Neurofeedback Therapy

What is Neurofeedback ?

Neurofeedback is a comprehensive system that promotes change at the cellular level of the brain and empowers the client to use his or her mind as a tool for healing. Trainees often report relief from symptoms related to depression, anxiety, PTSD, addictions and unresolved emotional issues. Neurofeedback training is also known to promote a state of focused relaxation that has benefited those with attention deficit disorder (ADHD/ADD), learning disorders, OCD, dyslexia, behavioural disorder, and traumatic brain injury. Other disorders that have responded well to neurotherapy include epilepsy, headaches, insomnia and chronic fatigue, etc. A growing number of health care providers have made neurotherapy their primary treatment modality, or as part of a larger clinical practice.

Tel : +65-6336-0035 email : neurofeedback@nsrcgroup.com

Neurofeedback: enhancing communication between mind and body

"A pill for every ill" means that drugs are the primary source of enhanced mood and wellness. What if you could control the mind/body connection without pills? Neurofeedback teaches you self-regulation skills. Your mind becomes your medication. Businessweek magazine recently said that Neurofeedback is moving towards mainstream medicine. It has been successfully applied to such disorders as anxiety, depression, ADHD, minor traumatic brain injury and age-related cognitive decline. How does Neurofeedback work and what can it do for you?

BRAIN WAVES AND YOU

Each of us has a countless number of neurons in our cerebral cortex or brain. Brain Waves are associated with the electrical activation and deactivation of neurons. The electrical patterns produced by neurons are called brain waves. Electroencephalographic (EEG) equipment is used to measure brain wave activity. Hospitals use it to diagnose seizure disorders. At death the EEG becomes a "flat line." EEG-Biofeedback (Neurofeedback) equipment also measures brain waves but unlike standard hospital equipment it feeds-back information about those waves to a trainee.

Brain waves do not cause mental or emotional states; they only reflect what is currently happening in our brain. Much like a mirror reflects the way we look. If we look in the mirror and see something out of place, we make an adjustment. The mirror is a very basic piece of biofeedback equipment. EEG-biofeedback (Neurofeedback) equipment is like a mirror to the mind. It assists the viewer (or, trainee) to identify and then modify his/her current brain wave pattern. The power to adjust emotional and mental states without the use of drugs can not be overstated.

Brain wave patterns are a mixture of the brain waves listed below. Individual brain waves have been associated with the following characteristics:

DELTA is associated with sleep.
THETA is associated with creativity, spontaneity as well as distractibility and inattention.
ALPHA is associated with meditation, inner peace, daydreaming and idleness of the visual system.
SENSORIMOTOR RHYTHM (SMR) is associated with idleness of the motor system and relaxation.
BETA is associated with focused attention and analytical thinking.
HIGH BETA is associated with muscle tension, anxiety, over-thinking as well as Peak Performance.

How Does Neurofeedback Work ?

Brain wave patterns are changeable. Each state of mind, or state of arousal, looks different. You may be alert or distracted, relaxed or tense, positive or negative. You know how you feel, but what you don’t know is how it looks—that is, on the inside of your brain. What if you did know? And what’s more, what if you could do something about it? How would it work?

Just as the doctor places a stethoscope on your chest to detect a heartbeat, the Neurofeedback practitioner places sensors on your head to detect brain wave signals. Then, a computer transforms those signals into graphics and sound. The action on the computer corresponds to the action in your brain directly beneath the sensors.

Let’s say a trainee wants to learn how to be alert instead of distracted. Every time the brain moves into an alert state the trainee hears a beep and sees graphics move on the computer screen. Whereas, every time the brain moves into a distracted state the beeping and graphics stop. Amazingly, the brain wants the action and sound to continue. It wants to be rewarded. It’s as simple as that. Within a few sessions the trainee gains a heightened awareness of mental drifting. Within 6-10 sessions most trainees start to pay attention for longer periods of time—even during boring tasks in the classroom or at work.

Regardless of the problem or goal, the results are the same: self-regulation skills are learned; greater mental and emotional control is achieved; nerve pathways are both exercised and strengthened. Young and old alike can easily master training. No computer skills are needed.

History of Neurofeedback :

In the 1960’s, Dr. Barry Sterman was training an experimental group of cats to increase SMR or Sensorimotor Rhythm—a brain wave. While Sterman was doing his own research, NASA asked him to investigate the possibility that exposure to hydrazine (rocket fuel) was causing seizures in humans. Sterman began his research with the same group of cats that were part of his SMR research project.

