Cognitive, Skill, & Artistic Performance:

Optimizing Micro Surgical Skills with EEG Neurofeedback  (BMC Neuroscience)

By Ros, T., Mosely, M., Bloom, P., Benjamin, L., Parkinson, L., & Gruzelier, J.; Departmennt of Psychology, University of London, UK; Department of Optometry and Visual Science, City University, London, UK; Wester Eye Hospital, London, UK: Department of Opthalmology, Stock Mandeville Hospital, Aylesbury, UK; & Brainhealth, The Diagnostic Clinic, London, UK

“BACKGROUND:  By enabling individuals to self-regulate their brainwave activity in the field of optimal performance in healthy individuals, neurofeedback has been found to improve cognitive and artistic performance.  Here we assessed whether two distinct EEG neurofeedback protocols could develop surgical skill, given the important role this skill plays in medicine. 

CONCLUSION: the best of our knowledge, this is the first study to show extensive evidence for performance enhancement in microsurgical procedure by means of EEG self-regulation.  More specifically, our data have shown that SMR/theta training provides statistically reliable improvements in surgical technique, together with a 26% reduction in time on task.  This may lead to reductions in surgical stress, contact time with the eye, and lessen the risk and extent of surgical complications [43], thereby improving surgical outcomes.  Our results are further supported by good agreements between qualitative and quantitative performance assessment measures.

....the data set provides encouraging evidence of optimized learning of a complex medical specialty via neurofeedback training.”


Self regulation, control, knowledge, awareness; enhanced skill:

Experiencing Your Brain:  Neurofeedback as a New Bridge Between Neuroscience and Phenomenology (Frontiers in Human Neuroscience)

By Bagdasaryan, Juliana, and Michel Quyen.

“Neurophenomenology is a scientific research program aimed to combine neuroscience with phenomenology in order to study human experience.  ....the difficulties to simultaneously acquire phenomenological and neuroscientific data have limited its implementation into research projects.  In our paper, we propose that neurofeedback paradigms, in which subjects learn to self-regulate their own neural activity, may offer a pragmatic way to integrate first-person and third-person descriptions.  Here, information from first- and third-person perspectives is braided together in the iterative causal closed loop, creating experimental situations in which they reciprocally constrain each other. In real-time, the subject is not only actively involved in the process of data acquisition, but also assisted to directly influence the neural data through conscious experience.  Thus, neurofeedback may help to gain a deeper phenomenological-physiological understanding of downward causations whereby conscious activities have direct causal effects on neuronal patterns..... 

CONCLUSION:  ...we have proposed that neurofeedback is an appropriate experimental paradigm to bridge the gap between neuroscience and personal experience.  ...This provides the subject a window to experience his or her own neural activity, which has proven to carry useful information in the context of self-regulation.  Such a setting combines seamlessly with the dynamical systems idea proposed by Varela in the “enactive” approach (Thompson and Varela, 2001), where the organism both initiates and is shaped by the environment (Varela et al., 1991).  Thus, neurofeedback experimentally implements the notion of an autonomous organism that is literally “self-governing” its neural dynamics and cognition by means of interaction between the environment (sensory feedback of brain activity) and the organism (personal experience).  ....The real-time dimension provided by neurofeedback facilitates the on-line comparison of data sources without a significant delay, which methodologically reconciles personal and neural data.  In that, we emphasized the relevance of understanding neural signatures of successful voluntary self-control that are probably mediated by hierarchically organized neural processing.  Identifying electrophysiological markers of neurofeedback and its evolution is therefore a major objective for future studies.

....Psychologically, the ability to self-regulate processes correlated to mental experience cannot be underestimated (Christoff et al., 2011).  The subject’s introspection is trained over time, giving him or her a better sense for self-awareness and self-control.  This can change the self-image, empowering the subject to a greater self-determination, especially valuable in developing personalities and certain clinical conditions.  

Altogether, the global perspective of neurofeedback has far-reaching implications: the capacity to voluntarily modulate physiological functions can yield control over various neural mechanisms of cognition and behavior.  Such a tool for self-regulation can assist us to achieve a better self-awareness, self-knowledge, and enhanced cognitive skills.  In addition, neurofeedback has proven clinical benefits.  If one can learn to regulate particular brain regions, or induce specific neural patterns, in the long term we may obtain an alternative method to treat diseases in a non-invasive, introspective way.”


