NEUROFEEDBACK THERAPY TRAINING

Neurofeedback therapy training is not new and has been the subject of researchers’ study for several decades. This method had been developed based on neuroplasticity characteristics of the brain: a capacity of neurons and neural networks in the brain to change their connections and behavior in response to new information, sensory stimulation, development, damage, or dysfunction. Neuroplasticity refers to the physiological changes in the brain that happen due to our interactions with our environment. Neuroplasticity allows our brains to continuously change and adapt, forging new neural connections as needed and abandoning pathways we no longer use. Neurofeedback therapy training can help you to rewire the brain for optimal performance, get rid of pathological states, and allow you to rule your life successfully and healthily. 

Understanding Brainwaves: How Neurons Communicate

The communication between neurons within our brains is fundamental to all our thoughts, emotions, and behaviors. Neurons primarily communicate through electrochemical signals, which form wave-like patterns known as brainwaves. Essentially, synchronized electrical pulses from large groups of interacting neurons create these brainwaves. Electroencephalography (EEG) measures them by recording electrical activity non-invasively through sensors attached to the scalp.

The Five Types of Brainwaves and Their Functions

Different brain waves could be recognized by their amplitudes and frequencies. Frequency indicates how fast the waves oscillate, measured by the number of waves per second (Hz), while amplitude represents the power of these waves measured by microvolt (μV). There are five main patterns of brain waves: DELTA (1-4 Hz), THETA (4-8 Hz), ALPHA (8-12 Hz) (includes Lower Alpha (8-10 Hz), and Upper Alpha (10-12 Hz)), BETA (12-30 Hz) (includes Lower Beta or so-called Sensorimotor rhythm – SMR (13-15 Hz) Beta (15-18 Hz) and High Beta (19-30 Hz)) and GAMMA (30-100 Hz).

Each brainwave state signifies a specific physiological function and corresponds to a distinct level of awareness. To summarize, delta waves appear in the EEG signal when a person sleeps, while theta waves emerge when someone feels sleepy. Additionally, alpha waves occur when a person is relaxed with loose muscles but remains awake, and beta waves signify alertness. Moreover, gamma waves become noticeable when a person is actively engaged in problem-solving. For more detailed information about brainwaves and their functions, visit our website’s “Brainwaves in Neurofeedback” page.

How It Works and Electrode Placement Guide

Neurofeedback therapy training involves a painless and non-invasive EEG biofeedback procedure that monitors brain activity associated with thoughts, sensations, actions, and emotions in the form of brainwaves. Furthermore, this process provides feedback signals that teach individuals to control their brain functions. Typically, neurofeedback incorporates both audio and video feedback. 

To detect and register these brainwaves, electrode sensors are attached to the scalp in various parts of the head and to the ear, following the international 10-20 electrode placement system. Moreover, the video guide provides detailed instructions and a practical guide for this system of EEG electrode placement.

DIFFERENT BRAIN REGION AND NEUROFEEDBACK THERAPY TRAINING

Mapping Brain Regions to Specific Functions for Neurofeedback

Each region of the brain represents a specific feeling or task. Consequently, identifying these areas provides the best and most accurate neurofeedback treatment. In fact, multiple studies have discovered that lesions occurring in specific brain regions produce particular symptoms, mostly related to these regions. Therefore, understanding these brain areas is key to developing targeted and effective neurofeedback interventions.

In the Frontal lobes, the electrode locations at FP1, FP2, FPZ, FZ, F3, F4, and F7 are responsible for various cognitive and emotional functions. Specifically, these regions influence immediate and sustained attention, time management, social skills, and emotions. Moreover, they play a critical role in empathy, working memory, executive planning, and moral fiber, or character development. As a result, proper functioning of these areas is crucial for effective decision-making and social interactions.

In the parietal lobes, the electrodes at PZ, P3, and P4 play a crucial role in processing and solving problems that the frontal lobes conceptualize. Specifically, these areas are crucial for complex tasks such as grammar, object naming, sentence construction, and mathematical processing. Notably, these functions are primarily associated with the left parietal lobe. In contrast, map orientation, spatial recognition, and knowing the difference between right and left are all functions of the right parietal lobe.

