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History of neurofeedback
... This is because the neurofeedback study is still in its early stages, and a general bibliometric analysis is prioritised now. The second limitation is that this paper only covers bibliometric analysis from 2000 to 2022 and does not include the early years of neurofeedback research in the 1960s and 1970s (Othmer, 2015). This is because in the early years of neurofeedback, many studies were animal-based, with few focusing on human studies in a clinical setting. ...
The application of neurofeedback is gaining increasing interest among neuroscientists as a potential neurorehabilitation approach in cases of various neuro-related functional abnormalities. Discovering the current state of research and identifying gaps in the field of neurofeedback is an essential step in planning and mapping out future research efforts. This bibliometric analysis paper aims to identify the publications and research in neurofeedback from 2000 to 2022. A comprehensive Scopus database search was conducted using the keyword "neurofeedback" and relevant publications from 2000 to 2022 were retrieved. Bibliometric analyses were performed using the Harzing's Publish or Perish and VOSviewer software programmes. The number of retrieved documents was 1835. The number of publications has shown a steadily increasing trend since 2000, with a prominent spike in publications in 2014–2015, indicating a sudden interest in neurofeedback. Among the retrieved documents, 50.3% were related to neuroscience, 23.7% related to medicine, and 13.1% related to psychology. The main contributors to this research come from the United States (24.7%), Germany (13.7%), the United Kingdom (9.4%), and Switzerland (4.9%). Based on the network visualisation of author keywords, the most frequently occurring keywords were neurofeedback, real-time functional magnetic resonance imaging (fMRI), brain-computer interface (BCI), neuromodulation, and neurofeedback training. This bibliometric analysis presents the current status, knowledge base, and future neurofeedback study directions. These findings will benefit future researchers interested in applying neurofeedback as a potential neurorehabilitation approach for a wider population.
... Hans Berger's pursuit of direct brain-brain communication, also known as telepathy, led to the discovery of Electroencephalogram (EEG) in 1929, and paved the way for the modern advances in Brain-Computer Interface (BCI) and Neurofeedback (NF) applications (Othmer, 2020;Berger, 1929). In NF, brain activity is captured and transduced into an auditory, visual or tactile feedback signal, used to train the patient to be able to control the brain activity (Sitaram et al., 2017). ...
Brain-Computer Interface (BCI) and Neurofeedback (NF) both rely on the technology to capture brain activity. However, the literature lacks a clear distinction between the two, with some scholars categorizing NF as a special case of BCI while others view BCI as a natural extension of NF, or classify them as fundamentally different entities. This ambiguity hinders the flow of information and expertise among scholars and can cause confusion. To address this issue, we conducted a study comparing BCI and NF from two perspectives: the background and context within which BCI and NF developed, and their system design. We utilized Functional Flow Block Diagram (FFBD) as a system modelling approach to visualize inputs, functions, and outputs to compare BCI and NF at a conceptual level. Our analysis revealed that while NF is a subset of the biofeedback method that requires data from the brain to be extracted and processed, the device performing these tasks is a BCI system by definition. Therefore, we conclude that NF should be considered a specific application of BCI technology. By clarifying the relationship between BCI and NF, we hope to facilitate better communication and collaboration among scholars in these fields.
... This new training modality highlighted the need to rethink the mechanism of action that underlies the Neurofeedback: indeed, the basic operant conditioning conception was no longer suitable for explaining ILF-Neurofeedback training, given the absence of overt reinforcers. A more naturalistic model has been suggested, in which the brain acts to bring about closure between its expectation for the signal and the actual signal, in line with its normal self-regulation response (Othmer, 2015b;Othmer and Othmer, 2020). Clinical results and theoretical observations implicated ILF-Neurofeedback training in arousal regulation, thus engaging our intrinsic control networks, the salience network (SN) and the default mode network (DMN). ...
Introduction
Neurofeedback training is increasingly applied as a therapeutic tool in a variety of disorders, with growing scientific and clinical interest in the last two decades. Different Neurofeedback approaches have been developed over time, so it is now important to be able to distinguish between them and investigate the effectiveness and efficiency characteristics of each specific protocol. In this study we intend to examine the effects of Neurofeedback based on slow brain activity, the so-called Infra-Low Frequency (ILF) training a recently developed methodology that seems promising for the regulation of the central nervous system.
Aims
With this review we intend to summarize the currently existing literature on ILF-Neurofeedback, examine its quality and formulate indications about the clinical effectiveness of ILF-Neurofeedback.
Methods
Literature search was first conducted according to PRISMA principles, described, and then assessed using the MMAT appraisal tool. 18 well-documented studies of ILF-Neurofeedback training in human subjects were picked up and analyzed. Reports include group interventions as well as single case studies.
