Article

Improved Neuronal Regulation in ADHD: An Application of Fifteen Sessions of Photic-Driven EEG Neurotherapy

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Abstract

This study tested a 15-session electroencephalograph (EEG) driven photic stimulation neural training procedure designed to enhance the regulation of brain wave activity and thus improve cognitive functioning in Attention Deficit Hyperactivity Disorder (ADHD) children. The subjects (N=25) were 8-14 year old children of intact families and were screened by a developmental pediatrician for other DSM-4 diagnoses and medical conditions. Some of the subjects were medicated and some were not. A quasi-experimental waiting control group design was used with repeated psychometric tests consisting of the Wechsler Intelligence Scale for Children Third Edition (WISC-3), Raven Progressive Matrices (RPM), Wechsler Individual Achievement Test (WIAT), Achenbach Child Behavior Checklist and Profiles (CBCL-P), the computerized performance Test of Variables of Attention (T.O.V.A.), and two separate EEG measures. No significant changes were noted in any waiting period control group tests. Experimental results revealed highly significant (P< 05 two-tailed) EEG changes, improvements in the WISC-3 processing speed and freedom from distractibility scales, WIAT, CBCL-P, and T.O.V.A. fourth quarter commission error test scores. The results of this study are encouraging. The primary goal was accomplished and the hypotheses were supported by the data. Further study is indicated to explore the effects of longer treatment courses, different training goals, and better data procurement procedures using outcome measures of EEG variability coupled with successful psychometric performance.

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... An early study by Carter and Russell (1993) administered up to 80 AVS sessions over 8 weeks to students with LD, and found significant increases in scales measuring memory, reading, and spelling, as well as in overall verbal IQ scores. A later study using 15 individual photic-driven EEG neurotherapy sessions with children diagnosed with attention deficit hyperactivity disorder (ADHD), found improvements in the WISC-III Processing Speed and Freedom From Distractability indexes (Patrick, 1994). Recent studies utilizing 30 (Joyce & Siever, 2000) and 40 (Micheletti, 1998) AVS sessions at varying frequencies for the treatment of ADHD found improved standardized test scores, a decrease in problem behaviors, and overall improvement in academic performance. ...
... Brainwave entrainment through the use of auditory and visual stimulation (AVS) affects electroencephalographic (EEG) output (a measure of brainwave activity), and can result in the suppression or enhancement of specific brainwave frequencies (Lubar, 1991). Studies supported evidence that changing the cerebral electrical activity associated with LD/ADHD improved symptoms and enhanced cognitive performance (Lubar, 1991; Patrick, 1994; Russell, 1997). Light or photic driven EEG neurotherapy found improved regulation of irregular or over aroused/under aroused brainwave states which affect learning and attending, yielding in increased neuroactivation (Boyde, 1998; Carter & Russell, 1993 Patrick, 1994; Siever, 2000). ...
... Studies supported evidence that changing the cerebral electrical activity associated with LD/ADHD improved symptoms and enhanced cognitive performance (Lubar, 1991; Patrick, 1994; Russell, 1997). Light or photic driven EEG neurotherapy found improved regulation of irregular or over aroused/under aroused brainwave states which affect learning and attending, yielding in increased neuroactivation (Boyde, 1998; Carter & Russell, 1993 Patrick, 1994; Siever, 2000). More recent studies using AVS also found a reduction of behavior disorders (Joyce & Siever, 2000; Russell, 1997) and improved academic performance on standardized tests (Carter & Russell, 1993 Micheletti, 1998; Olmstead, 2000; Patrick, 1994). ...
