Behavioral and electroencephalographic correlates of 40-Hz EEG biofeedback training in humans

Two groups of eight adults successfully trained with biofeedback for increases in 40-Hz EEG responses in left or right hemispheres also demonstrated significant 40-Hz EEG increases during baseline periods, and increases in the contralateral hemisphere during training periods. No changes in heart rate, 40-Hz EMG, or 21- to 31-Hz beta, alpha, or theta EEG occurred over training days. Three subjects returning for additional training demonstrated suppression of 40-Hz EEG. A group of four subjects experiencing daily bidirectional training produced substantial within-session control of 40-Hz EEG but no changes over days. Data from posttraining tests without feedback for successful subjects in both groups indicated significant control of 40-Hz EEG responses in the initial parts of these sessions, and some correlated changes in other EEG responses. Measures of successful subjects' experiences during training and control tests indicated awareness of changes in subjective concomitants of EEG responses. This study suggests further strategies for research on behavioral correlates of EEG activity.     

Maintenance and generalization of 40-Hz EEG biofeedback effects

Maintenance of conditioning of 40-Hz EEG activity was investigated in six adults 1 to 3 years after they had experienced biofeedback training to increase 40-Hz EEG. Subjects were first retrained to alternately increase and suppress 40-Hz EEG. All six subjects achieved a preset performance criterion in 16–20 minutes. Five of these subjects also subsequently demonstrated significant control of 40-Hz EEG without feedback. The sixth subject did not demonstrate control after 76 minutes and four sessions of attempted retraining with feedback. Transfer of 40-Hz EEG control to a problem-solving task was tested in all subjects in a final session. Cognitive test items were presented and subjects were instructed to alternately increase and suppress 40-Hz EEG while solving the problems. Rates of 40-Hz EEG in suppression periods during problem solving were significantly greater than during suppression periods without problems. No significant differences in problem-solving performance were found comparing 40-Hz increase and suppression periods. This study supports previous research suggesting an association between 40-Hz EEG and mental activity, and suggests methods for further study of transfer of EEG biofeedback effects.     

A double-blind investigation of the relationship between seizure activity and the sleep EEG following EEG biofeedback training

The sleep EEGs of eight medically refractory epileptic patients were examined as part of a double-blind, ABA crossover study designed to determine the effectiveness of EEG biofeedback for the control of seizures. The patients were initially reinforced for one of three EEG criteria recorded from electrodes placed over sensorimotor cortex: (a) suppression of 3- to 7-Hz activity, (b) enhancement of 12- to 15-Hz activity, or (c) simultaneous suppression of 3- to 7-Hz and enhancement of 11- to 19-Hz activity. Reinforcement contingencies were reversed during the second or B phase, and then reinstated in their original form during the final A′ phase. All-night polysomnographic recordings were obtained at the end of each conditioning phase and were subjected to both visual and computer-based power spectral analyses. Four of the patients showed changes in their nocturnal paroxysmal activity that were either partially or totally consistent with the ABA′ contingencies of the study. The spectral data proved difficult to interpret, though two trends emerged from the analyses. Decreases in nocturnal 4- to 7-Hz activity were correlated with decreases in seizure activity, and increases in 8- to 11-Hz activity were correlated with decreases in seizure activity. These findings were shown to strengthen the hypothesis that EEG biofeedback may produce changes in the sleep EEG that are related to seizure incidence.     

Electroencephalographic biofeedback of SMR and beta for treatment of attention deficit disorders in a clinical setting

Six children were provided with long-term biofeedback and academic treatment for attention deficit disorders. Their symptoms were primarily specific learning disabilities, and, in some cases, there were varying degrees of hyperkinesis. The training consisted of two sessions per week for 10 to 27 months, with a gradual phase-out. Feedback was provided for either increasing 12- to 15-Hz SMR or 16- to 20-Hz beta activity. Inhibit circuits were employed for blocking the SMR or beta when either gross movement, excessive EMG, or theta (4-8 Hz) activity was present. Treatment also consisted of combining the biofeedback with academic training, including reading, arithmetic, and spatial tasks to improve their attention. All children increased SMR or beta and decreased slow EEG and EMG activity. Changes could be seen in their power spectra after training in terms of increased beta and decreased slow activity. All six children demonstrated considerable improvement in their schoolwork in terms of grades or achievement test scores. None of the children are currently on any medications for hyperkinetic behavior. The results indicate that EEG biofeedback training, if applied comprehensively, can be highly effective in helping to remediate children who are experiencing attention deficit disorders.     