Results
Research data indicates good potential for ILF-Neurofeedback to influence brain activity and neurovegetative parameters. From the clinical profile, a salient common observation is a high level of individualization as a specific characteristic of ILF-Training: this feature seems to correlate with effectiveness of ILF-Neurofeedback, but also poses a challenge for researchers in terms of producing controlled and comparable findings; according to this point, some recommendation for future research on ILF-Neurofeedback are proposed. In conclusion, ILF-neurofeedback shows great potential for application for all those conditions in which the regulation of brain activity and neurophysiological processes are crucial. Further research will make it possible to complete the available data and to have a broader overview of its possible applications.
A good number of veterans while serving in recent combat zones experienced blast injuries resulting in traumatic brain injuries (TBIs), 80% of which were mild (m) with 25%–50% having prolonged postconcussive symptoms (PCSs). Neurofeedback (NFB) has demonstrated a decent degree of efficacy with mTBI PCSs in civilian and veteran populations. Using infra-low frequency NFB, the authors conducted a pilot study to determine the feasibility and initial efficacy with veterans. Because these results were promising, funding for a full clinical trial was subsequently applied for and acquired.
The treatment of patients suffering from an eating disorder and a comorbid post-traumatic stress disorder is challenging and often leads to poor outcomes. In a randomized control trial, we evaluated to what extent adding Infra-Low Frequency (ILF) neurofeedback could improve symptom reduction within an established inpatient treatment program. In a randomized two-group design, patients suffering from an eating disorder (anorexia nervosa, bulimia nervosa, or binge eating disorder) and comorbid post-traumatic stress disorder (N = 36) were examined while attending an inpatient treatment program in a clinic for psychosomatic disorders. The intervention group received ILF neurofeedback in addition to regular therapy, while the control group received “media-supported relaxation” as a placebo intervention. At the beginning and at the end of their treatment, all participants completed the Eating Disorder Examination-Questionnaire (EDE-Q) as a measure of eating disorder psychopathology and the Impact of Event Scale-Revised (IES-R) in order to assess symptoms of post-traumatic stress. Changes in EDE-Q and IES-R scores over time served as primary outcomes as well as an increase in body mass index in underweight patients. Secondary outcomes were the perceived benefit of the received intervention, global assessment of psychological treatment success, and complications in the course of treatment. Statistical evaluation was carried out with repeated measurement analysis of variance for the primary outcomes and with t-tests and Fisher’s exact test for the secondary outcomes. Our results indicate better treatment outcomes in the ILF neurofeedback group with regard to trauma-associated avoidance as well as with regard to restraint eating and increase in body weight. Furthermore, patients who had received ILF neurofeedback rated the intervention they received and, in tendency, their overall treatment more positively and they experienced fewer complications in the course of treatment. ILF neurofeedback is very well accepted by patients and seems to provide a relevant additional benefit in some aspects of symptom reduction. Findings confirm the feasibility of embedding this treatment approach in an inpatient setting and support the case for a larger study for greater statistical power. Clinical Trial Registration: “Infra-Low Frequency Neurofeedback training in the treatment of patients with eating disorder and comorbid post-traumatic stress disorder”; German Clinical Trials Registry (https://www.drks.de; Identifier: DRKS00027826).
There are several different methods of neurofeedback, most of which presume an operant conditioning model whereby the subject learns to control their brain activity in particular regions of the brain and/or at particular brainwave frequencies based on reinforcement. One method, however, called infra-low frequency [ILF] neurofeedback cannot be explained through this paradigm, yet it has profound effects on brain function. Like a conductor of a symphony, recent evidence demonstrates that the primary ILF (typically between 0.01–0.1 Hz), which correlates with the fluctuation of oxygenated and deoxygenated blood in the brain, regulates all of the classic brainwave bands (i.e. alpha, theta, delta, beta, gamma). The success of ILF neurofeedback suggests that all forms of neurofeedback may work through a similar mechanism that does not fit the operant conditioning paradigm. This chapter focuses on the possible mechanisms of action for ILF neurofeedback, which may be generalized, based on current evidence.
The efficacy of brain wave training and EEG biofeedback in the remediation of attentional deficits and specific learning disabilities is evaluated for a study population of fifteen school-age children in a clinical setting using psychological and academic testing. The Wechsler Intelligence Scale for Children--Revised (WISC-R) is used in combination with the Wide Range Achievement Test (WRAT), Peabody Picture Vocabulary Test (PPVT), the Tapping Subtest of the Harris Tests of Lateral Dominance, and the Benton Visual Retention Test (VRT). Behavioral changes are assessed by means of teacher and parental reporting. The training protocol is enhancement of EEG activity in the 15-18 Hz regime, with suppression of excessive activity in the 4-7 Hz and 22-30 Hz regions. Significant improvements in cognitive skills, academic performance, and behavior are found, and confirmed in follow-up. Average improvement in WISC-R full-scale IQ was 23 points. A preference for 15-18 Hz training versus 12-15 Hz training is indicated.
