Foundations of Neurofeedback ? Outline - BrainMaster

[pic] Technical Foundations of Neurofeedback
Principles and Processes for an Emerging Clinical Science of Brain and
Mind
Thomas F. Collura, Ph.D., QEEG-D, BCN-A
BrainMaster Technologies, Inc. Bedford, OH
Introduction 4
Chapter 1 - Overview 7
Chapter 2 - Neurophysiological Origins of EEG Signals and Rhythms 44
Chapter 3 - EEG Instrumentation and Measurement 92
Chapter 5 - EEG Components and Their Properties 130
Chapter 6 - Connectivity-based EEG Biofeedback 144
Chapter 7 - Neurofeedback Protocols 174
Chapter 8 - Use of Live Z-Scores 207
Chapter 9 - LORETA Neurofeedback 248
Chapter 10 - Neurofeedback in Practice 249
Chapter 11 - Session Management and Control 260
Chapter 12 - MINI-Q assessment and training methods 272
Chapter 13 - Photic Stimulation and Nonvolitional Neurofeedback 287
References 316 Introduction This book provides a survey of the basic technical underpinnings of
neurofeedback, also known as EEG biofeedback. Our considerations will
include biology, physics, electronics, biomedical signal analysis,
computers, and learning. We will investigate the origin of the brain
signals and the concepts surrounding the recording, processing, and
feedback of these signals. This provides an understanding of where the
signals come from, and how they are used in neurofeedback instrumentation.
We will also explore the basic physiological mechanisms that underly brain
rhythms, as well as the changes in these rhythms that can occur in the
course of neurofeedback training. These changes may be manifested in the
ongoing measurements, and also in changes in the behavior and self-reported
thoughts and feelings of the trainee. These changes will then be put in a
clinical context that should arm the practitioner with a solid technical
foundation for practice or research.
Neurofeedback is based upon sound scientific principles that have been
well established and documented through more than 80 years of basic and
clinical research. This book will provide an overview of these principles,
as well as references for readers who desire additional detail and support.
Overall, the principles are rather simple. We are able to measure and
identify brain states via recorded electrical activity, and we are further
able to guide a trainee's brain to achieve and sustain desirable states,
through straightforward instrumentation and computations. In the end, the
brain is able to learn and adapt, and in the presence of appropriate
equipment and guidance, this learning and adaptation can have profound and
beneficial effects. We have only begun to explore the capabilities of this
simple, elegant, yet powerful approach to individual assessment, clinical
intervention, and self-improvement.
At its core, neurofeedback embodies a process of neuronal self-
regulation and re-education, leading the brain to find new and beneficial
states and ways of processing information and feelings. However, it is by
no means a "weak" intervention, and can be as efficacious as medication in
many cases, and with fewer or no negative side-effects. Applications are
found with disorders as wide ranging as anxiety, depression, ADD/ADHD,
PTSD, alcoholism/addiction, and also autism, Asperger's, learning
disorders, dyslexia, and epilepsy. With regard to clinical efficacy, the
reader is directed toward excellent references including Arns et al. (2010,
ADD), Budzynski, Budzynski, Evans, and Abarbanal (2005, ADD), Coben and
Evans (2011, ADD), and Kropitov (2009, ADD). Neurofeedback is also used in
nonclinical settings including sports, performing arts, and academic
proficiency, where its applications are designated variously as "peak
performance," "mental fitness," and "optimal functioning." (Kenedy, ADD;
Gruzelier, ADD).
This material has grown out of a 1-day workshop on this topic that has
been taught by the author dozens of times in the past decade, often in
conjunction with other established educators in the field. This workshop,
which was first presented in 2001, grew from the demand of practitioners to
understand the foundations of the science that lies beneath the clinical
art of neurofeedback therapy. These practitioners have included, but have
not been limited to, psychologists, psychiatrists, counselors, social
workers, family therapists, chiropractors, nurses, and occupational
therapists. This and related workshops have been presented to hundreds of
practitioners under the sponsorship of the International Society for
Neurofeedback and Research (ISNR), the Association for Applied
Psychophysiology and Biofeedback (AAPB), and various regional biofeedback
societies, as well as BrainMaster Technologies, Inc., and Stress Therapy
Solutions, both of Bedford, Ohio. The result of the continual feedback and
revision is that there now exists enough material to easily cover a week of
instruction, while maintaining a focus on scientific and technical
principles. As a solution to the problem of what to do with all the
material that cannot fit into a 1 day course, this text compiles and
develops this material into a cohesive treatment.
