Pelvic floor biofeedback and stim device for urinary incontinence


Urinary incontinence (UI), a prevalent condition affecting individuals across various age groups, can have a profound impact on one’s quality of life. The involuntary loss of bladder control can lead to not only physical discomfort but also emotional and social challenges. In the pursuit of innovative and effective solutions, medical research and treatment has turned its attention to the promising technique of biofeedback. Pelvic floor biofeedback for urinary incontinence offers a transformative path to regain control and confidence. Urinary incontinence, affecting countless lives, stems from multifaceted factors like muscle weakness and bladder overactivity. Pelvic floor biofeedback bridges this gap by facilitating real-time communication with the body. Through sensors and personalized cues, individuals learn to interpret and influence their physiological responses, targeting the root causes.

What urinary incontinence is?

Urinary incontinence (UI) refers to the involuntary loss of bladder control, leading to the unintentional leakage of urine. It’s a common condition that can range in severity from occasional minor leaks to complete loss of bladder control. This loss of control can occur during activities such as coughing, sneezing, laughing, lifting, or even during moments of sudden urgency to urinate.
According to the World Health Organization, the prevalence of urinary incontinence reported in population-based studies ranges from 9.9% to 36.1% and is twice as high in older women as in older men. UI can occur at any age, but it is more common among women over 50. Urinary incontinence may be a temporary condition that results from an underlying medical condition. It can range from the discomfort of slight losses of urine to severe, frequent wetting.
Urinary incontinence can be caused by various factors, including weakened pelvic floor muscles, overactive bladder muscles, nerve damage, hormonal changes, and certain medical conditions. It can affect people of all ages and genders, although it’s more prevalent among older adults and women, especially after childbirth or during menopause.

What are the four types of urinary incontinence?

There are four types of urinary incontinence: urgency, stress, overflow, and neurogenic incontinence.

Stress urinary incontinence is the most common type, concerns urine leakage associated with physical exertion, coughing, and sneezing. Weakness or damage to the pelvic floor muscles and tissues that support the bladder and urethra can result in stress incontinence. 

During activities that increase intra-abdominal pressure, such as sneezing, coughing, laughing, or lifting, the pressure on the bladder exceeds the ability of the weakened muscles to keep the urethra closed. It is commonly seen in women, especially after childbirth, and may be related to weakened pelvic floor muscles or damaged urethral sphincters. This leads to leakage of urine. Stress incontinence is typically caused by weakened or stretched pelvic floor muscles and tissues that support the bladder and urethra. This weakening can be due to pregnancy, childbirth, obesity, hormonal changes, or aging.

Urgency urinary incontinence also known as overactive bladder (OAB) is characterized by a sudden and intense urge to urinate, often followed by involuntary urine leakage before reaching a restroom. Individuals with urgency incontinence may experience a frequent and uncontrollable need to urinate throughout the day and night. This type of incontinence is primarily caused by involuntary contractions of the bladder muscle (detrusor muscle) that create a sense of urgency. It can result from various factors, including neurological conditions, bladder irritation, certain medications, infections, or idiopathic (unknown) causes.

Overflow urinary incontinence is characterized by frequent or constant dribbling of urine from the bladder, often with the sensation of incomplete bladder emptying. Individuals may also experience difficulty initiating urination and a weak urinary stream. This type of incontinence is typically caused by an obstruction or blockage in the urinary tract, which prevents the bladder from emptying fully. Common causes include an enlarged prostate in men, urinary stones, constipation, or nerve damage that affects bladder contraction.

Neurogenic urinary incontinence occurs when there is a disruption in the normal communication between the nervous system and the bladder. It can manifest as either overactive or underactive bladder function, depending on which nerves are affected. Neurogenic incontinence can result from various neurological conditions or injuries, such as multiple sclerosis, Parkinson’s disease, spinal cord injuries, or stroke. These conditions can disrupt the coordination between the brain, spinal cord, and bladder, leading to either frequent and urgent voiding (overactive bladder) or an inability to empty the bladder completely (underactive bladder).

What are the causes of urinary incontinence?

Urinary incontinence can be caused by a variety of factors that affect the normal function of the urinary system. Some common causes include:

1. Weak Pelvic Floor Muscles

Weakened pelvic floor muscles, often due to childbirth, aging, or obesity, can lead to stress incontinence, where pressure on the bladder from activities like sneezing, laughing, or lifting causes urine leakage.

2. Overactive Bladder Muscles

When the muscles of the bladder contract involuntarily, creating a strong urge to urinate, it can result in urge incontinence or “overactive bladder.” This can be caused by various factors, including neurological conditions, infections, and certain medications.

3. Neurological Disorders

Conditions that affect the nervous system, such as multiple sclerosis, Parkinson’s disease, and stroke, can disrupt the signals between the brain and the bladder, leading to various types of incontinence.

4. Hormonal Changes

Hormonal fluctuations, especially in women during menopause, can lead to changes in the lining of the urethra and the bladder’s ability to store urine, contributing to incontinence.

5. Prostate Issues

In men, an enlarged prostate gland (benign prostatic hyperplasia) or prostate surgery can impact bladder control and lead to incontinence.

6. Urinary Tract Infections

Infections in the urinary tract can cause irritation and overactivity of the bladder, resulting in temporary incontinence.

7. Obstruction

An obstruction in the urinary tract, such as kidney stones or tumors, can disrupt the flow of urine and cause overflow incontinence.

8. Medications

Certain medications, like diuretics, sedatives, and alpha-blockers, can affect bladder function and contribute to incontinence.

9. Chronic Coughing

Conditions such as chronic bronchitis or smoking-related lung diseases can lead to chronic coughing, which can put stress on the pelvic muscles and lead to stress incontinence.

10. Physical Impairments

Mobility issues or physical disabilities that hinder a person’s ability to reach a restroom in time can contribute to functional incontinence.

11. Genetics

Some individuals may be genetically predisposed to developing weak pelvic floor muscles or other anatomical factors that increase the risk of incontinence.

12. Lifestyle Factors

Obesity, excessive caffeine or alcohol consumption, and inadequate fluid intake can exacerbate urinary incontinence symptoms.

Understanding the underlying cause of urinary incontinence is crucial for proper diagnosis and effective treatment.

The mechanism of urinary incontinence

The mechanism of urinary incontinence is closely tied to the role of pelvic floor muscles. Pelvic floor muscles are a group of skeletal muscles that form a sling-like structure at the base of the pelvis. These muscles are crucial for maintaining urinary continence. Here’s how they function:

1. Support: Pelvic floor muscles provide essential support to the bladder and other pelvic organs, keeping them in their proper position.

