Below you'll find abstracts from published papers on the efficacy of neurofeedback for performance enhancement and/or treating a variety of medical conditions. This content is for informational purposes only. The scientific principles discussed in these papers were considered during the design of the BrainKanix Neurofeedback programs. However, BrainKanix is not intended to diagnose, treat, cure, or prevent any disease or disorder. You should always seek the advice of your physician or other qualified health provider on any questions you may have regarding a medical condition.
(Please click any research paper's title to access the document.)
Sensorimotor rhythm (SMR) activity has been related to automaticity during skilled action execution. However, few studies have bridged the causal link between SMR activity and sports performance. This study investigated the effect of SMR neurofeedback training (SMR NFT) on golf putting performance. We hypothesized that preelite golfers would exhibit enhanced putting performance after SMR NFT. Sixteen preelite golfers were recruited and randomly assigned into either an SMR or a control group. Participants were asked to perform putting while electroencephalogram (EEG) was recorded, both before and after intervention. Our results showed that the SMR group performed more accurately when putting and exhibited greater SMR power than the control group after 8 intervention sessions. This study concludes that SMR NFT is effective for increasing SMR during action preparation and for enhancing golf putting performance. Moreover, greater SMR activity might be an EEG signature of improved attention processing, which induces superior putting performance.
Cheng, Ming-Yang et al. “Sensorimotor Rhythm Neurofeedback Enhances Golf Putting Performance.” Journal of sport & exercise psychology 37 6 (2015): 626-36 .
The purpose of the present research was to study the effect of neurofeedback training on the anxiety of elite female swimmers. To that aim, 20 professional swimmers were selected through purposive sampling and were randomly divided into an experimental and a control group. The procedure of the research involved 12 sessions (45 min per session) of neurofeedback training with two protocols: (1) increased SMR activity and decreased high beta and theta activity, (2) increased beta activity and decreased high beta activity. Before the training, the pretest was administered using SCAT and then the posttest was administered. Two-factor analysis of variance (2 2) was applied for data analysis and the results were: the main effect of test and the interaction between test and group were significant, but the main effect of group was not significant. Given the significance of the interaction between test and group, correlated t-test was applied to compare the pretest and posttest scores of each group. The results indicated that there is a significant difference between the pretest and posttest scores of the experimental group in anxiety. Yet this difference was not significant in the control group. Correlated t-test was also applied to compare the two groups in the pretest and the posttest. The results revealed that in the pretest there was no significant difference between the groups in terms of anxiety, but this difference was significant in the posttest. It can thus be concluded that neurofeedback training reduces anxiety in elite female swimmers.
Faridnia, Mehrsa, Masoumeh Bakhshi Shojaei and Azar. Rahimi. “The effect of neurofeedback training on the anxiety of elite female swimmers.” (2012).
Developing a Performance Brain Training™ Approach for Baseball: A Process Analysis with Descriptive Data
Neurofeedback may be useful for improving sports performance but few studies have examined this potential. Here we present data of five development players from a major league baseball team. The aims were to evaluate the feasibility of conducting sessions within a professional organization, assess changes in quantitative electroencephalograph (QEEG), NeuroPerformance Profile™, and report qualitative self-report data before and after brain training. The EEG was recorded with 19 electrodes for 20 min of baseline conditions and approximately 21 min of a continuous performance test. The fast Fourier transform analysis provided average cross-spectral matrices for bands delta (1–3.5 Hz), theta (4–7.5 Hz), alpha (8–12 Hz), low beta (13–16 Hz), beta 1 (13–21 Hz), beta 2 (22–32 Hz), and gamma (32–45 Hz) from the pre and post intervention evaluations in the baseline condition of eyes open. The continuous performance test metrics included the errors of omission, errors of commission, response time and response time variability. The 9 scales of the NeuroPerformance Profile™ were examined. The QEEG data, CPT data and NeuroPerformance Profile™ data were all compared between the pre and post 15 sessions of brain training using a within subject paired t test design corrected for multiple comparisons using false discovery rate method. Following brain training, comparative QEEG, CPT and NeuroPerformance Profile™ analyses illustrated significant differences. The QEEG findings of all participants illustrated significant changes within the training parameters but also across other frequency bands and electrode sites. Overall, the positive findings in both objective and subjective measures suggest further inquiry into the utility of brain training for performance enhancement with the specific application of sport is warranted. Particularly QEEG and CPT gains were noted in the areas that correspond to client self-report data demonstrating improvement in attention, decreased intrusive thought patterns and improvements in sleep patterns.
