FREQUENTLY ASKED QUESTIONS

What is the principle behind neurofeedback?

What happens during a neurofeedback session?

Are there any side effects of neurofeedback?

Could this work because of the placebo effect?

How many neurofeedback sessions will I need?

How often does a person come in for training?

Do I have to do neurofeedback sessions for the rest of my life?

Can I do neurofeedback training if I'm on medication

Will medical insurance cover neurofeedback treatments? 

Is it true that people taking stimulant medications can reduce their need for them? 

Why isn't neurofeedback as well-known as conventional therapy and medication?

How does the feedback process work? (for techies)
 
          

Q: What's the principle behind neurofeedback?

A: The brain generates electrical signals which are indicative of brain activity. Like all electricity, these signals can be measured in terms of frequency and power output. Neurofeedback targets this electrical activity which is actually more relevant than "chemical imbalances" which are often talked about. As the brain struggles to regulate the many functions it is tasked with, it can sometimes operate in a dysregulated manner creating abnormal brain wave patterns that correspond to symptoms and conditions that can detract from a person's quality of life. Using the principles of biofeedback, once a person becomes aware of their brain wave patterns, they can change those patterns and thus train their brain back toward a more optimal state. Through gaming software and the concept of operant conditioning, the brain is rewarded by sight and sound for reaching optimal state and quickly "learns" how to achieve and maintain that state. Through repetition, neurofeedback helps train the brain to achieve better regulatory control and when optimal states are reached, the symptoms associated with the dysregulation begin to disappear - often completely and permanently.

Q: What happens during a neurofeedback session?

A: Following an extensive intake consisting of many questions designed to help the clinician assess what your brain needs, sensors are strategically placed on your head which pick up brainwave activity and send it to the clinician's computer. It is important to know that electricity only flows from the client to the computer and never flows from the computer into a person's head. The clinician is now able to read your brain activity and "dissect" it by separating it into different bandwidths that are of interest (alpha, beta, theta, etc.). Then the clinician sets "goals" for your brain to meet. Finally, you get to play a simple video game, using only the electrical activity generated by your brain to control the game. When your brain is "in the zone", as defined by the clinician's preset goals for you, the game advances. If you fall out of the zone, the game slows down or stops. In this way, the brain learns over time through repetition how to achieve and maintain optimal state.

Q: Are there any side effects of neurofeedback?

A: Sometimes there are short-term side effects, just as you might experience from taking a new medication. Negative side effects, which are unlikely to last longer than three days, may include feeling edgy, being less focused, or sleeping more or less than you want to. If necessary, undesirable side effects can be easily reversed with an additional neurofeedback session using a different protocol.

Q: Could this work because of the placebo effect?

A: No. We know that the power of the mind can make any modality more effective if the subject believes in it. Neurofeedback, however, was developed using animals (who were not harmed), and animals are not subject to the placebo effect. Additionally, there is extensive research showing that effects can be reversed and are sometimes opposite to what is expected. Both of these observations contraindicate the presence of a placebo effect.

  
Q: How many neurofeedback sessions will I need?

A: Neurofeedback doesn't hijack your brain.  It gently nudges it. Each person is different and will respond at different rates to training. Clients often report noticing improvement after just three or four sessions. Generally, we tell clients to expect a minimum of 10 sessions with the understanding that some harder-to-treat conditions can take 20 or more sessions before improvements are evident and "hold" over time. In the most difficult or complex situations, 50 or more sessions may be required.

Q: How often does a person come in for training?

A: This depends on symptoms and their severity. In most cases, twice a week is typical in the beginning. After the desired results are attained, as determined by the lessening of symptoms, time between sessions will be gradually increased to see if the training "holds".

Q: Do I have to do neurofeedback sessions for the rest of my life?

A: For most people the answer is no. Generally, once your brain has been retrained to operate in a more optimal way, the brain will "default" to the newly learned state and remain that way. Some people may have to come in for a"tune-up" from time to time - a need determined on an individual basis.

Q: Can I do neurofeedback training if I'm on medication?

A: Generally yes. Medications can interfere with the brain's natural ability to manage itself and the body. We offer you a choice. During your first session, the clinician should ask about your medications. Some medications may slow the training process. Many people come for neurofeedback with the goal of getting off their medications but this should always be done with the knowledge and approval of your physician, working in conjunction with your neurofeedback clinician.

Q: Will medical insurance cover neurofeedback treatments?

A: Neurofeedback is a form of biofeedback (eeg biofeedback) and can be coded that way. Some insurance companies will pay for biofeedback and some will not. On request, Neurogenix will provide properly coded receipts for clients who wish to submit claims to their insurance companies.

Q: Is it true that people taking stimulant medications can reduce their need for them?

A: YES! There have been many scientific studies showing that neurofeedback can significantly reduce or completely eliminate the need for stimulant medications like Ritalin for people suffering with depression, ADD, or ADHD, and ....often the results are permanent.

Q: Why isn't neurofeedback as well-known as conventional therapy and medication?

A: Even though neurofeedback has been around for over 20 years in its current form (see our Resources tab for articles and information), U.S. consumers have been conditioned to expect the immediate results promised by medications. The drug industry has a lot of advertising money whereas the neurofeedback community does not. It should come as no surprise that without the backing of big business, or government, it has been very challenging getting the attention of the media and the mainstream medical and psychological communities. It has also been a significant challenge getting insurance companies to pay for this relative new treatment. However, things are slowly changing as numerous media have recently developed a fascination with neuroscience and all things brain related. There are neurofeedback practitioners in every state in the U.S. and in many foreign countries as well and many have advanced degrees such as psychologists and medical doctors. In our Resources section, you will find links to some media coverage of neurofeedback. You can always point your browser to YouTube or Google and search for neurofeedback which will yield dozens of leads to review. For a thorough introduction to the discovery and development of neurofeedback, read "A Symphony in the Brain" by Jim Robbins and be sure to get the latest edition.

Q: How Does the Feedback Process Work? (for techies)

A: The feedback loop begins with the client. Sensors 'pasted' to the client's head pick up microvolt-level EEG signals which are amplified and converted to digital voltages by the A/D subsystem at a nominal rate (either 160 or 256 Hz).

The samples are converted to equivalent peak-to-peak voltages. All filters in the software are Infinite Impulse Response (IIR) filters. The raw samples are lowpass-filtered by a 40 Hz filter to remove 60 Hz ambient noise. The clinician adjusts a threshold voltage value to inhibit the data in the presence of muscle (EMG) artifacts. The resulting lowpass signal is fed to a number of 'streams' of processing which are very similar, although some are labeled "Inhibit" and some labeled "Reward". A typical test run uses two inhibit streams and one reward stream.

In each stream, the lowpass signal is bandpass-filtered into various frequency bands (of the clinician's choice) using IIR digital filters. The filter output is fed to an exponentially-weighted moving average filter which produces a short-term average (peak- to-peak) voltage for further use. The time constant of the averaging filter is selectable but is usually 0.5 seconds. The moving average goes two places: directly to the client (game) computer (for visual stimulus) and to a comparator. The comparator produces a threshold-exceeded signal whenever the clinician-adjusted threshold voltage is less than the current moving average of the stream.

All the threshold-exceeded signals are processed by the reward decision logic which declares a ' client reward' when all streams defined as "Inhibit" are below threshold and all streams defined as "Reward" are above threshold. The client aural reward rate is further limited to no more than 2 Hz (so that each sound can be separately heard). The client reward command is sent to the client computer to create an aural stimulus.