Types of Neurofeedback: What Kind of Neurofeedback System are you looking for?
There are basically 7 types of Neurofeedback for the treatment of various disorders:
- Frequency/power neurofeedback: This method often includes the use of 2 to 4 scalp surface electrodes, known as “surface neurofeedback”. This is also referred to as "traditional neurofeedback," which is what many clinicians, and lay people use, and can be purchased or rented for office or home use. It is used to change the amplitude or speed of specific brain waves, in particular brain locations to treat ADHD, anxiety, and insomnia. The following are some of the more known standardized surface training neurofeedback software systems.
- Slow cortical potential neurofeedback (SCP-NF) improves the direction of slow cortical potentials to treat ADHD, epilepsy, and migraines (Christiansen, Reh, Schmidt, & Rief, 2014).
- Low-energy neurofeedback system (LENS) delivers a weak electromagnetic signal to change the patient’s brain waves while they are motionless with their eyes closed (Zandi-Mehran, Firoozabadi, & Rostami, 2014). This type of neurofeedback has been used to treat traumatic brain injury, ADHD, insomnia, fibromyalgia, restless legs syndrome, anxiety, depression, and anger.
- Hem Encephalographic (HEG) neurofeedback provides feedback on cerebral blood flow to treat migraine (Dias, Van Deusen, Oda, & Bonfim, 2012).
- Live Z-score neurofeedback is used to treat insomnia. It introduces the continuous comparison of variables of brain electrical activity to a systematic database to provide continuous feedback (Collura, Guan, Tarrant, Bailey, & Starr, 2010).
- Low-resolution electromagnetic tomography (LORE-TA) involves the use of 19 electrodes to monitor phase, power, and coherence (Pascual-Marqui, Michel, & Lehmann, 1994). This neurofeedback technique is used to treat addictions, depression, and obsessive-compulsive disorder.
- Functional magnetic resonance imaging (fMRI) is the most recent type of neurofeedback to regulate brain activity based on the activity feedback from deep subcortical areas of the brain (Hurt, Arnold, & Lofthouse, 2014; Lévesque, Beauregard, & Mensour, 2006a).
Traditional Neurofeedback involves direct attention to stimuli during a 45-60 minute session. Typical results are achieved in an average of 30-40 or more sessions. In Direct Neurofeedback, no sustained attention to stimuli is required. The majority of traditional or standardized neurofeedback devices are limited to the influence of the cortical surface. They are very useful and can be effective. Although, they can't address the subcortical regions of the brain. SW LORETA Neurofeedback, which is a Z Score multi-channel training system , and uses a full cap to target both the cortical and subcortical areas of the brain simultaneously, utilizing a highly customized protocol design to address the specific challenges assessed during an initial interview, and based upon a QEEG! Generally, SW LORETA training does not require more than 20 to 30 sessions, sometimes less training sessions depending upon whether those challenges are chronic. The best outcome from the use of SW LORETA training is when it is integrated with various modalities of psychotherapy and active imagination methods.
Some Neurofeedback software systems are passive meaning the client just closes their eyes and listens to tones or lights or both. These programs may be AVE systems: Audio Visual Entrainment Training devices. Audio-Visual Entrainment (AVE) is a technique that uses pulses of light and sound at specific frequencies to gently and safely guide the brain into various brainwave patterns. By altering your brainwave frequencies, you can boost your mood, improve sleep patterns, sharpen your mind, and increase relaxation levels, all with the simple push of a button! You can google MindAlive Inc. to inquire further about these devices and their cost.
The Brain lobes descriptions below provide the reader with a nice outline of the locations and their functions. This chart was borrowed from John Demos--(Getting Started With Neurofeedback, Demos, 2005). LH: Left Hemisphere. RH: Right Hemisphere. The areas below are based upon the 10-20 International site location map. Even numbers are located on the right hemisphere, odd numbers are located on the left hemisphere, and letter sites without numbers attached to them are along the midline of the scalp. Two to four channel neurofeedback software can target the scalp to address various surface areas on the scalp. These sites, or locations target the symptoms that might be the focus and protocol design to use for any given training session.
Sites
Functions
Considerations
Parietal lobes
Pz, P3, P4
LH: Problem solving, math, complex grammar, attention, association
RH: Spatial awareness, Geometry
Dyscalculia sense of direction learning disorders
Frontal lobes
FP1, FP2, FPZ, FZ, F3, F4, F7, F8: Frontal regions of the scalp. These address:
LH: Working memory, concentration, Executive planning, positive emotions.
