Frank Duffy, MD, Neurologist, Head of the Neuroimaging Department and of Neuroimaging Research at Boston Children’s Hospital, and Harvard Medical School Professor, conducted an independent review of the literature on neurofeedback for Clinical Electroencephalography (2000). He summarized his findings as follows:
“The literature, which lacks any negative study of substance, suggests that EEG biofeedback therapy 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.” Frank Duffy
In a recent paper Update on attention-deficit/hyperactivity disorder published in Current Opinion in Pediatrics Katie Campbell Daley reviewed the research and practice standards on treatment of ADHD. Dr. Campbell serves on the staff of the Department of Medicine, Children’s Hospital Boston and in the Department of Pediatrics of the Harvard Medical School. She concluded:
“Overall, these findings support the use of multi-modal treatment, including medication, parent/school counseling, and EEG biofeedback, in the long term management of ADHD, with EEG biofeedback in particular providing a sustained effect even without stimulant treatment…parents interested in non-psychopharmacologic treatment can pursue the use of complementary and alternative therapy. The therapy most promising by recent clinical trials appears to be EEG biofeedback.” Dr. Campbell
A recent special issue of Child and Adolescent Psychiatric Clinics of North America was devoted to emerging interventions that affect brain function. Neurofeedback was featured in seven of the ten chapters in the volume. The volume editors provided an overview and clinical perspective on all the approaches presented. About neurofeedback they concluded:
“EEG biofeedback meets the American Academy of Child and Adolescent Psychiatry criteria for clinical guideline (CG) for treatment of ADHD, seizure disorders, anxiety (OCD, GAD, PTSD, phobias), depression, reading disabilities, and addictive disorders. This suggests that EEG biofeedback should always be considered as an intervention for these disorders by the clinician.” Child and Adolescent Psychiatric Clinics of North America
“WebMD says that, although prescribing drugs such as Ritalin and Adderall are the most common way of managing ADHD — and bring improvement in about 80% of patients, says the American Psychiatric Association – they are not without problems. Many children taking them suffer side effects such as sleep problems, weight loss, jitters, and stomach upset, and nearly half of those with some types of ADHD don’t respond to the drugs at all. Some experts are also concerned with their long-term use.
A study, published in the December, 2002, issue of Applied Psychophysiology and Biofeedback, indicates that ADHD kids who had weekly sessions of traditional biofeedback therapy for a year were able to reduce or eliminate their medication – and maintained the same level of improvement in focus and concentration as when they had been on drug therapy.” Vincent J. Monastra ADHD Study cited by WebMD
“Professionals, like most people, tend to discount what they don’t understand or have no experience with. Most pediatricians know nothing about neurofeedback because it was not mentioned in medical school. Professionals in the field of A.D.D. have traditionally relied on drugs and behavior modification. They are comfortable with these approaches, even as they realized their limitations. As research and experience accumulates, however, neurofeedback is becoming more widely accepted. Unlike drugs, which are short acting, neurofeedback appears to produce permanent shifts in learning and behavior.” William Sears, M.D. and Lynda Thompson, Ph.D. (1998). The A.D.D Book: New Understanding, New Approaches to Parenting Your Child
Kropp, P., Siniatchkin, M.,Gerber, W. D. (2002). On the pathophysiology of migraine–links for “empirically based treatment” with neurofeedback:
“Revealed by SCPs, migraine can be regarded as a disorder related to a habituation deficit caused by a brainstem-related dysfunction. Habituation shows systematic variations around a migraine attack. After an attack, habituation is normal. With neurofeedback, migraine patients can learn to control their high negative SCPs and to habituate. Along with the ability to habituate the days with migraine can be reduced.” Journal Applied Psychophysiology and Biofeedback, 27(3), 203-13
Wing, K. (2001) Effect of neurofeedback on motor recovery of a patient with brain injury: a case study and its implications for stroke rehabilitation:
“NFB appears to be a powerful form of therapy that has been shown to facilitate long-lasting changes in the brain, as evidenced by improved function, even many years after injury.
Although NFB has been proven to be effective in the treatment of several different diagnoses, including stroke and head injury, it is underutilized in physical medicine and rehabilitation. There are several reasons, some of which are cost, training, availability of clinics, and lack of insurance coverage. However, the major reason could be simply the lack of awareness of this treatment approach.” Topics in Stroke Rehabilitation, 8(3), 45-53
Hammond, D. (2005). Neurofeedback Treatment of Depression and Anxiety
“Neurofeedback is an encouraging development that holds promise as a method for modifying biological brain patterns associated with a variety of mental health and medical (e.g., stroke, head injury, effects of aging) disorders-particularly because unlike drugs, electroconvulsive therapy, and intense transcranial magnetic stimulation, it is non-invasive and seldom associated with even mild side effects.
