Traumatic Brain Injury Rehabilitation: QEEG Biofeedback Treatment Protocols

Abstract

Interventions for improvement of cognitive problems in patients with traumatic brain injury (TBI) include electroencephalography biofeedback, also known as neurofeedback. Quantitative electroencephalography (QEEG) patterns are assessed in TBI patients and then compared to a database obtained from a normative population. Deviations in QEEG patterns from the normative group are the basis for an intervention plan. While QEEG patterns, obtained under an eyes closed, resting condition, provide information about deviations at rest, QEEG patterns obtained while the patient engages in cognitive tasks reflect specific deficiencies in brain functioning. This paper reviews and assesses QEEG patterns collected under both resting conditions as well as cognitive tasks. The article provides a theoretical and empirical base for QEEG interventions with TBI.

An Overview of the Use of Neurofeedback Biofeedback for the Treatment of Symptoms of Traumatic Brain Injury in Military and Civilian Populations

“…This allows for more clinical sensitivity and specificity, although protocols and use of the equipment can vary from practitioner to practioner. 4,12,18,[27][28][29] EEG patterns have been shown to be different in individuals following TBI, and have even been shown to predict prognosis in some cases. 7,12,26,27 Sideeffects from neurofeedback can include headaches, nausea, dizziness, fatigue, and agitation.…”

“…18 Although the research still lacks a large body of randomized, double-blinded, placebo-controlled studies following standardized protocols, the literature does suggest that survivors-in both civilian and military populationsof brain injuries of differing levels of severity report improvements across a wide range of complaints of problems with attention, impulse control, processing speed, shortterm memory, and mood. 4,8,[12][13][14][15][17][18][19][20][21][22][23][24][25][26][27][28][29] Research on the use of neurofeedback for veteran populations has often focused on its use when PTSD or substance abuse is comorbid with TBI from blast injuries, with significant improvements reported, once the original protocol was modified. 18,28 Generalizability from the research is complicated by not only the lack of randomized, double-blinded, placebo-controlled studies following standardized protocols, but also by the variety of types and causes of TBIs.…”

Audio-Visual and Autogenic Relaxation Alter Amplitude of Alpha EEG Band, Causing Improvements in Mental Work Performance in Athletes

“…The effect of alpha training has been also regularly analyzed with respect to rehabilitation (Thornton and Carmody 2009). In particular, it has been used in rehabilitation of psychomotor disorders as muscular relaxation, after which the signal of feedback stimulates motor activity (Egner and Gruzelier 2001).…”

Neurofeedback in Three Patients in the State of Unresponsive Wakefulness

“…Hoffman et al (1995) proposed that changes in coherence and phase-shift of the EEG in patients mainly lead to a decrease of multi-tasking and slowing of mental processing. One reason for these EEG abnormalities are axonal injuries that produce a diffuse slowing of the EEG with an enhancement of slow theta (4-7 Hz) activity and a suppression of fast beta (13-20 Hz) activity (Schaul 1998;Thornton and Carmody 2009).…”