Electroencephalographic biofeedback of SMR and beta for treatment of attention deficit disorders in a clinical setting

Six children were provided with long-term biofeedback and academic treatment for attention deficit disorders. Their symptoms were primarily specific learning disabilities, and, in some cases, there were varying degrees of hyperkinesis. The training consisted of two sessions per week for 10 to 27 months, with a gradual phase-out. Feedback was provided for either increasing 12-to 15-Hz SMR or 16- to 20-Hz beta activity. Inhibit circuits were employed for blocking the SMR or beta when either gross movement, excessive EMG, or theta (4–8 Hz) activity was present. Treatment also consisted of combining the biofeedback with academic training, including reading, arithmetic, and spatial tasks to improve their attention. All children increased SMR or beta and decreased slow EEG and EMG activity. Changes could be seen in their power spectra after training in terms of increased beta and decreased slow activity. All six children demonstrated considerable improvement in their schoolwork in terms of grades or achievement test scores. None of the children are currently on any medications for hyperkinetic behavior. The results indicate that EEG biofeedback training, if applied comprehensively, can be highly effective in helping to remediate children who are experiencing attention deficit disorders.The authors would like to thank Mr. Kevin Bianchini for his assistance in this study.     

Effect of voluntary EEG α power increase training on heart rate variability

The following objectives were set out to study the effect of EEG α power increase training on the heart rate variability (HRV) as an index of the autonomic regulation of cognitive functions: (1) to establish the interrelation between a voluntary increase in the α power in the individual upper α band and the HRV and related characteristics of cognitive and emotional spheres; (2) to determine the nature of the relationship between the α-activity indices and HRV depending on the resting α-frequency EEG pattern; and (3) to study how the individual α-frequency EEG pattern is reflected in the HRV changes as a result of biofeedback training. Psychometric indices of cognitive performance and the characteristics of EEG α activity and HRV were recorded in 27 healthy men 18–34 years of age before, during, and after ten training sessions of a voluntary increase in α power in the individual upper α band with the eyes closed. To determine the biofeedback effect in the α power increase training, the data of two groups were compared: the experimental, with a real biofeedback (14 subjects), and the control, with a sham biofeedback (13 subjects). The follow-up effect of the training was assessed one month after its end. The results showed that α biofeedback training increased the resting α frequency, improved cognitive performance, reduced psychoemotional stress, and increased HRV only in the subjects with a low baseline α frequency. In the subjects with a high baseline resting α frequency, the α biofeedback training had no effect on the resting α power and cognitive performance but reduced the HRV (judging by the pNN ₅₀ parameter). The positive correlation between the α peak frequency and HRV in subjects with initially low α frequency and the negative correlation in the subjects with a high baseline α frequency explains the opposite biofeedback effects on HRV in subjects with low and high α frequency. From the theoretical standpoint, the results of this study contribute to understanding the mechanisms of heart-brain neurovisceral relationships and their effect on the cognitive performance. From the applied standpoint, they suggest that EEG biofeedback can be used for improving autonomic regulation in healthy subjects and the development of individual approaches to the development of the biofeedback technology, which can be used both in clinical practice for treatment and rehabilitation of psychosomatic syndromes and in educational training.     

EEG and behavioral changes in a hyperkinetic child concurrent with training of the sensorimotor rhythm (SMR)

Reduced seizure incidence coupled with voluntary motor inhibition accompanied conditioned increases in the sensorimotor rhythm(SMR), a 12–14 Hz rhythm appearing over rolandic cortex. Although SMR biofeedback training has been successfully applied to various forms of epilepsy in humans, its potential use in decreasing hyperactivity has been limited to a few cases in which a seizure history was also a significant feature. The present study represents a first attempt to explore the technique's applicability to the problem of hyperkinesis independent of the epilepsy issue. The results of several months of EEG biofeedback training in a hyperkinetic child tend to corroborate and extend previous findings. Feedback presentations for SMR were contingent on the production of 12–14-Hz activity in the absence of 4–7-Hz slow-wave activity. A substantial increase in SMR occurred with progressive SMR training and was associated with enhanced motor inhibition, as gauged by laboratory measures of muscular tone(chin EMG) and by a global behavioral assessment in the classroom. Opposite trends in motor inhibition occurred when the training procedure was reversed and feedback presentations were contingent on the production of 4–7 Hz in the absence of 12–14-Hz activity. Although the preliminary nature of these results is stressed, the subject population has recently been increased to establish the validity and generality of the findings and will include the use of SMR biofeedback training after medication has been withdrawn.This research was a segment of the junior author's dissertation research.     