Development of brain matter:

Synchrony neurofeedback induces a sort of meditative state, while ...

Harvard Unveils MRI Study Proving Meditation Literally Rebuilds The Brain’s Gray Matter in 8 Weeks (FEEL guide; Health, Spirituality, the Human Brain)

“Test subjects taking part in an 8-week program of mindfulness meditation showed results that astonished even the most experienced neuroscientists at Harvard University.  The study was led by a Harvard-affiliated team of researchers based at Massachusetts General Hospital, and the team’s MRI scans documented for the very first time in medical history how meditation produced massive changes inside the brain’s gray matter....”

The Harvard article...

Eight Weeks to a Better Brain 

(Harvard Gazette)

By McGreevey, S.

The study calls itself "the first to document meditation-produced changes over time in the brain’s gray matter. 

.... Magnetic resonance (MR) images were taken of the brain structure of 16 study participants two weeks before and after they took part....  ....Participants ...were asked to keep track of how much time they practiced each day.  A set of MR brain images was also taken of a control group of nonmeditators over a similar time interval.

Meditation group participants reported spending an average of 27 minutes each day practicing mindfulness exercises, and their responses to a ... questionnaire indicated significant improvements compared with pre-participation responses. The analysis of MR images, ...found increased gray-matter density in the hippocampus, known to be important for learning and memory, and in structures associated with self-awareness, compassion, and introspection.  Participant-reported reductions in stress also were correlated with decreased gray-matter density in the amygdala, ...known to play an important role in anxiety and stress.  ....None of these changes were seen in the control group....  

‘It is fascinating to see the brain’s plasticity and that, by practicing meditation, we can play an active role in changing the brain and can increase our well-being and quality of life,’ says Britta Hölzel, first author of the paper and a research fellow at MGH and Giessen University in Germany...."  (Full text of study:

Consider that...

Synchrony Neurofeedback induces a meditative state in the estimation of the Venerable Thich Chi Thien at Tibetan Medical Institute, Dharamsala, India  (conducted by Sue Othmer):



Efficacy of Neurofeedback Versus Pharmacological Support in Subjects with ADHD, Applied Psychophysiology Biofeedback

By Gonzalez-Castro, P., Cueli, M., Rodriguez, C., Garcia, T., & Alvarez, L.

“Behavioral training in neurofeedback has proven to be an essential complement to generalize the effects of pharmacological support in subjects who have attention deficit with hyperactivity disorder (ADHD). Therefore, this investigation attempts to analyze the efficacy of neurofeedback compared with pharmacological support and the combination of both.  Participants were 131 students, classified into four groups: control (did not receive neurofeedback or pharmacological support), neurofeedback group, pharmacological support group, and combined group (neurofeedback + pharmacological support).  Participants' executive control and cortical activation were assessed before and after treatment.  Results indicate that the combined group obtained more benefits and that the neurofeedback group improved to a greater extent in executive control than the pharmacological support group.  It is concluded that this kind of training may be an alternative to stimulate activation in subjects with ADHD.”


Long Term Memory:

Studying Frequency Processing of the Brain to Enhance Long-Term Memory and Develop a Human Brain Protocol

By Friedrich, W., Du, S., & Balt, K.

“BACKGROUND:  The temporal lobe in conjunction with the hippocampus is responsible for memory processing.  The gamma wave is involved with this process.  To develop a human brain protocol, a better understanding of the relationship between gamma and long-term memory is vital.

METHODS:  Fifty-eight participants aged between 6 and 60 years participated in long-term memory experiments.  It is envisaged that the brain could be stimulated through binaural beats (sound frequency) at 40 Hz (gamma) to enhance long-term memory capacity.  EEG recordings have been transformed to sound and then to an information standard, namely ASCII.

RESULTS:  Statistical analysis showed a proportional relationship between long-term memory and gamma activity.  Results from EEG recordings indicate a pattern.  The pattern was obtained through the de-codification of an EEG recording to sound and then to ASCII.

