Neurofeedback protocols - Two distinct protocol for Therapy and

research

In the vast Neurofeedback literature there are plenty of protocols used. Number of protocols
have been discarded, quite a few are successful in the application value. Adapting suitable
protocol is a preliminary step in the Neurofeedback success. There is a chance that adapting
wrong feedback protocol can misfire and result in adverse effects. For a clinical application
there are numerous protocols available especially for ADHD (Gnecchi, Herrera Garcia, & de
Dios Ortiz Alvarado, 2007; Karimi, Haghshenas, & Rostami, 2011; Wang & Sourina, 2013) &
Schizophrenia(Surmeli, Ertem, Eralp, & Kos, 2012). There are limited protocols for enhancing
performance, creativity, improving cognitive abilities in healthy population. The operant control
of the brain waves has enabled wide scope for healthy beings to improve the abilities, provided
suitable methodology is incorporated. Here two protocols have been listed for such use. The
feedback protocols listed here are amplitude/power based i.e., the particular band frequency is
either inhibited or enhanced using the power denomination of that frequency.

There are 7 types of Neurofeedback for the treatment of various disorders:

1. The most frequently used neurofeedback is frequency/power neurofeedback. This
technique typically includes the use of 2 to 4 surface electrodes, sometimes called
surface neurofeedback. It is used to change the amplitude or speed of specific brain
waves in particular brain locations to treat ADHD, anxiety, and insomnia.
2. Slow cortical potential neurofeedback (SCP-NF) improves the direction of slow cortical
potentials to treat ADHD, epilepsy, and migraines (Christiansen, Reh, Schmidt, & Rief,
2014).
3. Low-energy neurofeedback system (LENS) delivers a weak electromagnetic signal to
change the patients brain waves while they are motionless with their eyes closed
(Zandi-Mehran, Firoozabadi, & Rostami, 2014). This type of neurofeedback has been
used to treat traumatic brain injury, ADHD, insomnia, fibromyalgia, restless legs
syndrome, anxiety, depression, and anger.
4. Hemoencephalographic (HEG) neurofeedback provides feedback on cerebral blood flow
to treat migraine (Dias, Van Deusen, Oda, & Bonfim, 2012).
5. Live Z-score neurofeedback is used to treat insomnia. It introduces the continuous
comparison of variables of brain electrical activity to a systematic database to provide
continuous feedback (Collura, Guan, Tarrant, Bailey, & Starr, 2010).
6. Low-resolution electromagnetic tomography (LORE-TA) involves the use of 19
electrodes to monitor phase, power, and coherence (Pascual-Marqui, Michel, &
Lehmann, 1994). This neurofeedback technique is used to treat addictions, depression,
and obsessive-compulsive disorder.
7. Functional magnetic resonance imaging (fMRI) is the most recent type of neurofeedback
to regulate brain activity based on the activity feedback from deep subcortical areas of the
brain (Hurt, Arnold, & Lofthouse, 2014; Lvesque, Beauregard, & Mensour, 2006a).
 1. SMR - training./ Beta enhancement/ Beta training / High frequency training
There are lot of debates over high frequency training vs low frequency training. One of widely
tested protocol among the high frequency training is Beta enhancement and simultaneously
theta inhibition. People have reported that this training helps in improving attention, Perceptual
ability and vigilance.

Training sites : Central regions(Cz, C3, C4). The sensory motor rhythm is generated by
motor cortex which lies in central regions, thus it is logical to assume that training these region
for selective improvement. Another possible assumption is that, since the central region
averages all the activity, training in these sites would result in overall training.
Neurologists have mentioned that the motor cortex helps the cerebral cortex to encode both
physical and cognitive tasks. Therefore, subjects who have trouble seeing the logical sequence
of cognitive tasks may benefit from neurofeedback training along the left hemisphere
sensorimotor cortex (C3). Training along the right hemisphere sensorimotor cortex (C4) may
invoke feelings, emotions, or calmness. Training at the median or may facilitate a mixed
response. The subjects who suffer from epilepsy are usually trained along the sensorimotor
cortex (C3) to increase SMR. Also, training along the sensorimotor cortex could be applied for
the treatment of stroke, epilepsy, paralysis, ADHD, and disorders of sensory/motor integration
(Table 2) (Demos, 2005).

