Neurofeedback for Anxiety Research

Does Neurofeedback Work for Anxiety?

There are many scientific papers about Neurofeedback for anxiety that have been published in peer-reviewed journals. The literature appears to be expanding exponentially on this topic. Here are some examples below.

In a multi-site research program 726 children and adolescents aged from 5 to 16 years and 363 adults aged from 17 to 67 years, who undertook an average of 20 neurofeedback sessions 85% showed improvement in their TOVA scores. Approximately two thirds of the subjects were male, 186 had been formally diagnosed with ADHD, the others presented with obvious behavioural problems with moderate to severe problems with attentiveness and impulse control measured by the Test of Variables of Attention TOVA. Some had also been diagnosed with disorders commonly seen with ADHD––oppositional-defiant disorder, conduct disorder, Tourette’s syndrome, minor traumatic brain injury, epilepsy, anxiety disorders and depression. These results are significant as the subjects had failed with traditional medication and many of the adults were symptomatic their whole lives.

Siegfried Othmer, clinician, researcher, president and founder of EEG Info, the largest neurofeedback organisation in the world, reported the results of neurofeedback with 400 cases of post traumatic stress disorder (PTSD) using multi-site research across a network of clinics. A wide variety of common symptoms, eg depression, anxiety, panic attacks, aggression, bruxism, migraine, irritable bowel, addictive behaviours, and chronic constipation, quantified in terms of severity on a Likert scale of 0-10, showed that all the symptoms were resolved at a similar rate over the period of training.

A landmark study into the use of neurofeedback for alcoholism was done in 1989 Vietnam veterans, who were suffering PTSD and were chronic alcoholics, which is a very difficult combination to treat. At the end of thirty training sessions they underwent profound personality changes measured by MMPI clinical scales, with significant increases in warmth, abstract thinking, boldness, conscientiousness, imaginativeness and self control, and significant decreases in anxiety and depression. These changes were not seen in the control group receiving standard medical/behavioural treatment, whose beta-endorphin levels (physiological indicator of stress) rose during the program compared to the neurofeedback group’s that fell. In a four year follow-up only 20% of the control group had remained sober compared to 80% of the neurofeedback group. 57 This sort of success is unprecedented when compared to conventional medical/behavioural approaches to alcoholism and PTSD that average a 20% success rate. Hardt had demonstrated 58 the same profound changes in anxiety (both state and trait) and the same areas of the MMPI, a decade before Peniston and Kulkosky, publishing his results in Science (July 1978). In 2006 Karen F. Trocki, PhD scientist at the Alcohol Research Group, Public Health Institute, Emeryville, CA, USA in her paper Is there an Anti-Neurofeedback Conspiracy? Referring to the Peniston and Kulkosky research made a very important observation and suggestion that could equally apply to all mood disorders, PTSD, ADHD, learning disorders, ODD, OCD, autism, Asperger’s, brain injuries, attachment disorder and conduct disorder and the suggestion for delivery is relevant too.

“As we all well know, addictions are very difficult to treat and relapse rates are very high. However over the past two decades a new kind of adjunct therapy for addictions has emerged that is ideally suited for delivery within treatment settings by mid-level licensed professionals such as nurses, social workers, counselors, or physical therapists. This is a treatment approach that has shown strong, positive results in long term follow-ups but the spread has been glacially slow. Given the strong positive findings it almost seems as though there is a sort of a conspiracy keeping this treatment from being used.”

Professor Ruth Lanius, at the Department of Psychiatry at Western’s Schulich School of Medicine & Dentistry and a scientist with Lawson Health Research Institute conducted research that demonstrated plasticity changes to the salience network and default mode network of the brain, which are known to be altered with PTSD, with associated measureable positive changes on subjective wellbeing. fMRI was used to measure brain states before and after neurofeedback sessions, which showed changes in connectivity that demonstrated neurofeedback was able to directly modulate the brain basis of emotional processing in PTSD. Lanius believes neurofeedback holds ‘great promise’ in treating PTSD and other issues associated with these brain networks.

Fourteen unmedicated subjects with major depressive disorder (MDD) were divided into an experimental group and control group and were trained with rtfMRI. Brain analysis indicated the experimental group had increased activity compared to the control group in the left superior temporal gyrus and temporal polar cortex and right thalamus. This was backed up with significant decreases in subjective anxiety ratings and increases in happiness ratings for the experimental group but not the controls. The researchers believe neurofeedback has ‘potential’ as a ‘novel’ treatment of depression.

