Key Applications of Neurofeedback
Essentially all of biofeedback is ultimately an appeal to the brain, and most conditions responsive to biofeedback are also found to be responsive to neurofeedback. On the other hand, there are some applications for which neurofeedback plays a unique role. The most prominent application is to Attention Deficit Hyperactivity Disorder.

Attention Deficit Hyperactivity Disorder (ADHD/ADD)
Attention Deficit Hyperactivity Disorder is the most prevalent disorder currently diagnosed among elementary school children. It is characterized by distractibility, impulsivity, hyperactivity and inattention. The condition is thought to be partly genetic, but also has a significant environmental component. The good news is that these characteristics yield to neurofeedback training, typically to the point at which the child may no longer meet diagnostic criteria for the condition.

It could be said that the business of the brain is paying attention—not only to the outside world, but also to internal processes, in which the brain monitors its own activities and those of the body. When we train certain brain rhythms we find that hyperactivity, impulsivity, and vigilance improves. Usually children can normalize their behavior with this training so that it is no longer out of line. Some twenty to forty training sessions may typically be required.

Beyond the attentional benefits, other benefits are observed as well, particularly with those aspects of behavior that are often seen together with ADHD. Fewer errors are made on cognitive challenge tests, response time usually improves (if it is slow to begin with), and response time is more consistent. Bedwetting may subside, and nocturnal teeth grinding. Sugar craving may disappear, as well as motor and vocal tics. Obsessiveness can also calm down. Even IQ scores are typically found to improve, and handwriting may suddenly get better. The effect of the training is therefore far-reaching, or to put it another way, the nervous system may simply be under better control, and its tone better modulated.

Significantly, the more severe disruptive behavior patterns that are often seen together with ADHD can also respond. This includes oppositionality, temper tantrums, rages, excessive anger, defiance of authority, patterns of lying, and even the more severe issues of overt aggressiveness, cruelty to animals, starting fights, and fire setting. Some of these children show no remorse, and can be described as cold-blooded. The benefit of training in these latter areas indicates that the neurofeedback can also help with children who are disregulated in the realm of moods and emotions. It can be helpful with the depressed child, with the anxious child, with the socially insecure and withdrawn. It can be helpful with the emotionally disturbed child. These are all recent findings that have not yet appeared prominently in the pediatric literature.

It is now customary to address ADHD with a variety of medications, including stimulants, anti-depressants, and anti-convulsants. Each of these categories of medication response is addressed differently with neurofeedback. Most children will be able to reduce or even eliminate the need for medication when this training is accomplished.

It is found that when the training is taken to completion, the benefits are observed to hold for the long term. However, ADHD children got to be who they are for a reason. Somehow their nervous systems are more vulnerable than those of other children, whether for genetic, nutritional, developmental, or family context reasons. These nervous systems are also more vulnerable to subsequent insults, in which case refresher sessions may have to be undertaken.

Neurofeedback for seizures
The field of neurofeedback started around seizures, and that is still a prominent area of application. The training generally makes the brain more stable, and that is of particular relevance for those brain that have a seizure focus or other source of instability. The training may have to be long-term, but some improvement is usually possible, which is observable in improved level of function, reduced number of medications, reduced medication dose and side effects, and perhaps avoidance of brain surgery for intractable seizures. Most people with medically intractable seizures have not had to undergo surgery after doing the neurofeedback training.

Neurofeedback for minor traumatic head trauma and stroke
The consequences of minor traumatic brain injury, whiplash, or post-concussion syndrome, include headaches, body pain, dizziness, nausea, disorientation, depression, effort fatigue, visual disturbances, auditory processing deficits, sleep problems, tinnitus (ringing in the ears), irritability and anxiety, and even personality changes or instability. There is no conventional medical treatment for such head injury symptoms; however, all of them usually respond to neurofeedback training. Such symptoms resolve to an average level of 80% (by self-report) within an average of 35 training sessions. Recoveries tend to hold for the long term, as the brain continues to employ its recovered capacities. The training may be fruitfully conducted at any time after the injury—even years later. Some natural ("spontaneous") recovery is expected early after head injury, but the EEG training can speed the process.

Significant recovery can be achieved for stroke as well. Many of the consequences of stroke are not localized to the site of injury, and are similar to those listed above for minor head injury: sleep problems, irritability, mood variability, depression. These typically respond to the training rather early. The specific deficits attributed to the stroke—gait, speech, one-side weakness or neglect, take more time for recovery, and also the recovery may not be complete. There may be benefit to continued long-term training on an episodic basis, as the brain gradually builds on its recovered capacities.

Neurofeedback for depression
Neurofeedback can be used to retrain the brain out of depression. It is now increasingly recognized that depression is on a continuum with anxiety. Whereas anxiety responds more readily to peripheral biofeedback intervention, depression seems to respond more readily to neurofeedback. The training also addresses the sleep disregulations that are typically seen in the context of anxiety and depression. Much of ADHD may also be affected by a depressive or anxiety component. Regulation of mood states may turn out to be one of the most prominent applications of neurofeedback.

Neurofeedback for addictions
The latest breakthrough in the field of neurofeedback is with respect to addictions, where conventional treatment has a notoriously bad record. Over the last ten years, neurofeedback has been found effective in keeping people in treatment successfully, and ultimately in maintaining sobriety after discharge from the treatment program. Secondarily, neurofeedback can be helpful with some craving issues, because brain function can be normalized so that there may no longer be the physiological dependency on the substance. Thirdly, it has helped in terms of personality measures (which were thought to be stable!). This is particularly important because much of addiction is sustained by issues of early trauma, and the training helps to resolve those issues.

The success in relapse prevention has been most solidly demonstrated for alcoholism, with follow-up data now available for ten years post-treatment. More recently, these findings have been reproduced also for cocaine, methamphetamine, and heroin addictions. The training involves both the high-frequency SMR-beta training and the low frequency Alpha-Theta training, and must be conducted by a suitably trained mental health professional. In all of the above research studies, the training was combined with conventional treatment which involved individual and group therapy, as well as continuing involvement with 12-step programs to aid in the maintenance of sobriety.

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