What conditions can Neurofeedback help?

There is mounting evidence that neurofeedback can be used to effectively moderate a range of conditions. The American Academy of Paediatrics listed neurofeedback as an evidence-based treatment for Attention Deficit Hyperactivity Disorder (ADHD). Neurofeedback therapy is being used to assist in the treatment of conditions like autism, learning difficulties and other developmental problems. It has been effectively used to modify anxiety, depression and addictions, and has been found to help stabilise some people with epilepsy. There is evidence that neurofeedback therapy can speed recovery after concussion and may help damaged, reactive areas of the brain. Interestingly, neurofeedback therapy has also been used to help athletes and business executives achieve peak performance.

Neurofeedback for ADHD

Neurofeedback has continued to gain support as an alternative treatment for ADHD in recent years1.In patients with ADHD symptoms, constant observation of altered brain activation is observed during an EEG (and other types of neurological imaging).Neurofeedback, as a type of biofeedback, makes use of the brains neuroplasticity to encourage it to self-regulate towards a normal brain activation pattern.

Neurofeedback has been documented to lead to significant reductions in ADHD core symptoms and has been gaining increased support in the treatment of ADHD1,2.Importantly, these results have been consistent across a range of studies2.Within academia, neurofeedback is becoming an accepted mode of treatment3.Excitingly, research is supporting neurofeedback as being more than just effective – it appears to be long lasting, especially when compared to non-active control methods4. Compared to active control methods, like medications, studies have shown neurofeedback is similar in effectiveness, but its changes last significantly longer3.

1. Holtmann M, Sonuga-Barke E, Cortese S, Brandeis D. Neurofeedback for ADHD: A Review of Current Evidence. Child and Adolescent Psychiatric Clinics of North America. 2014 [cited 18 December 2021];23(4):789-806. Available from: https://doi.org/10.1016/j.chc.2014.05.006 2. Micoulaud-Franchi,J.-A., Geoffroy, P. A., Fond, G., Lopez, R. Ã., Bioulac, S. Ã., & Philip,P. (2014). EEG neurofeedback treatments in children with ADHD: An updated meta-analysis of randomized controlled trials. Frontiers in Human Neuroscience, 8. [cited 28 February 2023]; Available from:https://doi.org/10.3389/fnhum.2014.00906 3. Gevensleben H, Kleemeyer M, Rothenberger L, Studer P, Flaig-Röhr A, Moll G et al. Neurofeedback in ADHD: Further Pieces of the Puzzle. Brain Topography. 2013 [cited 18 December 2021];27(1):20-32. Available from: https://rdcu.be/cDrAj 3. Van Doren J, Arns M, Heinrich H, Vollebregt M, Strehl U, K. Loo S. Sustained effects of neurofeedback in ADHD: a systematic review and meta-analysis. European Child & Adolescent Psychiatry [Internet]. 2018 [cited 18 December 2021];28(3):293-305. Available from: https://rdcu.be/cDr18

Neurofeedback for Anxiety and Depression

Anxiety and depression are the most common psychiatric conditions. Anxiety affects between 10% and 15% of Australians, while depression affects approximately 10% (Australian Bureau of Statistics, 2017-18 financial year). As such prevalent conditions, the need for less invasive and more efficient treatments is less invasive and more efficient treatments are needed.​

Neurofeedback has been associated with clinical improvement in generalised anxiety, phobic disorders, obsessive-compulsive disorder, and PTSD1. In many cases, neurofeedback showed statistically significant improvements in neurological functioning. More importantly, follow-up studies suggest that these improvements are maintained over the long term2.­ One study examining anxiety and fear in cancer patients found that after neurofeedback sessions, important improvements in psychometric traits were measured3. Overall, researchers seem to agree that neurofeedback can cause a significant decrease in anxiety symptoms.