When the experimental group of cats were exposed to hydrazine they were much more resistant to seizures than ordinary cats. He discovered that the effect could be generalized to humans. That is, individuals with epilepsy could reduce the incidence of seizures if they learned to increase SMR—just like his cats did. He also observed a decrease in hyperactivity and restlessness in certain trainees.

Thereafter, Dr. Joel Lubar, at the University of Tennessee, applied Sterman’s techniques to children with Attention Deficit Hyperactivity disorder (ADHD) and demonstrated that hyperactivity/impulsivity can be reduced and attention can be increased with SMR/beta training (or, fast wave training). Since then other researchers and clinicians have refined his techniques and applied them to many other disorders including anxiety, depression, post-traumatic stress disorder and traumatic brain injury, non-verbal learning disorder, Age-related Cognitive Decline, peak performance training etc.

Neurofeedback – Evaluation and Testing :

Testing precedes training. Computerized tests are used to measure the brain’s ability to focus, overall cognitive functioning and memory. Cognitive testing is an important first step in the treatment of ADHD, Age-Related Cognitive Decline and Minor Traumatic Brain Injury. For example, if you’re 50 or older you may feel that your memory is failing. But is it? How does your present memory compare to others of the same age? How does it compare to the population in general? Testing answers those questions and helps you to decide whether or not treatment is needed. Test(s) are re-administered after training.

In addition to computerized tests, symptom-check-lists may also be needed to diagnose adhd/add, depression, anxiety and many other disorders. More is needed than a sense that one is feeling better or mentally sharper. Progress ought to be measured.

The Measurement, Interpretation and and Use of EEG Frequency Bands

Thomas F. Collura, Ph.D., P.E. December 7, 1997

Introduction:

The EEG is an electrical waveform that is recorded from the brain by using electrodes appropriately placed on the head, then amplifying and displaying the electrical signal using a computer, or other suitable instrument. It consists of a wave that varies in time, much like a sound signal, or a vibration. As such, it contains frequency components that can be measured and analyzed, and these frequency components have interesting and valuable properties.

A great deal of history is involved in the definition, naming, and use of these frequency bands. They are named using Greek letters, a convention that was begun by Hans Berger, the discoverer of the EEG in humans. He observed all of the rhythms known today (except the 40 Hz "gamma" band), and described many of their basic properties. Since then, our definitions and understandings of the rhythms have been refined. However, there still remains some uncertainty, and controversy, in how to define and use these bands, for various purposes.

Approaches to understanding:

There are many ways to approach the understanding of brainwaves. Clinicians view them for diagnostic purposes, seek to identify patterns that associate with specific pathologies or conditions. Psychologists also study them in association with mental states, mental processing, and to test concepts of how the brain processes information. We also know from introspective reports, and structured experiments, which subjective states tend to be correlated with a predominance of the various brainwave components.

Brain rhythms can also be operantly trained, using biofeedback. By training an individual to learn how to produce (or reduce) specific frequencies, changes in the brain can be produced. From a training standpoint, we can learn what types of mental states or activities are affected by specific types of training. Similarly, we can learn which brain/mind states, qualities, or activities are associated with a preponderance of, or conversely a lack of, any particular rhythm or combination of rhythms.

Generally, we cannot tell from the EEG "what I am thinking" - but we may be able to say "You are thinking that this is interesting" or "You are thinking that this is not interesting" We might be able to say "you cannot relax without drifting off" which is to read into another's introspective state, but not in terms of knowing what is the content of the thoughts.

It is important that we allow the brainwave signals to tell us what they have to say, and not try to force their meaning into familiar, predefined terms. For example, to expect the brainwave, in a primitive sense, to indicate, for example, "this is the rhythm for attention." or "this is when you are thinking 'up'", and so on, are ill-conceived. Rather, we need to study the patterns that emerge during various behavioral, as well as introspective, states, and then see what they are defining in terms of a multidimensional representation of some state-space.

Research that is focused on understanding specific properties, such as attention, alertness, mental acuity, etc., has uncovered combinations of rhythms, and other EEG properties, that are relevant to these studies. Generally, "derived" properties are found useful, that involve computer-processing of the EEG, to produce measurements that are useful for research, monitoring, etc.

