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What is Neurofeedback Update

What is Neurofeedback Update

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Published by Larry Mynatt
This article was downloaded by: [174.63.80.40] On: 06 April 2012, At: 13:44 Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK

Journal of Neurotherapy: Investigations in Neuromodulation, Neurofeedback and Applied Neuroscience
Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/wneu20

What is Neurofeedback: An Upda
This article was downloaded by: [174.63.80.40] On: 06 April 2012, At: 13:44 Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK

Journal of Neurotherapy: Investigations in Neuromodulation, Neurofeedback and Applied Neuroscience
Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/wneu20

What is Neurofeedback: An Upda

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Published by: Larry Mynatt on Oct 24, 2012
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This article was downloaded by: [174.63.80.40]On: 06 April 2012, At: 13:44Publisher: RoutledgeInforma Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House,37-41 Mortimer Street, London W1T 3JH, UK
Journal of Neurotherapy: Investigations inNeuromodulation, Neurofeedback and AppliedNeuroscience
Publication details, including instructions for authors and subscription information:http://www.tandfonline.com/loi/wneu20
What is Neurofeedback: An Update
D. Corydon Hammond
aa
Physical Medicine & Rehabilitation, University of Utah School of Medicine, Salt Lake City,Utah, USAAvailable online: 30 Nov 2011
To cite this article:
D. Corydon Hammond (2011): What is Neurofeedback: An Update, Journal of Neurotherapy: Investigationsin Neuromodulation, Neurofeedback and Applied Neuroscience, 15:4, 305-336
To link to this article:
http://dx.doi.org/10.1080/10874208.2011.623090
PLEASE SCROLL DOWN FOR ARTICLEFull terms and conditions of use:http://www.tandfonline.com/page/terms-and-conditionsThis article may be used for research, teaching, and private study purposes. Any substantial or systematicreproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form toanyone is expressly forbidden.The publisher does not give any warranty express or implied or make any representation that the contentswill be complete or accurate or up to date. The accuracy of any instructions, formulae, and drug doses shouldbe independently verified with primary sources. The publisher shall not be liable for any loss, actions, claims,proceedings, demand, or costs or damages whatsoever or howsoever caused arising directly or indirectly inconnection with or arising out of the use of this material.
 
