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Effect of Neurofeedback on Variables of Attention in a Large Multi-Center Trial

Authors:
  • Kaiser Neuromap Institute LLC
  • The EEG Institute, a dba of EEG Info

Abstract

Background: Neurofeedback studies have been criticized for including small numbers of subjects. The effect of SMR-beta neuro-feedback training on the Test of Variables of Attention was evaluated in more than 1,000 subjects from thirty-two clinics.Methods: 1089 subjects (726 children, 324 females, 186 with ADHD or ADD diagnoses) underwent twenty or more sessions of SMR-beta neurofeedback training for attentional and behavioral complaints at thirty-two clinical settings affiliated with EEG Spectrum, Inc. Subjects were evaluated prior to training and at training completion. One hundred and fifty-seven subjects who elected extensive training (forty sessions or more) were tested after both twenty and forty training sessions.Results: Neurofeedback training produced significant improvement in attentiveness, impulse control, and response variability. Significant clinical improvement in one or more measures was seen in eighty-five percent of those subjects with moderate pre-training deficits.Conclusions: Neurofeedback training is effective in remediating atten-tional dysfunction. Nevertheless, large-scale studies with greater control (e.g., wait-list designs) are sorely needed.
... In early work with ADHD, we moved from Cz to C4 with SMR-band training in 1992, and reliably established that the two hemispheres needed to be trained differently. For many years, the standard protocol became the combination of C3-beta training (15)(16)(17)(18) with C4-SMR (12-15 Hz) for thousands of clinicians [33]. The right-hemisphere placement had a calming influence, while the left-hemisphere training was more activating. ...
... The attempt to discriminate formally between SMR and beta training was published in two papers [39,40]. Our multi-site retrospective appraisal of the protocol in application to ADHD (32 clinics; 1089 cases) was published in 2000 [33]. ...
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Clinical work conducted over the last seventeen years at the EEG Institute in Los Angeles and by other neurofeedback providers around the world has demonstrated the utility of extending frequency-based neurofeedback deep into the infra-low frequency (ILF) region, using the method of endogenous neuromodulation described herein. The method is characterized by the absence of any overt reinforcements, which makes it possible to extend the clinical reach to extremely low frequencies. As the training frequency is lowered, the signal becomes more difficult to discriminate, and ultimately it can only be discerned by the brain itself, in the process of endogenous neuromodulation. The method emulates how the brain does skill learning in general: It must observe itself performing the skill, with feedback on its performance. While the immediate target of ILF neurofeedback is enhanced self-regulatory competence--with symptomatic relief and functional recovery the secondary consequences, progressive lowering of the target frequencies has led to improved outcomes in application to challenging dysfunctions such as episodic suicidality, migraine, seizures, and bipolar mood swings. The work has also yielded insights into how the frequency domain is organized. The training proceeds best at frequencies that are specific to each individual, and these are referred to as optimal response frequencies (ORFs). These frequencies differ for various placements but stand in two fixed relationships to one another, one that holds over the EEG spectral range, and another that holds over the entire ILF range. Training in the ILF region engages the dynamics of the glial-neuronal networks, which govern tonic, resting state regulation. The collective clinical experience with ILF neuromodulation within a large practitioner network supports the case for making protocol-based, individualized ‘homeodynamic’ regulation a therapeutic priority, particularly for our most impacted clinical populations: addiction, trauma formations, traumatic brain injury, and the dementias. The case is made for further outcome studies and foundational research.
... In our early work with ADHD, we moved from Cz to C4 with SMR-band training in 1992, and reliably established that the two hemispheres needed to be trained differently. For many years, the standard protocol became the combination of C3-beta training (15-18 Hz) with C4-SMR (12-15 Hz) for thousands of clinicians (Kaiser & Othmer, 2000). The right-hemisphere placement had a calming influence, while the left-hemisphere training was more activating. ...
... The attempt to discriminate between SMR and beta training was published in two papers (Kaiser and Othmer, 1997;Barnea et al, 2004). Our multi-site retrospective appraisal of the protocol in application to ADHD was published in 2000 (Kaiser and Othmer, 2000). It was mainly families whose children did not do well with medication that were attracted to the training. ...