Another rtfMRI study once again demonstrated the power of the brain to plastically change or reregulate itself resulting in a reduction of symptoms for people with anxiety. The training reduced activation levels of the limbic system and increased them in the orbitofrontal cortex. The researchers observed the changes remained for several days after the training along with the subject’s feelings of lowered anxiety and increased calm. Matched subjects who did sham neurofeedback did not show any changes in brain plasticity or reduction of anxiety. The researchers concluded the findings show how neurofeedback produces ‘enhanced control’ over anxiety by ‘persistently’ creating neuroplastic changes in relevant brain networks.

In discussing the effects of alpha theta neurofeedback with the music and dance performance studies described previously, Gruzelier stated it provided a ‘significantly beneficial effect’ on a ‘highly relevant’ performance measure and it is ‘remarkable’ that the benefits were achieved by only 10 sessions of training. He concluded the scale of the improvements in music and dance implies ‘great potential’ for neurofeedback in the performing arts in general. He believes these ‘remarkable’ effects are produced by the slower rhythms creating enhanced connectivity in the brain, which facilitates memory associations along with sensory–motor integration. Gruzelier pointed out that the effects were not due to simply being more relaxed as the other groups in the music study showed the same level of pre-performance anxiety as the neurofeedback group.

Socially anxious and withdrawn students were randomly assigned to either alpha/theta neurofeedback or to a sham training group. The neurofeedback group showed a 25% improvement in mood overall with increases in composure, agreeableness, elevated mood, confidence and energy, using a self-rating assessment. The control group only showed improvements in composure but with less energy.

Alpha neurofeedback has been demonstrated to increase creativity and reduce anxiety, reported Hardt. 77 He conducted a small trial with seven volunteers, who were scientists at the Stanford Research Institute, and a control group of age matched executives from Silicon Valley. Both groups were given pre training stress tests (physiological stress response––measuring galvanic skin response, muscle tension [EMG], skin temperature, heart rate and respiration rate, and subjective stress questionnaire the Signals of Stress inventory [SOSI]), and a creativity inventory. The two groups were well matched on all three groups of tests. The alpha group did alpha EEG biofeedback training once per day and the control group went about their normal routine. At the end of five days the tests were repeated for both groups, and Hardt found that the physiological stress (emotional stress and auditory startle stress) in the alpha group was significantly reduced, but the control group had risen slightly. The subjective measure of stress (SOSI) showed an average of 56% decrease for the alpha group, and the control group had a 5% increase. The alpha group had a ‘dramatic’ increase in their Ideation Fluency scores, which Hardt described as ‘highly’ significant. He concluded that alpha training holds the promise of reducing anxiety and increasing creativity in a ‘wide’ range of people.

Abstracts

A Review of EEG Biofeedback Treatment of Anxiety Disorders [abs.] by Moore NC

ABSTRACT

Alpha, theta and alpha-theta enhancements are effective treatments of the anxiety disorders (Table 1). Alpha suppression is also effective, but less so (Table 2). Perceived success in carrying out the task plays an important role in clinical improvement.

Anxiety Change Through Electroencephalographic Alpha Feedback Seen Only in High Anxiety Subjects [abs.] by Hardt JV and Kamiya J

ABSTRACT

Subjects who were either high or low in trait anxiety used alpha feedback to increase and to decrease their electroencephalographic alpha activity. The alpha changes were tightly linked to anxiety changes, but only in high anxiety subjects (for whom anxiety was reduced in proportion to alpha increases, and was increased in proportion to alpha suppression).

Treatment of Chronic Anxiety Disorder with Neurotherapy: A Case Study by Thomas JE Ph.D. and Sattlberger E B.A.

ABSTRACT

The objective of the present case study is to report the effects of alpha-decrease biofeedback training on a patient diagnosed with Anxiety Disorder Three Minnesota Multiphasic Personality Inventories (MMPI and MMPI-2) were used as objective measures of treatment efficacy. Following 15 sessions of slow wave inhibit/fast wave increase EEG feedback training, the patient reported a significant reduction in anxiety-related symptoms.

Anxiety Change Through Electroencephalographic Alpha Feedback Seen Only in High Anxiety Subjects [abs.] by Hardt JV and Kamiya J

ABSTRACT

Subjects who were either high or low in trait anxiety used alpha feedback to increase and to decrease their electroencephalographic alpha activity. The alpha changes were tightly linked to anxiety changes, but only in high anxiety subjects (for whom anxiety was reduced in proportion to alpha increases, and was increased in proportion to alpha suppression).