CONCLUSIONS:  Stimulation of gamma should enhance long term memory capacity.  More research is required to unlock the human brains' protocol key.  This key will enable the processing of information directly to and from human memory via gamma, the hippocampus and the temporal lobe.”  


Associative Learning:

Electrophysiological CNS-processes related to associative learning in humans

By Christoffersen G.R., & Schachtman, T.R.

The authors reveal that their research has shown that different types of electrophysiological processes in the human brain "can be modified by conditioning: sensory evoked potentials, sensory induced gamma-band activity, periods of frequency-specific waves (alpha and beta waves, the sensorimotor rhythm and the mu-rhythm) and slow cortical potentials."  They state that in past experimental studies, neurofeedback enabled individuals some control over their central nervous systems and that the resulting ability to self-regulate brain activity has been helpful with epileptic seizures, Autism, ADHD, and tetraplegic patients through the use of brain computer interfaces.  Their review was "to summarize essential results on all types of electromagnetic brain processes that have been modified by classical or operant conditioning. The results are organized according to type of conditioned EEG-process, type of conditioning, and sensory modalities of the conditioning stimuli.”



Connectivity-Guided EEG Biofeedback for Autism Spectrum Disorder: Evidence of Neurophysiological Changes (Neuro Regulation)

By Coben, Robert, Sherlin, L., Hudspeth, William J., McKeon, K., & Ricca, R.

The authors state that the purpose of their project was "to test the hypothesis that lowering neural hyperconnectivity would lead to decreases in autistic symptoms."  Participants were given connectivity-guided EEG biofeedback, "which has been previously found to enhance neuropsychological functioning and lessen autistic symptoms."

They report, "Significant reductions in neural coherence across frontotemporal regions and source localized power changes were evident in frontal, temporal, and limbic regions following this treatment.  Concurrently, there were significant improvements on objective neuropsychological tests and parents reported positive gains (decreases in symptoms) following the treatment.  These findings further validate EEG biofeedback as a therapeutic modality for autistic children and suggest that changes in coherence anomalies may be related to the mechanism of action.

....connectivity-guided EEG biofeedback is a treatment capable of causing therapeutic neurophysiological changes in the brains of children with ASD.  Significant reductions in coherence between numerous neural regions occurred as a result of this intervention.  These findings were further substantiated by the eLORETA analysis, which showed prominent source localized changes in power in crucial regions of the brain for such children.  These changes were evident across frontal, temporal, and limbic regions.  The results of the current study also support and expand upon the findings found previously (Coben & Padolsky, 2007).  In our earlier study, we achieved an 89% success rate that was coupled with a 40% reduction in core ASD symptoms.  Moreover, significant improvements were noted for the experimental group on measures of attention, executive, visual perceptual, and language functions.”


Neuropathic Pain:

The Mechanism of Neurofeedback Training for Treatment of Central Neuropathic Pain in Paraplegia:  A Pilot Study

By M.A. Hassan, Fraser, M., Conway, B.A., Allan, D.B., & Vuckovic, A.

“BACKGROUND:  Central neuropathic pain has a prevalence of 40 % in patients with spinal cord injury. Electroencephalography (EEG) studies showed that this type of pain has identifiable signatures, that could potentially be targeted by a neuromodulation therapy. The aim of the study was to investigate the putative mechanism of neurofeedback training on central neuropathic pain and its underlying brain signatures in patients with chronic paraplegia.

METHODS:  Patients' EEG activity was modulated from the sensory-motor cortex, electrode location C3/Cz/C4/P4 in up to 40 training sessions....  Six out of seven patients reported immediate reduction of pain during neurofeedback training.  Four patients reported clinically significant long-term reduction of pain (>30 %) which lasted at least a month beyond the therapy.  ....

CONCLUSIONS:  Neurofeedback training produces both immediate and longer term reduction of central neuropathic pain that is accompanied with a measurable short and long term modulation of cortical activity.  The study is a registered UKCRN clinical trial Nr 9824.”



Slow Cortical Potential Neurofeedback in Chronic Tinnitus Therapy: A Case Report

By Milner, R., Lewandowska, M., Ganc, M., Ciesla, K., Niedzialek, I., Skarzynski, H.

