FAQ

Neurofeedback (also known as Brainwave Biofeedback or EEG Biofeedback) is a non-medication treatment alternative for ADHD and other neurobiologically based difficulties. The first published studies started appearing in the 1970’s. Advances in neuroscience and technology have resulted in increased research and clinical work each year.

 
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Neurofeedback is a way to train the brain toward better functioning. One or two sensors are placed on the scalp and ears. There is no breaking of the skin or any discomfort.
 

The sensors are like little stethescopes which “listen in” and feed the brain waves into an amplifier (an Electroencephalogram machine) that is linked to a computer. The brainwaves are converted into video and audio displays. By watching the screen and listening to tones, the individual is given immediate feedback that tells whether his/her brain is making faster or slower brainwaves moment to moment. Brainwaves change as a result of this training.

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This form of brain training involves operant conditioning and classical conditioning which are fundamental ways that explain how people learn. Operant conditioning states that behaviors that are followed by rewards increase, while those that don’t fade out. We are rewarding certain brain speeds at certain locations while decreasing others. Classical conditioning (think Pavlov’s dogs) involves the associating of an eeg state with the feeling of being attentive while relaxed (“in the zone”).
 

Some clinicians would say that we are training the brain’s ability to self regulate by challenging the brain’s self-regulatory mechanisms and are thus impacting brain timing and brain connectivity/communication. Some researchers attribute the functional gains to the brain functioning in a more efficient and stable manner, with some researchers attributing that to improvements in cerebral blood flow.

Some clinicians feel that neurofeedback is an appropriate intervention for anyone who has a neurobiologically based attention, learning, or mood disorder that is creating significant life difficulties. Other clinicians would say that neurofeedback is an appropriate intervention if there are significant brainwave abnormalities relative to the general population. An example is ADD/ADHD individuals who may have a higher percentage of slower brainwave activity (e.g theta waves) in comparison to faster brainwave activity (e.g. beta waves).
 

At the initial appointment we will review the advantages and disadvantages of the various treatment options. Depending upon the problem we will try to obtain some objective measures when feasible. As an example, prior to starting neurofeedback for attention problems a computerized test of attention will be used to help to determine the type and degree of attentional difficulties. This is also used as a baseline measure to help assess progress later.

Single or multiple channel quantitative EEG measures will be done. An individual’s performance on these measures will be compared to a normative database. This can be used to help predict whether a person is a good candidate for neurofeedback training. These measures of brainwave activity are also used to help determine the most efficient training protocol.

What is a brainmap and how does it help?

Please visit our Research page for more information on neurofeedback.

 
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A Quantitative Electroencephalogram (QEEG), also known as a Brainmap is a diagnostic technique that has potential benefits for neurofeedback. An elastic net with 19 sensors is placed on the head so that the brainwave activity for the whole scalp can be measured. There is no piercing of the skin. Brainwaves are then recorded with eyes closed and again with eyes open. This data is then compared to one or more normative databases. This results in a series of tables and graphs which indicate which areas have brainwave abnormalities, the degree of abnormality, and the brainwave frequencies that are involved. This leads to specific neurofeedback protocols. The benefit is that it may reduce the number of neurofeedback sessions and increase the effectiveness of treatment.
 

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Medication decisions should be made by you and your physician. Many patients start neurofeedback while on medication(s), and then we collaborate in helping their physician titrate the doseage down. If a patient is considering starting neurofeedback while starting medication, we recommend that they either start the neurofeedback without medication or start medication first prior to the neurofeedback so we can isolate what treatment is doing what.
 

We can train while on medication without difficulty, although some medications may slow down the training process. If a brainmap (Quantitative EEG) is done, we prefer to do that off medication if possible, recognizing that some patients can not safely go off of their medications for even a couple of days.

Please visit our Finances page for more information on neurofeedback treatment costs.

 
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Patients and parents are welcome to set up an initial consultation with me by calling my office (804) 794-4482. This appointment is typically covered by most insurance carriers. It is considered an Initial Evaluation (CPT code 90801) under your mental health benefits for psychotherapy. Your insurance carrier may require preauthorization for this and there is typically a co-pay.
 

For child patients, time will be spent with the parents and child together, and them some time with the child alone, and later with the parents alone. The purpose of the session will be to begin to get a comprehensive understanding of you or your child and the various problems, to get a good understanding of what has been already tried with what effects, to begin to get to know one another, and to help determine whether neurofeedback would be the most appropriate way to proceed.

Sometimes it makes more sense to do some testing to help make decisions, or to start off with counseling. Sometimes we will blend these options.

I am happy to answer any questions that you may have by email or phone.

Glenn Weiner, Ph.D.

glennweiner@gmail.com