Sherlin, L.H., Larson, N.C. & Sherlin, R.M. Appl Psychophysiol Biofeedback (2013) 38: 29. https://doi.org/10.1007/s10484-012-9205-2
Sport psychologists will find that neurofeedback is a cutting-edge technology that holds potential for improving concentration and attention, lowering anxiety and disruptive mental chatter, and in assisting in the rehabilitation of effects from concussions The Journal of the American Board of Sport Psychology, Volume 1-2007, Article # 1 Hammond, D.C. 6 and mild head injuries. The author’s experiences in treating patients with serious balance problems and observing their rapid improvements provides encouraging evidence for the potential neurofeedback to enhance physical balance in sports such as gymnastics, skiing, ice skating, hockey, skateboarding, and snowboarding. The rapid effects of this balance protocol make it particularly appealing. It is hoped that sport psychologists will experiment with applying this protocol with athletes and that controlled research will be conducted.
The Journal of the American Board of Sport Psychology, Volume 1-2007, Article # 1 Hammond, D.C.
Increasing Performance of Professional Soccer Players and Elite Track and Field Athletes with Peak Performance Training and Biofeedback: A Pilot Study
The aim of this pilot study was to investigate the effects of an intervention consisting of mental coaching combined with either electro encephalogram (EEG) alpha power feedback or heart rate variability (HRV) feedback on HRV, EEG outcomes and self-reported factors related to stress, performance, recovery and sleep quality in elite athletes. A prospective pilot study was performed with two distinct cohorts. Soccer players were provided with four sessions of mental coaching combined with daily HRV biofeedback (Group A); track and field athletes were provided with four sessions of mental coaching in combination with daily neurofeedback (Group B). Measurements were performed at baseline, post intervention and at 5 weeks follow-up. Objective measures: EEG and ECG. Subjective measures: Numeric Rating Scale for performance, Pittsburgh Sleep Quality Index, Rest and Stress Questionnaire and Sports Improvement-60. Group characteristics were too distinct to compare the interventions. Linear mixed models were used to analyze differences within groups over time. In Group A, significant changes over time were present in alpha power at 5 of 7 EEG locations (p < 0.01–0.03). LF/HF ratio significantly increased (p = 0.02) and the concentration (p = 0.02) and emotional scale (p = 0.03) of the SIM-60 increased significantly (p = 0.04). In Group B, the HRV low frequency power and recovery scale of the REST-Q significantly increased (p = 0.02 and <0.01 resp.). Other measures remained stable or improved non-significantly. A mental coaching program combined with either HRV or EEG alpha power feedback may increase HRV and alpha power and may lead to better performance-related outcomes and stress reduction. Further research is needed to elucidate the effects of either type of feedback and to compare effects with a control group.
Rijken, N.H., Soer, R., de Maar, E. et al. Appl Psychophysiol Biofeedback (2016) 41: 421. https://doi.org/10.1007/s10484-016-9344-y
Quantitative EEG Neurometric Analysis–Guided Neurofeedback Treatment in Postconcussion Syndrome (PCS): Forty Cases. How Is Neurometric Analysis Important for the Treatment of PCS and as a Biomarker?