“This study is the first to demonstrate outcomes of slow cortical potential (SCP) Neurofeedback training in chronic tinnitus. A 50-year old male patient with tinnitus participated in three SCP training blocks, separated with 1-month breaks. After the training the patient reported decreased tinnitus loudness and pitch, as well as improved quality of daily life. A quantitative electroencephalography analysis revealed close to normal changes of resting state bioelectrical activity in cortical areas considered to be involved in tinnitus generation. The present case study indicates that SCP Neurofeedback training can be considered a promising method for tinnitus treatment.”


Working memory:

Reorganization of functional brain networks mediates the improvement of cognitive performance following real-time neurofeedback training of working memory. 

By Zhang, G., Yao, L., Shen, J., Yang, Y., 7 Zhao, X

“Working memory (WM) is essential for individuals' cognitive functions.  ....our recent study used a real-time functional MRI (rtfMRI)-based neurofeedback method to conduct WM training, demonstrating that WM performance can be significantly improved after successfully upregulating the activity of the target region of interest (ROI) in the left dorsolateral prefrontal cortex (Zhang et al., [2013]: PloS One 8:e73735)....  Our analysis revealed an "ROI-network-behavior" correlation relationship underlying the rtfMRI training.  Further mediation analysis indicated that the reorganization of functional brain networks mediated the effect of self-regulation of the target brain activity on the improvement of cognitive performance following the neurofeedback training...."



Below are studies on: Peak Performance; cognitive, skill, and artistic performance; ADHD; Autism; Asperger’s; anxiety; addiction; dyslexia; migraines; fatigue; Parkinson’s; long term and short term memory; working memory; overeating; stroke; self regulation, awareness, control, knowledge and enhanced skill; neuropathic pain; teenage emotional turmoil; developing desirable brain gray matter; and associative learning. 

American Academy of Pediatrics publication on ADHD: 

In-School Neurofeedback Training for ADHD: Sustained Improvements From a Randomized Control Trial  (Pediatrics, 483-492.)

By Steiner, Naomi J., Frenette, Elizabeth C., Rene, Kirsten M., Brennan, Robert T., & Perrin, Ellen, C.

Tufts Medical Center, Department of Pediatrics, Boston, Massachusetts; and Harvard School of Public Health, Boston, Massachusetts 

“WHAT IS KNOWN ON THE SUBJECT:  We previously found significant improvements in ADHD symptoms immediately after neurofeedback training at school.

WHAT THIS STUDY ADDS:  This randomized controlled trial included a large sample of elementary school students with ADHD who received in-school computer attention training with neurofeedback or cognitive training.   

CONCLUSIONS:  Neurofeedback participants made more prompt and greater improvements in ADHD symptoms, which were sustained at the 6-month follow-up, than did CT participants or those in the control group.  ....

The finding that neurofeedback was superior to cognitive training on multiple scales further supports its efficacy as a treatment of children with ADHD.  Effects ...[showed] the promise of neurofeedback as a treatment with sustained gains for children with ADHD. 

....This is the first large randomized controlled trial to evaluate the long-term efficacy of in-school Computer Attention Training.  Despite the paucity of scientific data, both neurofeedback and cognitive training training systems are currently being used in school systems across the United States.... The direct impact of attention deficits on academic progress makes schools an ideal setting for such an intervention, because all children with ADHD in all communities could potentially have access to these services on an ongoing basis.” 



EEG Biofeedback Improves Attentional Bias in High Trait Anxiety Individuals  (BMC Neuroscience)

By Wang, Zhao, Y., Chen, S., Lin, G, Sun, P., & Wang, T.

“BACKGROUND:  Emotion-related attentional bias is implicated in the etiology and maintenance of anxiety disorders. Electroencephalogram (EEG) biofeedback can obviously improve the anxiety disorders and reduce stress level, and can also enhance attention performance in healthy subjects. The present study examined the effects and mechanisms of EEG biofeedback training on the attentional bias of high trait anxiety (HTA) individuals toward negative stimuli.  

RESULTS:  ...The EEG biofeedback significantly decreased the trait anxiety inventory score and reaction time in naming the color of negative words in the HTA group.  P300 latencies evoked by negative stimuli in the EEG biofeedback group were significantly reduced after the alpha training, while no significant changes were observed in the sham biofeedback group after the intervention.“ 



Neurofeedback Outcomes in Clients with Asperger's Syndrome  (Applied Psychophysiology and Biofeedback)

By Thompson, L, Thompson, M, Reid, A.

