Clinical Neurofeedback or Neurotherapy is a therapeutic intervention that provides immediate feedback from the brainwave activity. The therapy uses sounds or visual signals to retain or recognize these brain signals. It is also known as EEG (Electroencephalogram) Biofeedback.
While most of the mental health conditions respond well through medications and different types of therapies, many other conditions do not respond to typical treatment methods. This is where Neurofeedback helps. Neurotherapy treatment aims to retrain the brain, either developing new skills or increasing brain fitness and performance through exercise. The signs and symptoms of disorder improve over the long-term use of neurofeedback therapy.
When you train the brain, it seems to work towards homeostasis. This tends to move symptoms towards normality, regardless of the training effect. Simply put, Neurotherapy aims to improve brain performance. Regular physical activity and exercise improves muscle strength and boosts body endurance.
Similarly, the more your brain is exercised into reaching a more comfortable, more efficient state, the better it gets at it. Neurofeedback therapy requires time and repetition.
Common applications of Clinical Neurofeedback therapy include –
- Stress relief
- Anxiety management
- Building emotional resilience and improving mood
- Improving attention, focus, and concentration
- Improving learning and cognitive performance
- Motivational boost and energy, and learning to manage cravings, habit problems and addictions.
How does Neurofeedback help?
All our actions are driven by the brain. Siegfried Othmer, a member of the Board of the Western Association of Biofeedback and Neuroscience, explained the phenomenon of feedback on the human brain with a simple example of a bicycle. When we learn to ride for the first time, we intend to ride it in a certain way but the process of cycling runs on some principles.
After a lot of tries and fails, our brain understands and learns to respect the cycling principles and tries to balance it with our reaction towards it. This is feedback (from the cycle) which helps us accomplish the skill of riding in a predictive model.
The brain works on feedback. In ineffective feedback, when we feel stressed or threatened, we shut ourselves down. The more we realize how our brain works and how it reacts to the environment around us, the better we learn about delivering feedback. Successful effective feedback can help modulate brain waves to have a stress free life.
Neurofeedback is for individuals who –
- Are not capable of responding well to traditional treatment approaches and
- Are looking for an alternative to medication
- Would benefit from Neurotherapy along with psychotherapy
- Are looking to increase healthy brain function to reduce stress and improve attention and cognitive behaviour.
Difference Between Neurofeedback and Biofeedback
It’s easy to get confused between neurofeedback and biofeedback as their purpose is quite similar, to improve well-being. These therapies have major differences and can’t replace each other. Here are the major differences between the two.
What is Biofeedback used for?
Biofeedback is a mind-body technique that uses visual or auditory feedback to gain control over involuntary bodily functions. The goal of biofeedback is to make subtle changes in the body to achieve long-term results and control over the symptoms of an illness.
This may include gaining voluntary control over muscle tension, heart rate, pain perception, blood flow, and blood pressure. Biofeedback can be used to treat a variety of medical conditions including –
- Chronic pain
- Anxiety and stress
- Urinary Incontinence and
- Other physiological conditions.
What is Clinical Neurofeedback used for?
Neurofeedback or EEG biofeedback is a specific subset of biofeedback. It is a very specific protocol that is utilized to improve brainwave activity. EEG biofeedback is especially useful for treating neurological conditions such as
- Attention deficit hyperactivity disorder (ADHD)
- Chronic obstructive pulmonary disease (COPD)
- Post Traumatic Stress Disorder (PTSD)
- Sleep Disorders
- Brain injury
- Traumatic brain injury
- and other related conditions.
How Is Neurotherapy or Neurofeedback performed?
Neurofeedback is not considered a cure, but a method of managing the brain functions in a healthier manner. Neurotherapy practitioners who administer Neurofeedback helps patients learn to change their brainwave activity.
The Brainwave activity is measured with an electroencephalograph (EEG). The EEG equipment is connected with sensors placed on the scalp and ears of the patient, which are completely painless and safe. The central nervous system is taught to reorganize and regulate brainwave frequencies. The therapy assesses and provides information about dysfunctional areas of the brain that are causing symptoms so that they can be treated directly.
