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Neurofeedback being used clinically?
Common CNS symptoms that are commonly reported as clinically responsive to neurofeedback:
- ADD/ADHD, Attention Problems
- Conduct Disorders, Oppositional Behavior
- Behavior disorders
- Depression, Mood Regulation
- Affect regulation disorders
- Bipolar Disorder
- Anxiety Disorders
- Panic Attacks
- PTSD
- Insomnia, Frequent waking
- Restless Leg
- Bruxism
- Migraines
- Chronic Pain
- Seizures
- Learning Disabilities
- Pervasive Developmental Disorder
- Autism, Rumination
- Obsessive Compulsive, Rumination
- TBI Traumatic Brain Injury
- Tourette's Syndrome
- Peak Performance
- Anger, Rage
- Substance Abuse
Think CNS problem. There are clearly others not listed which have responded to neurofeedback, though in much smaller numbers, including Schizophrenia, and Parkinson's.
Neurofeedback is not targeting each disorder. It's used to change timing and activation patterns. It's creating changes in feedback loops and pathways that make up the brain. This creates improvement in brain regulation, which impacts a variety of symptoms.
Different problems may require different training targets. As examples, many clinicians report that depression may involve frontal lobe training, anxiety may involve some parietal training.
Just as there are different ways to exercise the body, there are different approaches to training or exercising the brain.
When does neurofeedback not work? There are various reasons.
Some commentary on neurofeedback regarding each disorder:
ADD/ADHD
More kids and adults with ADD/ADHD are using neurofeedback than any other problem. Experienced clinicians estimate that at a minimum, they have significant impact with 80-85% of these patients who complete 30-40 training sessions. Is it the most commonly treated because it's the easiest problem to deal with? Not really - ADD/ADHD is often many different symptoms rolled into one diagnosis. These must be sorted out as part of doing neurofeedback. There are some practical reasons that ADD/ADHD is the most common use for neurofeedback:
- Parents are far more motivated to help their children to succeed than to help themselves.
- Increasing concerns that putting a child on medications for years is not a good thing. Parents want an alternative that works.
- For many kids medications don't work very well. They have side effects, make the kid feel less normal, or create more problems.
- There are thousands of neurofeedback success stories around the country - many in ADD. More clinicians are adding neurofeedback because patients are asking for it or talking about it.
- Solid published research on ADD/ADHD and neurofeedback.
- Increased awareness of the role of the brain in ADHD (as well as other disorders). In the last 5 years, every magazine seems to have had a brain imaging picture on its cover. As a result, neurofeedback as a brain based intervention doesn't seem so foreign, and there is much more openness towards the concept.
Anxiety
Most clinicians say generalized anxiety is one of the first symptoms to start to respond to training. Significant improvements are typically estimated at 80-90% of those being trained. However, it also depends very much on what other comorbidities exist. More complex cases that have multiple other problems may take more expertise and time to respond. We still expect that these more complex cases in fact will respond to neurofeedback (listen to Dr. Angelo Bolea talk about some of his most difficult cases). However, they take more time, expertise, along with clinical skills. That means not everyone will achieve good results with these cases.
Depression
Even for long term non-responsive depression cases, neurofeedback typically responds. It can also help reduce multiple medications, which is not uncommon. From depression to dysthymia it's one of the more common conditions neurofeedback is used for. This is not to say it's easy. Clinical skills are important. There are a variety of protocol options, depending on the comorbidities associated with the client.
Learning Disabilities (LD)
Over the last few years, two professionals in particular published data about new training techniques they are using to target learning disabilities and with qEEG. This was really big news for the field of neurofeedback. It's common for reading, math and other problems to improve with neurofeedback and that may be enough. But some clients still could have significant deficits after neurofeedback training, even after some improvement. By adding in this new technique (coherence training - a fairly sophisticated component of training) several very solid professionals are reporting more consistent improvements - in dyslexia, reading and math deficits, and visual and auditory processing problems
Bipolar Disorder
Clinical reports from psychiatrists and psychologists indicate that neurofeedback helps bipolar patients become more stable, and better able to reduce medications
Cognitive Impairment (Traumatic Brain Injury, Stroke)
Neuropsychologists have reported that improvement with TBI often occurs even many years after the injury – that neural plasticity still exists. Emotional and behavioral improvements are significant for this group.
Migraines and Headaches
Therapists and MD's report that the incidence and intensity of migraines are often reduced – and sometimes eliminated.
Chronic Pain
For chronic pain, NF helps reduce pain or perhaps how the brain manages pain, even in severe cases
Sleep Dysregulation
The first changes clients typically observe after neurofeedback relate to sleep. These can include improvement in insomnia, bruxism, poor sleep quality, difficulty waking, frequent waking, and nightmares.
Autism & PDD
Reactive Attachment Disorder
Autism, PDD and RAD are the fastest growing areas of neurofeedback. The calming effects of neurofeedback produce noticeable results quickly in these severely affected populations.
Substance Abuse
In a study soon to be published, neurofeedback was compared with a successful 12 step program for crack, cocaine, methamphetamine, and heroin users. Sustained abstinence was significantly greater (2 times or greater) with the group that also got neurofeedback training. Previous published studies show similar results for alcoholics. Substance abuse is an obvious form of poor self-regulation, and self-medication.
Epilepsy
Multiple peer-reviewed studies show a reduction in seizures that are non-responsive to medications – and that the training effect holds. This literature is compelling in respected journals, and the clinical reports consistently reflect improvement. But for several reasons – including a lack of funding to educate MD's, the research is not well known.
Why aren't more pediatricians/MD's recommending or offering neurofeedback?
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