Neurofeedback Training for Rehabilitation

Neurofeedback training enhances structural and functional connectivity in key brain networks. 

Neurofeedback is non-invasive, medication-free complementary therapy for various aspects of neurorehabilitation.  

With neurofeedback training, we can help the brain re-establish key physical and functional connections following a traumatic brain injury.  

As the brain is pushed into a defensive state following physical trauma, character traits adapt resulting in hypervigilance, anxiety and mood and sleep dysregulation.  Neurofeedback training is shown to be effective in treating these issues. 

Key white matter tracts, or long distance information superhighways, have been shown to strengthen as a result of neurofeedback training, with concomitant positive cognitive effects.

A Kaiser Neuromap lets us identify areas of vulnerability on which to base Personalised Brain Training on. 

We can also address cortical motor areas as well as brain areas responsible for speech comprehension and generation. 

Neurofeedback is evidence-based and effective.  See also “Neurofeedback for Neurodegenerative Disorders” and “Neurofeedback for Aphasia“.

Neurofeedback training improves cognitive ability and strengthens white and gray matter per Ghaziri Study 2013 "Neurofeedback Training induces Changes in White and Gray Matter"
Neurofeedback can Strengthen Neuronal Pathways​

With neurofeedback, we can train white matter tracts, thus improving structural connectivity between distant brain areas.  

In healthy patients, this growth correlated with cognitive improvements.  

It is encouraging to see research demonstrating the positive structural effects neurofeedback can have.   

This is particularly relevant in rehabilitation following an insult to the brain, such as physical trauma.  

We are giving the brain impulses and guidance to improve its own regeneration. 

 

Comorbidities in Schizophrenia and other neuro-degenerative pathologies such as Parkinsons, include depression, anxiety, sleep and focus issues and mood dysregulation

As the brain’s functional connectivity is impacted by physical trauma, changes in character can occur.  These include aspects of self-sustainability, such as mood regulation, sleep and anxieties; and extend to sense of self, re-assessment of social and personal boundaries, impulsive aggression and rage, focus and productivity as well as sense of emotional security.

With neurofeedback training we can address these issues in a personalised manner, based on a Kaiser Neuromap.  The person feels more comfortable and optimistic about their progress as we restore hope and sense of accomplishment.

Comorbid mental health issues, such as anxiety, depression, aggressionPTSD and mood imbalances can be addressed directly with neurofeedback. We strengthen sense of self and improve emotional regulation.

Chronic Pain is another application for neurofeedback, where studies have demonstrated its efficacy. 

Rehabilitation often requires a multi-discipline approach.  The following case study illustrates the role of neurofeedback:

Subjective Account of Neurofeedback Training and Stroke / TBI

Girl Dancing following neurofeedback training for Stroke / TBI

The following account of the recovery of a Stroke patient illustrates the potential efficacy of neurofeedback for Stroke / TBI.  For Research on neurofeedback and Stroke / TBI see here

Claire (name changed) is a 48-year old female who is three years post-thalamic CVA (ruptured aneurysm).  In particular, her physical symptoms included severe muscle contractures in her wrist and elbows leading to impaired movement, as well as being wheel-chair bound.

After two neurofeedback sessions, she got her wrist and elbow released.  

Claire was getting active elbow extension and shoulder flexion after five sessions.  Pain was also resolved in her hand, which had been a major issue previously.

Functionally, she achieved improved independence in dressing skills, required only minimal assistance with bathing, and was able to walk with a cane.  

After thirty neurofeedback sessions, Claire started walking without her cane. 

Significant improvements (over 50%) included: 

 – Working memory, chronic aching pain, attention deficit

 – night sweats, vertigo and hot flashes

 – body awareness, balance, fine motor coordination, muscle spasticity, reflux and chronic nerve pain

 – paranoia

Note that this is a subjective account from a therapist and a causal relationship between training and improvements is not proven.