Article
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Brainwave entrainment (BWE), which uses rhythmic stimuli to alter brainwave frequency and thus brain states, has been investigated and used since the late 1800s, yet many clinicians and scientists are unaware of its existence. We aim to raise awareness and discuss its potential by presenting a systematic review of the literature from peer-reviewed journals on the psychological effects of BWE. Terms used to describe BWE and psychological outcomes were used to search English language studies from OVID Medline (1950-2007), PsychInfo (1806-2007), and Scopus. Twenty studies selected satisfied the following criterion: studies needed to use rhythmic stimuli with the aim ofaffecting psychological outcomes. Peer-reviewed experimental and quasi-experimental studies were accepted. Case studies and review articles were excluded. Psychological outcomes were measured using standard assessment methods or as deemed appropriate by peer review. Other clinical measurements, including electroencephalogram response, galvanic skin response, and neurotransmitter levels were not included. Psychological outcomes addressed cognition, stress and anxiety, pain relief, headaches or migraines, mood, behavior, and premenstrual syndrome (PMS). Protocols included the use of single, alternating, ascending, or descending frequencies or were determined by the subject, using auditory and/or photic stimulation. Studies examined single session effects and/or longer-term multiple session effects. Findings to date suggest that BWE is an effective therapeutic tool. People suffering from cognitive functioning deficits, stress, pain, headache/migraines, PMS, and behavioral problems benefited from BWE. However, more controlled trials are needed to test additional protocols with outcomes.
... Die heutige elektronisch gesteuerte Photostimulation wird für verschiedene neurodiagnostische und therapeutische Zwecke eingesetzt, u. a. zur Induktion von Entspannung [10] und speziell z. B. bei der Behandlung chronisch Schmerz- kranker [1] , bei der Behandlung des prämenstruellen Syndroms [8] oder bei Auf- merksamkeitsdefizit-/Hyperaktivitätsstö- rungen [6, 9]. Außerdem findet sie eine breite Anwendung in der Lernförderung [7]. ...
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The therapeutic effect of applying photic stimulation was evaluated in a sample of 17 patients with chronic tinnitus. The employed optical stimulation technique triggers the activity of brain waves and induces deep relaxation characterized by increased EEG activity in the theta and delta spectrum. The expected therapeutic effect beyond relaxation was a decrease in subjective tinnitus distress and further improvements in well-being. All patients received ten applications of photic stimulation, each lasting 30 min. Every application markedly increased the peripheral blood circulation, thus indicating a relaxation effect. The emotional and cognitive impairments as well as the subjective tinnitus distress significantly decreased during treatment while sleep disturbances showed a tendency towards improvement. Overall, tinnitus distress markedly decreased and general well-being improved. The photic stimulation technique is proposed as a relief for tinnitus patients who do not respond to conventional relaxation techniques.
... because they don't rely on a concentration and learning ability . Some studies indeed confirm the effectiveness of entrainment for ADHD [34,35], but not in all cognitive areas [30,36]. ...
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An EEG-Based audiovisual stimulation system was tested on a group of 32 ADHD patients. The efficacy was compared in a pre- and post analysis over a treatment period of 3 month with a control group and a group of patients with an EEGbased neurofeedback therapy. The number of impulsivity errors in a stop-signal paradigm at several distinct times during and after the therapy was used as a quality marker. The main feature of this method uses real-time-EEG data derived parameters for a controlled manipulation of EEG patterns with persistently strong audio-visual stimuli. It is based upon a direct feedback of changes in short-term coherences in the context of central nervous stimulus processing to control the stimulating frequency. The real-time EEG processing is done on the basis of time-dependent coherence analysis of the theta and beta band.
... because they don't rely on a concentration and learning ability . Some studies indeed confirm the effectiveness of entrainment for ADHD [34,35], but not in all cognitive areas [30,36]. ...
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An EEG-Based audiovisual stimulation system was tested on a group of 32 ADHD patients. The efficacy was compared in a pre- and post analysis over a treatment period of 3 month with a control group and a group of patients with an EEG-based neurofeedback therapy. The number of impulsivity errors in a stop-signal paradigm at several distinct times during and after the therapy was used as a quality marker. The main feature of this method uses real-time-EEG data derived pa-rameters for a controlled manipulation of EEG patterns with persistently strong audio-visual stimuli. It is based upon a direct feedback of changes in short-term coherences in the context of central nervous stimulus processing to control the stimulating frequency. The real-time EEG processing is done on the basis of time-dependent coherence analysis of the theta and beta band.
... Since the enhancement of beta (13-21 Hz) and inhibition of theta (4-8 Hz) is a goal of EEG biofeedback for the treatment of attention deficit hyperactivity disorder (ADHD; Lubar, Swartwood, Swartwood & O'Donnell, 1995), some have proposed using AVS in neurofeedback as a "priming stimulus" to encourage the endogenous production of desired cortical frequencies, which are then reinforced as the conditioned response. In a study of 25 ADHD children, Patrick (1996) found "photic-driven EEG neurotherapy" effective in improving cognitive, behavioral, and clinical EEG measures in less than half the number of sessions usually required. Meanwhile, Micheletti (1999) found AVS alone effective in improving cognitive and behavioral measures, in a study of 99 ADHD children. ...