It is hoped that newcomers and seasoned veterans alike will find this
material useful, relevant, and interesting. As a complete read, it can
provide instruction suitable for self-education, or even as a course text.
As a reference, it contains details and clarification of many key
principles that can be used as needed to answer specific questions.
Overall, the intent has been to place neurofeedback on an objective and
scientific framework, so that it can be understood, practiced, and accepted
as an evidence-based procedure.
The potential of neurofeedback as a therapeutic and as an agent for
change has only begun to be realized. Much like the "barnstormers" who
innovated aviation, or the "hackers" who pioneered early computing, the
neurofeedback community of the last several decades has been characterized
by devoted, creative, and open-minded individuals who refused to by stifled
by convention. It should be noted that various matters of the art of
practicing neurofeedback, the design or equipment, or the conduct of
sessions, are based upon field experience, and may not have cited
references in the literature. They are provided here to reflect the state
of the art, not as authoritative requirements. Chapter 1 - Overview
Definition of Neurofeedback Neurofeedback is a form of biofeedback training that uses the EEG
(Electroencephalogram), also known as the "brain wave" as the signal used
to control feedback. Sensors applied to the trainee's scalp record the
brainwaves, which are converted into feedback signals by a human/machine
interface using a computer and software. By using visual, sound, or
tactile feedback to produce learning in the brain, its primary use has been
to improve brain relaxation through increasing alpha waves or related
rhythms. A variety of additional benefits, derived from the improved
ability of the CNS (central nervous system) to modulate the
concentration/relaxation cycle and brain connectivity, may also be
obtained.
In summary, neurofeedback consists of the following key elements:
. Production of the EEG by the brain
. Recording of the EEG using suitable instrumentation
. Digitizing of the EEG into computer form
. Computation of EEG characteristics (signal processing)
. Production and presentation of feedback (visual, auditory, tactile,
etc)
. Resulting learning by the brain, leading to physiological change
This book will describe each of these processes in detail, and will
thus encompass the areas of neurophysiology, biomedical engineering,
digital signal processing, computer technology, and clinical theraputics.
In this chapter, we will provide an overview of the above concepts, and
present an integrated view of the process of neurofeedback.
It is important at the outset to distinguish neurofeedback from
conventional EEG, and also from quantitative EEG (QEEG). Although these
areas are related, they are by no means the same. Electroencephalography
(EEG) is a technique by which the brain's electrical activity is recorded
by the use of sensors placed on the scalp, and sensitive amplifiers. The
EEG was first recorded by the German psychiatrist Hans Berger in 1932, and
has become an accepted clinical tool for neurologists and psychiatrists.
Generally, EEG is analyzed by visually inspecting the waveforms, often
using a variety of montages. Neurologists are able to identify
abnormalities including epilepsy, head injuries, stroke, and other disease
conditions using the EEG. A clinical EEG practitioner in the medical
profession must first be a neurologist or psychiatrist, and complete an
additional 2 year residency and board certification in clinical
neurophysiology, sleep disorders, epilepsy, or a related field, to be
eligible to read and interpret clinical EEG's.
Quantitative EEG (QEEG) is a technique in which EEG recordings are
computer-analyzed to produce numbers referred to as "metrics" (e.g.
amplitude or power, ratios, coherence, phase, etc) used to guide decision-
making and theraputic planning. QEEG can also be used to monitor and
assess treatment progress. QEEG data typically consist of raw numbers,
statistics generally in the form of z-scores, and/or topographic or
connectivity maps. QEEG systems currently lack strong standardization, and
a wide range of methods and achievable results exist in the field.
Although QEEG uses computer software to produce results, an understanding
of basic EEG, and the ability to read and understand raw EEG waveforms, is
required in order to competently practice QEEG. Generally, a specialist
(e.g. a board certified MD, PhD, QEEG-T or QEEG-D) is consulted to read and
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