Preprint
Full-text available
Clinical work conducted over the last seventeen years at the EEG Institute in Los Angeles and by other neurofeedback providers around the world has demonstrated the utility of extending frequency-based neurofeedback deep into the infra-low frequency (ILF) region, using the method of endogenous neuromodulation described herein. The method is characterized by the absence of any overt reinforcements, which makes it possible to extend the clinical reach to extremely low frequencies. As the training frequency is lowered, the signal becomes more difficult to discriminate, and ultimately it can only be discerned by the brain itself, in the process of endogenous neuromodulation. The method emulates how the brain does skill learning in general: It must observe itself performing the skill, with feedback on its performance. While the immediate target of ILF neurofeedback is enhanced self-regulatory competence--with symptomatic relief and functional recovery the secondary consequences, progressive lowering of the target frequencies has led to improved outcomes in application to challenging dysfunctions such as episodic suicidality, migraine, seizures, and bipolar mood swings. The work has also yielded insights into how the frequency domain is organized. The training proceeds best at frequencies that are specific to each individual, and these are referred to as optimal response frequencies (ORFs). These frequencies differ for various placements but stand in two fixed relationships to one another, one that holds over the EEG spectral range, and another that holds over the entire ILF range. Training in the ILF region engages the dynamics of the glial-neuronal networks, which govern tonic, resting state regulation. The collective clinical experience with ILF neuromodulation within a large practitioner network supports the case for making protocol-based, individualized ‘homeodynamic’ regulation a therapeutic priority, particularly for our most impacted clinical populations: addiction, trauma formations, traumatic brain injury, and the dementias. The case is made for further outcome studies and foundational research.
... The increased theta/beta ratio has been proposed as a characteristic biomarker for CNS underarousal (Mann et al., 1992), whereas the SMR has been classically described as reflecting motor inhibition (Sterman & Friar, 1972;Sterman et al., 1970). The vast majority of EBF studies has been inspired by a two-phase protocol of Lubar et al. (1984), in which participants where first trained to increase their SMR and later to inhibit theta activity while simultaneously increasing beta activity Carmody et al., 2000;Fuchs et al., 2003;Gevensleben et al., 2009;Heywood & Beale, 2003;Holtmann et al., 2009;Kaiser, 1997;Kaiser & Othmer, 2000;Kropotov et al., 2005;La Vaque et al., 2002;Leins et al., 2007;Levesque et al., 2006;Linden et al., 1996;J.F. Lubar et al., 1995;Monastra et al., 2002;Rossiter, 2004;Rossiter, 1998;Rossiter & La Vaque, 1995;Strehl et al., 2006;Thompson & Thompson, 1998). ...
... F. Lubar & Shouse, 1976) reported improved attention and normalized levels of arousal, together with improved grades and achievement scores for the (eight) children under treatment. Subsequent studies have reported similarly positive results, showing improvements of behaviour, attention and impulsivity (Alhambra et al., 1995;Carmody et al., 2000;Drechsler et al., 2007;Gevensleben et al., 2010;Gevensleben et al., 2009;Heinrich et al., 2004;Kaiser & Othmer, 2000;Kropotov et al., 2005;Leins et al., 2007;Linden et al., 1996;J.F. Lubar et al., 1995;J. ...
... Kaiser and Othmer [55] Hirearical reductionism The concept of reducing phenomena to very basic levels of analysis. OCN provides an additional level of analysis for management studies, i.e., the neural level. ...
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This paper discusses the dawn of cognitive neuroscience in management and organizational research. The study does that in two tiers: first, it reviews the interdisciplinary field of organizational cognitive neuroscience, and second, it analyzes the role organizational cognitive neuroscience (OCN) could play in reducing counterproductive workplace behaviors (CWB). Theoretically, the literature has established the benefits of a neuro-scientific approach to understanding various organizational behaviors, but no research has been done on using organizational neuroscience techniques to study counterproductive work behaviors. This paper, however, has taken the first step towards this research avenue. The study will shed light on this interdisciplinary field of organizational cognitive neuroscience (OCN) and the benefits that organizations can reap from it with respect to understanding employee behavior. A research agenda for future studies is provided to scholars who are interested in advancing the investigation of cognition in counterproductive work behaviors, also by using neuroscience techniques. The study concludes by providing evidence drawn from the literature in favor of adopting an OCN approach in organizations.
... ***p < .01 MR = mental rotation; NF1 = a neurofeedback group that was trained using an automatically adjusted threshold design; NF2 = a neurofeedback group that was trained using a manually adjusted threshold design; UA = upper alpha changes to occur (Baehr et al., 1997;Hammond, 2005;Kaiser & Othmer, 2000). In our study, NF1 and NF2 exhibited higher amplitudes of UA after a single neurofeedback session compared to the resting state EEG. ...