The Process:

Step 1: Brain Map

A qEEG recording takes about 45minutes for a 20 minute recording.

A cap with 19 sensors is is fitted to our head and gels inserted to ensure connectivity.  The sensors only read – there is a tiny voltage on the surface of our head that these pick up.  The gels are easily washed out later.  This is also the last time we wear the cap (until a remap after ten sessions); training is done with single sensors. 

We analyse the data with Kaiser Neuromap software which gives us a unique view into character traits and vulnerabilities.  

Findings are presented in a separate one-hour conversation where we discuss the key elements.

Step 2: Neurofeedback

Neurofeedback process explained, illustrating real-time analysis of brain waves and feedback given

 We use a movie of choice as the feedback mechanism – our conscious mind engages with the film, and feedback is delivered by small changes in volume or picture size.  

Our pre-conscious mind adapts its behaviour to preserve the more comfortable volume and picture size, and learning occurs. 

Volume changes are slight, not stop-start, and the process is enjoyable. 

Key is that we are interested in the movie – our conscious mind is engaged with the content, which forms the reward, and our preconscious mind – without our conscious effort – changes its behaviour in response to the feedback.

Capturing the ultradian cycle with neurofeedback Personalised Brain Training using Kaiser Neuromap

A two hour training session allows us to do 90-110 minutes of neurofeedback training during which we can work on various brain sites. 

This captures an entire ultradian rhythm cycle and corresponds to the approximate duration of feature film movies.  

We can start with shorter sessions as appropriate, mainly with children. 

Ideally, we do two or more sessions per week to start with.  

We would expect to see responsiveness within the first few sessions and remap after twenty hours or about ten sessions.  

Generally, we would expect to doing twenty sessions over two months, though this can vary substantially. 

We can also accommodate intensives, where we do two sessions per day over a number of days, and have had good results with these.

 

Research Evidence for Neurofeedback Efficacy in Stroke / TBI

While outcomes are unpredictable, there is research to show that neurofeedback can have very beneficial effects on rehabilitation following Traumatic Brain Injury (TBI).  Moreover, case reports by clinicians show remarkable recoveries.  Neurofeedback training has also been shown to be able to strengthen white matter tracts, suggesting that positive structural changes are possible with training. The following research reports show improvements in motor and functional skills following neurofeedback training:

 – Alpha-Theta neurofeedback training has a “beneficial effect on symptom reduction as well as perceived stress.  It also has a beneficial effect on levels of serum cortisol” involving a significant reduction during acute recovery

 – neurofeedback training was shown to be effective with Postconcussion Syndrome (PCS) 

 – efficaceous treatment for chronic posttraumatic headache sustained in military service

 – neurofeedback therapy showed significant changes in structural and functional connectivity in young TBI patients, with cognitive scores and concussion symptoms improving significantly

 – neurofeedback is shown to be an effective intervention for auditory memory

 – deemed “probably an excellent complementary technique” that produced clear benefits in divided and sustained attention, visuospatial skills and the processing speed of motor-dependent tasks in persons with severe TBI

 – beneficial outcomes in upper limb stroke rehabilitation

 – neurofeedback training can lead to a learned modulation of brain signals with associated changes at both neural and behavioural level

 – modulation of premotor cortex and associated motor control areas can be achieved with neurofeedback training

 – improvements in TBI / PTSD in Vietnam Veterans across domains of cognition, pain, sleep, fatigue, mood/emotion, PTSD symptoms and overall activity levels

 – patients report improvement in a wide range of neuropsychiatric symptoms in TBI following neurofeedback training

 – result of 40 neurofeedback sessions included significant improvements in several motor tasks

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Concussions lead to Brain Changes

The recent rugby player study by the Drake Foundation showed that 23% of players (10 out of 44) had axonal or diffuse vascular injury.  This contrasted with athletes in non-collision sports.  

