Neurofeedback (EEG Biofeedback) at Cortica

What is neurofeedback? Neurofeedback is a way of training or “exercising” the brain to encourage certain patterns of electrical activity. Electrodes are placed on the scalp and the brain’s electrical activity is recorded and converted into a video display on a screen (which has the appearance of a video game or movie). When certain frequencies of brain activity increase, the brain is rewarded by the image on the screen. This trains the brain to produce more of those desirable patterns. Neurofeedback does not administer anything to the brain. The only “input” the brain gets is through watching the images on the screen, and these images are determined by the brain’s electrical activity.

What is a neurofeedback session like? During a neurofeedback session, electrodes are placed on the scalp. The individual is asked to be seated in a chair and view a computer screen. The session should largely take place with the individual quiet and still, but some movements and talking is permitted. Others present in the room should also speak as little as possible. Certain settings are adjusted at each neurofeedback session, including the brain wave frequency that is being targeted and the locations on the scalp where the electrodes are placed (which allows targeting of different regions of the brain). Selection of these settings depends on the individual’s symptoms and how these change during the course of treatment. It sometimes takes several sessions in order to determine the optimal frequency and electrode placement.

How can neurofeedback help? By improving the patterns of brain electrical activity, we can improve a wide range of cognitive, emotional, behavioral, and physiological symptoms. The range of symptoms for which neurofeedback has been studied and has research to support its use (either alone or in combination with other therapies) includes:

  • Headache

  • Anxiety

  • Stress (including post-traumatic stress)

  • Inattention

  • Hyperactivity

  • Impulsivity

  • Addiction

  • Sleep disturbance

  • Depression

  • Aggressive behaviors

  • Seizure

Neurofeedback has also been used to help athletes, pilots, surgeons, and other highly-skilled professionals to achieve peak performance. We recommend that when an individual begins neurofeedback therapy, an initial set of 20 sessions be completed. At that point, decisions can be made about future treatments. The benefits are generally cumulative and increase gradually over time; however, some individuals report changes within a few sessions.

What is the research supporting neurofeedback? The American Academy of Pediatrics placed neurofeedback as a Level 1 “Best Support” Intervention for the treatment of inattention, hyperactivity, and impulsivity. The National Institute of Health lists more than 8,500 peer-reviewed publications in biofeedback and 450 in neurofeedback.

"The literature, which lacks any negative study of substance, suggests that EEG biofeedback (neurofeedback) therapy should play a major therapeutic role in many difficult areas. In my opinion, if any medication had demonstrated such a wide spectrum of efficacy, it would be universally accepted and widely used."

-Frank Duffy, MD, Pediatric Neurologist and Professor at Harvard Medical School and Boston Children’s Hospital

What are the potential risks of neurofeedback? Because neurofeedback impacts how certain parts of the brain function, there is the potential for both positive changes as well as negative changes. Fortunately, adverse effects are extremely rare, and much less common than side effects from medication use. However, some of the symptoms experienced by past participants have included worsening of any current symptoms or onset of new neurological or behavioral symptoms. Adjustments to the neurofeedback parameters are generally effective at resolving negative symptoms that may occur during neurofeedback therapy.

Please speak to your neurofeedback clinician or Dr. Goh if you have any questions about potential risks and potential benefits. All treatments that have the potential for benefit also have the potential for risk. It is important to understand these risks prior to starting any treatment. If the individual experiences any new or worsening symptoms during the course of neurofeedback treatment, it is important to communicate these symptoms to your provider right away.