Neurofeedback as a treatment for depression has been less thoroughly researched. However, preliminary studies are encouraging2. Many pilot studies for neurofeedback as a treatment for major depressive disorders suggested that neurofeedback may be effective as a treatment for depression5.

1. Moore N. A Review of EEG Biofeedback Treatment of Anxiety Disorders. Clinical Electroencephalography [Internet]. 2000 [cited 18 December 2021];31(1):1-6. Available from: https://doi.org/10.1177/155005940003100105 2. Hammond D. Neurofeedback Treatment of Depression and Anxiety. Journal of Adult Development [Internet]. 2005 [cited 18 December 2021];12(2-3):131-137. Available from: https://rdcu.be/cDr2M 3. Benioudakis E, Kountzaki S, Batzou K, Markogiannaki K, Seliniotaki T, Darakis E et al. Can Neurofeedback Decrease Anxiety and Fear in Cancer Patients? A Case Study. Postępy Psychiatrii i Neurologii [Internet]. 2016 [cited 18 December 2021];25(1):59-65. Available from: https://doi.org/10.1016/j.pin.2015.12.001 4. Tolin D, Davies C, Moskow D, Hofmann S. Biofeedback and Neurofeedback for Anxiety Disorders: A Quantitative and Qualitative Systematic Review. Advances in Experimental Medicine and Biology [Internet]. 2020 [cited 18 December 2021];1191:265-289. Available from: https://doi.org/10.1007/978-981-32-9705-0_16 5. Peeters F, Oehlen M, Ronner J, van Os J, Lousberg R. Neurofeedback As a Treatment for Major Depressive Disorder – A Pilot Study. PLoS ONE [Internet]. 2014 [cited 18 December 2021];9(3):e91837. Available from: https://doi.org/10.1371/journal.pone.0091837

Neurofeedback for Autism

Autism (autism spectrum disorder – ASD) is estimated to affect around 1% of the general population1. While the severity and duration of the symptoms can vary, they tend to be lifelong, and chronic and often lead to poor outcomes in aduthood1. What complicates matters in autism is that despite numerous types of intervention, few have actually been scientifically investigated, and most of those either lack evidence or have been proven to be ineffetive2.

Neurofeedback, while in the early stages of research for ASD, has shown some initial scientific benefit toward helping treat ASD symptoms. In one study, neurofeedback accounted for a 26% average reduction in total autism symptoms (compared to 3% for the control group)3. In another study, a young boy diagnosed as mildly autistic showed positive changes in all diagnostic dimensions (as defined in the DSM-III-R)4. While there is still more research to be done, there is promising evidence to suggest that neurofeedback can help improve autism symptoms.

1. Simonoff E, Pickles A, Charman T, Chandler S, Loucas T, Baird G. Psychiatric Disorders in Children With Autism Spectrum Disorders: Prevalence, Comorbidity, and Associated Factors in a Population-Derived Sample. Journal of the American Academy of Child & Adolescent Psychiatry [Internet]. 2008 [cited 18 December 2021];47(8):921-929. Available from: https://doi.org/10.1097/CHI.0b013e318179964f 2. Rossignol D. Novel and emerging treatments for autism spectrum disorders: a systematic review. Ann Clin Psychiatry [Internet]. 2009 [cited 18 December 2021];21(4):213-36. Available from: https://pubmed.ncbi.nlm.nih.gov/19917212/ 3. Jarusiewicz B. Efficacy of Neurofeedback for Children in the Autistic Spectrum: A Pilot Study. Journal of Neurotherapy [Internet]. 2002 [cited 18 December 2021];6(4):39-49. Available from: https://doi.org/10.1300/J184v06n04_05 4. Sichel A, Fehmi L, Goldstein D. Positive Outcome with Neurofeedback Treatment in a Case of Mild Autism. Journal of Neurotherapy [Internet]. 1995 [cited 18 December 2021];1(1):60-64. Available from: https://doi.org/10.1300/J184v01n01_08