2. Sphincteric Function: The pelvic floor muscles encircle the urethra and the anal canal. They play a significant role in maintaining the closure of the urethra and preventing involuntary urine leakage. When these muscles contract, they compress the urethra, keeping it closed.

3. Voluntary Control: The external urethral sphincter, a part of the pelvic floor muscles, allows voluntary control over urination. When you choose to urinate, this muscle relaxes, allowing the release of urine. When you want to delay or stop urination, the external urethral sphincter contracts to close off the urethra.

The pelvic floor consists of layers of muscles and connective tissues connecting those muscles (ligaments) and wraps around the entirety of the pelvis. Two main muscles intertwine to form pelvic floor muscles:
Levator ani composes the bulk of the pelvic floor muscles and consists of three separate muscle components:
– pubococcygeus,
– puborectalis and
– iliococcygeus.
The coccygeus is the more minor muscle component in the pelvic floor muscles. It’s located toward the back of the pelvis.

Pelvic floor muscles can weaken as a result of injury or trauma, including childbirth and surgery. They can become stressed during pregnancy or from overuse (repeated heavy lifting, chronic coughing, constipation). They may grow weaker due to hormone changes during menopause and lose strength as a natural part of aging. Conditions like diabetes may also play a role in weakening pelvic floor muscles.

Understanding the role of pelvic floor muscles in maintaining continence and recognizing the factors that disrupt this balance is essential for diagnosing and effectively treating urinary incontinence. Strengthening these muscles through exercises like Kegel exercises can be a valuable part of managing certain types of incontinence, particularly stress incontinence. However, treatment approaches vary depending on the specific type and underlying causes of incontinence.

Common signs and symptoms of urinary incontinence include:

• Leaking urine when coughing, sneezing, laughing, or exercising.
• Feeling sudden, uncontrollable urges to urinate.
• Frequent urination.
• Waking up many times at night to urinate.
• Urinating during sleep.

Although pelvic floor muscles are hidden from view, they can be consciously controlled and therefore trained, much like arm, leg, or abdominal (tummy) muscles. Strengthening pelvic floor muscles will help to actively support and control the bladder. This reduces the likelihood of accidentally leaking from the bladder. Like other muscles in the body, pelvic floor muscles will become stronger with a regular exercise program. This is important for both men and women.

Treatment of urinary incontinence

The treatment of urinary incontinence varies based on the type and underlying causes of the condition. Here are some  treatment approaches for different types of urinary incontinence:

1. Behavioral Interventions:
Behavioral interventions involve modifying habits and patterns that contribute to urinary incontinence. These can include bladder training, scheduled voiding, and fluid and diet management to reduce irritants and excessive urine production.

• Bladder Training: This technique involves gradually increasing the time between trips to the restroom to improve bladder capacity and reduce the frequency of urge incontinence.
• Scheduled Voiding: Establishing a regular schedule for emptying the bladder can help manage both urge and overflow incontinence by preventing overfilling or constant dribbling.
• Fluid and Diet Management: Adjusting fluid intake, particularly reducing caffeine and alcohol consumption, can help decrease bladder irritability and excessive urine production.

2. Pelvic Floor Muscle Exercises (Kegel Exercises):
Kegel exercises focus on strengthening the pelvic floor muscles that support the bladder and urethra. They are effective for both stress and urge incontinence by improving muscle tone and control.

• Stress Incontinence: Strengthening the pelvic floor muscles through Kegel exercises can provide better support to the bladder and reduce stress incontinence episodes.
• Urge Incontinence: Kegel exercises can also help individuals gain better control over their bladder and reduce urgency.

3. Medications:
Medications can help manage urinary incontinence by reducing overactive bladder contractions or relaxing bladder muscles. Anticholinergics and beta-3 adrenergic agonists are commonly prescribed for urge incontinence.

• Anticholinergics: These medications relax the bladder muscles and reduce spasms, making them useful for treating urge incontinence. Examples include oxybutynin, tolterodine, and solifenacin.
• Beta-3 Adrenergic Agonists: Some medications like mirabegron can increase bladder capacity and decrease the frequency of contractions, helping with both urgency and frequency.

4. Medical Devices:
Medical devices such as pessaries, which support the bladder and urethra, and urethral inserts that prevent leakage during specific activities can provide temporary relief for stress incontinence.

• Pessaries: A pessary is a device inserted into the vagina to provide support to the urethra and bladder, helping manage stress incontinence.
• Urethral Inserts: These are tampon-like disposable devices that can be inserted into the urethra to prevent leakage during specific activities.

5. Incontinence Pads and Products:

• Absorbent pads and adult diapers can provide temporary relief and increased confidence, especially for individuals with more severe incontinence.

6. Surgery:
Surgical options are considered for more severe cases of urinary incontinence. Procedures like sling placement or bladder neck suspension can provide additional support to the urethra for stress incontinence.

• Sling Procedures: Surgical placement of a sling under the urethra or bladder neck can provide additional support to prevent stress incontinence.
• Bladder Neck Suspension: A surgical procedure that supports the bladder neck and urethra to treat stress incontinence.
Artificial Urinary Sphincter: For severe cases of stress incontinence, an artificial urinary sphincter can be implanted to provide manual control over the urethral opening.

7. Pelvic floor biofeedback:
Pelvic floor biofeedback is a non-invasive technique that uses sensors to provide real-time feedback about muscle activity and bladder function. For urinary incontinence, pelvic floor biofeedback assists in training individuals to strengthen pelvic floor muscles for stress incontinence and gain control over bladder contractions for urge incontinence.

• Pelvic floor biofeedback for urinary incontinence for pelvic floor muscle retraining is a treatment to help patients learn to strengthen or relax their pelvic floor muscles in order to improve bowel or bladder function and decrease some types of pelvic floor pain.
• Auxiliar muscles biofeedback: In addition to pelvic floor muscles, several other muscle groups such as abdominal, gluteal, quadriceps, etc. can play a role in managing urinary incontinence, depending on the type and underlying causes of the condition. EMG pelvic floor biofeedback is a valuable therapeutic technique used to target and train various muscle groups beyond the pelvic floor muscles in managing urinary incontinence, depending on the specific type and causes of the condition.

8. Neuromodulation:
• Sacral Nerve Stimulation: Electrical stimulation of the sacral nerves can help regulate bladder function and treat urge incontinence.

9. Botox Injections:
• Botox injections into the bladder muscle can help control overactive bladder symptoms by temporarily relaxing the muscle and reducing spasms.

10. Lifestyle Modifications:
• Maintaining a healthy weight, avoiding constipation, practicing good hygiene, and managing chronic cough can help alleviate urinary incontinence symptoms.