Generally, electrodes are placed in a way that a particular EEG channel is located on one brain
side (Bauer & Pllana, 2014). For instance, low beta and beta are trained on the right (C4) and
left (C3) brain side, respectively. If they were switched to the opposite brain side, undesirable
results could be obtained. For example, training low beta wave on the left side will result in a
depletion of mental energy instead of improvements in concentration. Thus, the location of the
EEG electrodes during the neurofeedback procedure is important (Evans, 2007).

Number of session required & protocol type : People have tested from 8 sessions to
40 sessions. A survey of these studies show that, generally 12- 18 sessions would be ideal
period of training. Protocol type includes enhancing (Increasing the power) Low beta (Range -
12 to 16Hz) while inhibiting(Decreasing the power) or controlling theta(Range - 4 to 6.5 Hz) &
low alpha(Range - 7 to 9 Hz).

Literature : Vernon et.al(2003) - Improvement in cognitive performance

Fuchs et.al(2003) - Improvement in attention and intelligence
Egner & Gruzeliar(2001) - Improvement in perceptual ability
Rasey et.al(1995) - improvement in attentional performance

Reference:
Egner, T., & Gruzelier, J. H. (2004). EEG Biofeedback of low beta band components:
frequency-specific effects on variables of attention and event-related brain potentials. Clinical
Neurophysiology, 115(1), 131-139. doi: 10.1016/S1388-2457(03)00353-5
Egner, T., & Gruzelier, J. H. (2003). Ecological validity of neurofeedback: modulation of slow
wave EEG enhances musical performance. Neuroreport, 14(9), 1221-1224.

Fuchs, T., Birbaumer, N., Lutzenberger, W., Gruzelier, J. H., & Kaiser, J. (2003). Neurofeedback
treatment for attention-deficit/hyperactivity disorder in children: A comparison with
methylphenidate. Applied Psychophysiol Biofeedback, 28(1), 1-12.

Rasey, H., Lubar, J. F., McIntyre, A., Zoffuto, A., & Abbott, P. L. (1995). EEG biofeedback for
the enhancement of attentional processing in normal college students. Journal of Neurotherapy,
1(3), 15-21. doi: 10.1300/J184v01n03_03.

Vernon, D., Egner, T., Cooper, N., Compton, T., Neilands, C., Sheri, A., et al. (2003). The effect
of training distinct neurofeedback protocols on aspects of cognitive performance. International
Journal of Psychophysiology, 47(1), 75-85. doi: 10.1016/S0167- 8760(02)00091-0.

Vernon, D. J. (2005). Can neurofeedback training enhance performance? An evaluation of the

evidence with implications for future research. Applied Psychophysiol Biofeedback, 30(4),
347-364. doi: 10.1007/s10484-005-8421-4.

2. Delta protocol :

Slow wave training is still a question. This protocol is introduced in the paper given by
Vernon(2005). It is not yet tested properly. Few experiments by egner, and others have been
reported but not accepted in full pledge.
Protocol type : Enhancement of Delta activity( Range - 2 to 4 Hz) results in self
regulation

Electrode site : Fronto - temporal sites (F7, F8)

Number of sessions - Not specified .

Reference -

Vernon, D., Egner, T., Cooper, N., Compton, T., Neilands, C., Sheri, A., et al. (2003). The effect
of training distinct neurofeedback protocols on aspects of cognitive performance. International
Journal of Psychophysiology, 47(1), 75-85. doi: 10.1016/S0167- 8760(02)00091-0.

Vernon, D. J. (2005). Can neurofeedback training enhance performance? An evaluation of the

evidence with implications for future research. Applied Psychophysiol Biofeedback, 30(4),
347-364. doi: 10.1007/s10484-005-8421-4.