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The effects of a single session of audio-visual stimulation (AVS) at the dominant alpha rhythm and twice-dominant alpha frequency on EEG coherence were studied in 23 subjects. An eyes-closed baseline EEG determined each subject's dominant alpha frequency. Subjects were stimulated at their dominant alpha frequency or at their twice dominant alpha frequency for 20 minutes, while EEG was recorded in five-minute intervals. A post-session baseline was recorded 30 minutes after each session. AVS decreased coherence in the intrahemispheric projections from the occipital region and the parietal midline, and generally increased coherence, with few exceptions, among all other longitudinal pairs. Interhemispheric coherence increased posteriorly and at high frequencies, and tended to decrease frontally and at low frequencies. Alpha AVS was more effective than twice-alpha AVS at increasing interhemispheric coherence, and tended to produce more effects overall. Although main effects of frequency and time were observed, when individual coherence pairs changed, they almost always changed in only one direction. Overall coherence was greater during the first 10 minutes than the last 10 minutes, and greatest in the beta 1 and delta 2 bands, and lowest in the alpha and delta 1 bands. Few, if any, significant effects persisted into the post-stimulation baseline. A new method of assessing the effects of multiple comparisons on experimentwise error, based on randomization theory, is proposed and implemented.
... Other standard EEG tests involve the use of Neurofeedback systems which acquire the brain waves simultaneously and aid in self training to alter and improve the brain activity. These tests have shown huge improvements in children suffering from Attention Deficit Hyperactivity Disorder (ADHD) and in patients with eating disorders, anxiety and depression ((Alhambra et al., 1995;Arns et al., 2013;Boutros et al., 2005;Gordon et al., 2010;Laporte et al., 2002;Patrick, 1996;Snyder et al., 2008;Swartwood et al., 2003)). ...
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... Certain studies of neurofeedback concerning test anxiety indicated that, the enhancement of the alpha frequency band would probably lead to a significant reduction in test anxiety [8]. Moreover, the stimulation of alpha rhythm seems to improve personal competence [9], while the beta stimulation has appeared to improve attention [10], [11], overall intelligence, short-term stress, and to relieve emotional exhaustion [9]. However, high beta frequencies have been associated with intensity or anxiety [12]. ...
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... Since the enhancement of beta (13-21 Hz) and inhibition of theta (4-8 Hz) is a goal of EEG biofeedback for the treatment of attention deficit hyperactivity disorder (ADHD; Lubar and Lubar, 1999;Lubar, Swartwood, Swartwood, and O'Donnell, 1995), some have proposed using AVS in neurofeedback as a "priming stimulus" to encourage the endogenous production of desired cortical frequencies, which are then reinforced as the conditioned response. In a study of 25 ADHD children, Patrick (1996) found "photic-driven EEG neurotherapy" effective in improving cognitive, behavioral, and clinical EEG measures in less than half the number of sessions usually required. Meanwhile, Micheletti (1999) found AVS alone effective in improving cognitive and behavioral measures, in a study of 99 ADHD children. ...
Thesis
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The photic driving response, the effect of a flashing light stimulus on the cortical EEG, has proven to be a sensistive neurometric that varies with differences in perception, mood, and physiological states. The diverse effects of photic stimulation have made commercially available "brainwave syncronizers" popular among consumers and even among some clinicians. It is common in the design of these devices to combine a rhythmic auditory stimulus with the visual stimulus. However, little if any experimental evidence supports the assumption that auditory stimulation enhances the photic driving effect. Therefore, this study compared the amplitude and coherence effects of three stimulation conditions (all sinusoidally-modulated): visual stimulation alone, auditory stimulation alone, and combined auditory and visual stimulation (AVS) at each subject's peak alpha frequency (PAF), in 30 college students, using the standard 10-20 19- electrode montage. An eyes-closed baseline EEG determined each subject's PAF. The three 5-minute stimulation conditions were then administered in a randomized, counterbalanced order, while EEG was recorded. A four minute eyes-closed poststimulation baseline was recorded after each stimulation condition. Amplitude and coherence values were calculated for 1-2 Hz, 2-4 Hz, 4-8 Hz, 8-12 Hz, 13-21 Hz, and 21- 32 Hz, and for the 1.5-Hz band surrounding each subject’s PAF. Visual stimulation or combined AVS significantly increased EEG amplitude at the PAF, 8-12 Hz, 13-21 Hz, and 21-32 Hz. Auditory stimulation alone had negligible effects on amplitude, and did not result in significant differences in amplitude between the visual and combined AVS condition. Similarly, the auditory stimulus had only chance-level effects on EEG coherence, while the visual alone and combined AVS conditions evoked significant changes in coherence across the spectrum. However, the interaction between auditory and visual stimulation resulted in significant differences between the visual alone and combined AVS conditions. No residual effects of stimulation on amplitude or coherence were observed in the four minute recordings following each of the three stimulation sessions. Two tables and eight figures are included. The Perl source code for 21 data analysis programs is provided, along with a tutorial chapter explaining how to use these algorithms in one's own research.