“This paper summarizes data from a review of neurofeedback (NFB) training with 150 clients with Asperger's Syndrome (AS) and 9 clients with Autistic Spectrum Disorder (ASD) seen over a 15 year period (1993-2008) in a clinical setting.  The main objective was to investigate whether electroncephalographic (EEG) biofeedback, also called neurofeedback (NFB), made a significant difference in clients diagnosed with AS.  

....Metacognitive strategies relevant to social understanding, spatial reasoning, reading comprehension, and math were taught when the feedback indicated that the client was relaxed, calm, and focused. Significant improvements were found on measures of attention (T.O.V.A. and IVA), core symptoms (Australian Scale for Asperger's Syndrome, Conners' Global Index, SNAP version of the DSM-IV criteria for ADHD, and the ADD-Q), achievement (Wide Range Achievement Test), and intelligence (Wechsler Intelligence Scales).  The average gain for the Full Scale IQ score was 9 points. ....The positive outcomes of decreased symptoms of Asperger's and ADHD (including a decrease in difficulties with attention, anxiety, aprosodias, and social functioning) plus improved academic and intellectual functioning, provide preliminary support for the use of neurofeedback as a helpful component of effective intervention in people with AS.”


Adolescent Emotional Turmoil:

Using real-time fMRI to influence differential effective connectivity in the developing emotion regulation network  (Neuroimage)

By Kadosh, K.C., Luo, Q., de Burca, C., Sokunbi, M.O., Feng, J., Linden, D.E., & Lau, J.Y

This research states that it is known that early emotional turmoil "can lead to persistent problems for some people" which suggests that early intervention during development may decrease  long term emotional hardship.  MRI and neurofeedback were administered with the goal of  emotional regulation with 17 individuals aged 7-16 years.  The authors found clear and specific evidence that they were shaping key social cognitive networks during development by using fMRI with neurofeedback.  



Improvements in Spelling after QEEG-based Neurofeedback in Dyslexia: A Randomized Controlled Treatment Study (Applied Psychophysiology and Biofeedback)

By Breteler, Marinus, Martijn Arns, Sylvia Peters, Ine Giepmans, and Ludo Verhoeven.

“Phonological theories of dyslexia assume a specific deficit in representation, storage and recall of phonemes.  Various brain imaging techniques, including qEEG, point to the importance of a range of areas, predominantly the left hemispheric temporal areas.  This study attempted to reduce reading and spelling deficits in children who are dyslexic, by means of neurofeedback training based on neurophysiological differences between the participants and gender and age matched controls.  Nineteen children were randomized into an experimental group receiving qEEG based neurofeedback (n = 10) and a control group (n = 9).  Both groups also received remedial teaching.  The experimental group improved considerably in spelling (Cohen’s d = 3).  ....A significant increase of alpha coherence was found, which may be an indication that attentional processes account for the improvement in spelling.  Consideration of subtypes of dyslexia may refine the results of future studies.”



Neurofeedback Reduces Overeating Episodes in Female Restrained Eaters:  A Randomized Controlled Pilot-Study

By Schmidt, J., & Martin, A.

“The treatment was evaluated in a randomized controlled trial, comparing a neurofeedback group (NFG; n = 14) with a waiting list control group (WLG; n = 13) in a sub-clinical sample of female restrained eaters.  At post-treatment, the number of weekly overeating episodes and subsequent distress were significantly reduced in the NFG compared to the WLG (p < .01; r > .50).  In a 3 month follow-up, effects in the NFG remained stable.  As secondary outcomes, perceived dieting success was enhanced after the treatment.  At follow-up, additional beneficial effects on trait food craving were observed.”  



Neurofeedback and Biofeedback with 37 Migraineurs:  A Clinical Outcome Study  (Behavioral and Brain Functions)

By: Stokes, Deborah, and Martha Lappin.

“Traditional peripheral biofeedback has grade A evidence for effectively treating migraines.  Two newer forms of neurobiofeedback, EEG biofeedback and hemoencephalography biofeedback were combined with thermal handwarming biofeedback to treat 37 migraineurs in a clinical outpatient setting.

