EEG Spectrum International - EEG Biofeedback: A Generalized Approach to Neuroregulation

EEG Biofeedback: A Generalized Approach to Neuroregulation
By Siegfried Othmer, Susan F. Othmer, and David A. Kaiser

To appear in "APPLIED NEUROPHYSIOLOGY
& BRAIN BIOFEEDBACK"
Edited by Rob Kall, Joe Kamiya, and Gary Schwartz

Summary
In the above we have made a case for global efficacy of EEG training for a broad variety of brain-based disorders. By building on early models of this work by Sterman and Lubar, a comprehensive view has emerged in which EEG training influences fundamental rhythmic timing mechanisms by which the brain manages activation, arousal, and affect. By challenging EEG activity in specific frequency regions in a training paradigm, normalization of activation and arousal mechanisms can be brought about, and cortical stability enhanced. Broad benefit for the organismic functioning has been demonstrated. Once the power of this technique is fully appreciated, the comprehensive reach of this 'new' intervention will result in a reframing of psychopathology in terms of a few key deficits in basic regulatory functioning which, by virtue of the centrality of rhythmic mechanisms, is amenable to redress with EEG biofeedback training to promote neuroregulatory capacity.

A case has been made for a very parsimonious set of protocols by which most of these objectives can be achieved. These protocols have been found to address the specific failure modes of the left and right hemispheres, and to address problems of inter-hemispheric communication. Consistency with the implications of pharmacological interventions for common disorders is indicated. The results alluded to here in cursory and summary fashion portend a significant new capability for remediating brain-based disorders which have been refractory to other interventions, and which represent a staggering loss of human potential, as well as being a considerable drain on health care resources.

Epilogue
The above review of various clinical conditions is too cursory to satisfy the discerning scientific mind, and raises more questions than we attempt to answer. For this we apologize. The prevailing constraints do not allow us to be both comprehensive and thorough. The intent is to draw the interest of the researcher as well as the clinician to this fascinating new field. If the reader's credulity has been challenged too severely, and if the above clinical findings were therefore to be collectively rejected, that would certainly be understandable, but still unfortunate. In any event, the field has grown in the face of a prevailing skepticism, and will continue to do so. The technique of EEG biofeedback is most humane in its implications, because it offers help with those mental disorders which interfere most severely with our human capacities. It deserves a full measure of attention from both the clinical and research communities.

It is unarguably a tragedy that in our adversarial health care system a new intervention is seen first and foremost as a nuisance and an intrusion, if not an outright fraud, by third- party payers; that the scientific community is so utterly invested in its prevailing system of thought as to be unable to appraise the new claims objectively; and that those who are in the greatest need of this new intervention are unable to afford it.

References for Table 2

ADHD
Alhambra, M.A., Fowler, T.P., & Alhambra, A.A. (1995). EEG Biofeedback: A New Treatment Option for ADD/ADHD. Journal of Neurotherapy, 1, 39-43

Cartozzo, H.A., Jacobs, D., & Gevirtz, R.N. (1995). EEG biofeedback and the remediation of ADHD symptomatology: A controlled treatment outcome study. Presentation at AAPB Conference, 1995.

Cartozzo, H.A., Jacobs, D., & Gevirtz, R.N. (1995). EEG biofeedback and the remediation of ADHD symptomatology: A controlled treatment outcome study. Presentation at AAPB Conference, 1995.

Fenger, T.N. (1995). Visual-motor integration and its relation to EEG neurofeedback brain wave patterns, reading, spelling, and arithmetic achievement in attention deficit disordered and learning disabled students. Presentation at 1995 Society for the Study of Neuronal Regulation, Scottsdale, AZ.

Kade, H.D. (1995). A comparison of brainwave biofeedback and cognitive rehabilitation for ADHD-inattentive type with learning disabilities. Presentation at AAPB Conference, 1995.

Kotwal, D.B., Burns, W.J., & Montgomery, D.D. (1996). Computer-assisted cognitive training for ADHD: A case study. Behavior Modification, 20, 85-96.