Mild traumatic brain injuries are common in rugby, with an incidence rate of 20.4 per 1,000 player match hours (14.8 per 1000h in Australia).  

In addition to mTBI, repeated head impacts can lead to neurodegeneration that becomes progressive.  This increases the risk of dementia

Drake Foundation study on brain abnormalities in rugby players using diffusion tensor imaging and advanced MRI

Personalised Brain Training for TBI

Neurofeedback Training has been shown to improve cognitive ability.  A study found that this brain training made positive structural changes to white and gray matter.  

With a Kaiser Neuromap we can train the brain in a personalised manner.

Neurofeedback training improves cognitive ability and strengthens white and gray matter per Ghaziri Study 2013 "Neurofeedback Training induces Changes in White and Gray Matter"

Neurofeedback is a form of complementary therapy and should not be seen as a replacement for conventional medicine.  qEEG brain map-based neurofeedback training takes a more holistic approach to brain functioning, rather than just focusing on medical symptoms.  It is not intended as a form of diagnosis nor medical intervention nor medical advice per the disclaimer.

Brain Maps and Personalised Brain Training

Kaiser Neuromap brain maps and Brodmann areas

Brain Maps expose Individual Vulnerabilities

With a Kaiser Neuromap, we can identify character traits, vulnerabilities and strengths. 

Different brain areas and networks govern our behaviour.  For example, there are parts of our brain which control mood regulation; spatial distractibility; physiological arousal; our sense of self; self-critical thoughts; anger and emotional attachment; and there are various sources of anxiety.

A brain map shows us which brain areas are behaving immaturely, and thus expose us to vulnerabilities or mental health issues.

Rather than fitting people into categories – diagnosis – we can assess vulnerability to behaviour patterns.  Every brain is different.  A brain map provides a more granular approach to understanding our strengths and weaknesses.

Neurofeedback process explained, illustrating real-time analysis of brain waves and feedback given

Personalised Brain Training with Neurofeedback

Neurofeedback lets us train dysrythmic brain areas.  With sensors comfortably fitted to the brain areas we want to train, we detect brainwave patterns real-time while watching a movie.  When these patterns are inefficient, the volume drops momentarily.  This is the feedback we are giving our brain, short and instantaneously.  

The brain area we are training recognises this – while our conscious mind is focussed on the movie – and adjusts its behaviour to restore the normal volume.  With repetition, throughout a session, learning occurs.  

Meanwhile our conscious mind is solely focussed on the movie; the training process is passive in this sense.    

The drop in volume is subtle, so we continue to understand the flow of the movie.  No current or electrical stimulation is fed to the brain; sensors simply read brainwaves and the feedback is purely audio-visual.

Neurofeedback is preconscious brain training aimed at enhancing our mental, emotional and spiritual health

Neurofeedback trains our Pre-Conscious Mind

 

Rather than engaging the conscious mind, which slows us down, we are training preconscious processes

This equips us with the ability to live in the moment and attain our potential (if we have to resort to conscious control, we are not living in the moment).

Personalised Brain Training is an advanced qEEG brain map-based approach to neurofeedback training developed by the founders of the field.  Taking Othmer Method / ILF training methods further, it employs Default Network Training protocols as developed by David Kaiser.

We take a holistic approach to healthy brain self-regulation, rather than categorisation or diagnosis. 

Neurofeedback is evidence-based complementary therapy with over 2000 PubMed peer-reviewed research reports

Neurofeedback is Evidence-based

Neurofeedback training is an evidence-based complementary therapy.  Its efficacy was first demonstrated some 50 years ago, and with advances in technology, training protocols have become more efficient and the feedback method – watching movies – thoroughly enjoyable. 

Neurofeedback is evidence-based.  It’s first application was discovered in 1971 when it was used to resolve intractable epilepsy. 

There are over 2,000 peer-reviewed research reports on PubMed demonstrating efficacy across a number of pathologies. 

In the US, it is an accepted complementary treatment for many challenges.