METHODS:  37 migraine patients underwent an average of 40 neurofeedback sessions combined with thermal biofeedback in an outpatient biofeedback clinic.  All patients were on at least one type of medication for migraine....  Patients kept daily headache diaries a minimum of two weeks prior to treatment and throughout treatment showing symptom frequency, severity, duration and medications used.  Treatments were conducted an average of three times weekly over an average span of 6 months.  Headache diaries were examined after treatment and a formal interview was conducted.  After an average of 14.5 months following treatment, a formal interview was conducted in order to ascertain duration of treatment effects.

RESULTS:  Of the 37 migraine patients treated, 26 patients or 70% experienced at least a 50% reduction in the frequency of their headaches which was sustained on average 14.5 months after treatments were discontinued.

CONCLUSIONS:  All combined neuro and biofeedback interventions were effective in reducing the frequency of migraines with clients using medication resulting in a more favorable outcome (70% experiencing at least a 50% reduction in headaches) than just medications alone (50% experience a 50% reduction) and that the effect size of our study involving three different types of biofeedback for migraine (1.09) was more robust than effect size of combined studies on thermal biofeedback alone for migraine (.5).  These non-invasive interventions may show promise for treating treatment-refractory migraine and for preventing the progression from episodic to chronic migraine.”



Neurofeedback training of alpha-band coherence enhances motor performance  (Clinical Neurophysiology) 

By Mottaz, A., Solca, M., Magnin, C., Corbet, T., Schneider, A., & Guggisbert, A.G.

“OBJECTIVE:  Neurofeedback training of motor cortex activations with brain-computer interface systems can enhance recovery in stroke patients. Here we propose a new approach which trains resting-state functional connectivity associated with motor performance instead of activations related to movements.

METHODS:  Ten healthy subjects and one stroke patient trained alpha-band coherence between their hand motor area and the rest of the brain using neurofeedback with source functional connectivity analysis and visual feedback.

RESULTS:  Seven out of ten healthy subjects were able to increase alpha-band coherence between the hand motor cortex and the rest of the brain in a single session. The patient with chronic stroke learned to enhance alpha-band coherence of his affected primary motor cortex in 7 neurofeedback sessions applied over one month. Coherence increased specifically in the targeted motor cortex and in alpha frequencies. This increase was associated with clinically meaningful and lasting improvement of motor function after stroke.

CONCLUSIONS:  These results provide proof of concept that neurofeedback training of alpha-band coherence is feasible and behaviorally useful.”



Neurofeedback Training for Opiate Addiction: Improvement of Mental Health and Craving  (Applied Psychophysiology and Biofeedback)

By: Dehghani-Arani, Fateme, Reza Rostami, and Hosein Nadali.

“Psychological improvements in patients with substance use disorders have been reported after neurofeedback treatment.  ....This study was carried out to examine the effectiveness of this therapeutic method for opiate dependence disorder... [and] investigate whether treatment leads to any changes in mental health and substance craving.  In this experimental study with a pre-post test design, 20 opiate dependent patients undergoing Methadone or Buprenorphine maintenance treatment were examined and matched and randomized into two groups.  While both experimental and control groups received their usual maintenance treatment, the experimental group received 30 sessions of neurofeedback treatment in addition.  ....Multivariate analysis of covariance showed that the experimental group achieved improvement in somatic symptoms, depression, and total score in general mental health; and in anticipation of positive outcome, desire to use opioid, and relief from withdrawal of craving in comparison with the control group.”




Psychological Benefits of Nonpharmacological Methods Aimed for Improving Balance in Parkinson's Disease: A Systematic Review  (Behavioural Neurology)

By Sumec, Rastislav, Filip, P., Sheardova, K., & Bares, M.

“Postural instability is one of the cardinal difficulties reported by [Parkinson's disease (PD)] patients to deal with.  ....The purpose of this review is to provide information about practical and creative methods designed to improve balance in PD and highlight their positive impact on patient's psychology.

