BRAIN INJURY

Head trauma and brain injury can cause long term problems with attention, focus, impulse control, memory, mood and performance. Neurofeedback has been used for many years to improve the symptoms and impact of head trauma and brain injury.

Research on neurofeedback goes back over 20 years. The first research by Sterman and Lubar focused on reduction of anxiety and on the treatment of epilepsy. Sterman (2000) reviewed this literature, which included blinded, placebo-controlled cross-over studies, on the use of neurofeedback with uncontrolled epilepsy. Out of a total of 174 medically intractible patients in these studies it was found that in 82% of cases there were significant improvements in the seizure rate, and there were no reports of an increase in seizures. Some of these studies evaluated pre- and post-treatment sleep EEG’s, finding that following treatment even when the patient was asleep, their EEG showed less epileptiform activity, thus demonstrating that conditioned changes in brain function.

Some recent studies with normal individuals also have implications for TBI treatment. Vernon et al. (2003) documented in a control group study that only 8 sessions of neurofeedback could improve memory recall, and a recent placebo controlled study (Hoedlmoser et al., 2008) of neurofeedback validated that only 10 sessions improved sleep onset latency and subsequent declarative learning in normal subjects. Other reviews have been published on the use of neurofeedback in the treatment of depression and anxiety (Hammond, 2005a), for improving physical balance (Hammond, 2005b), and in the treatment of obsessive-compulsive disorder (Hammond, 2003).

Although better and more well controlled research is needed preliminary neurofeedback treatment outcome studies of closed and open brain injuries too numerous to cite have been published. For example, Schoenberger et al (2001) compared treatment (25 sessions) with the Low Energy Neurofeedback System (LENS) of 9 mild and 3 moderate TBI patients with a wait-list control group. They found significant improvement in measures of attention and recall. Thornton and Carmody (2005) found 186% improvement in memory scores in TBI patients treated with neurofeedback compared to a control group with no TBI history. When Thornton and Carmody (2008) compared neurocognitive rehabilitation strategies, medication treatment, and neurofeedback treatment in an effect size analysis, neurofeedback appeared more efficacious than other treatment strategies. Ayers (1999) has even brought many patients out of coma using neurofeedback.