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This study explores a novel approach to enhancing cognitive proficiency by targeting neural mechanisms that facilitate science and math learning, especially mental rotation. The study specifically examines the relationship between upper alpha intensity and mental rotation skills. Although prior neurofeedback research for increasing upper alpha highlights this correlation, mostly with familiar objects, novel chemistry and math learning prompts envisioning unfamiliar objects which question the persistence of this correlation. This study revisits the upper alpha and mental rotation relationship in the context of unfamiliar objects with a single neurofeedback session and examines the efficiency of manual and automatic neurofeedback protocols. Results will provide a basis for integrating neurofeedback protocols into learning applications for enhanced learning. Our study encompassed three cohorts: Group 1 experienced an automatic neurofeedback protocol, Group 2 received a manual neurofeedback protocol, and the control group had no neurofeedback intervention. The experimental phases involved EEG measurement of individual upper alpha (frequency of maximal power + 2 Hz) intensity, mental rotation tasks featuring geometric and unfamiliar molecular stimuli, one neurofeedback session for applicable groups, post-treatment upper alpha level assessments, and a mental rotation retest. The neurofeedback groups exhibited increased levels of upper alpha power, which was correlated with improved response time in mental rotation, regardless of stimulus type, compared to the control group. Both neurofeedback protocols achieved comparable results. This study advocates integrating neurofeedback into learning software for optimal learning experiences, highlighting a single session’s efficacy and the substantial neurofeedback protocol’s impact in enhancing upper alpha oscillations.
... Die American Psychological Association (2016) beschreibt Neurofeedback und Biofeedback als eine relevante Therapiemethode für Menschen mit AD(H)S, jedoch ohne sich auf das hier angewendete ILF-Neurofeedback zu beziehen. Therapieerfolge des ILF-Neurofeedbacks nach Othmer sind international belegt (Othmer, 2016;Othmer & Steinberg, 2010;Kaiser & Othmer, 2000;Schneider et al., 2021). Während eine Metaanalyse ergab, dass im Vergleich zu nichtaktiven Kontrollbehandlungen die Neurofeedback-Therapie bei AD(H)S länger andauernde Behandlungseffekte zu haben scheint (Van Doren et al., 2019), waren diese Effekte laut einer anderen Metaanalyse unter Einschluss von geblindeten Ratings nicht von Dauer (Cortese et al., 2016). ...
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... Kaiser and Othmer [55] Hirearical reductionism The concept of reducing phenomena to very basic levels of analysis. OCN provides an additional level of analysis for management studies, i.e., the neural level. ...
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p>This paper discusses the dawn of cognitive neuroscience in management and organizational research. The study does that in two tiers: first, it reviews the interdisciplinary field of organizational cognitive neuroscience and second, it analyzes the role organizational cognitive neuroscience (OCN) could play in reducing counterproductive workplace behaviors (CWB). Theoretically the literature has established the benefits of a neuro-scientific approach towards understanding various organizational behaviors but no research has been done on using organizational neuroscience techniques to study counterproductive work behaviors. This paper however has taken the first step towards this research avenue. The study will shed light on this interdisciplinary field of organizational cognitive neuroscience (OCN) and the benefits that organizations can reap from it with respect to understanding employee behavior. A research agenda for future studies is provided to scholars who are interested in advancing the investigation of cognition in counterproductive work behaviors, also by using neuroscience techniques. The study concludes by providing evidences drawn from the literature in favor of adopting an OCN approach in organizations. </p
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Thesis (Ph. D.)--California School of Professional Psychology, San Diego, 1995.