Linden, M., Habib, T., & Radojevic, V. (1996). A controlled study of the effects of EEG biofeedback on cognition and behavior of children with attention deficit disorder and learning disabilities. Biofeedback & Self Regulation, 21, 35-49.

Lubar, J.F., Swartwood, M.O., Swartwood, J.N., & O'Donnell, P.H. (1995). Evaluation of the effectiveness of EEG neurofeedback training for ADHD in a clinical setting as measured by changes in T.O.V.A. scores, behavioral ratings, and WISC--R performance. Biofeedback & Self Regulation, 20, 83-99.

Lubar, J.F., & Shouse, M.N., (1976). EEG and behavioral changes in a hyperactive child concurrent with training of the sensorimotor rhythm (SMR). A preliminary report. Biofeedback and Self-Regulation, 1, 293-306.

Lubar, J.O., & Lubar, J.F. (1984). Electroencephalographic biofeedback of SMR and beta for treatment of attention deficit disorders in a clinical setting. Biofeedback & Self Regulation, 9, 1-23.

Nash, J.K., & Shakelford, A. (1995). Neurofeedback and cognitive training in the amelioration of attention deficit hyperactivity disorder. Presentation at 1995 Society for the Study of Neuronal Regulation, Scottsdale, AZ.

Rossiter, T.R., & La Vaque, T.J. (1995). A comparison of EEG biofeedback and psychostimulants in treating Attention Deficit Hyperactivity Disorders. Journal of Neurotherapy, 1, 48-59

Samples, J. (1994). The use of EEG biofeedback for attention-deficit hyperactivity disorder. Presentation at AAPB Conference, 1994. .

Scheinbaum, S., Newton, C.J., Zecker, S., & Rosenfeld, P. (1995). A controlled study of EEG biofeedback as a treatment for attention-deficit disorders. Presentation at AAPB Conference, 1995.

Shouse, M.N., & Lubar, J.F. (1979). Operant conditioning of EEG rhythms and ritalin in the treatment of hyperkinesis. Biofeedback and Self- Regulation, 4, 299.

Tansey, M.A., & Bruner, R.L. (1983). EMG and EEG biofeedback training in the treatment of a 10-year-old hyperactive boy with a developmental reading disorder. Biofeedback & Self Regulation, 8, 25-37.

Thompson, L., & Thompson, M. (1997). Training results with ADD clients: Is neurofeedback training for attention deficit disorder in adults as effective as similar training carried out with children. Presentation at 1997 Winter Conference on Brain Function/EEG, Palm Springs CA.

Toomim, M., Ibric, V., & Othmer, Siegfried (1994). EEG biofeedback training for attention deficit disorder and other behavioral disorders. Presentation at 1994 California Psychological Association Convention, San Francisco CA.

EPILEPSY

Andrews, D.J., & Schonfeld, W.H. (1992). Predictive factors for controlling seizures using a behavioural approach. Seizure, 1, 111-116.

Cott A, Pavloski RP, Black AH (1979). Reducing epileptic seizures through operant conditioning of central nervous system activity: procedural variables. Science, 203, 73-5

Ellertson, B., & Klove, H. (1976). Clinical application of biofeedback training in epilepsy. Scandinavian Journal of Behavior Therapy, 5, 133-144.

Finley, W.W., Smith, H.A., & Etherton, M.D. (1975). Reduction of seizures and normalization of the EEG in a severe epileptic following sensorimotor biofeedback training: Preliminary study. Biological Psychiatry, 2, 189-203.

Finley, W.W. (1977). Operant conditioning of the EEG in two patients with epilepsy: Methodologic and clinical considerations. Pavlovian Journal of Biological Science, 12, 93-111.

Hansen, LM, Trudeau, DL, & Grace, DL (1996). Neurotherapy and drug therapy in combination for adult ADHD, personality disorder, and seizure disorder: a case report. Journal of Neurotherapy, 2, 6-14.