Postconcussion syndrome (PCS) has been used to describe a range of residual symptoms that persist 12 months or more after the injury, often despite a lack of evidence of brain abnormalities on magnetic resonance imaging and computed tomography scans. In this clinical case series, the efficacy of quantitative EEG-guided neurofeedback in 40 subjects diagnosed with PCS was investigated. Overall improvement was seen in all the primary (Symptom Assessment-45 Questionnaire, Clinical Global Impressions Scale, Hamilton Depression Scale) and secondary measures (Minnesota Multiphasic Personality Inventory, Test of Variables for Attention). The Neuroguide Traumatic Brain Index for the group also showed a decrease. Thirty-nine subjects were followed up long term with an average follow-up length of 3.1 years (CI = 2.7-3.3). All but 2 subjects were stable and were off medication. Overall neurofeedback treatment was shown to be effective in this group of subjects studied.
Surmeli, Tanju, Emin Eralp, Ilham Mustafazade, Ismet Hadi Kos, Gül Elif Özer and Orkun H Surmeli. “Quantitative EEG Neurometric Analysis-Guided Neurofeedback Treatment in Postconcussion Syndrome (PCS): Forty Cases. How Is Neurometric Analysis Important for the Treatment of PCS and as a Biomarker?” Clinical EEG and neuroscience 48 3 (2017): 217-230 .
LORETA Z-score Neurofeedback-Effectiveness in Rehabilitation of Patients Suffering from Traumatic Brain Injury
This is a multi-case study involving sixty-seven patients diagnosed with Traumatic Brain Injury (TBI) that were subjected to Z-score neurofeedback (NFB) therapy. Most of the patients were diagnosed with mild TBI and treated within the first year after brain injury. A few patients were diagnosed with more severe TBI and treated after one year or later following their head injury incident. Most of the patients complained of headaches and cognitive problems while some of them also suffered from dizziness and overlapping depression. Those who complained of cognitive problems were subjected to analysis with computerized cognitive testing (NeuroTrax, Inc.) before and after ten sessions of NFB. During the NFB therapy the subjective response from patients was collected in order to discern whether or not there was an improvement of their symptoms. In addition, QEEG maps were completed before each NFB session initiation in order to see an objective improvement of QEEG abnormalities. Subsequent analysis revealed that 59 out of 67 patients (88%) noticed subjective improvement of their symptoms within 10 sessions of NFB therapy, out of which most of them reported an improvement after only 1-3 NFB sessions. 54 patients also had an objective improvement of QEEG maps (80%) manifesting as reduction of excessive beta activity and/or normalization of delta or theta power. 45 patients completed prior and post NFB neurocognitive testing with 34 patients (76%) having significant cognitive enhancement (Global Cognitive Score increased between 3-30 points). These results are very encouraging and indicate high potential of Z-score LORETA NFB rehabilitation of patients suffering from TBI.
Koberda JL (2015) LORETA Z-score Neurofeedback-Effectiveness in Rehabilitation of Patients Suffering from Traumatic Brain Injury. J Neurol Neurobiol 1(4): doi http://dx.doi.org/10.16966/2379- 7150.11
Peak performance appears to emerge from a brain that is both talented in the chosen profession and firmly established in higher values. To the extent one can remain anchored in the higher values of selflessness, peak performances can be maintained. The moment values degrade, even at the level of thoughts and feelings, performance is adversely affected. Higher values could be quantitatively measured in terms of applied neuroscience by sensorimotor rhythm values that appear at CPz (or above the default network in the brain). CPz refers to a location on the scalp, defined by the International 10–20 system, along the midline between central (Cz) and parietal (Pz) vertices. The higher the amplitude of SMR, the greater the self-regulation over one's own default network. This would amount to the individual's staying in a passive listening mode; this allows the real-time input from the environment to trigger action, rather than one's actions being skewed by one's own prerogatives. More critically, interpretations become more sensitive as resources dedicated to perceptions diminish. It has been empirically observed that as the SMR values increase (provided the Z-scores are largely within a normative database with respect to people performing at their peak), people gain regulation, control, and mastery over emotional, executive, and sensory quiescence, respectively. The individual Alpha frequency is also maintained above 8–9 µV in the eyes open condition and task condition, as one improves proficiency even over sensory quiescence. Wellness at the physical, emotional, and intellectual levels is accompanied by enhanced performance at each stage of sustainable growth.