Although NFB has been proven to be effective in the treatment of several different diagnoses, including stroke and head injury, it is underutilized in physical medicine and rehabilitation. There are several reasons, some of which are cost, training, availability of clinics, and lack of insurance coverage. However, the major reason could be simply the lack of awareness of this treatment approach.” Journal of Adult Development, Vol. 12, Nos 2/3
Peer Reviewed Journal Articles
Budzynski, T. H. (1996).
Brain brightening: Can neurofeedback improve cognitive process?
Biofeedback, 24(2), 14-17.
Hammond, D. C. (2005).
Neurofeedback with anxiety and affective disorders.
Child & Adolescent Psychiatric Clinics of North America, 14(1), 105-123.
Hammond, D. C. (2003)
QEEG-guided neurofeedback in the treatment of obsessive compulsive disorder.
Journal of Neurotherapy, 7(2), 25-52.
Hanslmayer, S., Sauseng, P., Doppelmayr, M., Schabus, M., & Klimesch, W. (2005)
Increasing individual upper alpha by neurofeedback improves cognitive performance in human subjects.
Applied Psychophysiology & Biofeedback, 30(1), 1-10.
Lubar, J. F. (2003)
Neurofeedback for the management of attentiondeficit / hyperactivity disorders.
Chapter in M. S. Schwartz & F. Andrasik (Eds.), Biofeedback: A Practitioner’s Guide (Third Edition. New York, Guilford, 409-437.
Monastra, V. J., (2005)
Electroencephalographic biofeedback (neurotherapy) as a treatment for attention deficit hyperactivity disorder: Rationale and empirical foundation.
Child & Adolescent Psychiatric Clinics of North America, 14(1), 55-82.
Nitsche, M. & Paulus, W. (2000)
Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation.
The Journal of Physiology, 527(3), 633-639.
Sterman, M. B. (2000)
Basic concepts and clinical findings in the treatment of seizure disorders with EEG operant conditioning.
Clinical Electroencephalography, 31(1), 45-55.
Thatcher, R. W. (2000)
EEG operant conditioning (biofeedback) and traumatic brain injury
Clinical Electroencephalography, 31(1), 38-44.
Thompson, L., & Thompson, M. (1998)
Neurofeedback combined with training in metacognitive strategies: Effectiveness in students with ADD.
Applied Psychophysiology & Biofeedback, 23(4), 243-263.
Trudeau, D. L. (2005)
Applicability of brain wave biofeedback to substance use disorder in adolescents.
Child & Adolescent Psychiatric Clinics of North America, 14(1), 125-136.
History of the Scientific Standards of QEEG Normative Databases
A review of the history of QEEG normative databases was published in Thatcher, R.W. and Lubar, J.F. History of the scientific standards of QEEG normative databases. In: Introduction to QEEG and Neurofeedback: Advanced Theory and Applications, T. Budzinsky, H. Budzinsky, J. Evans and A. Abarbanel (eds)., Academic Press, San Diego, CA, 2008. A copy of the publication can be downloaded at: https://www.appliedneuroscience.com/PDFs/History_of_QEEG_Databases.pdf.
QEEG Normative Database Publications and Validations:
Bosch-Bayard J, Valdes-Sosa P, Virues-Alba T, Aubert-Vazquez E, John ER, Harmony T, Riera-Diaz J, Trujillo-Barreto N.(2001). 3D statistical parametric mapping of EEG source spectra by means of variable resolution electromagnetic tomography (VARETA). Clin Electroencephalogr., 32(2):47-61.
Coburn, K.L., Lauterback, E.C., Boutros, N.N., Black, K.J., Arciniegas, D.B. and Coffey, C.E. (2006). The value of quantitative electroencephalography in clinical psychiatry: A report by the committee on research of the American Neuropsychiatric Association. J. Neuropsychiat. and Clin. Neurosci. 18: 460-500.
Congedo M, John RE, De Ridder D, Prichep L. (2010). Group independent component analysis of resting state EEG in large normative samples. Int J Psychophysiol. 78(2):89-99.
Congedo M, John RE, De Ridder D, Prichep L, Isenhart R. (2010). On the “dependence” of “independent” group EEG sources; an EEG study on two large databases. Brain Topogr., 23(2):134-138.
Duffy, F., Hughes, J. R., Miranda, F., Bernad, P. & Cook, P. (1994). Status of quantitative EEG (QEEG) in clinical practice. Clinical. Electroencephalography, 25(4), VI – XXII.
Galán, L., Biscay, R., and Valdés P., (1994). Multivariate statistical brain electromagnetic mapping. Brain Topgr., 7(1):17-28.
Gasser, T., Verleger, R., Bacher, P., & Sroka, L. (1988a). Development of the EEG of school-age children and adolescents. I. Analysis of band power. Electroencephalography and Clinical Neurophysiology, 69(2), 91-99.
Gasser, T., Jennen-Steinmetz, C., Sroka, L., Verleger, R., & Mocks, J. (1988b). Development of the EEG of school- age children and adolescents. II: Topography. Electroencephalography and Clinical Neurophysiology, 69(2),100-109.