RH: Episodic memory, social awareness Frontal poles: attention judgment
LH: Depression
RH: Anxiety, fear, executive planning, poor executive functioning
Temporal lobes
T3, T4, T5, T6
LH: Word recognition, reading, language, memory
RH: Object recognition, music, social cues
Facial recognition
Anger, rage, dyslexia, long-term memory, closed head injury
Occipital lobes
OZ, O1, O2
Visual learning, reading, parietal- temporal-occipital functions
Learning disorders
Sensorimotor cortex
CZ, C3, C4
LH: Attention, mental processing, RH: Calmness, emotion, Empathy Combined: Fine motor skills, manual dexterity, sensory and motor integration and processing
Paralysis (stroke), seizure disorder, poor handwriting, ADHD symptoms
Cingulate gyrus
FPZ, FZ, CZ, PZ, OZ
Mental flexibility, cooperation, attention, motivation, morals
Obsessions, compulsions, tics, perfectionism, worry, ADHD symptoms, OCD & OCD spectrum
Broca’s area
F7, T3
Verbal expression
Dyslexia, poor spelling, poor reading
Left hemisphere
All odd numbered sites
Logical sequencing, detail oriented, language abilities, word retrieval, fluency, reading, math, science, problem solving, verbal memory
Depression (underactivation)
Right hemisphere
All even numbered sites
Episodic memory encoding, social awareness, eye contact, music, humor, empathy, spatial awareness, art, insight, intuition, non-verbal memory, seeing the whole picture
Anxiety (overactivation)
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Abbreviations: LH, Left hemisphere, RH: Right hemisphere, AHHD: Attention deficit hyperactivity disorder, OCD: Obsessive compulsive disorder.
Alpha/theta is indicative of awareness and sleep. Alpha/theta training is another neurofeedback approach that can be used once the brain has been stabilized through neurofeedback training. A/T training is one of the most popular neurofeedback trainings for stress reduction (Gruzelier, 2009; Raymond, Varney, Parkinson, & Gruzelier, 2005). Furthermore, this training approach is helpful for deep levels of depression, addiction, anxiety while it increases creativity, relaxation, musical performance, and promotes healing from trauma reactions. The electrodes are usually located on O1, O2, CZ and PZ. Alpha/theta frequency range is 7–8.5 Hz with the typical value of 7.8 Hz. This training approach is implemented through the eyes-closed condition that increases the ratio of theta to alpha waves while using auditory feedback (Demos, 2005; Egner & Gruzelier, 2003; Thompson & Thompson, 2003).
When in search for a neurofeedback clinician, be certain that they are board certified, and inquire about what kind of neurofeedback software they use, as well as whether or not they administer QEEGs to assess whether your brain is presenting a hypo or hyper connectivity challenge, and to inform them on how to develop a customized protocol that will target your brain's specific issues. Ask them about their level of competency, how long have they been practicing, what kind of results do they obtain, what types of clinical issues are they comfortable in training and working with? What is their scope of practice? Are they knowledgeable about neuroscience, QEEGs, their own equipment, and do they use consultants when assessing various types of challenges a client is experiencing regarding their brain. Find out how long they have been practicing. After you have gathered your information, then contact ISNR or BCIA to ask them about what they know regarding that clinician, and what they can do to support you to understand the Neurofeedback training software that is being used by that clinician. It is important to find out whether a piece of equipment is FDA approved. Home training devices are becoming more popular. However, consider very seriously whether you want to work with an out of state clinician rather then a local Neurofeedback clinician, then find out what the State requirements are to work with an out-of-State clinician. Afterward, make certain to request a QEEG so that your clinician has a good understanding of what is happening with your brain, and how to design a protocol that will safely support neuro-regulation of your brain. If you work with an out of state clinic and clinician, be certain to locate a local clinician who is competent to provide you with a QEEG before you begin your training.
For more information regarding research papers, and what S LORETA and SW LORETA is google Applied Neuroscience Institute. They have marvelous free studies at the ANI website.
My next Blog will discuss what Neurodynamic Therapy is. This is a new model of how to integrate other modalities of psychotherapy, and active imagination to learn how to use advanced neurofeedback to shift states of mind from traumatized states to non-traumatized states of consciousness. This new model has positive implications for healing and resolving trauma. NDT was recently published as a chapter in, Introduction To Quantitative EEG and Neurofeedback, 3rd Edition (Chartier, Dellinger, Evans, Budzynski, 2023, Academic Press).
