Application of Neurofeedback in General Neurology Practice

Abstract

Neurofeedback (NFB), also called EEG biofeedback, is infrequently applied in general neurology practice. Therefore, this study was conducted to evaluate the clinical usefulness of NFB in neurological settings. Over the period of approximately 15 months, 25 subsequent patients who were interested in NFB therapy and completed at least 20 sessions of NFB treatment were analyzed for potential clinical benefits. Patients' subjective responses were collected after NFB treatment to see if any improvement of symptoms was accomplished with NFB therapy. Quantitative electroencephalography (QEEG) was completed before and after NFB therapy initiation and analyzed for any major changes in frequency bands expression. Patients' analysis revealed 84% subjective improvement rate and 75% objective QEEG improvement after completion of NFB therapy. These encouraging results indicate the need for more broad utilization of NFB in general neurology practice.

When Discussing Neurofeedback, Does Modality Matter?

“…Yet, the current QNF studies in the literature do report positive treatment outcomes. Moreover, while traditional and SCP NF mostly focus on ADHD symptoms, QNF studies report covering a wider range of symptoms, syndromes and disorders that include, behavior aspects, mood, cognitive dysfunction, epilepsy, head injuries, autism spectrum, migraines, learning disorders, schizophrenia, post-traumatic stress disorder, Down syndrome, and intellectual disability (Arns et al, 2012;Breteler et al, 2010;Coben & Myers, 2010;Huang-Storms, Bodenhamer-Davis, Davis, & Dunn, 2006;Koberda, Hillier, Jones, Moses, & Koberda 2012;Surmeli et al, 2012;Surmeli & Ertem, 2007, 2009Walker, 2009Walker, , 2010bWalker, , 2011Walker, , 2012bWalker, , 2013. This literature collection largely represents retrospective investigations from clinical settings.…”

“…This allows for more neuroregulation and enhanced QEEG normalization. Consequently, in clinical reports of ZNF it is suggested that positive clinical outcomes can be achieved in an average of 10 to 20 sessions (Collura et al, 2010;Koberda et al, 2012b;Wigton, 2013 The available z-score metrics and multiple channels of the ZNF modalities greatly enhance NF specificity. With surface 4ZNF and 19ZNF, the dysregulated areas and rhythms can be isolated for normalization, and even more so with the Laplacian montage (Thatcher, 2013).…”

Advances in Assessment and Treatment of ADHD Using Network Analyses

“…The goal is to reinforce increased stability within the various aspects of the human attention network depending on the patient's symptoms. Figure 2 is a Talairach atlas representation of the Brodmann areas (nodes) and connections between Brodmann areas of the dorsal attention network that is used in LORETA Z score NFB (Koberda, 2011;Koberda, Hiller, et al, 2012;Thatcher, 2012Thatcher, , 2013. Figure 3 is a Talairach atlas representation of the Brodmann areas (nodes) and connections between Brod- Figure 2.…”

“…Surface Z scores improve specificity by isolating dysregulated locations and rhythms, especially when using the Laplacian transform and low-resolution electromagnetic tomography (LORETA) Z scores (i.e., real-time or ''live'' comparisons to a normative database). For example, LORETA Z score biofeedback also often produces results in one 20-min session because EEG source localization has accuracies similar to fMRI of about 1 cm to 3 cm and therefore is much more specific than is surface EEG (see Koberda, 2011;Koberda, Hiller, Jones, Moses, & Koberda, 2012;Thatcher, 2010Thatcher, , 2012Thatcher, , 2013.…”

A Review of qEEG-Guided Neurofeedback

“…Moreover the pre-post qEEG data analysis was limited in scope. Koberda, Hillier, Jones, Moses, and Koberda (2012) reported on the use of qNF in a clinical setting of a neurology private practice. All 25 participants were treated with at least 20 sessions of a single-channel traditional NF protocol, which was guided by qEEG data and symptoms, with a goal to improve symptoms and normalize the qEEG.…”