ADHD (Hyperactive and/or Inattentive)
The value of neurofeedback as a non-medication treatment for ADHD is well documented.
Early research using neurofeedback for children with ADHD was conducted by Lubar et.al (1995). This found significant improvements on tests of attention and on parent and teacher behavioural rating scales. In addition 12 out of the 18 subjects showed a 12 point increase in intelligence scores.
A number of studies have compared neurofeedback to medication (Rossiter and LaVaque,1995; Alhambra et al, 1995; Skouse and Lubar,1979; Monastra et al, 2002) and found it to be equally effective for improving attention. The effects of medication only continue if the person continues to take it. By contrast the effects of neurofeedback are long term. Another advantage of neurofeedback is that, in addition to improvements with attention, there are also other more general improvements in behaviour, which have not been found to occur with medication.
Research has found neurofeedback to be an efficacious treatment for ADHD.
Anxiety is a term used to describe the physical sensations associated with the body’s fight-or-flight response. These often include rapid heart-rate, sweating, difficulty breathing, and dizziness. These feelings can vary in severity from general worry through to intense panic. There are a number of disorders that have anxiety as a common feature, such as phobias, generalalised anxiety disorder, and post-traumatic stress disorder.
Given that anti-anxiety medication can often only be used for a short period of time and can be accompanied by unwanted side effects and risk of dependency, neurofeedback offers an effective and safe alternative.
Articles that have reviewed research into neurofeedback treatment for anxiety (Moore, 2000; Hammond, 2005; Yucha and Montgomerey, 2008) have concluded that it can be regarded as an effective treatment for anxiety.
Neurofeedback, for example, has been found to have positive results in cases of Generalized Anxiety (Hardt and Kamiya, 1978; Rice et al, 1933), Stress (Sittenfield et al, 1976) and Phobias (Garnett and Silver, 1976). It has also been found to significantly improve sleep onset insomnia.
Depression is a psychological condition characterised by low mood, poor motivation, low energy and loss of interest in enjoyable activities. Other symptoms can include low self-esteem, negative thinking, reduced appetite and changes in sleep. Depression is traditionally treated using anti-depressant medications and psychological therapies.
A number of studies have found neurofeedback to be effective for treating depression (eg. Baehr et al 1999; Hammond, 2005; Diaz and Deuson, 2011). These studies reported significant reductions in depression as measured by valid psychological assessments (e.g. DASS and Beck Depression Inventory). Studies have also pointed to the enduring impact of treatment with follow-ups from 18 months to 5 years.
Addiction is characterised by compulsive seeking of rewarding stimuli, despite negative consequences. Addictions come in many forms, such as alcohol or drugs, gambling, food, and video gaming. Addiction involves dysregulation of the brain’s reward pathways. Neurofeedback has been found to significantly reduce relapse rates by addressing the physiological, emotional and personality factors that underlie addiction and dependency.
Early studies (Tremlow & Bowen 1976; Tremlow et al, 1977) with alcoholics found reduced depression along with other positive changes. Alcohol abuse decreased by between 67% and 97%. Later studies (Peniston & Kulkolsky 1989; Saxby &Peniston 1995; Peniston &Kulkolsky 1990) compared neurofeedback with traditional treatment for alcoholism. These studies found a dramatically lower relapse rate after one year of discharge of 20% for the neurofeedback group as compared to 80% of the traditional substance abuse control group. They found no further relapse in the neurofeedback group after 21 months.
Further studies (Fahrion 1995; Scott and Kaiser 1998; Taub et al 1994; and Trudeau 2005) have all provided further evidence that supports neurofeedback in the treatment of substance abuse.
Experiencing traumatic events can lead to changes in functioning. Post-traumatic stress disorder (PTSD) is an anxiety disorder characterised by repeated, intrusive memories of traumatic events. Trauma experienced during early development can have long-term consequences for emotional attachment and social functioning.
Early work in the treatment of PTSD with neurofeedback was conducted by Peniston and Kulkolsky (1991). They compared traditional medical care with a group who also undertook neurofeedback. In addition to more positive outcome measures for the neurofeedback group they also found that only 3 out of the 15 in the neurofeedback group had relapsed in a 30 month follow up, whereas all those in the traditional group had relapsed.
