EEG Biofeedback

1. EEG Biofeedback Neurofeedback

2. Brain Wave Activity • Delta – sleep state (1-3 Hz) • Theta – between sleep and awake (4-7 Hz) • Alpha – relaxed state (8-12 Hz) • Low Beta – focused concentration (SMR-Sensory Motor Rhythms) (12-15 Hz) • Mid-range Beta – alert state (15-18 Hz) • High Beta – very alert, vigilant (Above 18) • Gamma – Hyper vigilant (Above 40)

3. Attentional Shifting • Ability to produce the right states associated with focus and attention • Poor concentration: lack of sufficient levels of SMR • Attentional deficits: excessive amounts of slow brain wave activity (Theta waves) Neurofeedback: electroencephalograph (EEG) recording system  and training software trains an individual to concentrate while receiving visual and auditory feedback from a computer.

4. Literature Review • 95% of learning disabled children could be correctly identified strictly on the basis of the EEG (Lubar, 1989) • Possible to control seizure susceptibility and hyperactivity with EEG training that attempted to "train down" the low frequency activity at the same time that certain higher-frequency activity is promoted (12-18 Hz) (Sterman, 1978) • Study of both attention and learning problems using EEG biofeedback was performed, specific learning disabilities were often characterized by elevated low-frequency (Theta waves) activity in the EEG (Lubar, 1984).

5. Literature Review • First of many studies in which improvements in IQ score were documented for EEG training (Tansey, 1983) • 24 subjects with learning disorders (Tansey 1990), an average improvement in Wechsler full-scale IQ score of 19 points was demonstrated • “Significant improvements in cognitive skills, academic performance and behavior are found, and confirmed in follow up. Average improvement in WISC-R Full Scale IQ was 23 points.” (Othmer, 1992) • Neurofeedback may be an effective supplement to special education in improving IQ and reading performance (Orlando, 2004)

6. Procedure NDB: • To assess the neurological status of the patient and to determine to what extent there is a neurological basis of the patient’s complaints • To identify possible strengths and weaknesses in the organization and electrophysiological status of the patient’s brain so as to aid in the efficient and optimal design of Neurotherapy • To increase efficiency and to objectively evaluate the efficacy of treatment by comparing the patient’s EEG before, during and after treatment.

7. Procedure • After initial interview: the first EEG training session (two hours) • Sometimes a full brain map, or quantitative EEG (QEEG) is obtained • The first six sessions are completed as quickly as possible and then the frequency of training reduces to two or three times per week. • 30-40 sessions (depending on the severity of the disorder and other comorbid symptoms present) • Approximately 30-45 minutes for each session (approximately 4-6 months)

8. Procedure • Electrodes are placed on the scalp and to the earlobes • Series of tasks (reading, listening to stories, etc.) are presented • EEG waves are recorded as a spectrum of frequencies • Rewarded by changes in the game when certain level of beta wave activity is produced • Changes on the screen occur milliseconds after they occur in the brain, computer tones are then heard to signal the change the moment goal is achieved. Video

9. Outcomes • Possibility of improvement in capability, rather than simply adjustment and coping strategies • Some improvement is generally seen within ten sessions and permanent in most cases. • Children show no resistance to biofeedback. • In between 40 and 60 sessions, the individual is able to produce more SMR at will • Improvements in behaviour (control of temper tantrums, violence, cruelty) • Recovery of "affect", or emotional responsiveness (depression) • No known adverse side effects of the training, provided that it is conducted under professional guidance • Increased openness to change and responsiveness to psychotherapy

10. Limitations • Cost of treatment (typically, $3000 and up), many medical and psychological insurance plans cover biofeedback for various conditions • Performed only by a qualified practitioner in a clinical setting • There is only a small number of EEG normative reference databases adequate to meet the minimal standards necessary for responsible and ethical uses of a NDB in the field of EEG Biofeedback. Improvements are expected in the future. • Not as quick acting as medications

11. Limitations of Previous Research • Lack of appropriate control conditions • Small clinical practices and extremely small sample sizes • Case studies • More research necessary to distinguish which learning problems improve with EEG biofeedback training, ex. dyslexia

12. Final Comments • Guidelines for researchers in the area of EEG biofeedback were recently published to aid future studies (La Vaque, et al., 2002), and the quality of research is expected to improve • Clear evidence that EEG biofeedback procedures do produce predictable and lasting changes in the EEG (e.g., Strawson & Gruzelier, 2002), and that characteristics of the EEG are correlated with important psychological conditions (John, Pricep, Friedman, & Easton, 1988)