 Evaluating the Efficacy of a Biofeedback Intervention to Reduce Children’s Anxiety [abs.]by Wenck LS, Leu PW, D’Amato RC

ABSTRACT

This study explored the reduction of anxiety with children using a combination of electromyograph and thermal biofeedback techniques. One hundred and fifty children (7th and 8th graders) were identified by teachers as anxious and randomly assigned to biofeedback intervention and no-intervention groups.

 Biofeedback Treatments of Generalized Anxiety Disorder: Preliminary Results [abs.] by Rice KM, Blanchard EB, Purcell M

ABSTRACT

Forty-five individuals with generalized anxiety (38 with GAD as defined by DSM-III) were randomized to 4 treatment conditions or a waiting list control. Patients received 8 sessions of either frontal EMG biofeedback, biofeedback to increase EEG alpha, biofeedback to decrease EEG alpha, or a pseudomeditation control condition.

Articles

Case Study: Anxiety and panic Attacks by The Biocybernaut Institute

ABSTRACT

This 29 year old woman was a victim of repeated panic attacks. She decided to try alpha brain wave training after the discouraging and ineffective experiences she had while seeking treatment for her condition through the modes of traditional medicine, which included medical doctors, therapists, even hypnotists.

Treatment of Chronic Anxiety Disorder with Neurotherapy: A Case Study by Thomas JE Ph.D. and Sattlberger E B.A.

ABSTRACT

The objective of the present case study is to report the effects of alpha-decrease biofeedback training on a patient diagnosed with Anxiety Disorder Three Minnesota Multiphasic Personality Inventories (MMPI and MMPI-2) were used as objective measures of treatment efficacy. Following 15 sessions of slow wave inhibit/fast wave increase EEG feedback training, the patient reported a significant reduction in anxiety-related symptoms.

Notes

1. Effect of neuro-feedback on variables of attention in a large multi-center trial. Journal of Neurotherapy, 4(1), 2000

2. Remediation of PTSD using Infra-Low Frequency Neurofeedback. EEG Info Newsletter – March 7, 2012

3. Peniston, E.G. and Kulkosky, P.J. (1989) Alpha-theta brainwave training and b-endorphin levels in alcoholics. Alcoholism: Clinical and Experimental Research. 13: 271-279. Peniston, E.G. et al (1990) Alcoholic personality and alpha-theta brainwave training. Medical Psychotherapy. 3: 37-55. Peniston, E.G. et al (1993) EEG Alpha/theta Brainwave Synchronisation for Vietnam Theatre Veterans with Combat Related Stress Disorders and Alcohol Abuse. Advances in Medical Psychotherapy. 6:37-50

4. In his article A Tale of Self Discovery Megabrain Report The Journal of Mind Technology Vol 2 No.3, p14-28

5. Is there an Anti-Neurofeedback Conspiracy? Journal of Addictions Nursing 17:199–202, 2006

6. Plastic modulation of PTSD resting-state networks and subjective wellbeing by EEG neurofeedback. Acta Psychiatrica Scandinavica 2013

7. Real-Time fMRI Neurofeedback Training of Amygdala Activity in Patients with Major Depressive

Disorder. PLoS ONE 9(2): e88785. doi:10.1371/journal.pone.0088785 2014

8. Orbitofrontal cortex neurofeedback produces lasting changes in contamination anxiety and resting- state connectivity. Translational Psychiatry 3, e250; doi:10.1038/tp.2013.24, Published online 2013

9. Validating the efficacy of neurofeedback for optimising performance. Progress in Brain Research. 2006 159 pp. 421-431. ISSN 00796123 Article: Goldsmiths Research Online.

10. The effects of alpha/theta neurofeedback on personality and mood. Cognitive Brain Research, 23: 287–292. 2005b

11. In his article A Tale of Self Discovery p14-28 Megabrain Report The Journal of Mind Technology Vol.2 No.3

Discuss how you can beat the issues you and/or your child are struggling with using the most powerful and precise form of brain training known as neurofeedback. It’s fun, easy, non-invasive, safe, natural, holistic and the most powerful of all autism treatments with no adverse side effects. Neurofeedback is a powerful and effective way to change you and/or your child’s life for the better.

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