Heart-rate reactivity to cold pressor stress following biofeedback training

Three previous studies have shown that biofeedback training is useful in modifying heart-rate and pain ratings during ice water stimulation (cold pressor test). Subjects were given an initial cold pressor followed by heart-rate biofeedback training and a final cold pressor test in which they were instructed to control their heart rate in accordance with the prior training. It was assumed that a heart-rate control skill had been learned. In the present study, two groups of subjects (N = 9 each) were given either increase or decrease heart-rate biofeedback training following the same procedures as previously, but subjects were not instructed to control their heart rate during the final cold pressor test. Heart rate, skin conductance, electromyographic activity, and respiration were measured. The biofeedback training effects replicate the previous results. However, no heart-rate or pain rating differences were found between the two groups during the final cold pressor test. Thus, previous findings cannot be accounted for simply by a shift in heart rate and/or pain reactivity following training itself. The findings suggest that a biofeedback strategy may be useful in modifying physiological and subjective responses to painful stimuli but only if it can be used as an active coping skill.     

Effects of biofeedback on the discrimination of electrodermal activity

Twenty-four subjects were tested on their ability to discriminate between the presence and absence of negative skin potential responses before and after training to control skin potential. Training consisted of 52 discrete 30-second trials during which subjects were asked either to increase or to inhibit palmar sweating. Subjects in groups N and P were provided with analogue feedback on their skin potential activity. Group N was correctly informed that increases in sweating were indicated by increases in the negativity of skin potential; group P was misinformed that these were indicated by increases in the positivity of skin potential. Subjects in the control (C) group received no feedback. Reliable evidence of discrimination was obtained only in groups N and P, following training. However, reliable evidence of control was obtained only in group N. Thus, training to control skin potential led to an ability to identify afferentation associated with the more common (i.e., negative) skin potential responses, even though biofeedback training appeared unsuccessful in the case of group P. These findings are discussed in the context of "discrimination" or "awareness" accounts of the process of acquiring control of internal response.     

Biodesensitization: Biofeedback-controlled systematic desensitization of the stress response to infant crying

Infant crying can be a source of parental stress both psychologically and physiologically and also may be an antecedent to physical child abuse or neglect. Biodesensitization is a new therapeutic technique that allows people to control the source of stress and develop self-control over their physiological responses to the stress-eliciting stimuli. Randomly assigned between three groups, 15 female participants were either given EEG biofeedback pretraining without stress, pretraining while listening to infant crying, or no stress management pretraining while listening to crying. After the pretraining manipulation all participants had biodesensitization training while listening to infant crying. Compared to control participants who were habituated to crying, stress management training significantly reduced the EEG cortical arousal as well as perceived arousal, and anxiety associated with listening to infant crying. The shift in participants' EEG power spectrum produced by infant crying was significantly correlated with perceived arousal and this relationship was strengthened after biofeedback training. In conjunction with other research, the experimental results suggest that stress management training may help ameliorate an aversive response to infant crying and possibly prevent child abuse as a response to physiological hyperreactivity.The author is grateful to Stan Sadava, Shoshana Tyson, and Joanna Manning for their helpful comments on this paper.     