... al, 1999;Markland, 1990). There is now an emerging medical and psychological literature demonstrating efficacy and safety of this variant on meditation in a wide variety of psychiatric, psychosomatic and neurological conditions, ranging from anxiety including post-traumatic stress to depression, ADHD, various pain disorders and substance dependence (Cantor & Stevens, 2009;Thomas & Siever, 1989;Patrick, 1996). LSM has also been described in the literature as "audiovisual entrainment", "lightand-sound neurotherapy", and "light-and-sound stimulation", with most research on mechanism of action focusing on the calming effect of the audiovisual stimulation on psychological and neurological function, as manifested by a relaxation response. ...
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Our experience of using and interacting with the newest computer information technologies is profoundly affected by the extent to which we feel ourselves to be really ‘present’ in the computer-mediated world that the technology makes available to us. This feeling, which is described as 'Presence’, is the “feeling of being inside the mediated world”. It is a crucial and increasingly necessary element in both design and usage of many recent and developing interactive technologies. In the same way that ‘feeling present’, or consciously ‘being there’, in the physical world around us is based upon perception, physical action and activity in that world, so the feeling of presence in a technologically-mediated environment is a function of the possibilities for interaction. Unlike the physical world, the extent to which presence is experienced in an interactive context can be manipulated by design. For example, by linking the display of appropriate information directly to movements of the body of the interacting person, the illusion of flying, or swimming underwater, or walking in a wide variety or seemingly-real places – all actually generated by the technology. Interacting with Presence provides an introduction and overview of the increasingly important topic of mediated presence or tele-presence – which is the compelling illusion of being physically located in a computer-generated or augmented world. This timely edited volume presents a range of theoretic perspectives and empirical evidence casting new light on understanding and designing for presence in interaction. Because of its experiential impact on the user, presence is emerging as a key concept for understanding and predicting developments in diverse areas such as interactive entertainment, gaming, psychotherapy, education, scientific visualization, sports training and rehabilitation, and many more.
... that this entrainment effect might generalize beyond the primary sensory cortex in normal individuals and alter the activity of endogenous EEG rhythms. Recently, audio-visual stimulation (AVS) has been proposed to be effective as an adjunct to EEG biofeedback (neurofeedback) therapy, when used as a " priming stimulus " to activate desired cortical frequencies (Patrick, 1996). ...
Article
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Recently, audio-visual stimulation (AVS) has been proposed to be effective as an adjunct to EEG biofeedback (neurofeedback) therapy, when used as a “priming stimulus” to activate desired cortical frequencies. Since standard neurofeedback therapies for ADD/HD involve training subjects to enhance activity in the 13-21 Hz bandpass, we hypothesized that this activity could also be enhanced by AVS at a constant frequency in this range. Further, we hypothesized that auditory or visual stimulation alone might induce an entrainment effect. EEG was recorded from fifteen college students under the following conditions: (A) auditory stimulation alone, with eyes open; (B) auditory stimulation alone, with eyes closed; (C) visual stimulation alone, with eyes closed; (D) both auditory and visual stimulation, with eyes closed. An eyes-closed and eyes-open baseline condition were recorded prior to the first session. An ANOVA on the differences between the four stimulation conditions and baseline revealed no significant differences between the conditions, so the averages of all four conditions were analyzed as a single group. A significant increase was observed in the 13-21 Hz band (p = 0.045). This increase was of greater magnitude and significance in the narrower, 16-20 Hz band (p = 0.008). When this band was analyzed in half-Hz intervals, a prominent peak was observed at 18.5 Hz (p = 0.001). Applying this same analysis to the individual conditions suggested that the eyes-closed conditions with auditory or visual stimulation alone had more generalized effects throughout the 16-20 Hz band. These results support the hypothesis that AVS entrains endogenous EEG rhythms, and suggest a possible adjunctive role for AVS in EEG biofeedback therapies. However, the relatively weak generalization to frequencies adjacent to the stimulation frequency suggests that variable-frequency AVS might be more effective at activating the desired range of frequencies within a given bandpass.