Kuhlman, W.N., & Allison, T. (1977). EEG feedback training in the treatment of epilepsy: Some questions and some answers. Pavlovian Journal of Biological Science, 12, 112-122.

*Kuhlman, W.N., & Allison, T. (1977). EEG feedback training in the treatment of epilepsy: Some questions and some answers. Pavlovian Journal of Biological Science, 12, 112-122.

Lantz, D., & Sterman, M.B., (1988). Neuropsychological assessment of subjects with uncontrolled epilepsy: Effects of EEG biofeedback training. Epilepsia, 29, 163-171.

Lubar, J.F., & Bahler, W.W., (1976). Behavioral management of epileptic seizures following EEG biofeedback training of the sensorimotor rhythm. Biofeedback and Self-Regulation, 7, 77-104.

Lubar, J.F., Shabsin, H.S., Natelson, S.E., Holder, G.S., Whittsett, S.F., Pamplin, W.E., & Krulikowski, D.I. (1981). EEG operant conditioning in intractible epileptics. Archives of Neurology, 38, 700- 704.

*Quy, R.J., Hutt, S.J., & Forrest, S. (1979). Sensorimotor rhythm feedback training and epilepsy: Some methodological and conceptual issues. Biological Psychology, 9, 129-149.

Seifert, A.R., & Lubar, J.F. (1975). Reduction of epileptic seizures through EEG biofeedback training. Biological Psychology, 3, 157-184.

Shouse, M.N., & Lubar, J.F. (1979). Operant conditioning of EEG rhythms and ritalin in the treatment of hyperkinesis. Biofeedback and Self- Regulation, 4, 299.

Sterman, M.B., Macdonald, L.R., & Stone, R.K. (1974). Biofeedback training of the sensorimotor electroencephalogram rhythm in man: Effects on epilepsy. Epilepsia, 15, 395-416.

Sterman, M.B. (1977). Sensorimotor EEG operant conditioning: Experimental and clinical effects. Pavlovian Journal of Biological Science, 12, 63-92.

Tansey, M.A. (1986). A simple and a complex tic (Gilles de la Tourette's syndrome): Their response to EEG sensorimotor rhythm biofeedback training. International Journal of Psychophysiology, 4, 91-97.

Tansey, M.A. (1985). The response of a case of petit mal epilepsy to EEG sensorimotor rhythm biofeedback training. International Journal of Psychophysiology, 3, 81-84.

Tozzo, C.A., Elfner, L.F., & May, Jr., J.G. (1988). EEG Biofeedback and relaxation training in the control of epileptic seizures. International Journal of Psychophysiology, 6, 185-194.

Walker, J. (1995). Remediation of nocturnal seizures by EEG biofeedback. Presentation at 1995 Society for the Study of Neuronal Regulation. Scottsdale, AZ.

Wyler, A.R., Lockard, J.S., & Ward, A.A. (1976). Conditioned EEG desynchronization and seizure occurrence in patients. Electroencephalography and Clinical Neurophysiology, 41, 501- 512.

LEARNING DISABILITIES

Cunningham, M.D., & Murphy, P.J. (1981). The effects of bilateral EEG biofeedback on verbal, visual-spatial & creative skills in learning disabled male adolescents. Journal of Learning Disabilities, 14, 204-208.

Linden, M., Habib, T., & Radojevic, V. (1996). A controlled study of the effects of EEG biofeedback on cognition and behavior of children with attention deficit disorder and learning disabilities. Biofeedback & Self Regulation, 21, 35-49.

Tansey, M.A., Tansey, J.A., & Tachiki, K.H. (1994). Electroencephalographic cartography of conscious states. International Journal of Neuroscience, 77, 89-98.

Tansey, M.A. (1993). Ten-year stability of EEG biofeedback results for a hyperactive boy who failed fourth grade perceptually impaired class. Biofeedback & Self Regulation, 18 , 33-44.

