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neurofeedback Research

Substance Abuse & Addiction

Review Papers

Effects of an EEG Biofeedback Protocol on a Mixed Substance Abusing Population [pdf]
by Scott WC, Kaiser DA, Othmer S, Sideroff SI

Alcohol and drug abuse is an ongoing societal and treatment problem. While major resources have been employed to study and treat addiction, there has been little significant improvement in the success rate of treatment. Relapse rates remain high, typically over 70%. Gossop et al. reported 60% of heroine addicts relapsed one year following addiction treatment. Peniston and associates have demonstrated significantly higher abstinence rates with alcoholics when they incorporated EEG biofeedback into the treatment protocol. Eighty percent of subjects in these experiments were abstinent one-year posttreatment.

The progression of neurofeedback: an evolving paradigm in addiction treatment and relapse prevention
by Keerthy R Sunder, Jeffrey L Bohnen

Addiction is characterized by improper engagement of neurobiological systems involved in adaptive decision-making. The prevalence of relapse among addiction patients may be explained by the persistence of maladaptive patterns of synaptic connectivity. An effective approach to addiction treatment and relapse prevention may thus rely on enhancing the brain’s capacity for neuroplasticity and self-regulation. A growing body of evidence indicates that neurofeedback is capable of promoting neuroplasticity, resolving maladaptive activity, and improving self-regulation.

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EEG Biofeedback as a Treatment for Substance Use Disorders: Review, Rating of Efficacy, and Recommendations for Further Research [abs.]
by Sokhadze, T. M., Cannon, R. L., Trudeau, D. L. (2008)

Electroencephalographic (EEG) biofeedback has been employed in substance use disorder (SUD) over the last three decades. The SUD is a complex series of disorders with frequent comorbidities and EEG abnormalities of several types. EEG biofeedback has been employed in conjunction with other therapies and may be useful in enhancing certain outcomes of therapy.

The Peniston-Kulkosky Brainwave Neurofeedback Therapeutic Protocol: The Future Psychotherapy for Alcoholism/PTSD/Behavioral Medicine [abs.]
by Peniston EO Ed.D., A.B.M.P.P., B.C.E.T.S., F.A.A.E.T.S.

This paper is a review not only of the Peniston-Kulkosky protocol for alcoholism and PTSD but of the prior history of alpha training leading up to their epoch-making studies, as well as of the follow-on studies that replicated their work.

Applicability of Brain Wave Biofeedback to Substance Use Disorder in Adolescents
by Trudeau DL

Neurofeedback treatment for addictions in adults is probably efficacious, and several reported approaches are described with their indications. Neurofeedback is promising as a treatment modality for adolescents, especially those with stimulant abuse and attention conduct problems. It is attractive as a medication-free, neurophysiologic, and self-actualizing treatment for substance-based, brain-impaired and self-defeating disorder.


Neurofeedback Training for Opiate Addiction: Improvement of Mental Health and Craving [pdf]
by Fateme Dehghani-Arani, Reza Rostami, Hosein Nadali

Psychological improvements in patients with substance use disorders have been reported after neurofeedback treatment. However, neurofeedback has not been commonly accepted as a treatment for substance dependence. This study was carried out to examine the effectiveness of this therapeutic method for opiate dependence disorder. The specific aim was to investigate whether treatment leads to any changes in mental health and substance craving. In this experimental study with a pre-post test design, 20 opiate dependent patients undergoing Methadone or Buprenorphine maintenance treatment were examined and matched and randomized into two groups. While both experimental and control groups received their usual maintenance treatment, the experimental group received 30 sessions of neurofeedback treatment in addition. The neurofeedback treatment consisted of sensory motor rhythm training on Cz, followed by an alpha-theta protocol on Pz. Data from the general health questionnaire and a heroin craving questionnaire were collected before and after treatment. Multivariate analysis of covariance showed that the experimental group achieved improvement in somatic symptoms, depression, and total score in general mental health; and in anticipation of positive outcome, desire to use opioid, and relief from withdrawal of craving in comparison with the control group. The study supports the effectiveness of neurofeedback training as a therapeutic method in opiate dependence disorder, in supplement to pharmacotherapy.

Is there an Anti-Neurofeedback Conspiracy? [pdf]
by Trocki KF PhD

As we all well know, addictions are very difficult to treat and relapse rates are very high. Furthermore the individuals with the best outcomes are likely to be white, of high socioeconomic status (SES) better educated, addicted to a single drug, or in a socially stable living situation. However over the past two decades a new kind of adjunct therapy for addictions has emerged that is ideally suited for delivery within treatment settings by midlevel licensed professionals such as nurses, socialworkers, counselors, or physical therapists. This is a treatment approach that has shown strong, positive results in long term follow-ups but the spread has been glacially slow. Given the strong positive findings it almost seems as though there is a sort of a conspiracy keeping this treatment from being used.