Since our initial reports of successful seizure reduction in drug-refractory epileptics through the application of EEG biofeedback techniques developed in cat research (Sterman & Friar, 1972; Sterman, Macdonald, & Stone, 1974), there have been abundant confirmations of this therapeutic effect in man (Finley, Smith, & Etherton, 1975; Seifert & Lubar, 1975; Ellertsen & Klove, 1976; Lubar & Bahler, 1976; Wyler, Lockard, Ward, & Finch, 1976; Wyler, Robbins, & Dodrill, 1979; Sterman & Macdonald, 1978; Kuhlman, 1978; Cott, Pavloski, & Black, 1979; Sterman & Shouse, 1981; Lubar, Shabsin, Natelson, Holder, Whitsett, Pamplin, & Krulikowski, 1981). Moreover, the questions immediately raised concerning the incorporation of adequate control procedures and the specificity of this effect have now been put to rest. What remains at issue, however, is an understanding of the mechanism responsible for the elevated seizure thresholds produced by this technique (see, for example, Wyler, Chapter 6). Also in question is the appropriate clinical utilization of EEG biofeedback therapy as an alternative to extended drug trials or neurosurgery for poorly controlled patients. This discussion will address both of these issues.
This chapter addresses the question of how to classify the neuromodulation effects resulting from widely differing neurofeedback approaches developed over the last four decades. A proliferation of targets and objectives has been observed to which attention is directed in the training. With regard to clinical outcomes, however, one encounters a broad zone of commonality. Why is it that the premises and technological approaches within the neurofeedback network of scholars and clinicians are so disparate, yet they largely achieve common clinical goals? This in-depth analysis may lead one closer to the "essence" of neurofeedback and provide focus for further development efforts. This chapter attempts to appraise the "state of the field" at this moment. The objective is to discern the commonalities among the various approaches on the one hand, and among the clinical findings on the other. This will lead to a codification of a "minimal set of claims" that could serve to cover the commonalities among the techniques, and it will lead to a simple classification scheme for the various clinical findings. The evidence in favor of such a minimal set of claims will be adduced largely by reference.
This chapter focuses on assessing and treating open head trauma, coma, and stroke using real time digital electroencephalogram EEG neurofeedback. The chapter is organized into separate sections devoted to the nature, diagnosis, and EEG neurofeedback treatment of head trauma, coma, and stroke. EEG is malleable in cases of open head injury, coma, and stroke. Real-time digital EEG feedback technological advances now enable permanent changes in the EEG pattern, often with improved neurological function and emotional well-being. The author considers two clinical factors to be of utmost importance in the field of neurofeedback: (1) practitioners of EEG neurofeedback need to be familiar with brain anatomy and physiology; and (2) they should always observe the raw EEG, whether analog or digital, and constantly view in real time the minute-by-minute voltage changes and the evolving EEG pattern during training.
This chapter explains neurofeedback in the treatment of addictive disorders. It has long been clear that alcoholism is associated with poor synchrony and deficient alpha EEG activity. Further, alcoholics have been shown more likely to increase the amount of alpha activity after consumption of alcohol. Taken together, these findings suggest that those with a predisposition to alcoholism have deficient alpha activity and are especially vulnerable to alcohol's capacity to produce an electroencephalographically measurable reinforcing state of increased slow-wave activity. The chapter discusses alpha-theta neurofeedback therapy and neurofeedback for addiction and PTSD. The chapter presents a schematic of the therapeutic procedures employed in the Peniston and Kulkosky brain wave neurofeedback therapy (PKBNT) for alcoholism and PTSD. The first step before using the Peniston and Kulkosky therapy involves psychiatric assessments and collection of personal data. These data include chronological age (years), alcoholic and/or PTSD history (years), prior hospitalizations (number), social position (Hollingshead's two-factor index), and intelligence quotient (Shipley Institute scale).
This study investigated the treatment outcome of males dependent on crack cocaine participating in an inpatient treatment facility in which electroencephalographic operant conditioning training (EEG-OC) was added to the treatment protocol. Eighty-seven men were assessed twelve months after completion of the EEG portion of the program. Follow-up procedures of urinalyses, self-report measures, length of residence, and scores on a measure of depression were obtained and showed significant changes after treatment. The addition of EEG-OC to crack cocaine treatment regimens may promise to be an effective intervention for treating crack cocaine abuse and increasing treatment retention.