It’s important to note that the appropriate treatment depends on a thorough evaluation by a healthcare professional, who will consider factors such as the type and severity of incontinence, its underlying causes, the individual’s overall health, and their preferences. A comprehensive treatment plan may involve a combination of approaches, with pelvic floor biofeedback playing a pivotal role in empowering individuals to gain control over their bodily functions and improve their quality of life.

Pelvic Floor Muscle Exercises (Kegel Exercises)

In the context of urinary incontinence, particularly stress incontinence and some forms of urge incontinence, it’s essential to target and strengthen the pelvic floor muscles. These muscles play a crucial role in supporting the bladder, urethra, and other pelvic organs, and they are directly involved in urinary control. Strengthening these muscles can improve their ability to contract and relax appropriately, helping to prevent leakage and improve bladder control.

1. Support: Pelvic floor muscles provide support to the bladder, helping to keep it in its proper position.
2. Sphincteric Function: These muscles help maintain closure of the urethra, preventing urine leakage when there is increased abdominal pressure (as in stress incontinence).
3. Urge Control: Strong pelvic floor muscles can also help suppress sudden urges to urinate (as in some forms of urge incontinence) by providing better voluntary control.

Pelvic floor muscle exercises, often referred to as Kegel exercises, are designed to target and strengthen these muscles. When done correctly and regularly, Kegel exercises can be effective in reducing urinary incontinence episodes and improving overall bladder control.

To perform Kegel exercises:

1. Locate the Muscles: Identify the pelvic floor muscles by trying to stop the flow of urine during urination. The muscles you engage to do this are the ones you’ll be working on during Kegel exercises.

2. Isolate the Muscles: Once you’ve identified the muscles, practice contracting and relaxing them without using other muscles like the abdomen or buttocks.

3. Start Slowly: Begin with short contractions, holding for a few seconds, and then relax. Gradually increase the duration and intensity of the contractions as you become more comfortable.

4. Be Consistent: Perform these exercises regularly. It’s often recommended to aim for several sets of 10 repetitions throughout the day.

Remember that it’s crucial to perform Kegel exercises correctly to avoid straining other muscles and to ensure you’re targeting the pelvic floor muscles effectively. If you’re uncertain about how to do Kegel exercises properly, consider consulting a healthcare professional or a pelvic floor physical therapist who can provide guidance and personalized instructions. Additionally, pelvic floor biofeedback techniques can assist in ensuring that you’re engaging the right muscles during pelvic floor exercises, enhancing their effectiveness in managing urinary incontinence.

Auxiliary muscles exercise in urinary incontinence

In addition to pelvic floor muscles, several other muscle groups can play a role in managing urinary incontinence, depending on the type and underlying causes of the condition. Here are some of the muscles and muscle groups that may be involved in the treatment of urinary incontinence:

1. Abdominal Muscles (Transverse Abdominis): Strengthening the transverse abdominis, which is the deepest layer of abdominal muscles, can help provide additional support to the pelvic organs and reduce pressure on the bladder. This is particularly relevant for stress incontinence.

2. Oblique Abdominal Muscles: The oblique muscles, both internal and external, can help stabilize the trunk and provide support to the pelvic area. Exercises that engage these muscles can assist in managing stress incontinence.

3. Gluteal Muscles: The gluteal muscles (buttocks) play a role in pelvic stability and posture. Strengthening these muscles can help maintain proper alignment of the pelvis and contribute to better overall pelvic health.

4. Thigh Muscles (Quadriceps and Hamstrings): Strong thigh muscles can assist in activities like rising from a seated position and maintaining balance, which can reduce the risk of falls and related stress incontinence.

5. Lower Back Muscles (Erector Spinae): Strengthening the lower back muscles can help support the spine and maintain proper posture, indirectly contributing to pelvic health.

6. Diaphragm: The diaphragm, the primary muscle used in breathing, is connected to the pelvic floor through the core muscles. Learning to engage and coordinate the diaphragm with the pelvic floor can assist in overall core stability and urinary control.

7. Hip Adductors and Abductors: The muscles responsible for moving the thighs toward or away from the midline of the body can impact pelvic stability and balance.

It’s important to note that while these muscle groups can indirectly influence urinary continence, the primary focus for addressing urinary incontinence remains the pelvic floor muscles. Strengthening the pelvic floor muscles through exercises like Kegel exercises is usually the first-line approach for treating stress incontinence and some forms of urge incontinence.

However, a comprehensive approach to managing urinary incontinence may include exercises that engage these other muscle groups as part of a broader physical therapy or rehabilitation program. Additionally, maintaining overall physical fitness, which involves working on various muscle groups, can contribute to improved pelvic health and better urinary control. Consultation with a healthcare professional or a pelvic floor physical therapist can help design a personalized exercise regimen tailored to your specific needs and condition.

EMG Pelvic floor biofeedback for urinary incontinence

What pelvic floor biofeedback muscle retraining is?

Pelvic floor biofeedback muscle retraining is a treatment to help patients learn to strengthen or relax their pelvic floor muscles in order to improve bowel or bladder function. It is a painless process that uses special sensors and a computer or mobile phone monitor to display information about muscle activity. This information or “feedback” is used to gain sensitivity, and with practice, control over pelvic floor muscle function. An important part of pelvic floor biofeedback therapy is the consistent practice of pelvic floor muscle exercises at home. With pelvic floor biofeedback, an individual can learn to stop using the incorrect muscles and start using the correct ones.

Pelvic floor biofeedback has shown promising effectiveness in the management of urinary incontinence, particularly for conditions like stress incontinence and urge incontinence. This non-invasive technique utilizes real-time physiological data to help individuals gain awareness and control over their pelvic floor muscles and bladder function. Here’s how pelvic floor biofeedback proves effective:

Stress Incontinence: Pelvic floor biofeedback helps individuals strengthen their pelvic floor muscles, which are crucial for supporting the bladder and preventing leakage during activities that increase intra-abdominal pressure. By providing visual or auditory cues that indicate when the correct muscles are being contracted, individuals can learn proper muscle engagement techniques. Over time, consistent practice guided by pelvic floor biofeedback can lead to improved muscle strength and endurance, resulting in reduced or eliminated episodes of stress incontinence.

Urge Incontinence (Overactive Bladder): Pelvic floor biofeedback assists in training individuals to recognize the early signs of an impending urge to urinate. By monitoring bladder contractions and providing feedback when the bladder muscles start to contract involuntarily, individuals can learn to control these contractions and suppress the urge. This technique essentially empowers individuals to retrain their bladder and enhance their ability to delay urination until an appropriate time and place.