How brain rhythms are generated:

Populations of cells generate rhythms when they depolarize in synchrony. This activity occurs primarily in the upper 4 layers (about 1/4 inch thick) of the outer layers of the cerebral cortex. The presence of an EEG rhythm indicates that there is some brain activity occurring in terms of millions of cells acting together, in a synchronized fashion. The exact causes of this, and what it means for the brain and information processing, is an entire dissertation in itself.

Overall, the observed brainwave frequencies must be thought of as "epiphenomena," which are the byproduct of normal brain function, but not a brain signal in themselves. The brain does not communicate, or do its business, using the EEG. Rather, it is a secondary measure, such as the vibration measured from an engine, or the temperature of an electronic circuit. Therefore, the brain does not, for example, produce alpha waves for any purpose. It produces them as a result of certain types of brain activity, and we can learn to recognize them, and take advantage of them, by learning what they represent, and what happens when we work with them.

Distribution in Time and Space:

The brain consists of over 100 billion cells, organized into many different regions, all doing different things, all acting simultaneously. The brain is not a computer. It is an assemblage of millions and billions of computers. Therefore, at any time and any particular location, the brain may produce a combination of frequencies. Variations in time, and in space (observed as different places on the scalp) are important to understand.

EEG signals are seen to wax and wane, which means to grow larger and smaller, in time, generally showing moment-to-moment variation at all times. Alpha is almost always seen in "spindles" and "bursts," almost never seen in a continuous wave. It is the production of more, or larger, bursts of rhythmic activity, that is associated with their being a higher "amount" of that component. Beta, for example, may occur in very small bursts, of 1/10 second or less, so that it comes and goes very rapidly. Alpha, on the other hand, generally waxes and wanes with bursts of from about 1/5 second, up to 1 or 2 seconds in length.

Spatial distribution can be seen in all components. Some of these are described below. Since the brain consists of broadly identifiable areas (frontal (motor and sensory cortex), parietal, occipital (visual), temporal (hearing, language), rhythms are seen to be associated with the particular involved area. Electrode placement is therefore important when measuring or training for particular rhythms. Training at a location will affect the EEG activity primarily at that location.

The EEG is thus like a symphony, which is a complex mixture of sounds, changing in time and in space. The brain is a massively parallel processor that contains many thousands of cell systems. There may be a preponderance of one or more rhythms at any time, and this combination of frequencies, in time and in space, can help us to understand the condition, and the activities, of the brain. There has been work that suggests the existence of a specific "alpha state," for example. Even though the brain may be producing a preponderance of alpha waves at any instant, this does not necessarily suggest an "alpha state," per se. Brain states may exist, and they may be correlated with the presence or absence of various frequencies, in time and space, rather than just one frequency.

Training of EEG rhythms

Biofeedback techniques can be used to train EEG rhythms. Training systems can use visual feedback, auditory feedback (sounds), or use a personal trainer to provide verbal feedback, thus making the trainee aware of which brain rhythms are present. Displays can be of many types, and computer displays are capable of producing a wide variety of useful displays. These can include "thermometers", video games, and other graphic displays. Systems can be set up to train to reinforce, or to reduce, any rhythm or combination of rhythms, or for more complex situations such as training different locations to be synchronized, or desynchronized, or to train different locations to produce (or inhibit) different frequencies.

Early EEG training emphasized the production of a particular frequency, for example, alpha-wave training. More recently, the emphasis has been on training flexibility, or appropriateness, of brain rhythms. That is, the brain needs to produce the desired rhythms at the proper times, and in the proper locations. The development of these complex protocols is an important area of current research, and clinical development.

We can also train more complex, derived properties, such as brainwave synchrony, coherence, or relationships between brain rhythms recorded from different sites. This has been found particularly useful in training concentration and relaxation, for peak-performance training, and for athletics, golfers, etc. Certain EEG properties have been found conducive to being "in the zone," which is a highly efficient and responsive state, useful for improving performance in many applications.

It is important to realize that, although rhythms can be trained, to produce desired results, the production (or reduction) of the specific rhythm is not an end in itself, and the change in the EEG may not signify that the desired change has occurred. Rather, the desired brain/mind changes are a byproduct of the training, independent of changes in the EEG itself. The brain is a self-regulating system, and may behave much like a thermostat, that tries to keep the system stable. To use an analogy, if a window is left open in a house in the winter, the house may not be cold, but the furnace will be working hard, and the heating bills will be high. If the window is closed, representing a return to normal operation, the temperature may not rise significantly, but the furnace will work less. Thus, the brain may achieve a desired state, even if the measured variable, the brain rhythms, do not change significantly, in and of themselves. Nonetheless, changes in the brain have occurred, and their benefits may be forthcoming, even in the absence of large changes in the EEG signal.