Peniston et al (1993) worked with Vietnam War veterans with a 15 year history of PTSD and alcohol abuse. Follow up assessment 26 months after treatment found that only 4 out of the 20 people had relapsed. Othmer (2009,2012) has reported on 400 cases using neurofeedback to treat PTSD with very impressive results.
The work of Sebern Fisher (Fisher, 2014) and a study by Pop-Jordanova and Zorcee (2005) indicate that neurofeedback represents a very useful tool for treatment of children with attachment disorder and PTSD.
Pain is a complex physical and emotional response to injury. There are a great number of factors that influence a person’s experience of pain, including both physical and psychological factors. An extensive body of research on chronic pain has found biofeedback and neurofeedback to be as effective as traditional medication treatment and more effective than no treatment control groups. Yucha and Montgomerey (2008) in their review rated the outcome of biofeedback and neurofeedback as an efficacious treatment of chronic pain.
Headaches are the experience of pain in the head and neck. Headaches are among the most commonly experienced physical discomforts, and can affect employment, family relationships and social functioning. Studies have shown that biofeedback and neurofeedback are efficacious treatments for tension, migraine, and mixed headaches. A recent study by Stokes and Lappin (2010) found that 70% of migraine sufferers experienced at least a 50% reduction in headaches following neurofeedback, which was significantly better than the medication treatment group.
Insomnia is a disorder affecting sleep. It can affect sleep onset, sleep maintenance or sleep quality. Insomnia can be a disorder alone, or can also be secondary to other problems such as pain, depression, reflux or restless legs. Treatment for sleep traditionally involved psychotherapy to manage stress and develop a sleep routine, or medication. Cortos and colleagues (2010) demonstrated the effectiveness of neurofeedback in the treatment of insomnia. Similar results by Hammer and colleagues (2011) where it was found that neurofeedback led to improved sleep and daytime functioning, with study volunteers becoming “normal sleepers” following treatment.
Brain injury can cause a wide range of difficulties with functioning. Brain injuries can be caused by external events such as a blow to the head, or internal causes such as stroke. Depending on the type of injury and severity, brain injury can cause memory problems, headaches, pain, speech and language difficulties, balance and movement problems, cognitive dysfunction, personality changes, and many others. Brain injury can also lead to other difficulties such as loss of independence, changes in social groups, changes in employment and reduced physical capacity.
The treatment of Traumatic Brain Injury (TBI) with neurofeedback has a relatively long history dating back to the work of Margaret Ayers (1987). Neurofeedback can help to improve memory, attention and behavioural performance. Walker et al (2002) found 88% of mild TBI patients showed improvement in functioning and were able to return to work. Thornton and Carmody (2005, 2008) in their review of research demonstrated the effectiveness of neurofeedback beyond traditional rehabilitation methods.
Neurofeedback using pulsed electromagnetic waves of extremely low power has also been found to be effective in the treatment of TBI. Larson, Harrington and Hicks (2006) reported on its effectiveness in reducing 15 different symptoms with 100 TBI patients.
Autism Spectrum Disorder
Autism Spectrum Disorder (ASD) is a developmental disorder affecting around 1.5% of the population. Children and adults with ASD experience difficulties with communication and social interactions, and often also experience sensory sensitivity and anxiety. High functioning ASD (formerly known as Asperger’s Syndrome) has a mild to moderate impact on a person’s functioning, and more severe ASD can have more profound affects on speech development, emotional regulation and social interactions.
Research indicates that neurofeedback can improve functioning in people with autism. A controlled study of 37 people with ASD conducted by Coben and Padolsky (2007) reported symptom improvement in 89% of cases, with a 40% reduction in core ASD symptoms. Thompson et al (2010) have provided a review of their work with 150 autistic clients and the positive results they obtained.
Improving Cognitive Performance
Neurofeedback has been found to be effective in improving the cognitive functioning of children and adults. Lubar and colleagues (1995), for example, found that neurofeedback to improve concentration also led to significant improvements in IQ scores. Budzynski (1996, 2007) developed a neurofeedback protocol which was found to be effective at improving the cognitive function of the elderly. They found improvements in attention, planning, organization, problem solving and overall task performance. Studies with children who have learning difficulties (e.g. Vernon et al, 2003; Orlando & Rivers, 2004) have found neurofeedback led to improvements in semantic processing and working memory as well as increased reading scores and reading comprehension. There was also an increase in verbal IQ and full scale IQ.