Clinical Neurofeedback: Case Studies, Proposed Mechanism, and Implications for Pediatric Neurology Practice

Georgetown University Medical Center, Department of Pediatrics, Washington, DC 2000, USA.
Journal of child neurology (Impact Factor: 1.72). 05/2011; 26(8):1045-51. DOI: 10.1177/0883073811405052
Source: PubMed


Trends in alternative medicine use by American health care consumers are rising substantially. Extensive literature exists reporting on the effectiveness of neurofeedback in the treatment of autism, closed head injury, insomnia, migraine, depression, attention deficit hyperactivity disorder, epilepsy, and posttraumatic stress disorder. We speculated that neurofeedback might serve as a therapeutic modality for patients with medically refractory neurological disorders and have begun referring patients to train with clinical neurofeedback practitioners. The modality is not always covered by insurance. Confident their child's medical and neurological needs would continue to be met, the parents of 3 children with epilepsy spectrum disorder decided to have their child train in the modality. The children's individual progress following neurofeedback are each presented here. A proposed mechanism and practice implications are discussed.

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Available from: Siegfried Othmer, Feb 13, 2015
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    • "Parents routinely report that their children show less resort to medication. With regard to seizure susceptibility, clinical experience indicates that ILF feedback impacts incidence to a clinically significant degree in the majority of cases of medically refractory pediatric epilepsy (Legarda, 2011). Re-titration of AEDs is usually indicated. "
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    ABSTRACT: Neuromodulation in the bioelectrical domain is an attractive option for the remediation of functionally based deficits. Most of the interest to date has focused on exogenous methods, such as repetitive transcranial magnetic stimulation, transient direct current stimulation, vagus nerve stimulation, and deep brain stimulation. Much less attention has been given to endogenous methods of exploiting latent brain plasticity. These have reached a level of sophistication and maturity that invites attention. Over the last 7 years, the domain of infralow frequencies has been exploited productively for the enhancement of neuroregulation. The principal mechanism is putatively the renormalization of functional connectivity of our resting-state networks. The endogeneous techniques are particularly attractive for the pediatric population, where they can be utilized before dysfunctional patterns of brain behavior become consolidated and further elaborated into clinical syndromes.
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    • "A newer approach, infralow frequency neurofeedback targets frequencies as low as 0.01 Hz (Legarda, McMahon, & Othmer, 2011). Few studies have been published using this technique, though some evidence suggests it is a future direction for PTSD or other disorders (Legarda et al., 2011; Othmer, Othmer, & Legarda, 2011). "
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    ABSTRACT: Although many psychological disorders have significant basis in neurobiological dysfunction, most treatment approaches either neglect biological aspects of the problem, or approach dysfunction through pharmacological treatment alone, which may expose individuals to negative side effects. In recent decades, neurofeedback has been promoted as an alternative approach to treating neurobiological dysfunction. Neurofeedback helps individuals gain control over subtle brain activity fluctuations through real-time rewards for pre-established target brainwave frequencies at specific cortical locations. This paper reviews the effectiveness of neurofeedback in a range of conditions, including ADHD, autism spectrum disorders, substance use, PTSD, and learning difficulties. Neurofeedback has emerged as superior or equivalent to either alternative or no treatment in many of the examined studies, suggesting it produces some effects worthy of further examination. In light of its potential to address neurobiological dysfunction directly, future research is suggested in order to refine protocols, as well as to establish effectiveness and efficacy. Potential mechanisms of neurofeedback are discussed, including global connectivity, neuroplasticity, and reinforcement of the default mode network, central executive network, and salience network.
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