Efficacy and Benefits of pelvic floor biofeedback

Numerous clinical studies have demonstrated the effectiveness of pelvic floor biofeedback in reducing urinary incontinence episodes and improving overall bladder control. It offers several benefits, including:

1. Personalized Training: Pelvic floor biofeedback tailors training to an individual’s specific needs, adapting to their progress and challenges.
2. Non-Invasive: Unlike surgical interventions, pelvic floor biofeedback is non-invasive and carries minimal risks or side effects.
3. Empowerment: By providing real-time feedback, individuals feel empowered and engaged in their treatment process.
4. Holistic Approach: Pelvic floor biofeedback complements other treatment options, such as pelvic floor exercises and lifestyle modifications.
5. Psychological Well-being: Gaining control over bladder function often leads to improved self-esteem, confidence, and emotional well-being.
6. Long-Term Benefits: Consistent pelvic floor biofeedback training can lead to sustainable improvements, reducing the need for medication or more invasive procedures.

While pelvic floor biofeedback offers promising outcomes, its effectiveness can vary based on factors like individual commitment, the severity of incontinence, and the guidance of skilled healthcare professionals. Combining pelvic floor biofeedback with other strategies, such as pelvic floor exercises and behavioral modifications, can enhance its overall impact. As technology advances and research continues, biofeedback holds the potential to play an increasingly significant

Electromyographic (EMG) biofeedback for auxiliary muscles in UI

Electromyographic (EMG) biofeedback is a valuable therapeutic technique used to target and train various muscle groups beyond the pelvic floor muscles in managing urinary incontinence, depending on the specific type and causes of the condition.

Here’s how EMG auxiliary muscle biofeedback can be employed for these purposes:
1. Abdominal Muscles (Transverse Abdominis and Obliques):
• Purpose: Strengthening the transverse abdominis and oblique abdominal muscles can provide additional support to the pelvic area, reducing pressure on the bladder and assisting in the management of stress incontinence.
EMG sensors can be placed on the abdominal muscles to monitor their activity during specific exercises. Patients can visualize this activity on a screen or receive auditory cues, helping them learn to engage and strengthen these muscles effectively.

2. Lower Back Muscles (Erector Spinae):
Purpose: Strengthening the erector spinae muscles can contribute to better spinal stability and posture, indirectly influencing pelvic health and urinary control.
EMG sensors can be positioned on the lower back muscles, allowing patients to monitor muscle engagement and ensure that they are targeting the correct muscles during exercises.

3. Hip Muscles (Adductors and Abductors):
Purpose: The hip adductors and abductors play a role in pelvic stability and balance, which can affect urinary control.
EMG biofeedback can be used to assess the activity of these hip muscles during specific movements or exercises, helping individuals focus on improving their strength and coordination in this area.

4. Diaphragm:
Purpose: Coordinating the diaphragm with pelvic floor muscles and other core muscles can enhance overall core stability and control, indirectly impacting urinary continence.
EMG sensors placed on the diaphragm can assist individuals in learning to coordinate its activity with the pelvic floor and other muscle groups during exercises aimed at improving core strength and stability.

How EMG biofeedback for auxiliary muscles works

• EMG biofeedback involves the placement of sensors or electrodes on the targeted muscle groups. These sensors detect and record the electrical activity generated by muscle contractions.
• The EMG signals are then transmitted to a monitoring device, which can be a computer screen or an auditory feedback system.
• Patients receive real-time visual or auditory cues based on their muscle activity. This feedback allows them to observe and adjust their muscle engagement, ensuring they are targeting the right muscles and using proper techniques during exercises.
• Over time, patients can learn to control and strengthen these muscle groups effectively, which can contribute to improved bladder control and the management of urinary incontinence.

EMG biofeedback can be particularly beneficial when working on specific muscle groups to complement other treatment approaches, such as pelvic floor exercises. It helps individuals gain awareness of muscle activity and ensures that exercises are performed correctly, ultimately enhancing the effectiveness of the overall incontinence management plan.

Sacral Area Biofeedback

Sacral area biofeedback and stimulation are therapeutic approaches used in the treatment of urinary incontinence, particularly for certain types of incontinence like overactive bladder (urge incontinence) and some cases of mixed incontinence.

Sacral area biofeedback involves the use of sensors or electrodes placed on or near the sacral area, which is the region at the base of the spine near the tailbone. These sensors detect electrical or muscular activity in the pelvic floor and bladder muscles. Here’s an overview of these techniques:

• Mechanism: During biofeedback sessions, the sensors provide real-time information on the activity of the pelvic floor muscles and the bladder. Patients can see this feedback on a monitor, allowing them to gain awareness of muscle contractions and bladder function.
• Benefits: Sacral area biofeedback helps individuals learn to control pelvic floor muscles more effectively, improve coordination, and increase the ability to suppress unwanted contractions. It can also enhance the relaxation of the bladder muscles when needed.
• Training: Biofeedback sessions are often conducted by trained healthcare professionals, such as pelvic floor physical therapists. These sessions guide patients in practicing muscle control techniques while monitoring their progress on the biofeedback display.
• Effectiveness: Sacral area biofeedback is particularly useful for people with urge incontinence or overactive bladder. It assists in training individuals to gain better control over bladder contractions, reduce urgency, and improve bladder capacity.

Sacral Nerve Stimulation (SNS)

Sacral nerve stimulation, also known as neuromodulation, involves the implantation of a device that sends electrical impulses to the sacral nerves, which are involved in bladder control.

• Mechanism: The implanted device delivers controlled electrical stimulation to the sacral nerves, modulating their activity. This neuromodulation affects the communication between the brain, spinal cord, and bladder, helping to regulate bladder function.
• Benefits: SNS is typically recommended for individuals with overactive bladder symptoms who have not responded to conservative treatments. It can reduce urgency, frequency, and incontinence episodes.
• Procedure: The SNS device is surgically implanted, and its settings can be adjusted externally by a healthcare professional. It is a reversible procedure, and if the individual does not experience relief or encounters side effects, the device can be turned off or removed.
• Effectiveness: SNS has shown promising results in the treatment of overactive bladder, improving urinary symptoms and quality of life for many patients.

Both sacral area biofeedback and sacral nerve stimulation are typically considered after conservative treatments like pelvic floor exercises and medications have been tried without success. They offer alternative options for individuals who are seeking additional interventions to manage urinary incontinence, particularly when it is related to overactive bladder or neurological factors. These treatments are usually recommended and managed by urologists or healthcare providers with expertise in incontinence management.