The electrode locations at T3, T4, T5, and T6 in the temporal lobes serve multiple functions. Specifically, the left hemisphere functions are associated with reading (word recognition), memory, learning, and maintaining a positive mood. In contrast, right hemisphere functions are related to music, anxiety, facial recognition, and a sense of direction.

Understanding Electrode Placement for Targeted Neurofeedback

Accurate electrode placement is key to targeting specific brain functions through neurofeedback.

In the Occipital lobes, the electrode locations at O2, O1, and Oz are primarily involved in processing visual memories, accurate reading, and traumatic memories associated with visual flashbacks. Additionally, these areas help with locating objects in the environment, seeing colors, recognizing drawings, and accurately identifying objects. Furthermore, they play a role in reading, writing, and spelling.

In the Sensory and Motor (Sensorimotor) cortex, the electrode location at CZ, C3, and C4 have functions of conscious control of all skeletal movements such as typing, playing musical instruments, handwriting, operation of complex machinery, speaking, and the ability to recognize where bodily sensations originate. The motor cortex helps the cerebral cortex to encode both physical and cognitive tasks. Therefore, subjects with trouble seeing the logical sequence of cognitive tasks may benefit from neurofeedback therapy training along the left hemisphere sensorimotor cortex (C3). 

Training along the right hemisphere sensorimotor cortex (C4) may evoke feelings, emotions, or a sense of calmness. In contrast, training at the median location may facilitate a mixed response. Additionally, individuals with epilepsy often undergo training along the sensorimotor cortex (C3) to boost SMR (12-15 Hz). Moreover, this training may help treat conditions such as stroke, epilepsy, paralysis, ADHD, and disorders related to sensory and motor integration.

Importance of Electrode Placement in Neurofeedback: Ensuring Effective Brainwave Training

Generally, practitioners place electrodes to ensure that a specific EEG channel is located on one side of the brain. For example, they train low beta and beta waves on the right (C4) and left (C3) sides of the brain, respectively. If they relocate these electrodes to the opposite sides, they could produce undesirable results. For example, training low beta waves on the left side will deplete mental energy instead of improvements in concentration. Thus, the location of the EEG electrodes during the neurofeedback procedure is essential.

BRAIN LOBES WITH THEIR FUNCTIONS AND ELECTRODE APPLICATION SITES FOR NEUROFEEDBACK THERAPY TRAINING

Lobes Electrode application sites Lobe function Considerations

Left hemisphere (LH)

All odd numbered sites

Logical sequencing, detail oriented, language abilities, word retrieval, fluency, reading, math performance, science performance, problem-solving, verbal memory

Underactivation leads to depression

Right hemisphere (RH)

All even numbered sites

Episodic memory encoding, social awareness, eye contact, music, humor, empathy, spatial awareness, art performance, insight, intuition, non-verbal memory, seeing the whole picture

Overactivation leads to anxiety

Frontal lobes

Fp1, Fp2, Fpz, Fz, F3, F4, F7, F8

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

Parietal lobes

Pz, P3, P4

LH: Problem-solving, math performance, complex grammar, attention, association
RH: Spatial awareness, Geometry

Dyscalculia, sense of direction, learning disorders

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 disorders, closed head injury

Occipital lobes

O1, O2, Oz

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, Attention Deficit and Hyperactivity Disorders (ADHD) symptoms

Cingulate gyrus

Fpz, Fz, Cz, Pz, Oz

Mental flexibility, cooperation, attention, motivation, morals

Obsessions, compulsions, tics, perfection­ism, worry, ADHD symptoms, Obsessive Compulsive Disorder (OCD) & Autistic Spectrum Disorder (ASD)

Broca's area

F7, T3

Verbal expression

Dyslexia, poor spelling, poor reading

HOW DOES NEUROFEEDBACK THERAPY TRAINING WORKS?

During a neurofeedback EEG biofeedback session, the recorded EEG brainwave frequencies are segmented into bands and displayed on a computer screen, often as a video game or other feedback signals. The person effectively “plays” the game with their brain to achieve the mental state necessary for producing the desired brainwave. As activity in a desirable frequency band increases, the video game either moves faster or the movie continues playing. 

