The Science Behind Neurofeedback

Posted on September 1 2019

We are often presented with questions from our participants regarding how neurofeedback actually works.  Specifically, what exactly about this intervention causes the brain to operate differently and how the positive changes can be permanent for some?  This discussion is an in depth explanation of how neurofeedback promotes positive change and the science behind the intervention.

The brain is a remarkable organ that has the ability to self-regulate.  By this we mean the brain automatically controls its own blood supply and can direct increased blood flow to more active areas of the brain as needed.  As you may know, blood carries life sustaining oxygen as well as other nutrients such as glucose that provide cells what they need to function and grow.  The concept of measuring blood flow in the brain is called “perfusion.”  Perfusion can be clearly measured via SPECT and PET scans, and more recently it has been proven that the EEG patterns can actively correlate with perfusion. 

Although the EEG has its origins in the early 20th century, it wasn’t until Dr. Barry Sterman’s work in the 1960’s that we learned EEG patterns can be identified as regulated or dysregulated, and these brain wave patterns can be controlled by the participant via the concept of operant conditioning.  For example, the brain of an adult or child with ADHD may show a low activation type dysregulation, meaning the brain lacks activity in certain regions that is necessary for the person to maintain sustained focus and effort.  The concept of operant conditioning is basically a method of “positive reinforcement,” whereby when we reward regulated brain wave patterns we tend to get more of that type of pattern and less dysregulated patterns.  The brain then changes structurally and biologically at a cellular level.  At microscopic levels small connections are made in the brain’s neurons and these neuronal connections are developed via perfusion.  So, in the case of our ADHD child or adult, we are using the EEG to find areas of the brain that are under focused, increase activity in these regions via operant conditioning, and allowing the brain to do what it does naturally - namely grow and develop these new connections via perfusion.   

Another issue to consider with neurofeedback is the effect chronic stress has on the brain.  When stressed, the body automatically secrets a cortisol hormone to activate organs of the body to respond to the stressful event.  When a person is chronically stressed this hormone is secreted excessively.  Unfortunately, research shows that cortisol can have a negative impact on the brain, among other organs of the body. Specifically, we know cortisol can negatively impact the hippocampus and the temporal lobe regions of the brain.  This impedes the brain’s ability to focus and learn, among other negative consequences.  For this type of condition we use neurofeedback to help train a relaxation response to counter-act the release of cortisol and to provide a calming effect for the brain and the central nervous system. 

The amount of training (i.e. operant conditioning) required for most participants is 20-40 sessions.  At this point most participants (or their brains rather!) have received enough positive reinforcement and neuronal growth to make pronounced change possible.  Research demonstrates that approximately 50-60% see significant reduction of symptoms at this point in the neurofeedback process and approximately 80% will report positive improvement at single or multiple levels.  Some may require periodic maintenance sessions after completing the initial program if they find symptoms returning.

The place to start is a one-time consultation where we can measure you (or your child’s) brain wave patterns for evidence of dysregulation.  At that appointment we will discuss how the type of dysregulation discovered can be causing certain problems and how neurofeedback training may help address those problems.  A number of behavioral conditions can be associated with certain types of dysregulation, including ADHD, trauma issues and PTSD, anxiety, stress, depression, autism, migraine headaches, among others.  A good assessment will help individualized your training plan (in neurofeedback “one size” training methods does not fit all) and help you achieve the results you desire. 

A special thank-you to Dr. Jay Gunkelman, Dr. Seigried Othmer, and Dr. Lynda Thompson whose articles and publications were researched and utilized in putting together this information. 