It’s important to note that the effectiveness of biofeedback for urinary incontinence can vary based on factors such as the individual’s dedication to the therapy, the severity of their condition, the guidance of a skilled healthcare professional, and the consistency of practice.

Clinical studies have generally reported success rates ranging from around 60% to 90% in terms of improvement in symptoms and quality of life. However, these success rates can vary widely depending on the study population, methodology, and duration of treatment.

Auxiliary Muscles and Pelvic Floor Biofeedback Personal Use Device

NeuroTrack MyoPlus 2 Pro
NeuroTrac Simplex EMG Biofeedback box
Motor tics

Effectiveness of Neurofeedback in Tourette’s Syndrome and Tic Disorder Management

Tics are irregular, uncontrollable, unwanted, and repetitive movements of muscles that can occur in any part of the body. Movements of the limbs and other body parts are known as motor tics. Involuntary repetitive sounds, such as grunting, sniffing, or throat clearing, are called vocal tics. Tourette’s syndrome (TS) is a complex neurological disorder. It is characterized by multiple tics – both motor and vocal. It is the most severe and least common tic disorder. This disorder is related to multiple neuroanatomical and neurophysiological deviations, primarily reduced sensorimotor rhythm (SMR) and excessive fronto-central Theta activity. Recent research has proposed neurofeedback in Tourette’s Syndrome and Tic Disorders as a promising treatment option, particularly in terms of helping patients control their tics and treat the cognitive dysfunctions commonly associated with TS.

Tic disorders can usually be classified as motor, vocal, or Tourette’s syndrome, which is a combination of both. Motor and vocal tics can be short-lived (transient) or chronic. Tourette’s is considered to be a chronic tic disorder.

Children with transient tic disorder will present with one or more tics for at least 1 month, but for less than 12 consecutive months. The onset of the tics must have been before the individual turned 18 years of age. Motor tics are more commonly seen in cases of transient tic disorder than vocal tics. Tics may vary in type and severity over time. According to the American Academy of Child and Adolescent Psychiatry, a transient tic disorder, or provisional tic disorder affects up to 10% of children during their early school years.

Tics that appear before the age of 18 and last for 1 year or more may be classified as a chronic tic disorder. These tics can be either motor or vocal, but not both. A chronic tic disorder is less common than transient tic disorder, with less than 1% of children affected.

If the child is younger at the onset of a chronic motor or vocal tic disorder, they have a greater chance of recovery, with tics usually disappearing within 6 years. People who continue to experience symptoms beyond age 18 are less likely to see their symptoms resolved.

Some research suggests that tics are more common among children with learning disabilities and are seen more in special education classrooms. Children within the autism spectrum are also more likely to have tics.

Tourette’s syndrome (TS) is the most severe and least common tic disorder. The Centers for Disease Control and Prevention (CDC) report that the exact number of people with TS is unknown. CDC research suggests that half of all children with the condition are not diagnosed. Currently, 0.3% of children aged 6 to 17 in the US have been diagnosed with TS. Symptoms of TS vary in their severity over time. For many people, symptoms improve with age. TS is often accompanied by other conditions, such as attention deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD).

Tourette Syndrome is a neurodevelopmental disorder characterized by persistent, chronic, and involuntary tics. These tics manifest as either motor or phonic (vocalizations) and can range from simple tics such as blinking, sniffing, and head twitching to more complex such as repetitive swearing, spinning around, and jumping. The cause of Tourette’s is unknown but it is likely that both hereditary and nongenetic factors contribute to its development.

The onset of Tourette syndrome is usually in childhood between the ages of 2 and 21 years. The disorder affects more males than females with a ratio of approximately 3 males to every 1 female diagnosed. Tourette’s is a highly individualistic disorder with differing levels of severity, frequency, and impairment. 

Whilst the exact cause of Tourette Syndrome is unknown, it is believed that the presence of tics is associated with abnormalities in the brain. In particular, it is suggested there is a distribution in the circuits which link the basal ganglia (the site which controls voluntary motor movements, eye movements, and emotion) to the frontal cortex.

Individuals with Tourette Syndrome display impaired performance in cognitive tasks in terms of memory, attention, reading, and writing. These impairments are often more severe in individuals diagnosed with comorbid ADHD who also display less cognitive flexibility. It is estimated that 70% of patients with Tourette Syndrome exhibit ADHD type behaviors and as such, Tourette Syndrome can be a debilitating diagnosis for many people.

If someone has tics, it doesn’t mean that this person has Tourette’s syndrome. Tics have to be present for at least one year to be classified as Tourette’s syndrome and at least one of tics has to be vocal.

Symptoms of Tic Disorder

The defining symptom of tic disorders is the presence of one or more tics. These tics can be classified as:

  • Motor tics: These include tics, such as head and shoulder movements, jerking of the head, twisting the neck, rolling the eyes, blinking, jerking, banging, clicking fingers, or touching things or other people. Motor tics tend to appear before vocal tics, although this is not always the case.
  • Vocal tics: These are sounds, such as coughing, blowing, throat clearing or grunting, or repeating words or phrases.

Tics can also be divided into the following categories:

  • Simple tics: These are sudden and fleeting tics using few muscle groups. Examples include nose twitching, eye darting, or throat clearing.
  • Complex tics: These involve coordinated movements using several muscle groups. Examples include hopping or stepping in a certain way, gesturing, or repeating words or phrases.

Tics are usually preceded by an uncomfortable urge, such as an itch or tingle. While it is possible to hold back from carrying out the tic, this requires a great deal of effort and often causes tension and stress. Relief from these sensations is experienced upon carrying out the tic.

The symptoms of tic disorders may:
• worsen with emotions, such as anxiety, excitement, anger, and fatigue,
• worsen during periods of illness,
• worsen with extreme temperatures,
• occur during sleep,
• vary over time,
• vary in type and severity,
• improve over time.

Causes and risk factors for Tourette's syndrome and Tic Disorders

The exact cause of tic disorders is unknown. Within Tourette’s research, recent studies have identified some specific gene mutations that may have a role. Brain chemistry also seems to be important, especially the brain chemicals glutamate, serotonin, and dopamine.

Tics that have a direct cause fit into a different category of diagnosis. These include tics due to:
• head injuries,
• stroke,
• infections,
• poisons,
• surgery,
• other injuries.

In addition, tics can be associated with more serious medical disorders, such as Huntington’s disease or Creutzfeldt-Jakob disease.

Risk factors for tic disorders include:
Genetics: Tics tend to run in families, so there may be a genetic basis to these disorders.
Sex: Men are more likely to be affected by tic disorders than women.