When activity in an adverse band increases, the visual display is inhibited. During this process, the person’s brain activity is compared to a goal on the computer. The sounds and images act as rewards, telling the person immediately when their brain reaches the goal – as they are activating or suppressing the target brain area. Gradually, the brain responds to the cues, and a “learning” of new brain wave patterns occurs. The brain wave frequencies targeted in neurofeedback are specific to each individual.

When the brainwave frequencies shift into the desired pattern, symptoms may significantly decrease or even disappear. Once this happens, practitioners consider the training or treatment complete, and the results tend to be permanent. Although predicting the success of training for every individual might be challenging, practitioners can usually assure a reasonable expectation of results early in the training process. Some health conditions are severe, and in many cases, working in conjunction with a primary care physician can provide significant benefits. Specifically, neurofeedback therapy training offers hope for improvement and can serve as an effective alternative to medications or drugs. Consequently, it often reduces or even eliminates the need for these conventional treatments.

THE SYMPTOMS AND DISORDERS ASSOCIATED WITH SPECIFIC BRAINWAVE IMBALANCE

Many pathological states and disorders are caused by poorly functioning patterns in the brain and an imbalance of brainwaves in different regions of the brain. Here are some of them.

Delta/Theta Imbalance

  • Cognitive Impairment
  •  Impulsivity
  • Hyperactivity
  • Focus and Attention Issues
  • ADHD
  • Socially Inappropriate
  • Easily distracted
  • Excessive Speech
  • Disorganized
  • Hyper-emotional
  • Traumatic Brain Injury
  • Dementia
  • Learning Disorders
  • Autism / Asperger’s

Alpha Imbalance

  • Depression
  • Victim Mentality
  • Excessive Self Concern
  • Passive Aggressive
  • Irritability
  • Avoidance Behavior
  • Rumination
  • Anger
  • Self-Deprecation
  • Agitation
  • Fibromyalgia
  • Withdrawal Behavior

Beta Imbalance

  • Anxiety
  • OCD
  • Migraine
  • Tension Headaches
  • Insomnia
  • Obsessive Thinking
  • Excessive Rationalization
  • Poor Emotional Self-awareness
  • Panic Attacks
  • Worry
  • Chronic Pain
  • Hyper-vigilant
  • Dislike Change
  • Restless

NEUROFEEDBACK THERAPY TRAINING PROTOCOLS

There are two classical directions in neurofeedback therapy training. One is to focus on low frequencies (alpha or theta) to strengthen relaxation and focus, and the other is to emphasize high frequencies (low beta, beta) to reinforce activation, organize, and inhibit distractibility. 
Neurofeedback EEG biofeedback treatment protocols mainly focus on alpha, beta, delta, theta, and gamma training/treatment or a combination of them, such as the alpha/ theta ratio or the beta/theta ratio. 

ALPHA PROTOCOL

Researchers have conducted various studies on the alpha protocol. Typically, the brain’s alpha wave corresponds to alert relaxation. The alpha mood reflects a calm and pleasant state. Alpha frequencies represent the brain’s creative activity, contributing to relaxation (relaxing the muscles) and eventually leading to sleep.

The most common frequency bandwidth for alpha treatment is the 7-10 Hz range. This frequency range is typically used for promoting meditation, improving sleep, and alleviating stress and anxiety. Specifically, a frequency of 10 Hz is effective in inducing deep muscle relaxation, reducing pain, regulating breathing rate, and lowering heart rate.

Alpha training is usually used to treat various diseases, such as pain relief (9 Hz simulation), stress and anxiety reduction (10 and 30 Hz simulation), memory improvement, improved mental performance, and brain injury treatment (10.2 Hz simulation).

SMR PROTOCOL

SMR training is a standard protocol used to improve attention and focus. The SMR frequency band (12-15Hz) is associated with an alert, attentive state and calm or silent motor activities. SMR training enhances focus and attention by decreasing drowsy, mind-wandering Theta waves and anxious or racing High Beta waves while increasing the calm, focused SMR waves. SMR training also improves motoric precision and balance and the ability to relax.

Sensorimotor neurofeedback positively affects attention regulation and reduces motor activity because the SMR occurs only when one is still. SMR neurofeedback is commonly used in epilepsy because it has been demonstrated to reduce seizure activity.

