Experimental and Clinical Results

Frank H. Duffy, M.D., Professor and Pediatric Neurologist at Harvard Medical School, recently stated in an editorial in the January 2000 issue of the journal Clinical Electroencephalography that the scholarly literature suggests that neurofeedback should play a major therapeutic role in many difficult areas. 


In my opinion, if any medication had demonstrated such a wide spectrum of efficacy it would be universally accepted and widely used”(p. v). “It is a field to be taken seriously by all.” (p. vii).

 


There is now good scientific evidence from both controlled research and clinical studies as well as long-term follow-up that EEG-biofeedback can be an effective treatment for seizures and attention deficit compared to both common drug treatments and placebo, and that treatment affects are long-lasting. There is growing scientific and clinical evidence supporting the effectiveness of EEG biofeedback in the treatment of the following conditions: alcoholism, anxiety disorders, asthma, chronic pain, depression, essential hypertension, insomnia, migraine and tension type headaches, irritable bowel, motion sickness, and Raynaud’s disease.


Bibliography of Scientific Studies for Neurofeedback and
Pain & Headache

 
Coger, R., & Werbach, M. (1975). Attention, anxiety, and the effects of learned enhancement of EEG alpha in chronic pain: A pilot study in biofeedback. Chapter in B. L. Drue, Jr. (Ed.), Pain Research and Treatment. New York: Academic Press.

Gannon, L., & Sternbach, R. A. (1971). Alpha enhancement as a treatment for pain: A case study. Behavior Therapy & Experimental Psychiatry2, 209-213.

 

Ham, L. P., & Packard, R. C. (1996). A retrospective, follow-up study of biofeedback-assisted relaxation therapy in patients with posttraumatic headache. Biofeedback & Self-Regulation21(2), 93-104.

Kropp, P., Siniatchkin, M., & Gerber,W-D. (2002). On the pathophysiology of migraine: Links for Aempirically based treatment@ with neurofeedback.  Applied Psychophysiology & Biofeedback27(3), 203-213.

 

Lehmann, D., Lang, W., & Debruyne, P. (1976). Controlled EEG alpha feedback training in normals and headache patients. Archives of Psychiatry,221, 331-343.

 

Matthew, A., Mishm, H., & Kumamiah, V. (1987). Alpha feedback in the treatment of tension headache. Journal of Personality & Clinical Studies3(1), 17-22.

 

McKenzie, R., Ehrisman, W., Montgomery, P. S., & Barnes, R. H. (1974). The treatment of headache by means of electroencephalographic biofeedback. Headache13, 164-172.

 

Pelletier, K. R., & Pepper, E. (1977). Developing a biofeedback model: Alpha EEG feedback as a means for pain control. International Journal of Clinical & Experimental Hypnosis25, 361-371.

 

Rosenfeld, J. P., Dowman, R., Heinricher, N., & Silvia, R. (1984). Operantly controlled somatosensory evoked potentials: Specific effects on pain processes. Chapter in B. Rockstroh, T. Elbert, W. Lutzenberger, & N. Birbaumer (Eds.), Self-Regulation of the Brain and Behavior. Berlin: Springer-Verlag, pp. 164-179.

 

Rosenfeld, J. P., Silvia, R., Weitkunat, R., & Dowman, R. (1985). Operant control of human somatosensory evoked potentials alters experimental pain perception. Chapter in H. L. Fields, R. Dubner, & F. Cervero (Eds.), Advances in Pain Research and TherapyVolume 9Proceedings of the Fourth World Congress on Pain. New York: Raven Press, 343-349.

 

Siniatchkin, M., Hierundar, A., Kropp, P., Kuhnert, R., Gerber, W-D., & Stephani, U. (2000). Self-regulation of slow cortical potentials in children with migraine: An exploratory study. Applied Psychophysiology & Biofeedback25(1), 13-32.

Kropp P, Siniatchkin M, Gerber WD.  Institute of Medical Psychology, University of Kiel, Niemannsweg 147, D-24105 Kiel, Germany. kropp@med-psych.uni-kiel.de  Appl Psychophysiol Biofeedback. 2002 Sep;27(3):203-13. On the pathophysiology of migraine–links for “empirically based treatment” with neurofeedback.