Tansey, M.A. (1991). Wechsler (WISC--R) changes following treatment of learning disabilities via EEG biofeedback training in a private practice setting. Australian Journal of Psychology, 43, 147-153.

Tansey, M.A. (1990). Righting the rhythms of reason: EEG biofeedback training as a therapeutic modality in a clinical office setting. Medical Psychotherapy: An International Journal, 3, 57-68.

Tansey, M.A. (1985). Brainwave signatures--an index reflective of the brain's functional neuroanatomy: Further findings on the effect of EEG sensorimotor rhythm biofeedback training on the neurologic precursors of learning disabilities. International Journal of Psychophysiology, Nov, 3 , 85-99.

Tansey, M.A. (1984). EEG sensorimotor rhythm biofeedback training: Some effects on the neurologic precursors of learning disabilities. International Journal of Psychophysiology, 1, 163-177..

TRAUMATIC BRAIN INJURY

Ayers, M.A. (1993). Controlled study of EEG neurofeedback training and clinical psychotherapy for right hemispheric closed head injury. Presentation at 1993 AAPB Conference.

Byers, A. (1995). Neurofeedback therapy recovery from some cognitive deficits secondary to mild head injury after neurofeedback therapy: A single case controlled study. Presentation at 1995 Society for the Study of Neuronal Regulation, Scottsdale, AZ.

Hoffman, D., & Stockdale, S. (1995). Neurofeedback in the treatment of mild closed head injury. Presentation at 1995 Society for the Study of Neuronal Regulation, Scottsdale, AZ.

Salerno, J. (1997). Neurofeedback in closed head injury: A multiple case design study. Presentation at 1997 Association of Applied Psychophysiology and Biofeedback, San Diego CA.

Tansey, M.A. (1994). 14 Hz EEG neurofeedback as a treatment for cerebellar atrophy. Presentation at 1994 Society for the Study of Neuronal Regulation, Las Vegas NV.

Weiler, E.W.J., Schumann, J.M., & Brill, K. (1994). Vertebro-basilary insufficiency and neurofeedback. Presentation at 1994 Society for the Study of Neuronal Regulation, Las Vegas NV.

STROKE

Ayers, M.E. (1994). A controlled study of EEG neurofeedback and physical therapy with pediatric stroke, age seven months to age fifteen, occurring prior to birth. Presentation at 1994 Society for the Study of Neuronal Regulation, Las Vegas NV.

Rozelle, G.R., & Budzynski, T.H. (1995). Neurotherapy for stroke rehabilitation: A single case study. Biofeedback & Self Regulation, 20, 211-228.

CHRONIC FATIGUE SYNDROME

James, L.C., & Folen, R.A. (1996). EEG biofeedback as a treatment for chronic fatigue syndrome: A controlled case report. Behavioral Medicine, 22, 77-81.

Tansey, M.A. (1994). Chronic fatigue syndrome: Its response to 14 Hz EEG neurotherapy training. Presentation at 1994 Society for the Study of Neuronal Regulation, Las Vegas NV.

Tansey, M.A. (1993). Neurofeedback and chronic fatigue syndrome: New findings with respect to diagnosis and treatment. The CFIDS Chronicle, 9, 30-32.

Lowe, F. (1994). A controlled study of the treatment of chronic fatigue syndrome (CFS) with 13-14 Hz beta band electroencephalograph (EEG). biofeedback. Presentation at 1994 Society for the Study of Neuronal Regulation, Las Vegas NV.

AUTISM

Cowan, J.D. EEG biofeedback for the attention problems of autism: A case study. Presentation at AAPB Conference, 1994.

Sichel, A.G., Fehmi, L.G., and Goldstein, D.M. (1995). Positive outcome with neurofeedback treatment in a case of mild autism. Journal of Neurotherapy, 1, (1) 60-64.

DEVELOPMENTAL DELAY

Fleischman, M.J. (1997). Maintenance of cognitive improvements in mildly developmentally delayed twins treated with EEG biofeedback. Presentation at 1997 Winter Conference on Brain Function/EEG, Palm Springs CA.