The prime goal of Neurotherapy is to stimulate neuroplastic change, that is a change in structure and/or function of brain cells. Typically, neuroplastic change means rearranging neurons. Brain healing can be achieved with neuroplastic changes.
In the case of traumatic brain injury, the first thing necessary is the recovery of general cellular function in both neurons and glia (which are support cells in the brain).
Some curated to already existing external stimuli can help revive brain circuits which have become dormant. Some examples of such stimuli are low-intensity laser light (soft laser or cold laser) and intentional thinking and behaviours (i.e. internally-driven neuroplastic change).
The brain is capable of modulating its own functioning – balancing excitation and inhibition.
Catching up on sleep is important for brain healing. In deep sleep, it’s known that the brain undergoes a sort of cellular clean-up process.
- Neuro Differentiation and Learning
After a neurofeedback therapy, the recovered brain is in a position to start re-learning lost functions.
Types of Neurotherapy
Broadly, Neurotherapy is categorized into two types –
Neurotherapy based on learning, conditioning and training – This includes biofeedback and neurofeedback. These training include skills development, or better brain fitness through different exercises. This type of Neurotherapy is usually a combination of neuro-modulation and neuro-relaxation.
Neurotherapy based on brain stimulation – In this type, externally driven factors result in neuroplasticity or brain cells rearrangements. Brain stimulation based Neurotherapy can take several forms.
- tDCS – Trans-cranial Direct Current Stimulation (tDCS)
- Audio-visual entrainment (AVE)
- CES – Cranial Electrostimulation
Benefits of Neurofeedback therapy
The effects and benefits of neurofeedback training last long after the entire therapy is stopped. As the brain has learned (or relearned) more efficient ways of performing, it will continue this way as new pathways in the brain are created. Some important advantages of Neurofeedback therapy are –
- Improves overall brain health
- Enhanced memory and focus
- Decreased impulsivity
- Reduced ADHD Symptoms
- Reduced anxiety
- Improved Depression Symptoms
- Better mental clarity
- More restful sleep
- Improved mood
Types of Neurofeedback
- Traditional SMR Neurofeedback – Sensory Motor Rhythm (SMR) training is a common protocol used to improve focus, attention, motoric precision and balance and the ability to relax.
- Alpha/Theta Neurofeedback (A/T) – It is deep state neurofeedback and is usually performed with eyes closed. Alpha waves of the brain are associated with being in a calm, relaxed, meditative, mindful state. By using auditory functions, Alpha training improves sleep quality and relaxation.
- Neuro-Gen HPN Neurofeedback – It is a High-Performance Neurofeedback, which uses a specific type of next-generation neurofeedback. It is designed to significantly accelerate the training process. Training with Neuro-Gen HPN is pleasant and results are often noticed immediately.
- Hemoencephalography (HEG) – HEG training aims to boost blood flow activity to the brain and as a result, it improves mental and emotional functioning. It brings changes in the brain’s energy consumption, which is a crucial boosting factor for the blood flow, oxygen, nutrient, and glucose supply.
- Interactive Metronome (IM) – It is a therapeutic assessment and training program that improves attention, concentration, motor planning and sequencing. It is majorly used as neurofeedback for ADHD in a child.
- Beta Reset Neurofeedback – Beta reset is especially useful in the treatment of chronic and neurodegenerative conditions. This therapy is intended to interrupt and correct neuronal and non-neuronal dysregulation.
- Coherence Training – Coherence training is all about communication between different neurological regions in the brain. It is used to improve the connectivity between different brain regions, resulting in improved neural connectivity and neural network dynamics.
What problems can Neurofeedback help solve?
Neurofeedback for Insomnia
A night of proper sleep is imperative for a physical, mental, and emotional well-being, Insomnia is very difficult to treat but over the years neurofeedback has gained popularity. Neurofeedback allows a patient to view their brainwaves in real-time.