Mechanics of SMR Feedback and Electrode Placement

A thalamocortical loop regulates SMR. Attention regulation is a function of certain areas in the thalamus, and therefore, increasing SMR generally leads to a decrease in theta, which, in turn, is correlated with an increase in arousal. Thus, SMR training is used in some cases of ADHD.
When applying SMR feedback, localization of electrode placement is critical.

The SMR is functionally bound to the primary motor and sensory cortices found centrally within the brain at the most posterior part of the frontal lobe. To correctly measure SMR, the electrodes must be placed over these areas. Furthermore, the SMR has a unique pattern to it. Although it has a specific frequency band (12–15 Hz), simply up-training this frequency is not the most effective method. The SMR comes and goes in a spindle-like pattern, and the longer these spindles persist, the better. So, apart from uptraining the amplitude of the frequency band, one might also reward the patient when he can produce the frequency for increasingly more extended periods (rewarding based on a duration above the threshold). This kind of SMR feedback is known as discrete SMR training because you reward each discrete spindle.

The electrodes are usually located on C4 or CZ.

BETA PROTOCOL

Brain beta activity serves as a valuable indicator of mental performance. However, inappropriate beta activity can signify mental and physical disorders such as depression, ADHD, and insomnia. Beta brain waves are associated with conscious precision, strong focus, and the ability to solve problems. Moreover, medications designed to stimulate alertness and concentration, such as Ritalin and Adderall, also lead to increased production of beta brainwaves in the brain.

Neurofeedback EEG biofeedback Beta training improves focus and attention (simulation of increased beta 12-14 Hz), improves reading ability (simulation of 7-9 Hz), and introduces positive changes in school performance. It also enhances computational performance, cognitive processing, reduction of worries, overthinking, obsessive-compulsive disorder (OCD), alcoholism, and insomnia (simulation of 14-22 Hz and 12-15 Hz). Meanwhile, this type of neurofeedback improves sleep cognitive performance as well as reduces fatigue and stress (simulation of light and sound of beta). The beta training in the range of 12-15 Hz (SMR) reduces anxiety, epilepsy, anger, and stress.

The electrodes are usually located on C3, C4, and CZ.

THETA PROTOCOL

Theta brain waves are related to several brain activities, such as memory, emotion, creativity, sleep, meditation, and hypnosis. These waves are also associated with the first sleep phase, when sleep is light, and the person quickly wakes up. Theta treatment reduces anxiety, depression, daydreaming, distractibility, emotional disorders, and ADHD.

THETA/BETA RATIO PROTOCOL

Theta Beta Ratio (TBR) reflects interactions between the brain’s subcortical and prefrontal cortical areas.
Increased TBR is related to less self-reported attentional control and correlated to a more substantial decline in attentional control after stress induction. These are core elements of cognitive performance anxiety (CPA), a phenomenon defined as when fears compromise an individual’s capacity to execute a task.

The application of TBR (Theta/Beta Ratio) Neurofeedback therapy might be effective in addressing attentional dysfunction, such as that observed in ADHD patients. This approach aims to enhance resilience to the adverse cognitive effects of stress.

The TBR protocol focuses on reducing theta (4–8 Hz) activity while increasing beta (13–20 Hz) activity. Typically, EEG electrodes are placed at the Cz location on the scalp to monitor and modulate these brainwave frequencies.

ALPHA/THETA PROTOCOL

The relationship between alpha and theta brainwaves serves as an indicator of both awareness and sleep. Consequently, Alpha/theta neurofeedback therapy training has become one of the most popular methods for stress reduction. Furthermore, this treatment is utilized for addressing deep levels of depression, addiction, and anxiety. In addition, it enhances creativity, relaxation, and musical performance, while also promoting healing from trauma reactions. Typically, electrodes are placed on O1, O2, CZ, and PZ. The alpha/theta frequency range spans from 7 to 8.5 Hz, with a common value of 7.8 Hz. This therapy is conducted under closed-eye conditions and involves increasing the ratio of theta to alpha waves through auditory feedback.

DELTA PROTOCOL

Delta waves are the slowest brain waves, and they are associated with stages 3 and 4 of sleep. They represent increased comfort, reduced pain, and sleep. Thus, they are used to alleviate headaches, traumatic brain injury, and learning disorders and to treat hard and sharp muscle contractions (by simulating a 1-3 Hz delta wave). They also reduce concerns and improve sleep.

