What is Neurfoeedback Therapy?

During my first week of my internship, I have learned so much-- so much that I don't even know where to begin. But before I describe all the grueling details of neurofeedback therapy, let me give you a brief introduction.

What Even Is Neurofeedback Therapy?

Neurofeedback is a form of physical therapy that centers around improving mental performance. During a typical training session, a patient is seated in front of two monitors. Electrodes are placed on their ears and head, allowing the first monitor to display their brainwave frequencies. Based on the goal of the training session, an individualized treatment is programmed into the computer (for example, decreasing beta waves). Throughout the session, the first monitor displays brainwave readings, while the second monitor can be used for visual training, such as playing movies/games.

But how can just seeing brainwave frequencies improve mental performance? Neurofeedback therapy uses self-awareness to promote subconscious mental conditioning. This phenomenon is called "operant conditioning." For example, if a client wanted to feel more focused, their individualized neurofeedback training would discourage theta wave frequencies (see below about types of brainwaves.) The monitor would display a reading of the client's theta wave levels. Through practice and awareness of their levels, the client would eventually understand the correlation between the display and their state of mind, giving him/her the ability to influence the theta wave levels. The brain slowly reconditions itself, manipulating its own brainwaves to receive a reward. In training terms, this reward is given in many forms: more points on a therapy game, a reward sound, or a clearer resolution of the display monitor. If the client's brainwaves are not in accordance with the session's intent, the reward is revoked (the points decrease, a sound is not played, or the screen becomes darker.) All these signals are recorded in a EEG reading. 


The EEG Recording

EEG Recording

EEG stands for "electroencephalogram," and is a recording of all brainwave activity measured from the scalp. Through the use of electrodes, brainwaves can be measured and displayed through EEG. An EEG measures the neural oscillations over a short period of time, often a 30 minute training period. It fully captures all neural voltage fluctuations and records them on a graph (micro-Volts/time). As seen above, the EEG recording fully captures the physical nature of the brainwaves, allowing its various properties to be analyzed after the training session. In the report above, the y-axis lists electrode locations on the patient's scalp (see "The 10/20 System"), while the x-axis is time. In a future post, I will dissect an EEG reading and the significance of all present frequencies.

The qEEG Report 

qEEG stands for a "quantitative electroencephalogram." This report quantifies the brain's numerous electric signals into "bands" of frequencies. This report gives an EEG report some actual meaning. An EEG really means nothing when it is first recorded. It's just a jumble of brainwaves that reflect the patients state of mind; but until a qEEG report is written, an EEG is useless. qEEG uses the EEG data and transforms it into a qualitative analysis, showing what exactly needs to be targeted and where the deficiencies are. Rather than displaying the brainwaves, the qEEG color codes the patients brain itself to depict any abnormalities in specific brain regions. It is often referred to as EEG interpretation and analysis. Below is an example of such a report.

This is often performed as an initial test (to determine what treatment should be used) and a final test (to show improvement). However, a brain map can be very expensive so a large percent of patients do not pursue it. For most, it isn't even necessary -- people with many mental conditions will notice improvement (behavior changes, more focus, etc.) after training, so proof is not really necessary.