Conditions associated with tic disorders

Conditions associated with tic disorders, especially in children with TS, include:

• anxiety
• depression
• autic spectrum disorder
• learning difficulties
• speech and language difficulties
• sleep difficulties

Other conditions associated with tic disorders are related to the effect of the tics on self-esteem and self-image. Some research has found that children with TS or any chronic tic disorder experience a lower quality of life and lower self-esteem than those without one of these conditions.

In addition, the Tourette Association of America says that people with TS often experience difficulties with social functioning due to their tics and associated conditions, such as ADHD or anxiety.

Tourette graphic

Brain changes in Tourette's Syndrome and Tic Disorders

The frequent comorbidity of TS and ADHD may reflect a common underlying neurobiological substrate, and studies confirm the hypothesized involvement of fronto-striatal circuits in both TS and ADHD. However, poor inhibitory control and volumetric reductions in fronto-striatal circuits appear to be core features of ADHD, whereas reduced volumes of the caudate nucleus, together with activation and hypertrophy of prefrontal regions that likely help to suppress tics, seem to be core features of TS. (Neuroimaging of tic disorders with co-existing attention-deficit/hyperactivity disorder – Kerstin J. Plessen, M.D., Jason M. Royal, D.M.A., and Bradley S. Peterson, M.D.)

Activity in a region of the brain called the supplementary motor area (SMA) has been associated with tics. The investigators put tic patients into the MRI scanner and had a real-time functional magnetic resonance imaging neurofeedback session. The patients could see the SMA light up and they could try to control that area by focusing their thoughts on it. The patients who received the real neurofeedback had a greater reduction of tics on the Yale Global Tic Severity Scale as compared with the sham control.

Researchers at Washington University School of Medicine in St. Louis have identified areas in the brains of children with Tourette’s syndrome that appear markedly different from the same areas in brains of children who don’t have the disorder. 

In kids with Tourette’s, the researchers also found less white matter around the orbital prefrontal cortex, just above the eyes, and in the medial prefrontal cortex, also near the front, than in kids without the condition.

White matter acts like the brain’s wiring. It consists of axons that — unlike the axons in gray matter — are coated with myelin and transmit signals to the gray matter. Less white matter could mean less efficient transmission of sensations, whereas extra gray matter could mean nerve cells are sending extra signals.

In a scan of a child with Tourette’s, yellow indicates an area with less white matter than in the same brain region in kids who don’t have the disorder. The scans also revealed areas in the brains of kids with Tourette’s that have more gray matter (posterior thalamus, hypothalamus, and midbrain) than in children without the condition.

Deficits in executive functioning which contribute to ADHD symptoms also appear in TS, with the same losses of structural integrity in the cortico-striatal and cortico-thalamic pathways common to both disorders. Neurophysiological processes governing these deficits in executive functioning have proven modifiable by neurofeedback.

Clinical researchers Chuanjun Zhuo & Li Li (2014) found that neurofeedback training improved motor and vocal tic symptoms (e.g. a reduction in the frequency and intensity of tics) in adolescents with refractory Tourette syndrome.

Simone Messerotti Benvenuti et al. (2011) SMR up-training/Theta down-training schedule was utilized for sixteen sessions, followed by a further six purely using SMR up-training. SMR increase was better obtained when SMR up-training was administered alone, Whereas Theta decrease was observed after both types of trainings. 

After 40 sessions of SMR training, 75% of patients demonstrated an increase in the production of SMR and a positive change in theta/beta ratio.

It was therefore hypothesized that this training of the sensorimotor cortex results in increased voluntary muscle control and elimination of tics.

Neurofeedback in Tourette’s syndrome and Tic Disorders

Neurofeedback training is a self-regulation strategy. The brain is trained at the point where the tics are to reduce or eliminate them. In a brain with TS there is over-arousal. There is a high degree of excitability of the motor system. The overarching need is for this brain to experience calming, both in general and specifically in regard to motor circuits. When such calming is achieved tics (motor and vocal) may be reduced.

With the right approach, Neurofeedback practitioners have seen significant improvement in symptoms in the vast majority of cases. Nonetheless every case is different and sometimes you may not experience the reduction of tics but overall you should feel more relaxed and you should notice a better quality of sleep. This is a condition that appears to benefit from long-term training.

Presently, medications used to treat tics can cause unforeseen side effects, whereas neurofeedback therapy can be tailored to more accurately target the area of the brain that needs changing.

By Dr. Clare Albright – “Neurofeedback – Transforming Your Life With Brain Biofeedback” –

Learn, why Neurofeedback management of the Migraine is so effective, what neurofeedback protocol to use. Get rid of migraine headache.

Neurofeedback for Migraines. Neurofeedback Protocols.

Migraine is a debilitating illness with long term consequences for the brain. Researches had explored the origins of migraine and suggest that it is an electrical phenomenon initiated in the occipital cortex. Assessments of the brain using the EEG have found abnormal electrical activity supporting this idea. Neurofeedback for migraines is a treatment targeting electrical firing patterns in the brain. Many research data had shown that NFB training/treatment successfully suppresses abnormal brain wave activity leading to a significant decrease in migraine frequency and improvement in associated psychoneurological states such as anxiety, depression, and sleep.


Migraine is a severe health problem which is the second most common one among the primary headaches, which affects 3-10 to 30-38% of the world’s population and which affects the quality of life negatively. Migraine is a disabling neurological condition characterized by episodic attacks of usually unilateral headache, with pulsating character and light and sound intolerance, associated with nausea and vomiting.

The tendency to suffer from migraine has a genetic component, but attacks can be triggered by a series of internal and external factors.

Migraine is a disease with many faces. The most common form is migraine without aura, occurring in about 80% of patients, while migraine with aura occurs in about 20% of the patients.

The annual costs of migraines such as diagnosis, treatment, reduced productivity, and absence from work is estimated to be 5 billion euros in the European Union and about 29 billion in the USA.

The incidence of migraine before puberty is greater in boys than in girls. It grows up to 12 years in both sexes and is the highest in the age range of 30–40 years. After puberty, the ratio changes and increases in favor of women and with 40 are 3.5:1. After 40 years, the strength of the symptoms is reduced (except for women in perimenopause), and the beginning of migraine headaches in the fifties is rare.

Migraine trigger checklist

Migraine trigger checklist

The main symptom of migraine is recurring, severe, most often localized in one half of the head (hemicrania), throbbing headache, which can last from 4 to 72 hours. It usually begins in the temporal region, in the eyeballs or in the frontal region. Pain may also occur in the face, neck. During a migraine attack, visual disturbances, increased sensitivity in the hands, dizziness, tinnitus, and increased sensitivity to light or noise may be observed. At the end of an attack, nausea and vomiting may occur.