Effect of EEG Biofeedback on Chemical Dependency [pdf]
by Kaiser DA and Scott W

A behavioral research team announced today that it has doubled the recovery rate for drug addicts in a study that gave patients feedback on their brain's electrical activity in conjunction with conventional treatment for drug abuse. William C. Scott, principal investigator of the study, said that across the country, drug rehab programs have generally achieved a success rate of 20 to 30 percent in relapse prevention one to two years following treatment. In the current study, in excess of 50% of experimental subjects remained drug-free a year later. The study used Neurofeedback, a technique that trains patients to alter their brainwave patterns as they receive information about those patterns.

Research Papers

Treatment Effects Related to EEG-Biofeedback for Crack Cocaine Dependency in a Faith-Based Homeless Mission
by Burkett, V.S., Cummins, J.M., Dickson, R.M., & Skolnick, M.H.

EEG biofeedback has been demonstrated as effective in the treatment of alcoholism, as evidenced by Peniston and Kulkosky's research efforts (1989, 1990). Most research with alpha-theta EEG biofeedback has addressed alcohol addiction. Given that cocaine is the most common drug problem of patients entering treatment for drug abuse (NIDA's Drug Abuse Treatment Outcome Study, 1999), research in the treatment of this "untreatable" population is warranted.

National Institute on Drug Abuse [pdf]
For the past three decades, the National Institute on Drug Abuse (NIDA) has led the way in supporting research to prevent and treat drug abuse and addiction and mitigate the impact of their consequences.

Alpha-Theta Brainwave Training and Beta-Endorphin Levels in Alcoholics [abs.]
by Peniston EG and Kulkosky PJ

An alpha-theta brainwave biofeedfack training program was applied as a novel treatment technique for chronic alcoholics. Following a temperature biofeedback pretraining phase, experimental subjects completed 15 30-min sessions of alpha-theta biofeedback training. Compared to a nonalcoholic control group and a traditionally treated alcoholic control group, alcoholics receiving brainwave training (BWT) showed significant increases in percentages of EEG record in alpha and theta rhythms, and increased alpha rhythm amplitudes.

Alterations in EEG Amplitude, Personality Factors & Brainmapping following Alpha-theta Brainwave Training [abs.]
by Fahrion SL, Walters ED, Coyne L, Allen T

A controlled case study was conducted of effects of EEG alpha and theta brainwave training with a recovering alcoholic patient who experienced craving and fear of relapse after 18 months of abstinence. Training consisted of six sessions of thermal biofeedback to increase central nervous system (CNS) relaxation. Effects were documented with pretreatment and post-treatment personality testing, 20-channel digitized EEG evaluations both under relaxed conditions and under stress, minute-by-minute physiologic recordings of autonomic and EEG data during each training session, blood pressure, and heart rate indications taken both during relaxation and under stress, and by clinical observation.

Experiments on Brainwave Therapy for Alcoholism
by Kulkosky PJ

In 1989, E.G. Peniston and P.J. Kulkosky published an innovative therapy for the treatment of alcoholism and prevention of its relapse. This therapy combined systematic desensitization, temperature biofeedback, guided imagery, constructed visualizations, rhythmic breathing, autogenic training, alpha theta brainwave biofeedback, and booster sessions to treat chronic alcoholism in male inpatients.

Alpha-Theta Brainwave Neurofeedback Training: An Effective Treatment for Male and Female Alcoholics with Depressive Symptoms [abs.]
by Saxby E and Peniston EG

This is the report of an experimental study of 14 alcoholic outpatients using the Peniston and Kulkosky (1989, 1991) brainwave treatment protocol for alcohol abuse. After temperature biofeedback pre-training, experimental subjects completed twenty 40-minute sessions of alpha-theta brainwave neurofeedback training. Experimentally treated alcoholics with depressive syndrome showed sharp reductions in self-assessed depression (Beck's Depression Inventory). On the Millon Clinical Multiaxial Inventory-I, the experimental subjects showed significant decreases on the BR scores: schizoid, avoidant, dependent, histrionic, passive-aggression, schizotypal, borderline, anxiety, somatoform, hypomanic, dysthymic, alcohol abuse, drug abuse, psychotic thinking, and psychotic depression. Twenty-one-month follow-up data indicated sustained prevention of relapse in alcoholics who completed BWNT. Only one of the fourteen experienced relapse.

Three Year Outcome of Alpha/Theta Neurofeedback Training in the Treatment of Problem Drinking among Dine' (Navajo) People
by Kelley MJ

This three year follow-up study presents the treatment outcomes of 19 Dine' (Navajo) clients who completed a culturally sensitive, alpha/theta Neurofeedback training program. In an attempt to both replicate the earlier positive studies of Peniston (1989) and to determine if Neurofeedback skills would significantly decrease both alcohol consumption and other behavioral indicators of substance abuse, these participants received an average of 40 culturally modified Neurofeedback training sessions. This training was adjunctive to their normal 33 day residential treatment.