... ussell, 1997 . Significant improvement in cognitive and behavioral functioning , related to the number of AVS sessions, has been reported for learning-disabled boys Ž . Carter and Russell, 1993 . Finally, AVS may be useful for the clinical application of neurofeedback therapy, serving as an adjunct method for Ž priming desired cortical frequencies Patrick, . 1996 . In light of the recent clinical applications of AVS, it is important to develop a more thorough understanding of AVS effects on cortical activity. ...
Article
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The effects of audio-visual stimulation at the dominant alpha frequency and twice dominant alpha frequency on the EEG were investigated. An eyes-closed baseline EEG determined each subject's dominant alpha frequency. Subjects were stimulated at their dominant alpha frequency and at twice dominant alpha frequency for 20 min on two occasions. A 30-min post-session eyes-closed EEG was recorded after each session. Power data were analyzed for 19 locations in six bandpasses using repeated-measures ANOVAs and appropriate post-hoc tests. Alpha stimulation significantly increased power over baseline levels in the delta 1, delta 2, theta, beta 1 and beta 2, with significant effects remaining 30 min later in beta 1. Twice alpha stimulation significantly increased theta, beta 1 and beta 2 power over baseline levels, with significant effects remaining 30 min later in theta, alpha, beta 1 and beta 2.
... al, 1999;Markland, 1990). There is now an emerging medical and psychological literature demonstrating efficacy and safety of this variant on meditation in a wide variety of psychiatric, psychosomatic and neurological conditions, ranging from anxiety including post-traumatic stress to depression, ADHD, various pain disorders and substance dependence (Cantor & Stevens, 2009;Thomas & Siever, 1989;Patrick, 1996). LSM has also been described in the literature as "audiovisual entrainment", "lightand-sound neurotherapy", and "light-and-sound stimulation", with most research on mechanism of action focusing on the calming effect of the audiovisual stimulation on psychological and neurological function, as manifested by a relaxation response. ...
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The connection of virtual reality to holistic healthcare may appear paradoxical on first blush. Yet, a novel paradigm in immersive media technology that seeks to enable an induced state of wellbeing, by creating uplifting states of consciousness rather than generating aversive stimuli or presenting cumbersome tasks for users is now within reach for clinical application. Demand for innovative and patient-centered care to alleviate stress-related and psychosomatic conditions is certainly high in medical and workplace settings. A mental health treatment modality that is effective, safe and free of adverse effects makes up the desirable set of criteria not only from a patient's perspective, but also from the perspective of clinicians who provide healthcare service to patients. As the boundaries between real and virtual, technologically mediated and 'organic' states of consciously experienced presence continue to blur, the need to address this convergence in a therapeutic paradigm is increasingly relevant and warranted. We review the scientific rationale, clinical results and user feedback from patients who have undertaken a standardized course of sensory-based technology-enhanced multimodal meditation to therapeutically address symptoms in a psychosupportive paradigm. Relationships to physiological parameters of human consciousness, rationale to support replicable and evidencebased application in supporting health and wellbeing are reviewed. We highlight the role of 'slow technology' and an inclusive design approach in supporting further development of therapeutics, as well the subjective and experiential nature of the world of inner presence that invite the possibility of further experience design for use in health and wellness. The relevance of leisure states to wellbeing, and specifically the positive experiential learning through inspirational or motivational shifts in consciousness, is described as an important health promotion avenue to pursue on an individual and societal level.