There are migraines with and without aura. Aura is a complex of neuropsychological symptoms that anticipate the onset of pain, become the first signs of a migraine, or develop simultaneously with a headache. They are caused by a spasm of cerebral vessels, which occurs at the initial stage of an attack.

Symptoms associated with Migraine are:

  • Severe pain in the head or eyes;
  • Being worse on one side of the head;
  • Nausea
  • Vomiting;
  • Dizziness ;
  • Perceiving an aura;
  • Blurred or tunnel vision;
  • Seeing auras;
  • Photophobia (sensitivity to light);
  • Phonophobia (sensitivity to sound);
  • Osmophobia (sensitivity to smells);
  • Poor concentration;
  • Ringing in the ears;
  • Sweating;
  • Feeling very hot or very cold;
  • Abdominal pain (which can sometimes cause diarrhea);
  • A frequent need to urinate. 

The pathogenesis of migraine

The pathogenesis of migraine has long been a subject of discussion among scientists. It has been considered that typical headaches are caused by intracranial vasodilation preceded by vasoconstriction causing aura—vascular theory. Today it is known that this is not the case, and although new findings have emerged, the exact mechanism and genetic determinants are not yet fully clarified.

For a long time, it was thought that the cause of the aura, which precedes headaches, is cerebral vasoconstriction. Today, this theory is denied, and the aura is explained by neural dysfunction rather than ischemia due to vasoconstriction.

The frequency with which migraine attacks occur may vary from once in a lifetime to almost daily, an indication that the degree of migraine predisposition varies individually. It is necessary to consider both the factors that influence the threshold of a person’s susceptibility to a migraine attack and also the mechanisms that trigger the attack and the associated symptoms.

Acute migraine attacks occur in the context of an individual’s inherent level of vulnerability. The greater the vulnerability/lower the threshold, the more frequent attacks occur. Attacks are initiated when internal or environmental triggers are of sufficient intensity to activate a series of events that culminate in the generation of a migraine headache. Many migraineurs experience vague vegetative or affective symptoms as much as 24 hours prior to the onset of a migraine attack. This phase is called the prodrome and should not be confused with the aura phase.

The aura phase consists of focal neurological symptoms that persist up to one hour. Symptoms may include visual, sensory, or language disturbance, as well as symptoms, localizing to the brainstem.

Within an hour of resolution of the aura symptoms, the typical migraine headache usually appears with its unilateral throbbing pain and associated nausea, vomiting, photophobia, or phonophobia. Without treatment, the headache may persist for up to 72 hours before ending in a resolution phase often characterized by deep sleep.

For up to twenty-four hours after the spontaneous throbbing has resolved, many patients may experience malaise, fatigue, and transient return of the head pain in a similar location for a few seconds or minutes following coughing, sudden head movement, or Valsalva movements. This phase is sometimes called the migraine hangover (postdrome).

It is becoming increasingly clear that much of the vulnerability to migraine is inherited.

Migraine is, in essence, a familial episodic disorder whose key marker is a headache, with certain associated features. One of the most important aspects of the pathophysiology of migraine is the inherited nature of the disorder. It is clear from clinical practice that many patients have first-degree relatives who also suffer from migraines. Transmission of migraines from parents to children has been reported as early as the seventeenth century, and numerous published studies have reported a positive family history.

In approximately 50% of the reported families, Familial hemiplegic migraine (FHM) has been assigned to chromosome 19p13. The biological basis for the linkage to chromosome 19 is mutations involving the Ca 2.1 (P/Q) type voltage-gated calcium channel CACNA1A gene. Dysfunction of these channels might impair serotonin release and predispose patients to migraine or impair their self-aborting mechanism.

Migraine aura

Migraine aura is defined as a focal neurological disturbance manifest as visual, sensory or motor symptoms. It is seen in about 30% of patients, and it is clearly neurally driven. Visual aura has been described as affecting the visual field, suggesting the visual cortex, and it starts at the center of the visual field, propagating to the periphery at a speed of 3 mm/min. Blood flow studies in patients have also shown that a focal hyperemia tends to precede the spreading oligemia. However some researchers conclude that migraine aura is evoked by aberrant firing of neurons.

Shown is the entire hemisphere, from a posterior-medial view. The aura-related changes appeared first in extrastriata cortex. The spread of the aura began and was most systematic in the representation of the lower visual field, becoming less regular as it progressed into the representation of the upper visual field.


The study of anatomy and physiology of pain-producing structures in the cranium and the central nervous system modulation of the input have led to the conclusion that migraine involves alterations in the subcortical aminergic sensory modulatory systems that influence the brain widely.

Available research data had shown that no structural differences have been found in individuals with migraine compared to individuals without migraine. This research suggests that migraine is an electrical phenomenon initiated within the cortex of the brain. This phenomenon is known as Cortical Spreading Depression (CSD) referring to a wave of electrophysiological hyperactivity that spreads through the brain from the occipital lobes forward. This wave affects the cortex in several ways: altering the electrical polarity of neurons, decreasing blood flow and associated levels of oxygen in the cortex and altering the degree of vasodilation within the vascular system of the cortex. These changes release of nerve irritating chemicals into the brain. These chemicals irritate the pain transmitting the “trigeminal” nerve system in the meninges, the sensitive membranes that cover the brain. The result is severe blinding pain.

Consequences of migraine to the brain are:

  • impaired ability in tests of short and long term memory,
  •  small areas of stroke-like damage to the brain,
  • with a high frequency of Migraine (more than three attacks per month) show significantly more areas of damage than those with fewer attacks,
  • with a history of Migraines longer than 15 years were found to have more changes in the brain than those with a shorter history,
  • higher frequency migraines show abnormalities in both white and gray matter of the brain,
  • people with migraine are more at risk for future strokes,
  • show a predilection toward damage in the following sites:
    – frontal lobe
    – limbic system
    – parietal lobes
    – brainstem
    – cerebellum

Chronic migraine comorbidities


There are two ways in which anomalies in the EEG have been associated with migraine: via the relationship of migraine to seizure activity and as a function of slow brain waves found elsewhere in the brain. Migraine and epilepsy frequently coexist and are often difficult to differentiate. Both migraine and seizure prone individuals show abnormal occipital discharges that are typically high voltage (200–300 mV), with a diphasic morphology, and a unilateral or bilateral occipital and postero-temporal distribution.