  • Psychophysiological data support the concept that migraine is the result of cortical hypersensitivity, hyperactivity, and a lack of habituation. There is evidence that this is a brain-stem related information processing dysfunction. This cortical activity reflects a periodicity between 2 migraine attacks and it may be due to endogenous or exogenous factors. In the few days preceding the next attack slow cortical potentials are highest and habituation delay experimentally recorded during contingent negative variation is at a maximum. These striking features of slow cortical potentials are predictors of the next attack. The pronounced negativity can be fed back to the patient. The data support the hypothesis that a change in amplitudes of slow cortical potentials is caused by altered habituation during the recording session. This kind of neurofeedback can be characterized as “empirically based” because it improves habituation and it proves to be clinically efficient.

 

Tansey, M. A. (1991). A neurobiological treatment for migraine: The response of four cases of migraine to EEG biofeedback training. Headache QuarterlyCurrent Treatment & Research, 90-96.

  • One of the research team said:
    “This exploratory study provided results emphasizing the potential significance of neurofeedback in the prophylactic treatment of migraine in childhood.  We hope the clinical efficacy of neurofeedback in migraine will be studied and proved not only for children but for adults as well.”

Sample Clinical Results

  • When a woman came in for training for her migraines, she happened to have a migraine at the time of her first session. After only three minutes of EEG training, the migraine headache was gone.
  • A woman happened to be in our office, who had never done EEG training.  She started developing an aura, which presaged the onset of her usual migraines within about twenty minutes. She was asked to try the training for her migraines. Within minutes, her aura was aborted, and she did not get her usual migraine headache.
  • A man came to an office for his migraines. He had a migraine history going back some twenty-five years. As soon as Imitrex came on the market, he used it on a weekly basis. Beginning with his very first EEG biofeedback training session, he no longer needed the Imitrex, and after 18 training sessions, he no longer reported any migraines.
  • Migraines are considered an “easy” disorder to resolve within the neurofeedback community.
  • Multiple clinicians have reported that migraine headaches remediate within 15 minutes.  Even if dramatic results are not seen immediately, then the migraine episode is turned during the session to amelioration and early termination.
  • Follow-up results date from 1987 for long term migraine headache relief.  The general pattern is that the person may still be suseseptible to migraines during high stress or after multiple triggering events, but that the worst is always in the past.
  • One woman had stopped having her migraines but the low barometric pressure of a hurricane woke a woman up with headache.  Neurofeedback enabled her to abort her headache between the time she got out of bed with a headache and went to the kitchen for her imitrex.  It had just gone away that quickly.  That had never happened before.

Consensus within the Community of Practitioners

  • Improved brain cortex self-regulation enables greater inhibition of the migraine process.
  • Migraines are considered an “easy” disorder to resolve within the neurofeedback community.   The success rate is high (80-95%), takes 6-25 sessions to resolve, and results endure.   Positive side effects vary but most often include mental clarity and improved sleep.  Those who enjoy the benefits of neurofeedback are initially grateful, but then get on with their lives and
  • Successful practitioners typically concentrate on a single method located at either, C3-C4, P3-4, or Fpz.  Rarely does anyone use each of these sites with multiple biofeedback, neurofeedback, or related neurotherapy methodologies.  All methods work very well.
  • Theoretically, competing mechanisms of action include:
    • learning to alter characteristic brain waves (biofeedback induced changes in voltage output on the scalp);
    • More self-awareness for improved self-regulation;
    • stretching brain plasticity (exercise, stretching, aerobic cross-training);
    • brain relaxation, release of constraints;
    • balancing of autonomic nervous system arousal;
    • interupting increasingly cacophonous feedback loops;
    • infrared brightening;
    • renormalization of brain functioning–synchronization through chaos;
    • disrupting attractors (breaking up storm patterns) and clearing them during sleep;
    • increased oxygenation to frontal or parietal lobes;
    • efficient waste removal with improved blood perfusion;
    • vasculargenisis (new blood tubing); and
    • angiogenisis (new dendrites or network connections).
  • Clearly, more research is needed.

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