.... [During the neurofeedback training method,] a participant receives feedback of signals which represent his/her subconscious neural activities.  By observing his/her brainwaves on a computer screen, it is possible to learn to control and change them. This training leads to a point when one is able to control their brainwaves subconsciously not only through the exercise, but in their everyday life too [129].  It is already being used for treating many brain disorders [130].  In PD, balance and gait are tasks requiring attention.  ....When applied on PD patients in a RCT study, NFT showed an improvement in both static and dynamic balance [50]. 

Researchers have tried to prove the same point using audiobiofeedback.  In this method patients received an auditory feedback modulated by their movement.  It showed an improvement in balance.  The training also appeared to have a positive impact on psychosocial aspects of PD and the depression level of patients.  Patients reported a high satisfaction attending this training [51].

Other researchers claimed that audiobiofeedback has disadvantages regarding the fact that audio information is quite nonintuitive and therefore it is not possible for patients to react on it fast enough.  They suggested more intuitive, vibrotactile neurofeedback stimulus, which has been reported to have much faster reaction time [52].  Vibrotactile NFT really showed an ability to improve balance and also a potential to reduce the number of falls [133].”


Fatigue and cognition among cancer survivors:

A Systematic Review of the Safety and Effect of Neurofeedback on Fatigue and Cognition (Integrative Cancer Therapy)

By Luctkar-Flude, M, & Groll, D

“BACKGROUND:  Many cancer survivors continue to experience ongoing symptoms, such as fatigue and cognitive impairment, which ...have few effective, evidence-based treatment options.  Neurofeedback is a noninvasive, drug-free form of brain training that may alleviate long-term symptoms reported by cancer patients.

METHODS:  A systematic review of the literature was conducted using Joanna Briggs Institute (JBI) methodology.  A comprehensive search of 5 databases was conducted: Medline, CINAHL, AMED, PsycInfo, and Embase.  Randomized and nonrandomized controlled trials, controlled before and after studies, cohort, case control studies, and descriptive studies were included in this review.

RESULTS:  Twenty-seven relevant studies were included in the critical appraisals.  The quality of most studies was poor to moderate based on the JBI critical appraisal checklists.  Seventeen studies were deemed of sufficient quality to be included in the review: 10 experimental studies and 7 descriptive studies.  Of these, only 2 were rated as high-quality studies and the remaining were rated as moderate quality.  All 17 included studies reported positive results for at least one fatigue or cognitive outcome in a variety of populations, including 1 study with breast cancer survivors.  Neurofeedback interventions were well tolerated with only 3 studies reporting any side effects.

CONCLUSIONS:  Despite issues with methodological quality, the overall positive findings and few reported side effects suggest neurofeedback could be helpful in alleviating fatigue and cognitive impairment.  Currently, there is insufficient evidence that neurofeedback is an effective therapy for management of these symptoms in cancer survivors, however, these promising results support the need for further research with this patient population.”


It is helpful to remain conscious of three key considerations about research, particularly regarding neurofeedback:

1.  Because developments from Siegfried and Sue Othmer’s EEG Institute continually emerge, studies on the efficacy of neurofeedback sometimes are as relevant as they are new.  The Othmers’ ever-growing clinical findings, quickly followed by refinements of and additions to treatment protocols, software, and instrumentation, continue to unfold.  Many studies on the efficacy of neurofeedback, therefore, could not consider what we know and utilize this month versus a few months ago even, and most symptom areas studies have not even begun.  One cannot overestimate the importance of weighing the date of research on the efficacy of neurofeedback. 

2.  It may be particularly important to note the sources of funding of research on neurofeedback.  For example, the pharmaceutical companies' profits may be affected as further research is demonstrating the efficacy of something that sometimes decreases and sometimes eliminates the need for some medications.  Some entities could have a vested interest in funding poorly designed research and/or suggesting that excellent research is invalid. 

3.  Following are sample publications from the American Academy of Pediatrics, National Institutes of Health, BMC Neuroscience, and others demonstrating neurofeedback's effect on some of the illnesses and disorders where neurofeedback has been clinically effective.  Neurofeedback does not target illness.  What Neurofeedback provides is fundamentally different.  Neurofeedback promotes brain health by equipping the brain with key information about the brain's electrical functioning, that the brain uses to better manage itself and function more effectively and efficiently.  The healthier brain better manages the whole physical and mental person, and positively affects the individual's entire system.

Unlocking Brain Potential