LYME DISEASE

Kirk, L. (1994). EEG Neuropathy in Lyme disease. Presentation at 1994 Society for the Study of Neuronal Regulation, Las Vegas NV.

Brown, V.W. (1995). Neurofeedback and Lyme disesase: A clinical application of the five phase model of CNS functional transformation. Presentation at 1995 Society for the Study of Neuronal Regulation.

PMS

Othmer, S., & Othmer, S.F. (1994). EEG biofeedback training for PMS. Presentation at 1994 Society for the Study of Neuronal Regulation, Las Vegas NV.

CHRONIC PAIN

Fehmi, L. (1987). Biofeedback assisted attention training: Open Focus Workshop. Psychotherapy in Private Practice, 5, 47-49

Othmer, S., & Othmer, S.F. (1994). EEG biofeedback training for chronic pain. Presentation at 1994 Society for the Study of Neuronal Regulation, Las Vegas NV. POST-TRAUMATIC

POST-TRAUMATIC STRESS DISORDER

Manchester, C. (1995). The application of entrainment integrated with neurofeedback in the treatment of patients with Post Traumatic Stress Disorder with dissociative and somatic symptoms. Presentation at 1995 Society for the Study of Neuronal Regulation, Scottsdale, AZ.

BIPOLAR DISORDER

Othmer, S. & Othmer, S. (1995). EEG biofeedback training for bipolar disorder. Presentation at 1995 Society for the Study of Neuronal Regulation, Scottsdale, AZ.

MULTIPLE SCLEROSIS

Walker, J. (1995). Remediation of neurologic deficits in patients with multiple sclerosis by EEG biofeedback. Presentation at 1995 Society for the Study of Neuronal Regulation.

TOURETTE'S SYNDROME

Tansey, M.A. (1986). A simple and a complex tic (Gilles de la Tourette's syndrome).: Their response to EEG sensorimotor rhythm biofeedback training. International Journal of Psychophysiology, 4, 91-97.

General References

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Biographical Material on Authors

Siegfried Othmer received his Ph.D. in physics at Cornell University in 1970. After a first career in aerospace, he and his wife Susan were drawn to the field of EEG biofeedback in 1985 because it had been profoundly helpful to their epileptic son. Siegfried Othmer is Chief Scientist at EEG Spectrum, a clinical service delivery organization and network of EEG biofeedback clinicians which has been in existence since 1988. Susan F. Othmer received her B.A. in physics at Cornell, and pursued her Ph.D. in neurophysiology there and at the Brain Research Institute at UCLA. Her Ph.D. work was aborted because of their epileptic son, but eventually this son drew her back to the field of brain research. Susan Othmer is Clinical Director at the home office of EEG Spectrum. David A. Kaiser obtained his Ph.D. at UCLA in research psychology, with a special interest in EEG phenomenology. He is a cognitive neuroscientist at EEG Spectrum.

Acknowledgements

The helpful discussions with M.Barry Sterman on the topics discussed here are gratefully acknowledged.

Figure 1. TOVA test results for four dependent measures for 342 subjects. A large effect size is indicated for those in severe deficit on any of the four subscales.

Figure 2. Individual pre-post test data for the impulsivity measure, for those with starting values of less than 100 in standard score, are shown rank-ordered in terms of starting value. A general tendency toward improvement, irrespective of pre-training status, is noted.

Figure 3. Average pre and post WISC-R Scores for all 15 study subjects.

Figure 4. Pre and post data for the Benton Visual Retention Test.

Figure 5. Pre and post test data for the Tapping Subtest of the Harris Tests of Lateral Dominance. The average increase in tapping performance is 20%; the median increase is 40%; and three subjects increased tapping speed by over 100%.

Figure 6. Pre and post values of right/left ratio in tapping performance. We observe a tightening of the distribution and a depletion of mixed dominance.