Neurofeedback Applications in Medical Conditions
Neurofeedback is most strongly supported for treating attention-deficit/hyperactivity disorder (ADHD), with additional evidence for headaches, chronic pain, anxiety disorders, and functional gastrointestinal disorders. 1
ADHD Applications
Neurofeedback, particularly EEG biofeedback (also called neurofeedback), has substantial evidence supporting its use in ADHD treatment:
Mechanism: Neurofeedback for ADHD typically uses EEG biofeedback to help patients learn to control their brain waves consciously 2
Efficacy: While considered "probably efficacious" for ADHD treatment 1, recent meta-analyses show mixed results:
Comparison to other treatments:
Pain Management Applications
Neurofeedback shows promise for several pain conditions:
- Headaches: Surface electromyography (sEMG) and peripheral temperature biofeedback are effective for migraine and tension headaches 1
- Chronic pain syndromes: Various biofeedback modalities show positive effects on pain reduction 1
Gastrointestinal Applications
- Functional GI disorders: Biofeedback applications for functional gastrointestinal disorders show particular promise 1
- Techniques used: Includes anorectal EMG biofeedback and manometric feedback 1
Anxiety and Mood Disorders
- Anxiety: Heart rate variability biofeedback shows efficacy for performance anxiety 1
- Depression: Biofeedback-assisted relaxation training can help decrease anxiety and depressive symptoms 1
Neurological Conditions
- Epilepsy: Case studies suggest neurofeedback may benefit some patients with epilepsy spectrum disorders, particularly those with medically refractory conditions 5
- Sleep disorders: Specific biofeedback targeting lowered sympathetic nervous system arousal shows promise 1
Other Applications
- Learning disorders: Surface EMG biofeedback has been applied to various learning disorders 1
- Developmental disabilities: Sophisticated multichannel sEMG biofeedback helps with developmental disabilities and neuromuscular challenges 1
- Asthma: Bifrontal sEMG biofeedback has shown benefits 1
Treatment Implementation
- Technology format: Modern biofeedback systems use multimedia game formats available for personal computers, smartphones, and tablet devices, making them particularly appealing to tech-savvy youth 1
- Session structure: Regular practice is essential for both prevention and acute relief, as patients learn to control and reset their autonomic nervous system response patterns 1
- Professional certification: Clinicians can be certified in biofeedback through the Biofeedback Certification International Alliance, which ensures proper education and training standards 1
Emerging Applications
- Psychiatric treatment targeting: Neurofeedback is being explored as a neurotherapeutic approach where individuals learn to modify brain function to optimize symptoms, cognition, or behavior 1
- TMS targeting: Neuroimaging-based predictive models can inform which sites to target using transcranial magnetic stimulation, with connectivity models showing dramatic increases in treatment response 1
Limitations and Considerations
- Cost and time investment: Neurofeedback can be expensive and time-consuming, with benefits that may not be long-lasting 2
- Treatment duration: It might take months to show desired improvements 2
- Insurance coverage: The modality is not always covered by insurance 5
While neurofeedback shows promise for multiple conditions, the strongest evidence supports its use for ADHD, headaches, and chronic pain. For other conditions, it should be considered as a complementary approach alongside established treatments.