Each time they produce the desired brain activity, they receive positive feedback through auditory or visual cues, or tokens, and negative feedback for undesired brain activity.
The neurofeedback intervention for Neurofeedback for insomnia aims to minimize hyperarousal. If the patient manages to reduce this state as it occurs, they receive positive feedback. Neurofeedback for Insomnia is used for some other common sleep issues including
- Bruxism (Teeth grinding during sleep)
- Difficulty waking from sleep
- Difficulty getting to bed
- Not feeling rested after sleep
- Physically restless sleep
- Restless leg syndrome
- Sleeping too long (over 10 hours)
- Sleep terrors – Abrupt arousal with intense fear, difficult to awaken, no dream recall or memory of events
Neurofeedback for Anxiety
Anxiety and stress are associated with chronic medical conditions. Chronic anxiety can decrease growth hormones, increase catecholamine release, and aberrantly activate immune and inflammatory cascades. It also has a direct neurobiological consequence. Stress hormones affect neuroanatomical structures and bring changes to the hippocampus and basolateral amygdala.
Alpha electroencephalography (EEG) recordings have proved to reduce anxiety. Alpha EEG biofeedback is a non-invasive drug-free technique where the brain activity is monitored by recording electrodes placed at designated locations on the scalp.
The waveforms are analyzed and then fed back to the patient through computer generated auditory or visual stimuli. Neurofeedback targets the internal variables factors like operant brainwaves conditioning in an attempt to decrease anxiety.
Neurofeedback Therapy for Depression
Major Depressive Disorder (MDD), or Depression, is the one of the most commonly found mental disorders. It degrades the quality of life and pushes on into low self-esteem, guilt, and deep sadness. Medications just treat the symptoms and do not correct the source of the problem in the brain. As per WHO data, 1/3rd of the depressed patients around the world do not respond to the typical treatments. It is termed as Treatment-resistant depression (TRD). For these patients there are very limited treatment options and neurofeedback is one of them.
In Neurofeedback therapy for depression, the brain function is measured with a quantitative EEG brain map to determine the reason for mood problems. Once the source of the problem is detected, the brain area is targeted for change through neurofeedback
EEG neurofeedback for depression has mainly been based on models of altered hemispheric asymmetry. fMRI-based neurofeedback (fMRI-NF) uses functional localizer scans that allow the dynamic adjustment of the target areas or networks in the brain. It helps in self-regulation training for better emotion processing. Neurofeedback therapy for depression boosts self-esteem and brain connectivity.
Neurofeedback Therapy for ADHD
Attention deficit hyperactivity disorder or ADHD affects learning, attention, impulse control, and activity levels. These symptoms can make managing and organizing daily life challenging. In a person with ADHD, the brain displays a set of characteristic patterns of behaviour.
In a neurofeedback therapy session for ADHD, the neurofeedback specialist doctor or neuro therapist, attaches electrodes running from an EEG machine to the person’s head to measure brain activity.
A real-time scan of the brain waves shows up on a screen. The practitioner instructs the person to perform a specific task, which alters the brain waves.
As the brain responds to the external stimuli, the feedback on the EEG will show how the stimuli changes, interrupts or increases brain activity. Neurotherapy for ADHD is proved to have large-scale improvements in impulsivity and inattention and medium-scale improvements in hyperactivity.
Neurofeedback for Epilepsy
Uncontrolled epileptic seizures have also been effectively treated using neurofeedback. Though most seizure patients are adequately controlled by medication, Neurofeedback has been found to be helpful with all kinds of epilepsy, including grand mal, petit mal (absence), and complex partial seizures.
After sufficient training sessions of neurofeedback, the aura rate and seizure rate of Epilepsy goes down. There is no recommended set mark or an exact number of doses of the therapy which can normalize the brain wave activity or the produced EEG patterns which don’t trigger seizures. But the neurofeedback therapy is quite effective in case of Epilepsy.
