EEG Biofeedback Training for Minor Traumatic Brain Injury
The long-term consequences of Minor Traumatic Brain Injury (MTBI) have recently become more widely acknowledged. Persons suffering loss of function due to minor head injuries were usually given CAT scans and MRI scans, which might not reveal any organic injury. As a result, victims were often not taken seriously, and accused of fabricating their symptoms and malingering. More recently, tests of brain function have demonstrated a basis for the symptoms which are described. Such tests include PET scans, topographic brain mapping of EEG activity, and evoked response measurements. These functional tests reveal changes in cortical activation, anomalous EEG activity traceable to head injury, and slowed response.
The symptoms which accompany minor head injury include principally loss of energy; headaches and chronic pain; dizziness and vertigo; memory impairment; difficulty concentrating; anxiety, depression, and mood swings; sleep disturbances; irritability; visual perception problems and dyslexia; and even apparent personality changes. Seizures may also be observed, or seizure-like activity such as auras. If persons exhibited certain weaknesses before the accident, such as attention deficit disorder, migraine headaches, or sleep difficulties, then such symptoms might be considerably exacerbated by the head injury. The apparent severity of the injury, including the length of period of unconsciousness (if any), has little to do with the severity of subsequent symptoms. New symptoms may arise months or even years after the head injury.
We know of no published literature on the use of EEG biofeedback for head injury. We are aware only of clinical work in this field in a number of settings. Over the past six years, we have obtained considerable clinical evidence for the effectiveness of EEG biofeedback training as an adjunct modality for remediating the symptoms of minor closed head injury. By September of 1992, we had accumulated a clinical history of EEG training for 88 cases of (mostly minor) traumatic brain injury. The training appears to be effective even years post-injury, when spontaneous remediation is no longer expected. The training can impact favorably on all of the symptoms listed above.
By means of EEG training, we have been able to restore to productive life a number of individuals who had been totally disabled for a number of years due to head injury. The training is not always that effective. However, essentially everyone who undertakes the training for head injury derives significant benefit. The training needs to be undertaken for a minimum of ten training sessions in order to be able to make a meaningful assessment of whether the training is worthwhile. Completion of training may take anywhere from 25 to more than 100 sessions. Of course, anyone continuing for 100 sessions would only be motivated to do so if there were continuing benefit. The gains made in the training appear to hold for the long term. That is, once the brain is taught again how to regulate itself, it does not relinquish that capability.
When clients are seen within the first six months after head injury, there is a concern about new symptoms continuing to emerge post-injury. Clients must be aware that this may happen despite the biofeedback training, since the latter takes effect gradually. If this understanding exists, and the client is willing to proceed, there may be additional benefit if the training is undertaken soon after injury.