Alpha Conditioning as an Adjunct Treatment for Drug Dependence: Part I [abs.]
by Goldberg RJ, Greenwood JC, Taintor Z

The effects of alpha conditioning on the habits of four methadone maintained patients were assessed. All four learned some control over alpha activity in the 5-week, 10-session training period.

Alpha Wave Biofeedback Training Therapy in Alcoholics [abs.]
by Passini FT, Watson CG, Dehnel L, Herder J, Watkins B

This investigation evaluated the therapeutic efficacy of alpha-wave biofeedback treatment for alcoholics. Twenty-five Ss were compared to a matched control group before and after administration of a 3-week alpha-wave biofeedback regimen on a wide variety of criteria that included State-Trait Anxiety, the MMPI, Multiple Affect Adjective Check List, Zuckerman's Sensation Seeking Scale, Watson's Anhedonia Scale, the Brief Psychiatric Rating Scale, and baseline alpha.

Self-Regulation of Slow Cortical Potentials in Psychiatric Patients: Alcohol Dependency [abs.]
by Schneider F, Elbert T, Heimann H, Welker A, Stetter F, Mattes R, Birbaumer N, Mann K

Ten unmediated alcohol-dependent male inpatients participated in a Slow Cortical Potential (SCP) self-regulation task utilizing biofeedback and instrumental conditioning. These patients were hospitalized for treatment of alcohol dependency after chronic abuse of alcoholic beverages. Somatic withdrawal symptomatology had occurred recently and the patients were free of any withdrawal symptoms of the autonomic nervous system.

Alpha Biofeedback Therapy in Alcoholics: An 18-month Follow-up [abs.]
by Watson CG, Herder J, Passini FT

In an earlier study on patients with alcohol problems, an experimental group given 10 hour-long alpha biofeedback training sessions showed greater improvement on State and Trait Anxiety scores than did a control sample. In the present study an 18-month follow-up was done on those Ss.

Recent Research

Mind over chatter: Plastic up-regulation of the fMRI salience network directly after EEG neurofeedback.
Ros T, Théberge J, Frewen PA, Kluetsch R, Densmore M, Calhoun VD, and Lanius RA
NeuroImage, 65, 2013, pp 324-35

Improving Visual Perception through Neurofeedback.
Scharnowski F, Hutton C, Josephs O, Weiskopf N, and Rees G
Journal of Neuroscience, 32, 2012, pp 17830-41

The effectiveness of neurofeedback training on EEG coherence and neuropsychological functions in children with reading disability.
Nazari MA, Mosanezhad E, Hashemi T, and Jahan A
Clinical EEG and Neuroscience, 43, 2012, pp 315-22

Self-regulation of brain oscillations as a treatment for aberrant brain connections in children with autism.
Pineda JA, Juavinett A, and Datko M
Medical Hypotheses, 79, 2012, pp 790-8

Evidence-based information on the clinical use of neurofeedback for ADHD.
Moriyama TS, Polanczyk G, Caye A, Banaschewski T, Brandeis D, and Rohde LA
Neurotherapeutics, 9, 2012, pp 588-98

Current status of neurofeedback for attention-deficit/hyperactivity disorder.
Lofthouse N, Arnold LE, and Hurt E
Current Psychiatry Reports, 14, 2012, pp 536-42

Individual alpha neurofeedback training effect on short term memory.
Nan W, Rodrigues JP, Ma J, Qu X, Wan F, Mak PI, Mak PU, Vai MI, and Rosa A
International Journal of Psychophysiology, 86, 2012, pp 83-7

Neurotherapy of traumatic brain injury/posttraumatic stress symptoms in OEF/OIF veterans.
Nelson DV, and Esty ML
Journal of Neuropsychiatry and Clinical Neurosciences, 24, 2012, pp 237-40

Schizophrenia and the efficacy of qEEG-guided neurofeedback treatment: a clinical case series.
Surmeli T, Ertem A, Eralp E, and Kos IH
Clinical EEG and Neuroscience, 43, 2012, pp 133-44

Which attention-deficit/hyperactivity disorder children will be improved through neurofeedback therapy?
Ahmadlou M, Rostami R, and Sadeghi V
Neuroscience Letters, 516, 2012, pp 156-60

Neurofeedback in children with ADHD: validation and challenges.
Gevensleben H, Rothenberger A, Moll GH, and Heinrich H
Expert Review of Neurotherapeutics, 12, 2012, pp 447-60

Taking back the brain: could neurofeedback training be effective for relieving distressing auditory verbal hallucinations in patients with schizophrenia?
McCarthy-Jones S
Schizophrenia Bulletin, 38, 2012, pp 678-82

A review of neurofeedback treatment for pediatric ADHD.
Lofthouse N, Arnold LE, Hersch S, Hurt E, and DeBeus R
Journal of Attention Disorders, 16, 2012, pp 351-72