Using Neurofeedback To Improve College Entrance Exam Scores

Posted on July 3 2013

By Dr. Brad Oostindie - Clinical Director

Over the past several months several parents of high school age children approached me about using neurofeedback to improve college entrance test scores such as the ACT and SAT.  Over the past 10 years of practicing neurofeedback as a specialty I have run across several participants who reported a significant increase in ACT scores subsequent to neurofeedback training for another issue or concern.  In many of these situations an ACT score increase of 3-7 points was observed.  The most recent report I received was an increase of an ACT score from 23 to 29 upon completing a neurofeedback protocol of about 30 sessions.  In fact, over the course of practicing neurofeedback I do not recall ever running across a situation where a decrease in ACT score was observed post neurofeedback.

Because of the interest in this area I thought it would be good to review the available research on this topic and offer opinions on the topic on our website blog.  Unfortunately, there are very few documented studies of controlled research related to this subject.  In a 2005 study in Hartford, Connecticut, repeat SAT scores improved by 233, 180, and 136 points for three individuals following 10 half-hour neurofeedback sessions. A typical test-retest improvement for SAT is reported to be only 14 points according to Educational Testing Service data.  For those unfamiliar with how to evaluate an effective study, a sample size of 3 is hardly enough to be considered adequate size.  However, the results are very encouraging and in combination with many neuro-therapists observed “results” with participants who report an increase in ACT/SAT scores, it serves as a starting point for identifying a possible usefulness in using neurofeedback as a tool to use in improving one’s performance on these type of tests.

Related to this topic are many controlled studies (with adequate sample size) that show increase in IQ scores post neurofeedback training.  Typically these increases can be in the range of 10-12 points, an increase that exceeds what the test makers would suggest could occur by chance in a test-retest situation.  Since IQ is typically seen as a measure of the brain’s overall intelligence and potential (among other things), an increase in IQ can result in improved test taking abilities and problem solving in responding to test questions.

At this point the neurofeedback community needs a well-defined, controlled, adequately sized study of participants who complete a standardized neurofeedback protocol in between SAT or ACT test completion to objectively measure whether or not significant score increases occur, and whether or not these increases can be reasonably connected with the neurofeedback experience.  Personally, I believe a positive connection will be observed between neurofeedback and ACT/SAT score increase should this type of study be completed. 

If you are interested in using neurofeedback for your son or daughter prior to them taking or retaking the ACT and/or SAT, please contact our office for a 12-16 session package.  1-800-850-0535. 

Who responds well to neurofeedback?

Posted on January 16 2012

By Dr. Brad Oostindie

I have had the opportunity to practice neurofeedback as a specialty since 2004, and since that time I have been able to assess and treat well over a thousand of participants using this “next generation of behavioral healthcare” treatment.  A common question I receive from a potential participant at his or her assessment session is “Will neurofeedback really benefit me?”  While it is impossible to predict the future,  it is my opinion there are a few factors to consider in attempting to answer this question:

- Number of sessions completed:  Those who complete 30-50 sessions tend increase their odds of better improvement.  Less than that can work, but reduces the odds. 
- Protocol followed: An experienced neurofeedback provider will be able to “prescribe” the best protocol for you.  “One size” does not fit all.
- Medications:  Depending on the type of medication you are taking that may play a role in how effective the training is for you.
- Condition: Some conditions are more difficult to address than others and may take more time to see results.  For example, those with autism can take more time to respond than ADHD.
- Equipment Used:  There is a wide variety of EEG equipment available for providers to use.  Some equipment provides poor quality EEG connection and this can be a negative.

Overall, I tell our Ready To Focus participants the following based on my experience:  Approximately a third of all participants may see very good results.  By this I mean that neurofeedback will address the majority of issues you wanted it to.  Another third of participants may see very solid results, but areas that could still use development and gain.  By this I mean that neurofeedback will address many of the issues (but not all) and it is possible that occasional follow-up appointments every once and a while will be needed to keep you on track.  The last third will struggle somewhat with neurofeedback and may require either additional therapies to reach their goal or longer term commitment to neurofeedback if the goal is to use it as a primary treatment.  These statements coincide with neurofeedback literature and research that supports a 60% success rate with the treatment depending on the condition being treated (Gunkleman, 2005)