Nidamangala Srinivasa Srinivasan (2012) Enhancing Neuroplasticity to Improve Peak Performance. Biofeedback: Spring 2012, Vol. 40, No. 1, pp. 30-33.
Distinct EEG effects related to neurofeedback training in children with ADHD: A randomized controlled trial
In a randomized controlled trial, neurofeedback (NF) training was found to be superior to a computerized attention skills training concerning the reduction of ADHD symptomatology (Gevensleben et al., 2009). The aims of this investigation were to assess the impact of different NF protocols (theta/beta training and training of slow cortical potentials, SCPs) on the resting EEG and the association between distinct EEG measures and behavioral improvements. In 72 (of initially 102) children with ADHD, aged 8-12, EEG changes after either a NF training (n=46) or the control training (n=26) could be studied. The combined NF training consisted of one block of theta/beta training and one block of SCP training, each block comprising 18 units of 50 minutes (balanced order). Spontaneous EEG was recorded in a two-minute resting condition before the start of the training, between the two training blocks and after the end of the training. Activity in the different EEG frequency bands was analyzed. In contrast to the control condition, the combined NF training was accompanied by a reduction of theta activity. Protocol-specific EEG changes (theta/beta training: decrease of posterior-midline theta activity; SCP training: increase of central-midline alpha activity) were associated with improvements in the German ADHD rating scale. Related EEG-based predictors were obtained. Thus, differential EEG patterns for theta/beta and SCP training provide further evidence that distinct neuronal mechanisms may contribute to similar behavioral improvements in children with ADHD
Child and Adolescent Psychiatry, University of Göttingen, v.Siebold-Str. 5, D-37075 Göttingen, Germany.
Neurofeedback for the treatment of children and adolescents with ADHD: a randomized and controlled clinical trial using parental reports
BackgroundA randomized and controlled clinical study was performed to evaluate the use of neurofeedback (NF) to treat attention-deficit/hyperactivity disorder (ADHD) in children and adolescents.MethodsThe ADHD population was selected from an outpatient clinic for Child and Adolescent Mental Health in Norway. Ninety-one of the 275 children and adolescents ranging in age from 6 to 18 years (10.5 years) participated in 30 sessions of an intensive NF program. The reinforcement contingency was based on the subjects’ production of cortical beta1 activity (15–18 Hz). The ADHD participants were randomized into three groups, with 30 in the NF group, 31 controls in a group that was given methylphenidate, and 30 in a group that received NF and methylphenidate. ADHD core symptoms were reported by parents using the parent form of the Clinician’s Manual for Assessment by Russell A. Barkley.ResultsNinety-one children and adolescents were effectively randomized by age, sex, intelligence and distribution of ADHD core symptoms. The parents reported significant effects of the treatments, but no significant differences between the treatment groups were observed.ConclusionsNF was as effective as methylphenidate at treating the attentional and hyperactivity symptoms of ADHD, based on parental reports.Trial registrationCurrent Controlled Trials NCT01252446
Duric, Nezla Sehovic et al. “Neurofeedback for the treatment of children and adolescents with ADHD: a randomized and controlled clinical trial using parental reports.” BMC Psychiatry (2012).
A robust body of research documents that there are biological predispositions that often exist for depression, anxiety, and obsessive–compulsive disorder. However, new research has shown that medication is only mildly more effective than placebo in the treatment of these problems. In treating these conditions, neurofeedback (EEG biofeedback) may offer an alternative to invasive treatments such as medication, ECT, and intense levels of transcrancial magnetic stimulation. This paper reviews the neurofeedback literature with these problems, finding particularly positive research support for the treatment of anxiety disorders. New findings on the neurofeedback treatment of depression are presented.