Gordon, E., Cooper, N., Rennie, C., Hermens, D. and Williams, L.M. (2005). Integrative neuroscience: The role of a standardized database. Clin. EEG and Neurosci., 36(2): 64-75.
Hernandez-Gonzalez G, Bringas-Vega ML, Galán-Garcia L, Bosch-Bayard J, Lorenzo-Ceballos Y, Melie-Garcia L, Valdes-Urrutia L, Cobas-Ruiz M, Valdes-Sosa PA; Cuban Human Brain Mapping Project (CHBMP). (2011). Multimodal quantitative neuroimaging databases and methods: the Cuban Human Brain Mapping Project. Clin EEG Neurosci., 42(3):149-59.
Hughes, J. R. & John, E. R. (1999). Conventional and quantitative electroencephalography in psychiatry. Neuropsychiatry, 11, 190-208.
John, E.R. (1977) Functional Neuroscience, Vol. II: Neurometrics: Quantitative Electrophysiological Analyses. E.R. John and R.W. Thatcher, Editors. L. Erlbaum Assoc., N.J.
John, E.R. Karmel, B., Corning, W. Easton, P., Brown, D., Ahn, H., John, M., Harmony, T., Prichep, L., Toro, A., Gerson, I., Bartlett, F., Thatcher, R., Kaye, H., Valdes, P., Schwartz, E. (1977). Neurometrics: Numerical taxonomy identifies different profiles of brain functions within groups of behaviorally similar people. Science, 196:1393 1410.
John, E. R., Prichep, L. S. & Easton, P. (1987). Normative data banks and neurometrics: Basic concepts, methods and results of norm construction. In A. Remond (Ed.), Handbook of electroencephalography and clinical neurophysiology: Vol. III. Computer analysis of the EEG and other neurophysiological signals (pp. 449-495). Amsterdam: Elsevier.
John, E.R., Ahn, H., Prichep, L.S., Trepetin, M., Brown, D. and Kaye, H. (1980) Developmental equations for the electroencephalogram. Science, 210: 1255-1258.
John, E. R., Prichep, L. S., Fridman, J. & Easton, P. (1988). Neurometrics: Computer assisted differential diagnosis of brain dysfunctions. Science, 293: 162-169.
John, E.R. (1990). Machinery of the Mind: Data, theory, and speculations about higher brain function. Birkhauser, Boston.
Koenig T, Prichep L, Lehmann D, Sosa PV, Braeker E, Kleinlogel H, Isenhart R, John ER. (2002). Millisecond by millisecond, year by year: normative EEG microstates and developmental stages. Neuroimage, 16(1):41-48.
Matousek, M. & Petersen, I. (1973a). Automatic evaluation of background activity by means of age-dependent EEG quotients. EEG & Clin. Neurophysiol., 35: 603-612.
Matousek, M. & Petersen, I. (1973b). Frequency analysis of the EEG background activity by means of age dependent EEG quotients. In Automation of clinical electroencephalography, Kellaway & I. Petersen (Eds.), (pp. 75-102). New York: Raven Press.
Prichep, L.S. (2005). Use of normative databases and statistical methods in demonstrating clinical utility of QEEG: Importance and cautions. Clin. EEG and Neurosci., 36(2): 82-87.
Thatcher, R.W., Walker, R.A., Biver, C., North, D., Curtin, R., (2003). Quantitative EEG Normative databases: Validation and Clinical Correlation, J. Neurotherapy, 7(3-4): 87-121.
Thatcher, R. W. (1998). EEG normative databases and EEG biofeedback. Journal of Neurotherapy, 2(4): 8-39.
Thatcher, R.W., North, D., and Biver, C. (2005a) EEG inverse solutions and parametric vs. non-parametric statistics of Low Resolution Electromagnetic Tomography (LORETA). Clin. EEG and Neuroscience, 36(1):1-8.
Thatcher, R.W., North, D., and Biver, C. (2005b) Evaluation and Validity of a LORETA normative EEG database. Clin. EEG and Neuroscience, 36(2): 116-122.
Thatcher, R.W., McAlaster, R., Lester, M.L., Horst, R.L. and Cantor, D.S. (1983). Hemispheric EEG Asymmetries Related to Cognitive Functioning in Children. In: Cognitive Processing in the Right Hemisphere, A. Perecuman (Ed.), New York: Academic Press.
Thatcher, R.W. (1992). Cyclic cortical reorganization during early childhood. Brain and Cognition, 20: 24-50.
Thatcher, R.W. and Lubar, J.F. History of the scientific standards of QEEG normative databases. (2008) In: Introduction to QEEG and Neurofeedback: Advanced Theory and Applications, T. Budzinsky, H. Budzinsky, J. Evans and A. Abarbanel (eds)., Academic Press, San Diego, CA.
Thatcher, R.W. (2010) Reliability and validity of quantitative electroencephalography (qEEG). J. of Neurotherapy, 14:122-152.