Neurofeedback for Emotional Regulation

Emotional regulation refers to an individual’s ability to control or manage emotional states. This can include managing their mood or responding appropriately to a scenario. Research shows that neurofeedback can enhance connections within the brain responsible for emotions, leading to a greater capacity for emotional regulation.1 Because the brain is highly interconnected, it is theorised that neurofeedback targeting an area of the brain can effect greater change than alternative methods targeting behavioural output. However, more research is needed to quantify this hypothesis.1

A separate study examining neurofeedback for emotional regulation also noted positive improvements, suggesting that participants could better regulate brain regions associated with emotions.2 While research regarding Neurofeedback for Emotional Regulation is still in its infancy, the results are promising. Early research suggests that neurofeedback has the potential to be a powerful aid to help individuals improve their emotional regulation.  

1. Dehghani, Amin, Hamid Soltanian-Zadeh, and Gholam-Ali Hossein-Zadeh. “Probing Fmri Brain Connectivity and Activity Changes during Emotion Regulation by EEG Neurofeedback.” Frontiers in Human Neuroscience 16 (2023). https://doi.org/10.3389/fnhum.2022.988890. 2. Cavazza, Marc, Fred Charles, Gabor Aranyi, Julie Porteous, Stephen W. Gilroy, Gal Raz, Nimrod Jakob Keynan, et al. “Towards Emotional Regulation through Neurofeedback.” Proceedings of the 5th Augmented Human International Conference, 2014. https://doi.org/10.1145/2582051.2582093.

Neurofeedback for Brain Damage

Brain injury can have significant implications for an individual’s cognitive performance. Acquired brain injury (any injury to the brain sustained after birth) can impact processing speed, attention, working memory, executive functioning and self-regulation of emotions and behaviour.1 Many of these key domains are already discussed on this page.

One study investigating the specific impact of Neurofeedback on attention deficits in patients with acquired brain injury found that patients who received neurofeedback had improved significantly more in attention than the control group.2 The study also found that after ten sessions, 67%of patients could better regulate their attention toward ‘normal’.2 A separate study found similar results, with patients receiving neurofeedback scoring higher on intrinsic alertness.3

An ongoing study examining the use of Neurofeedback to treat symptoms of traumatic brain injury (a type of acquired brain injury) has published preliminary results. So far, it found neurofeedback can improve attention, impulse control, processing speed, short-term memory and mood.4

While more work is needed to fully understand the interaction between Neurofeedback and brain injury1,4, preliminary literature shows exciting promise for neurofeedback in treating symptoms of some brain injuries. In our own practice, we have first-hand experience of how neurofeedback can offer significant improvement for individuals living with brain injuries.

1. Ali, Jordan I., Jeremy Viczko, and Colette M. Smart. “Efficacy of Neurofeedback Interventions for Cognitive Rehabilitation Following Brain Injury: Systematic Review and Recommendations for Future Research.” Journal of the International Neuropsychological Society 26, no. 1 (2020): 31–46. https://doi.org/10.1017/s1355617719001061. 2. Keller, Ingo. “Neurofeedback Therapy of Attention Deficits in Patients with Traumatic Brain Injury.” Journal of Neurotherapy 5, no. 1-2 (2001): 19–32. https://doi.org/10.1300/j184v05n01_03. 3. Annaheim, Christine, Kerstin Hug, Caroline Stumm, Maya Messerli, Yves Simon, and Margret Hund-Georgiadis.“Neurofeedback in Patients with Frontal Brain Lesions: A Randomized, Controlled Double-Blind Trial.” Frontiers in Human Neuroscience 16 (2022). https://doi.org/10.3389/fnhum.2022.979723. 4. Gray, Sarah N. “An Overview of the Use of Neurofeedback Biofeedback for the Treatment of Symptoms of Traumatic Brain Injury in Military and Civilian Populations.” Medical Acupuncture29, no. 4 (2017): 215–19. https://doi.org/10.1089/acu.2017.1220.