Summary of EEG Frequency Bands:

The basic EEG rhythms are summarized briefly as follows, with regard to their typical distribution on the scalp, subject states, tasks, physiological correlates, and the effects of training. This summary should be taken as a general roadmap, not as fixed and hard rules.

* Delta (0.1-3 Hz):

Distribution: generally broad or diffused, may be bilateral, widespread
Subjective feeling states: deep, dreamless sleep, non-REM sleep, trance, unconscious
Associated tasks & behaviors: lethargic, not moving, not attentive
Physiological correlates: not moving, low-level of arousal
Effects of Training: can induce drowsiness, trance, deeply relaxed states

* Theta (4-7 Hz):

Distribution: usually regional, may involve many lobes, can be lateralized or diffuse;
Subjective feeling states: intuitive, creative, recall, fantasy, imagery, creative, dreamlike, switching thoughts, drowsy; "oneness", "knowing"
Associated tasks & behaviors: creative, intuitive; but may also be distracted, unfocused
Physiological correlates: healing, integration of mind/body
Effects of Training: if enhanced, can induce drifting, trancelike state if suppressed, can improve concentration, ability to focus attention

* Alpha (8-12 Hz):

Distribution: regional, usually involves entire lobe; strong occipital w/eyes closed
Subjective feeling states: relaxed, not agitated, but not drowsy; tranquil, conscious
Associated tasks & behaviors: meditation, no action
Physiological correlates: relaxed, healing
Effects of Training: can produce relaxation

Sub band low alpha: 8-10: inner-awareness of self, mind/body integration, balance
Sub band high alpha: 10-12: centering, healing, mind/body connection

* Beta (above 12 Hz)

The beta band has a relatively large range, and has been defined as anything above the alpha band.

* Low Beta (12-15 Hz), formerly "SMR":

Distribution: localized by side and by lobe (frontal, occipital, etc.)
Subjective feeling states: relaxed yet focused, integrated
Associated tasks & behaviors: low SMR can reflect "ADD", lack of focused attention
Physiological correlates: is inhibited by motion; restraining body may increase SMR
Effects of Training: increasing SMR can produce relaxed focus, improved attentive abilities, may remediate Attention Disorders.

* Midrange Beta (15-18 Hz)

Distribution: localized, over various areas. May be focused on one electrode.
Subjective feeling states: thinking, aware of self & surroundings
Associated tasks & behaviors: mental activity
Physiological correlates: alert, active, but not agitated
Effects of Training: can increase mental ability, focus, alertness, IQ

* High Beta (above 18 Hz):

Distribution: localized, may be very focused.
Subjective feeling states: alertness, agitation
Associated tasks & behaviors: mental activity, e.g. math, planning, etc.
Physiological correlates: general activation of mind & body functions.
Effects of Training: can induce alertness, but may also produce agitation, etc.

* Gamma (40 Hz):

Distribution: very localized
Subjective feeling states: thinking; integrated thought
Associated tasks & behaviors: high-level information processing, "binding
Physiological correlates: associated with information-rich task processing
Effects of Training: not known

Measuring frequencies

Frequencies may be measured in several ways. One is to use a Fast Fourier Transform (FFT) to estimate the amount of energy for all frequencies, in a defined interval of time, usually about 1 second. This is accurate, but lacks fast response, if training is a primary goal. Filtering is also used, which provides a faster response, but is limited to specific bands. Digital filters are implemented using computer software, and are a preferred method.

Copyright (c) 1997, 1998, 1999, 2000, 2001, 2002, 2003, 2004, 2005 Thomas F. Collura, Ph.D.

Disclaimer

The material to be presented in this page and all subsidiary pages at this site includes many results which have been obtained in a clinical setting, and they do not yet have grounding in research under more controlled conditions. They must therefore be regarded as preliminary and experimental.

The techniques discussed herein should be employed only by professionals who are appropriately trained, and who are operating within the scope of their present license to practice. The presentation of these results is intended for educational purposes, and to serve as a quick source of information to provoke the interest of researchers within the mental health community who are involved with these conditions. Other terms for EEG-Biofeedback,include "neurofeedback" and "neurotherapy".

Please note that Neuroscience Research Centre is solely an educational and research institution and not an equipment manufacturer.

Professionals who provide neurofeedback should also refer to the article on High Risk Conditions