... Other investigators have used fixed frequency photic stimulation, consisting of visible light flashes, as an adjunct to conventional EEG biofeedback in the treatment of 32 children with attention deficit disorder. 16 Following 15 sessions of treatment during which stimulation was gradually withdrawn, participants in the treatment group demonstrated decreased impulsivity and improved attention, while the wait-list control group showed no change. Another group of researchers has developed a system of EEG-driven photic stimulation, which is different from the Flexyx Neurotherapy System that is evaluated in this study in terms of (1) system hardware, (2) feedback intensity, and (3) relationship between EEG activity and feedback. ...
Article
To conduct a preliminary experimental evaluation of the potential efficacy of Flexyx Neurotherapy System (FNS), an innovative electroencephalography (EEG)-based therapy used clinically in the treatment of traumatic brain injury (TBI). Twelve people aged 21 to 53 who had experienced mild to moderately severe closed head injury at least 12 months previously and who reported substantial cognitive difficulties after injury, which interfered with their functioning. Participants were randomly assigned to an immediate treatment group or a wait-list control group and received 25 sessions of FNS treatment. They were assessed at pretreatment, posttreatment, and follow-up with standardized neuropsychological and mood measures. Comparison of the two groups on outcome measures indicated improvement after treatment for participants' reports of depression, fatigue, and other problematic symptoms, as well as for some measures of cognitive functioning. Most participants experienced meaningful improvement in occupational and social functioning. On the basis of these results, FNS appears to be a promising new therapy for TBI and merits more extensive evaluation.
... éÒÌÓ‚˚ ‰Îfl ËÒÔÓθÁÓ‚ ‡ÌËfl ùùÉ ˜ÂÎÓ‚ÂÍ ‡ ÔË ÍÓÂ͈ËË Ì·Π‡"ÓÔËflÚÌ˚ı Ò‰‚Ë"Ó‚ Â"Ó ÙÛÌ͈Ë-ÓÌ ‡Î¸ÌÓ"Ó ÒÓÒÚÓflÌËfl ·˚ÎË Á ‡ÎÓÊÂÌ˚ ¢ ‚ ÒÂÂ-‰ËÌ ÔÓ¯ÎÓ"Ó ÒÚÓÎÂÚËfl, ÍÓ"‰ ‡ ÌÂÁ ‡‚ËÒËÏÓ ‚ÓÁ-ÌËÍÎË ‰‚ ‡ ÔÓ‰ıÓ‰ ‡ -ÏÂÚÓ‰ÓÎÓ"Ëfl ·ËÓ˝ÎÂÍÚ˘Â-ÒÍÓ"Ó ÛÔ ‡‚ÎÂÌËfl Ë ÛÊ ÓÔËÒ ‡ÌÌ˚È ‚˚¯Â ÏÂÚÓ‰ ‡‰ ‡ÔÚË‚ÌÓ"Ó ·ËÓÛÔ ‡‚ÎÂÌËfl ÙÛÌ͈ËflÏË Ò Ó· ‡Ú-ÌÓÈ Ò‚flÁ¸˛ (ÏÂÚÓ‰ Åéë). [79], "photic-driven EEG neurotherapy" [97], "photic feedback treatment" [74] ËÎË "alpha power dependent light stimulation" [114]. ...
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Recent literature on different kinds of stress and its behavioral, physiological and medical consequences for humans is reviewed and summarized. Modern non-drug approaches to prevention and correction of stress-induced functional disturbances in humans are analyzed, traditional and instrumental methods of anti-stress therapy are reviewed. The most attention is paid to the approaches that utilize human brain electrical activity characteristics reflected in the electroencephalogram (EEG).
... In this area, the efficacy of neurofeedback is well established and documented Butnik, 2005;Carmody et al., 2001;Fuchs et al., 2003;Gruzelier & Egner, 2005;Heinrich et al., 2004;Kaiser & Othmer, 2000;Linden et al., 1996;Lubar & Lubar, 1999;Masterpasqual & Healey, 2003;Monastra et al., 2002;Monastra et al., 2005;Nash, 2000;Patrick, 1996;Robbins, 2000;Rossiter & La Vaque, 1995;Schulenburg, 1999;Thompson & Thompson, 1998;Tinius & Tinius, 2000;Vernon et Complimentary Contributor Copy Neurofeedback and Offender Treatment 9 al., 2004). In these publications, a total of 1232 subjects were studied. ...
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