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Previous work in cats demonstrated a discrete 12–16 Hz rhythm in sensorimotor cortex (SMR), present only during absence of movement, that could be operantly conditioned. Trained cats were resistant to drug‐induced seizures. Similar biofeedback training procedures were employed with epileptic and nonepileptic human subjects, utilizing lights, tones, and slides. Initially SMR activity was detected only at low voltage by tuned filters. Biofeedback training sessions resulted in a significant increase in this activity after 2 to 3 months. Learned SMR responses in nonepileptic subjects were trains of pure or polyrhythmic 12–16 Hz activity at 20 to 25 μV over central and frontal areas. Although epileptic subjects failed to develop the enhanced SMR amplitude, they did demonstrate increased occurrence of this frequency. Training in four epileptic patients, who previously were not controlled by chemotherapy, was accompanied by a significant reduction of EEG and clinical epileptic manifestations, as indicated by sequential power spectral analysis, clinical EEG records, and seizure logs. Tonic‐clonic and myoclonic seizures were most markedly reduced. RÉsumé Des travaux antérieurs chez des chats ont démontré qu'il y a un rythme discret à 12–16 Hz dans le cortex sensorimoteur (SMR) évident seulement au repos mais suceptible d'étre conditioné. Les chats entrainés étaient résistants aux crises provoquées par des drogues. Des procédés analogues de biofeedback training ont été employeś chez des personnes avec ou sans épilepsie, en utilisant des lumières des sons et des diapositives. Au début, le rythme du cortex sensorimoteur était détecté seulement à des bas voltages avec des filtres à sonorisation appropriée. A la suite de séances de biofeedback training, il y avait après 2–3 mois, une augmentation significative de L'activité rythmique des régions sensorimotrices. Chez les sujets sans épilepsies, les activités acquises à la suite de L'apprentissage étaient constituées par des bouffées d'activités mono‐ ou polyrythmique à 12–16 Hz et de 20–25 μV d'amplitude, intéressant les régions centrales et frontales. Bien que les sujets avec épilepsie ne soient pas arriveés à augmenter L'amplitude des rythmes des régions sensorimotrices, ils ont cependant mis en évidence une augmentation quantitative de ces rythmes. Chez 4 sujets avec épilepsie qui avant L'entra înement n'étaient pas contrôlés par les médicaments, on a observéà la suite de L'entraînement une diminution significative des decharges paroxystiques sur L'EEG et des crises diminution objectiveée par L'analyse séquentielle des spectres de puissances et par le compte rendu du nombre des crises. Les crises tonico‐cloniques et myocloniques etaient le plus remarquablement diminuées. RESUMEN Estudios previos en gatos nan demostrado que un discreto ritmo de 12 a 16 Hz en la corteza sensorial‐motora (SMR), registrable solamente en ausencia de movimiento, podía ser condicionado. Los gatos entrenados eran resistentes a los ataques inducidos. Un entrenamiento semejante (bio‐feedback) se utilizeó en enfermos epilépticos y en individuos sanos mediante el empleo de luces, tonos y diapositivas. Inicialmente la actividad SMR se registró solamente con voltajes bajos y filtros apropiados. El entrenamiento con retro‐información boilógica (biofeedback) produjo un aumento significativo de esta actividad a los 2 o 3 meses. En individuos sanos, las respuestas SMR aprendidas, se expresaban en forma de trenes de una actividad, pura o polirítmica, de 12 a 16 Hz y de 20 a 25 micro‐voltios en las areas frontal y central. Los enfermos epilépticos mostraron un aumento de estas frecuencias a pesar de que no se pudo conseguir un incremento de la amplitud SMR. En cuatro enfermos epilépticos entrenados sin posible control farmacológico previo, se consiguió una reducción significativa de las manifestaciones clínicas o electroencefalográficas de la epilepsyía, como demostró el análisis espectral secuencial y los trazados clónicos de EEG Los ataques tónico‐clónicos y las mioclónias fueron los que más se redujeron. ZUSAMMEnfassung Frühere Untersuchungen bei Katzen liessen einen diskreten 12 bis 16 Hz‐Rhythmus im sensomotorischen Cortex (SMR) erkennen. Er war nur bei Bewegungsruhe vorhanden und konnte konditioniert werden. Trainierte Katzen waren gegenüber medicamentös erzeugten Anfällen resistent. Ahnliche Programme mit biologischem Rückkopplungstraining wurden mit epileptischen und nicht epileptischen Patienten durchgeführt, wobei Licht, Töne und Dias verwendet wurden. Anfangs wurde die SMR.‐Aktivität nur mit niedriger Amplitude durch abgestimmte Filter gefunden. Nach 2 bis 3 Monaten dauerndem Training der biologischen Rückkopplung wurde eine signifikante Zunahme dieser Aktivität gefunden. Bei nicht epileptischen Patienten bestanden die erlernten SMR‐Ant‐worten in Zügen reiner oder polyrhythmischer 12 bis 16 Hz‐Aktivität mit 20 bis 25 μV über den zentralen und frontalen Ableitepunkten. Obwohl epileptische Patienten keine verstärkte SMR‐Amplitude aufwiesen, zeigten sie doch eine vermehrte Häufigkeit dieser Frequenz. Das Training von 4 epileptischen Patienten, deren Anfälle durch Chemotherapie vorher nicht zu kontrollieren waren, wurde von einer signifikanten Verminderung der epileptischen Manifestationen im EEG und klinisch begleitet. Das zeigten die sequentielle Power‐Spektrumanalyse, klinische EEG‐Untersuchugnen und Anfallsaufzeichnungen. Tonisch‐klonische und myoklonische Anfälle wurden am deutlichsten vermindert.