Other research

For your convenience, we have compiled a list of further reading of the scientific literature on Neurofeedback. This list also contains the references for any scientific claims made on this website (which are otherwise not referenced). For a comprehensive collection of Neurofeedback research, see this page from the International Society for Neurofeedback and Research.

In October 2012, the American Academy of Paediatrics, the professional body for US paediatricians, published an independently written report that declared EEG Biofeedback as a Level 1 Evidence-Based Intervention for Attention and Hyperactivity behavioural problems in children and adolescents. If you want to learn about how they reached this conclusion and some other recent research on Neurofeedback for ADHD, you can download their free report.

One of Barry Sterman’s original studies following his accidental discovery was that cats who had been ‘brain-trained‘ at a particular frequency were less susceptible to seizures when injected with rocket fuel in research sponsored by NASA. This is one of the studies we often quote when asked if Neurofeedback’s success could be due to a placebo effect:

  • Sterman, M. B., LoPresti, R. W., & Fairchild, M. D. (1969). Electroencephalographic and behavioural studies of monomethylhydrazine toxicity in the cat. CALIFORNIA UNIV LOS ANGELES BRAIN RESEARCH INST.

Once Barry Sterman had replicated this effect in monkeys he then demonstrated he could suppress epileptic seizures in humans:

  • Sterman, M. B., & Friar, L. (1972). Suppression of seizures in epileptics following sensorimotor EEG feedback training. Electroencephalography & Clinical Neurophysiology, 33, 89–95.​

Other relevant studies:

  • Beau­re­gard, M., & Levesque, J. (2006). Func­tional mag­netic res­o­nance imag­ing inves­ti­ga­tion of the effects of Neurofeedback train­ing on neural bases of selec­tive atten­tion and response inhi­bi­tion in chil­dren with attention-deficit/hyperactivity dis­or­der. Applied Psy­chol­ogy and Biofeed­back, 31, 3–20.
  • Bagdasaryan, J. and Le Van Quyen, M. (2013). Experiencing your brain: neurofeedback as a new bridge between neuroscience and phenomenology. Frontiers in Human Neuroscience, 7. https://doi.org/10.3389/fnhum.2013.00680
  • Gevensleben, H., Holl, B., Albrecht, B., Vogel, C., Schlamp, D., et al. (2009). Is Neurofeedback an effi­ca­cious treat­ment for ADHD? A ran­dom­ized con­trolled clin­i­cal trial. Jour­nal of Child Psy­chol­ogy and Psy­chi­a­try, 50, 780–789.
  • Levesque, J., Beau­re­gard, M., & Men­sour, B. (2006). Effect of Neurofeedback train­ing on the neural sub­strates of selec­tive atten­tion in chil­dren with atten­tion deficit/hyperactivity dis­or­der: A func­tional mag­netic res­o­nance imag­ing study. Neu­ro­science Let­ters, 394, 216–221.
  • Omizo, M. M., & Michael, W. B. (1982). Biofeedback-induced relax­ation train­ing and impul­siv­ity, atten­tion to task, and locus of con­trol among hyper­ac­tive boys. Jour­nal of Learn­ing Dis­abil­i­ties, 15, 414–416.
  • Rivera, E., & Omizo, M. M. (1980). The effects of relax­ation and biofeed­back on atten­tion to task and impul­siv­ity among male hyper­ac­tive chil­dren. The Excep­tional Child, 27, 41–51.

An important note:

It is important to note that neurofeedback is not an ‘all in one’ treatment solution. While preliminary research has shown it to be effective at helping a range of conditions, more research is required to understand its full potential. In addition, the emergence of neurofeedback as an effective treatment does not detract from the efficacy of other therapies or treatments. Before commencing your neurofeedback journey, you will have an introduction consult with one of our practitioners. They may recommend other treatments to peruse in conjunction with neurofeedback. Find out more about the treatment process.

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