WHAT IS NEUROFEEDBACK: AN UPDATE
D. Corydon Hammond
Physical Medicine & Rehabilitation, University of Utah School of Medicine, Salt Lake City, Utah, USA
Written to educate both professionals and the general public, this article provides an updateand overview of the field of neurofeedback (EEG biofeedback). The process of assessmentand neurofeedback training is explained. Then, areas in which neurofeedback is being usedas a treatment are identified and a survey of research findings is presented. Potential risks,side effects, and adverse reactions are cited and guidelines provided for selecting a legiti-mately qualified practitioner.
INTRODUCTION
In the late 1960s and 1970s it was learned that it was possible to recondition and retrainbrainwave patterns (Kamiya, 2011; Sterman,LoPresti, & Fairchild, 2010). Some of this workbeganwithtrainingtoincreasealphabrainwaveactivity for the purpose of increasing relaxation,whereas other work originating at University of California, Los Angeles focused first on animaland then human research on assisting uncon-trolled epilepsy. This brainwave training iscalled EEG biofeedback or neurofeedback.Prior to a more detailed discussion, the authorwill review some preliminary information about brainwave activity. Brainwaves occur at variousfrequencies. Some are fast, and some are quiteslow. The classic names of these EEG bands aredelta, theta, alpha, beta, and gamma. They aremeasured in cycles per second or hertz (Hz).The following definitions, although lacking inscientific rigor, will provide the general readerwith some conception of the activity associatedwith different frequency bands.
Gamma
brainwaves are very fast EEGactivity above 30Hz. Although further researchis required on these frequencies, we know that some of this activity is associated with intenselyfocused attention and in assisting the brain toprocess and bind together information fromdifferent areas of the brain.
Beta
brainwavesare small, relatively fast brainwaves (above13–30Hz) associated with a state of mental,intellectual activity and outwardly focusedconcentration. This is basically a ‘‘bright-eyed,bushy-tailed’’ state of alertness. Activity in thelower end of this frequency band (e.g., thesensorimotor rhythm, or SMR) is associatedwith relaxed attentiveness.
Alpha
brainwaves(8–12Hz) are slower and larger. They aregenerally associated with a state of relaxation. Activityinthelowerhalfofthisrangerepresentsto a considerable degree the brain shifting intoan idling gear, relaxed and a bit disengaged,waiting to respond when needed. If peoplemerely close their eyes and begin picturing something peaceful, in less than half a minutethere begins to be an increase in alpha brain-waves. These brainwaves are especially largein the back third of the head.
Theta
(4–8Hz)activity generally represents a more daydream-like, rather spacey state of mind that is associa-ted with mental inefficiency. At very slowlevels, theta brainwave activity is a very relaxedstate, representing the twilight zone betweenwaking and sleep.
Delta
brainwaves (.53.5Hz) are very slow, high-amplitude (magni-tude) brainwaves and are what we experience
Received 1 August 2011; accepted 15 August 2011. Address correspondence to D. Corydon Hammond, PhD, Physical Medicine & Rehabilitation, University of Utah School of Medicine, 30 North 1900 East, Salt Lake City, UT 84132-2119, USA. E-mail: d.c.hammond@utah.edu
 Journal of Neurotherapy
, 15:305–336, 2011Copyright
#
Taylor & Francis Group, LLCISSN: 1087-4208 print
=
1530-017X onlineDOI: 10.1080/10874208.2011.623090
305
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in deep, restorative sleep. In general, different levels of awareness are associated with domi-nant brainwave states.Itshouldbenoted,however,thateachofusalwayshassomedegreeofeachofthesevariousbrainwavefrequenciespresentindifferentpartsof our brain. Delta brainwaves will also occur,for instance, when areas of the brain go ‘‘off line’’ to take up nourishment, and delta is alsoassociated with learning disabilities. If someoneis becoming drowsy, there are more delta andslower theta brainwaves creeping in, and if people are somewhat inattentive to externalthings and their minds are wandering, there ismore theta present. If someone is exceptionallyanxious and tense, an excessively high fre-quency of beta brainwaves may be present indifferent parts of the brain, but in other casesthis may be associated with an excess of inef-ficient alpha activity in frontal areas that areassociated with emotional control. Personswith Attention-Deficit 
=
Hyperactivity Disorder(ADD, ADHD), head injuries, stroke, epilepsy,developmental disabilities, and often chronicfatiguesyndromeandfibromyalgiatendtohaveexcessive slow waves (usually theta and some-times excess alpha) present. When an excessiveamount of slow waves are present in the execu-tive (frontal) parts of the brain, it becomesdifficult to control attention, behavior, and
=
oremotions. Such persons generally have prob-lems with concentration, memory, controlling their impulses and moods, or hyperactivity.They have problems focusing and exhibidiminished intellectual efficiency. As the reader can see, there can be com-plexity involved in how the brain is operating.Research (Hammond, 2010b) has found that there is heterogeneity in the EEG patternsassociated with different diagnostic conditionssuch as ADD
=
 ADHD, anxiety, or obsessive-compulsive disorder. For example, scientificresearch has identified a
minimum
of threemajor subtypes of ADD
=
 ADHD, none of whichcan be diagnosed from only observing theperson’s behavior and each of which requiresa different treatment protocol. The picturecan become even more complicated by thefact that sometimes there are other comorbidproblems present, and not simply ADD
=
 ADHDalone. Therefore, appropriate assessment isimportant prior to beginning to do neurofeed-back to determine what EEG frequencies areexcessive or deficient, or if there are problemsin processing speed or coherence, and in what parts of the brain. Proper assessment allows thetreatment to be individualized and tailored tothe patient.Neurofeedback training is EEG (brainwave)biofeedback. During typical training, one ormore electrodes are placed on the scalp andone or two are usually put on the earlobes.Then, high-tech electronic equipment providesreal-time,instantaneousfeedback(usuallyaudi-tory and visual) about your brainwave activity.The electrodes allow us to measure the electri-cal patterns coming from the brain
 — 
much likeaphysicianlistenstoyourheartfromthesurfaceof your skin. No electrical current is put intoyour brain. Your brain’s electrical activity isrelayed to the computer and recorded.Ordinarily, patients cannot reliably influ-encetheirbrainwavepatternsbecausetheylackawareness of them. However, when they cansee their brainwaves on a computer screen afew thousandths of a second after they occur,it gives them the ability to influence and gradu-ally change them. The mechanism of action isgenerally considered to be operant condition-ing. We are literally reconditioning and retrain-ing the brain. At rst, the changes areshort-lived, but the changes gradually becomemore enduring. With continuing feedback,coaching, and practice, healthier brainwavepatterns can usually be retrained in most people. As is reviewed later in the article, most research suggests that significant improvementsseem to occur 75 to 80
%
of the time. The pro-cess is a little like exercising or doing physicaltherapy with the brain, enhancing cognitiveflexibility and control. Thus, whether symptomsstem from ADD
=
 ADHD, a learning disability, astroke, head injury, deficits following neurosur-gery, uncontrolled epilepsy, cognitive dysfunc-tion associated with aging, depression,anxiety, obsessive-compulsive disorder, autism,or other brain-related conditions, neurofeed-back training offers additional opportunities
306 D. C. HAMMOND
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