GAMMA PROTOCOL

Gamma waves have the highest frequency and are associated with cognitive processing and memory. Thus, when these waves are faster, memory recall is more rapid. Gamma waves are fast rhythms crucial for the brain’s neural connections and data transfer to the outside world. Notably, they are primarily observed in the hippocampus, a brain area responsible for converting short-term to long-term memory. Additionally, these rapid rhythms can be seen during sudden attacks such as seizures and spasms. Consequently, gamma training promotes enhanced cognition, mental sharpness, and overall brain activity. It helps to improve poor calculation skills, organizes brain function, accelerates information processing, and enhances short-term memory. Moreover, it may also contribute to a reduction in the frequency of migraine attacks.

NEUROFEEDBACK THERAPY TRAINING HOME USE DEVICE

Personal Improvement vs. Medical Application

Neurofeedback devices and systems are used for both medical and non-medical uses, and the dividing line between them may be thin.

Non-medical applications of neurofeedback EEG biofeedback primarily focus on personal enhancement and mental conditioning. For instance, these applications aim to improve relaxation, attention, focus, concentration, and self-awareness. Additionally, they can serve as adjuncts to practices such as meditation, counseling, hypnosis, or achieving altered states of consciousness. Importantly, these benefits can often be pursued without professional intervention.

However, when the goal shifts to addressing or alleviating specific medical conditions, it becomes essential to seek professional help. Furthermore, it is crucial to understand that neurofeedback systems designed for recreational, educational, or entertainment purposes are not classified as medical devices. For those interested, detailed information on various neurofeedback devices for home use, including their indications and methods, can be found here.

However, if direct benefits are claimed for relaxation or relief from the symptoms of disorders, then the device is considered medical.

Distinguishing Between Medical and Educational Neurofeedback Use

In the nonclinical embodiment, most of the same functions and capabilities are present, but they are presented in the context of an educational and recreational device. It is nonetheless true that the actual benefits may be essentially the same in both embodiments depending on how the user configures and applies the device. However, the labeling and claims are different. The same instrument is being provided in both cases but with different intents.

Clearly, the distinction between medical and non-medical embodiments of Neurofeedback EEG biofeedback devices lies primarily in the user’s claims, expectations, and applications. Specifically, medical devices are designed to address and alleviate specific health conditions, typically under the guidance of a professional. Conversely, non-medical devices focus on personal improvement and mental conditioning, such as enhancing relaxation and concentration, and are often used independently. Thus, understanding these differences is essential for selecting the appropriate device based on individual needs and goals.

For example, although neurofeedback can be used to improve attention and concentration, and this can be considered a personal improvement application, in cases of suspected or diagnosed Attention Deficit Hyperactivity Disorder, the use of this procedure might be regarded as a medical procedure.

It may thus be argued that neurofeedback treatment intended to reduce the symptoms of ADHD, especially when the removal from stimulants (Ritalin, etc) is desired, that neurofeedback is being used in a medical context. However, suppose a parent, teacher, or counselor uses neurofeedback in a home or educational setting to educate a child on how to reach a state of relaxed attentiveness and improve academic success. In that case, the treatment may be considered education, not treatment.

Leveraging Neuroplasticity Through Neurofeedback EEG Biofeedback: How Brain Learning and Reinforcement Work

Neurofeedback EEG biofeedback takes advantage of the brain’s ability to change itself through a process known as Neuroplasticity. It utilizes the same learning process when we acquire a new skill. The brain learns by forming connections between nerve cells and utilizing important pathways that connect different locations in the brain.

The more frequently you utilize these pathways, the better the brain performs the associated task.

This type of learning is a type in which responses come to be controlled by their consequences. Quite simply, Neurofeedback offers the perfect learning conditions, since it facilitates awareness of when the brain is producing healthier brainwave patterns, provides reinforcement for the positive change, and multiple opportunities to provide practice during a training session.

Neuphony EEG Headset

Neuphony Flex EEG Cap

Forbrain

Mendi NIRS Neurofeedback Headband

NeeuroSenzeband