Hammond, D. Corydon. "Neurofeedback Treatment of Depression and Anxiety." Journal of Adult Development 12.2-3 (2005): 131-37. Web.
The use of neurofeedback as an operant conditioning paradigm has disclosed that participants are able to gain some control over particular aspects of their electroencephalogram (EEG). Based on the association between theta activity (4-7 Hz) and working memory performance, and sensorimotor rhythm (SMR) activity (12-15 Hz) and attentional processing, we investigated the possibility that training healthy individuals to enhance either of these frequencies would specifically influence a particular aspect of cognitive performance, relative to a non-neurofeedback control-group. The results revealed that after eight sessions of neurofeedback the SMR-group were able to selectively enhance their SMR activity, as indexed by increased SMR/theta and SMR/beta ratios. In contrast, those trained to selectively enhance theta activity failed to exhibit any changes in their EEG. Furthermore, the SMR-group exhibited a significant and clear improvement in cued recall performance, using a semantic working memory task, and to a lesser extent showed improved accuracy of focused attentional processing using a 2-sequence continuous performance task. This suggests that normal healthy individuals can learn to increase a specific component of their EEG activity, and that such enhanced activity may facilitate semantic processing in a working memory task and to a lesser extent focused attention. We discuss possible mechanisms that could mediate such effects and indicate a number of directions for future research.
Vernon, David, Tobias Egner, Nick Cooper, Theresa Compton, Claire Neilands, Amna Sheri, and John Gruzelier. "The Effect of Training Distinct Neurofeedback Protocols on Aspects of Cognitive Performance." International Journal of Psychophysiology 47.1 (2003): 75-85.
An Assessment of an Automated EEG Biofeedback System for Attention Deficits in a Substance Use Disorders Residential Treatment Setting
Attention deficits are prevalent among individuals with substance use disorders and may interfere with recovery. The present study evaluated the effectiveness of an automated electroencephalogram (EEG) biofeedback system in recovering illicit substance users who had attention deficits upon admission to a comprehensive residential treatment facility. All participants (n = 95) received group, family, and individual counseling. Participants were randomly assigned to 1 of 3 groups that either received 15 sessions of automated EEG biofeedback (AEB), 15 sessions of clinician guided EEG biofeedback (CEB), or 15 additional therapy sessions (AT). For the AEB and CEB groups, operant contingencies reinforced EEG frequencies in the 15-18 Hz (β) and 12-15 Hz (sensorimotor rhythm, "SMR") ranges and reduce low frequencies in the 1-12 Hz (Δ, θ, and α) and 22-30 Hz (high β) ranges. The Test of Variables of Attention (TOVA), a "Go-NoGo" task, was the outcome measure. Attention scores did not change on any TOVA measure in the AT group. Reaction time variability, omission errors, commission errors, and d' improved significantly (all p values < .01) in the AEB and CEB groups. AEB and CEB did not differ significantly from each other on any measure. The results demonstrate that automated neurofeedback can effectively improve attention in recovering illicit substance users in the context of a comprehensive residential substance abuse treatment facility.
Keith, Julian R., Lobsang Rapgay, Don Theodore, Jeffrey M. Schwartz, and Jae L. Ross. "An Assessment of an Automated EEG Biofeedback System for Attention Deficits in a Substance Use Disorders Residential Treatment Setting." Psychology of Addictive Behaviors 29.1 (2015): 17-25.
This study examined whether an EEG biofeedback protocol could improve outcome measures for a mixed substance abusing inpatient population.
Scott, William C., BSW, CCPD, David Kaiser, Ph.D, Siegfried Othmer, Ph.D, and Stephen I. Sideroff, Ph.D. "Effects of an EEG Biofeedback Protocol on a Mixed Substance Abusing Population."The American Journal of Drug and Alcohol Abuse 31(2005): 455-69.