Neurofeedback for Post Traumatic Stress Disorder (PTSD)
Post-traumatic stress disorder (PTSD) is a neuropsychiatric affective disorder that can develop after traumatic life-events. Neurofeedback, a relatively user friendly method to control and train brain activity, has been proved to be able to induce a specific increase of functional connectivity within the salience network of the brain.
Neurofeedback of slow-wave frequency bands is used in the treatment of PTSD for controlling the after-effects of trauma. Neurofeedback significantly aids in reducing PTSD symptoms.
Neurofeedback Therapy Side Effects
Neurofeedback is a non-invasive, painless, and safe process. There are no cases reported with lasting adverse effects. With a prolonged treatment, there can be short-lived side effects including difficulty paying attention, sadness, inattention, difficulty falling asleep, irritability, restlessness, and headaches.
These effects are very short-lived and are usually gone the next day. It is possible to monitor these effects and alter the treatment dosage to make certain adjustments so that they do not recur.
Does Neurofeedback actually work?
When medicines are not effectively curing a condition, neurofeedback is advised by a doctor. Neurotherapy and Neurofeedback treatment is very effective and useful as there are no side effects to this.
The success rate claimed by researchers in various scientific researches for neurofeedback for certain conditions is 75%-80%.
Neurofeedback Therapy at Cadabams
Changing behaviour by studying external responses is an area that Cadabam’s Hospitals specializes in. One such treatment is neurofeedback.
Cadabams is one of the most prominent names among the Neurotherapy experts who provide the best neurofeedback therapy in Bangalore.
The Neurofeedback specialists at Cadabams assess and analyze a patient’s previous health records, medical history, lifestyle and other vital information to understand and know more about the patient’s behaviour.
With the use of advanced instruments and monitoring procedures, neurofeedback specialists identify neurological responses and train the brain to induce better patient outcomes.
> How long does Neurofeedback take to work?
Each Neurofeedback session takes between 50 and 60 minutes. The actual training time lasts a maximum of 30 minutes. Additional time is required for the set up of sensor placement and adjustment. Doctors at Cadabams also take some time to briefly speak to the patient before and after each Neurotherapy training session to monitor how things are progressing.
> Can Neurofeedback help with Cognitive Disabilities or Learning Disorders?
Neurofeedback helps treat brain injuries and those suffering from any type of disability. Neurofeedback helps the brain become more efficient and flexible so that it works at its best capacity. In case of a brain injury due to stroke, with the help of neurofeedback therapy, the brain can learn to reroute signals to create new neural pathways. Neurofeedback also works wonderfully for learning disabilities.
> Does Neurofeedback change your personality?
The therapy of Neurofeedback does not change your underlying personality but it works as a powerful modality that lets your true self shine by shunting the negative personality traits like social awkwardness, depression, fear, or anxiety. It supports the brain to function more efficiently and run like a well-oiled machine. Patients undergoing neurotherapy report feeling lighter, calmer, happier, and having a more positive outlook on life.
> Can a successful outcome always be predicted?
It’s impossible for any medical practitioner to predict with certainty that neurotherapy training will be successful or not. For common conditions, Neurofeedback specialists can do a reasonable prediction of outcomes. After the first or second session, a doctor can presume the effectiveness of the therapy and might alter or modify the therapy.
> Does Neurofeedback enhance performances and improves I.Q.?
I.Q. scores usually hit 10 to 20 points high after a neurofeedback training, but it does not imply that it makes people intelligent. It is the efficiency and flexibility of the brain which has been improved through neurofeedback. It cannot generate a skill to perform well. It only helps to fine tune performance. Attaining any kind of peak performance requires the brain to learn a very specific, recognizable mental state of focus.
Sometimes we call it ‘The Zone’. Everyone experiences it once in a while where they feel super energetic and perform their best. Neurofeedback training might help you learn how to achieve this mental state. It increases intuition, enhances the clarity of thought, and takes off any negative feelings of fear, loss of control, or self-consciousness which are the most common causes which disturb the ability to perform well.