ANNOTATED RESEARCH

Substance Abuse

Scott, W. C., Kaiser, B.W., Othmer, S., Siderof, S. I.,  (2005). Effects of an EEG Biofeedback Protocol on a Mixed Substance Abusing Population.  American Journal of Drug and Alcohol Abuse, 31(3):455-69

This study examined the effect of EEG biofeedback (neurofeedback) for substance abuse disorder and if its use can effect the outcome of treatment. 121 inpatient individuals of a substance abuse facility were participants in the study.  All participants were randomly assigned to either EEG biofeedback or control group. This double blind study allowed for 40-50 neurofeedback sessions with the control group receiving additional time in treatment equivalent to experimental procedure time. The Test of Variable Attention (TOVA) and the Minnesota Multiphasic Personality Inventory (MMPI) were administered to all participants. Treatment retention, abstinence rates, psychometrics, and cognitive measures were compared.  Results indicated that the experimental group remained in treatment significantly longer than control group (p <0.005), 77% of experimental group remained abstinent at the 12 month follow-up compared to 44% of controls. TOVA scores improved (p<0.005) after an average of 13 sessions and there were 5 of the 10 MMPI scales indicated significant differences. Results indicated neurofeedback enhanced treatment retention, variables of attention and abstinence rates at the one year follow-up.




ADD/ ADHD

Arns, M., deRidder, S., Strehl, U., Breteler, M., Coenen, A. (2009).  Efficacy of Neurofeedback Treatment in ADHD: The Effects on Inattention, Impulsivity and Hyperactivity:  A Meta-analysis. Clinical EEG Neuroscience. July:40(3): 180-9

Researchers studied the effect of neurofeedback for ADHD. ADHD subjects were divided into categories of inattentive/impulsive type and hyperactive type. The meta-analysis included prospective controlled studies and studies that employed a pre and post-design.  The findings found a large effect size (ES) on those with impulsivity/inattention type and a medium ES for hyperactive type. The lower ES for hyperactivity indicates that the hyperactive type is probably most sensitive to non-specific treatment factors. According to the International Society for Neurofeedback Research (ISNR) and Association for Applied Psychophysiology and Biofeedback (AAPB) guidelines for efficacy rating concluded that neurofeedback can be considered “Efficacious and Specific” (level 5) with a large ES for inattentive/impulsive type and medium ES for hyperactive type.  




Migraines

Walker, J.E., (2011).  QEEG Guided neurofeedback for recurrent migraine headaches. Clinical EEG Neuroscience, Jan:42(1):59-61

This study examined the effectiveness of using the Quantitative Electroencephalograph (QEEG) guided method of designing protocols used for neurofeedback treatment for addressing migraine headache.  The study included 71 participants with ages between 17-62 years old. The study looked at the effectiveness of neurofeedback compared to those who chose medication as an intervention. There were 46 participants who choose neurofeedback, the others were treated with medication. The QEEG found that those with migraine headache showed excessive 21-30 hertz activity.  he protocols consisted of reducing 21-30 hertz activity and increasing 10 hertz. All patients were classified as migraine without aura. In the neurofeedback group, 54% experienced complete cessation of migraines and 39% experienced greater than 50% reduction in frequency. 4% had less than 50% reduction, and only one patient reported no reduction. he control group treated with medication experienced no change in frequency (68%), a reduction of less than 50% (20%), or a reduction greater than 50% (8%). Neurofeedback was indicated to be dramatically effective in abolishing or significantly reducing headache frequency in patients with recurrent migraine.



Epilepsy

 

Tan, G., Thornby, J., Hammond, D. C., Strehl, U., Canady, B., Arneman, K., Kaiser, D. A. (2009). Meta-analysis of EEG Biofeedback in treating Epilepsy.  Clin EEG Neurosci. 2009 Jul;40(3):173-9.

Approximately one-third of patients diagnosed with epilepsy do not find relief from medical treatment.  The effectiveness of neurofeedback was examined. An extensive search through MedLine, PsychInfo and PsychLit regarding literature between 1970 and 2005. The search resulted in 63 studies that were published, 10 provided ample outcome information to be included.  All studies examined included participants who used medications and did not control seizure activity. 9 of 10 studied used a sensorimotor (SMR) protocol, and one trained with slow cortical potentials (SCP). All 10 studies included in the meta-analysis reported a mean decrease in seizure activity following neurofeedback treatment. Sixty-four of 87 participants (74%) reported fewer weekly seizures.  Based on the analysis, neurofeedback was found to produce a significant reduction in frequency. The clinical significance is that the participants were unable to control seizure with medical treatments indicating neurofeedback was significant in addressing seizure activity.



Anxiety & Depression

 

Hammond, D. C., (2005).  Neurofeedback Treatment of Depression and Anxiety. Journal of Adult Development.   Vol. 12, Nos. 2/3, August 2005.

Due to a growing understanding that medication is just mildly more effective than placebo in treating depression and anxiety, it is important that other alternative methods of treatment are examined. Neurofeedback is an encouraging modality that holds promise for regulating brainwave patterns associated with a wide variety of mental and medical disorders. Frank H. Duffy (2000), a Professor and Pediatric Neurologist at Harvard Medical School, recently stated that scholarly literature now suggests that neurofeedback “should play a major therapeutic role in many difficult areas. In my opinion, if any medication had demonstrated such a wide spectrum of efficacy it would be universally accepted and widely used;” and that “It is a field to be taken seriously by all.” This paper reports that patients suffering with depression using neurofeedback protocols results in significant, enduring improvements approximately 80% of the time when patients have the frontal alpha asymmetry that reflects a biological predisposition to depression. Most patients perceive a difference after between three to six 30-min sessions, feel a very significant improvement after 10–12 sessions, and usually complete treatment within 20–22 sessions. Neurofeedback not only improves depression that has commonly been medication resistant, but it also commonly reduces anxiety and rumination, increases ego-strength, and as one would expect from activating an approach motivation area of the brain, decreases withdrawal and introversion. Neurofeedback treatment of OCD are intriguing and encouraging, research that was reviewed on the neurofeedback treatment of generalized and phobic anxiety, as well as PTSD, is more rigorous, warranting at least the status of being considered a probably efficacious treatment.



Mild Cognitive Impairment

Lacvy, Y., Dwolatzky, T., Kaplan, Z., Guez, J., Todder, D. (2019).  Neurofeedback Improves Memory and Peak Alpha Frequency in Individuals with Mild Cognitive Impairment. Applied Psychophysiology and Biofeedback. 2019 Mar44(1):41-49.

Mild cognitive impairment (MCI) is characterized as a brain-based disorder and associated with the risk of developing Alzheimer’s disease. Currently there are no known definitive treatments. This study examined the benefits of neurofeedback for subjects with MCI. The study concluded that pre-and post-treatment scores indicated significant improvements in verbal memory, orientation, and recall on the Mini Mental Status Exam (MMSE) and Memory Assessment Scale (MAS). Other improvements were identified on a behavior rating inventory of executive functioning and a psychiatric assessment to measure distress. Some executive processing functions did not significantly improve. These results support QEEG based neurofeedback for training as “probably efficacious” as a treatment for dementia. The strong correlation of efficacy with pretreatment memory suggests the importance of learning and memory in this treatments mechanism of action and suggest that neurofeedback is more strongly indicated as an earlier stage intervention.