and academic achievement. Though the changes in TBR's were not correlated with all outcome measures, post-treatment TBR's were correlated to post-treatment visual-motor integration scores. The possible intervening variable relationship of visual-motor integration with TBR's and achievement changes is discussed.