Migraine has been associated with abnormal EEG activity elsewhere in the brain. Both unilateral and bilateral increased delta wave activity has been recorded during a hemiplegic migraine and during attacks of migraine with disturbed consciousness. It is shown that in the waking, non-migraine state there are slow waves in the theta range (48 hertz). Neurofeedback for migraines has been used to target and suppress this slow-wave activity in both adults and children with a concomitant reduction in frequency and intensity of migraine. Some research has shown that neurofeedback blood flows up training in the frontal cortex results in a 70% reduction in the frequency of migraines compared with 50% reduction using medication alone. NFB training is also associated with decreases in anxiety, depression and improved sleep, each of which has been associated with migraines.

Newer methods, i.e. EEG frequency analysis and topographic brain mapping, are promising tools in this field. So far, mostly small studies have been published with somewhat inconsistent results. A pattern of increased alpha rhythm variability (and/or asymmetry) in the headache-free phase seems to emerge, however. Significant asymmetry of alpha and theta during headache has been reported in topographic brain mapping study.

The EEG patterns observed in migraine patients seem to suggest a possible physiological connection between sleep, hyperventilation, and migraine.

EEG activity seems to change shortly before the attack. This suggests that migraineurs are most susceptible to attack when anterior QEEG delta power and posterior alpha asymmetry values are high.
Occipitoparietal and temporal alpha power were more asymmetric before the attack compared with the interictal baseline

Different research had found the increased power in 19 cortical areas in delta (1.5-3.5 Hz), theta (4.0-7.5 Hz) and high-frequency beta (21-30 Hz) bands. Multiple types of research had shown significant abnormalities in the high-frequency beta band (21-30 Hz) in parietal, central and frontal regions.

How Neurofeedback Training Manage Migraines? Migraine Neurofeedback Protocols.

Despite a large number of medications are used to treat migraine today, only 20% of patients report their effectiveness. Many develop resistance to medications, and therefore the dose of the drug is gradually increasing, which is required to achieve the effect of relieving headache. Often the medication is accompanied by side effects.

In patients with migraine, changes in the biological parameters of brain activity, brain waves, are often recorded. Neurofeedback is recently developed technologies for treating migraines are based on recording these changes in brain wave activity and transmitting information about their condition in the form of audio and video signals to the patient. Based on these audio and video signals, the patient learns how to manage his condition so as to regulate brain wave activity and normalize it. Normalization of wave activity leads to a significant decrease in both the frequency and intensity of headaches. At first, these changes are not stable but gradually become stable and permanent. It becomes possible (after about 10 sessions of treatment) to manage the condition without the support of special equipment and computer program.

Migraine research points to electrophysiological anomalies in the brain as correlates of migraine headaches. Neurofeedback, as a therapy, is specifically designed to target dysregulated firing patterns in the brain. Research has demonstrated the ability of NFB to successfully treat anomalous brainwave patterns in a variety of conditions and most specifically with migraines.

After performing diagnostic scanning and getting brain mapping pattern of the patients with migraine some clinicians provide neurofeedback training with an increase of SMR and low beta 12-15 Hz and decrease theta (4-7Hz) and high beta (21-30 Hz) at each affected site in a number of 5 sessions for each affected site.

qEEG Before and after Neurofeedback for Migraines

More frequently are used the Neurofeedback Protocol for migraine management as follow:

Left-sided headaches – at C3 (T3)
down-trained: 2-7 Hz and high-frequency beta
up-trained: 15-18 Hz

Right-sided headaches – at C4 (T4)
down-trained: 2-7 Hz and high-frequency beta
up-trained: 12-15 Hz

An average number of neurofeedback sessions to get a significant change to occur are around 20-30 sessions. A person can get a neurofeedback session as much as twice a day with at least a two-hour break in between. It is recommended that a person try to do neurofeedback at least two or three times a week until the sessions are completed. Results appear to solidify and happen faster when done more frequently.

How effective is neurofeedback for migraines?

Neurofeedback for migraines can help with dysfunctions in the central nervous system, such as the increased excitability of the cerebral cortex. Because of working directly with the central nervous system, Neurofeedback training can be very effective in stabilizing the excitability of the cerebral cortex what will result in reduced headaches, less sensitivity, and improvements in other symptoms associated with Migraine.
The researchers concluded, “Neurofeedback appears to be dramatically effective in abolishing or significantly reducing headache frequency in patients with recurrent migraine”.

Walker (Walker, J. E. (2011). QEEG‐Guided Neurofeedback for Recurrent Migraine Headaches. Clinical EEG and Neuroscience, 42(1), 59‐61. doi:10.1177/155005941104200112) examined the effects of neurofeedback therapy versus drug therapy in 71 patients with recurrent migraine headaches. After completion of a quantitative electroencephalogram (QEEG) procedure, all results indicated an excess of high-frequency beta activity (21‐30 Hz). Twenty‐five patients chose to continue with drug therapy for their recurring migraines, whilst 46 of the 71 patients selected neurofeedback training. Of those who chose neurofeedback therapy, the majority (54%) reported complete abolishment of their migraines, 39% experienced a significant reduction in migraine frequency of greater than 50%, and 4% experienced a decrease in the frequency of less than 50%. Only one patient did not report a reduction in headache frequency. The control group of participants who opted to continue drug therapy as opposed to neurofeedback experienced no change in headache frequency (68%), a reduction of less than 50% (20%), or a reduction greater than 50% (8%). Overall, the study demonstrates that neurofeedback is significantly effective in abolishing or substantially reducing the frequency of headaches in patients with recurrent migraines.

Effectiveness of Neurofeedback vs. Drug Management of the Migraine

Effectiveness of Neurofeedback for Migraines

Complete abolishment of the migraines
Significant reduction in migraine frequency of greater than 50%
Decrease in migraine frequency of less than 50%
No change in migraine frequency
Web Designer 0.5%

Effectiveness of Drug Therapy for Migrains

Complete abolishment of the migraines
Web Designer 0%
Significant reduction in migraine frequency of greater than 50%
Decrease in migraine frequency of less than 50%
No change in migraine frequency

After Neurofeedback for migraines the reduction of frequency and intensity of headaches usually was sustained at the 14.5 months follow‐up assessment.

Some of the benefits of neurofeedback for migraines:

  • It helps to retrain the brain and or optimize the functioning of the entire brain by removing barriers and improving the connections and brainwave activity in a certain region of the brain or among different regions of the brain.
  • It releases the old stuck or abnormal patterns to create new and more effective, stronger and organized patterns.
  • Training protocols are generated from the initial QEEG brain mapping. Training involves audiovisual feedback that INVOLUNTARILY teaches the individual to self-regulate the abnormal brain wave patterns that are presented to them on a computer screen in a number of ways.
  • There are no contraindications or side effects of neurofeedback for migraines.