Alpha power voluntary increasing training for cognition enhancement study

With the aim simultaneous alpha EEG stimulating and EMG decreasing biofeedback training impact on the alpha-activity and cognitive functions 27 healthy male subjects (18-34 years) were investigated in pre- and post 10 training sessions of the voluntary increasing alpha power in individual upper alpha range. The accuracy of conceptual span task, fluency and flexibility in alternatives use task performance and alpha-activity indices were compared in real (14 participants) and sham (13 participants) biofeedback groups for the discrimination of the feedback role in training. The follow up effect oftrainings was studied through month over the training sessions. Results showed that alpha biofeedback training enhanced the fluency and accuracy in cognitive performance, increased resting frequency, width and power in individual upper alpha range only in participants with low baseline alpha frequency. While mock biofeedback increased resting alpha power only in participants with high baseline resting alpha frequency and did not change the cognitive performance. Biofeedback training eliminated the alpha power decrease in response to arithmetic task in both with high and low alpha frequency participants and this effect was followed up over the month. Mock biofeedback training has no such effect. It could be concluded that alpha-EEG-EMG biofeedback has application not only for cognition enhancement, but also in prognostic aims in clinical practice and brain-computer interface technology.     

Training for voluntarily increasing individual upper α power as a method for cognitive enhancement

In order to estimate the effect of simultaneous α EEG stimulating and electromyogram (EMG) decreasing biofeedback training on the α activity and cognitive functions, fluency, accuracy, and flexibility during cognitive tasks, as well as α-activity characteristics before, during, and after ten training sessions of voluntarily increasing α power in an individual upper α range with the eyes closed were studied in 27 healthy men aged 18–34 years. To isolate the biofeedback effect in training for the α power increase, data on two groups of subjects were compared: an experimental group (14 subjects) with true biofeedback and a control group (13 subjects) with sham biofeedback. Follow-up testing was performed one month after the end of training to estimate the stability of the effect. The results showed that the training for the upper α power increase using biofeedback increased the frequency, width, and power in an individual upper α range at rest and improved cognitive performance only in subjects with a low baseline α frequency. Conversely, sham biofeedback training (without the feedback signal) increased the α power, though less efficiently, only in subjects with a high baseline α frequency, this increase was not accompanied by improved cognitive performance. The biofeedback α training eliminated the decrease in the α amplitude in response to a cognitive task after the biofeedback training course, this effect being preserved within one month. It may be concluded that α EEG-EMG biofeedback training can be used for improving cognitive processes in healthy subjects, as well as for prognostic purposes in clinical practice and in the brain-computer interface technology.     

Peak High-Frequency HRV and Peak Alpha Frequency Higher in PTSD

Posttraumatic stress disorder (PTSD) is difficult to treat and current PTSD treatments are not effective for all people. Despite limited evidence for its efficacy, some clinicians have implemented biofeedback for PTSD treatment. As a first step in constructing an effective biofeedback treatment program, we assessed respiration, electroencephalography (EEG) and heart rate variability (HRV) as potential biofeedback parameters for a future clinical trial. This cross-sectional study included 86 veterans; 59 with and 27 without PTSD. Data were collected on EEG measures, HRV, and respiration rate during an attentive resting state. Measures were analyzed to assess sensitivity to PTSD status and the relationship to PTSD symptoms. Peak alpha frequency was higher in the PTSD group (F(1,84) = 6.14, p = 0.01). Peak high-frequency HRV was lower in the PTSD group (F(2,78) = 26.5, p < 0.00005) when adjusting for respiration rate. All other EEG and HRV measures and respiration were not different between groups. Peak high-frequency HRV and peak alpha frequency are sensitive to PTSD status and may be potential biofeedback parameters for future PTSD clinical trials.     

A controlled study of the effects of EEG biofeedback on cognition and behavior of children with attention deficit disorder and learning disabilities

Eighteen children with ADD/ADHD, some of whom were also LD, ranging in ages from 5 through 15 were randomly assigned to one of two conditions. The experimental condition consisted of 40 45-minute sessions of training in enhancing beta activity and suppressing theta activity, spaced over 6 months. The control condition, waiting list group, received no EEG biofeedback. No other psychological treatment or medication was administered to any subjects. All subjects were measured at pretreatment and at posttreatment on an IQ test and parent behavior rating scales for inattention, hyperactivity, and aggressive/defiant (oppositional) behaviors. At posttreatment the experimental group demonstrated a significant increase (mean of 9 points) on the K-Bit IQ Composite as compared to the control group (p<.05). The experimental group also significantly reduced inattentive behaviors as rated by parents (p<.05). The significant improvements in intellectual functioning and attentive behaviors might be explained as a result of the attentional enhancement affected by EEG biofeedback training. Further research utilizing improved data collection and analysis, more stringent control groups, and larger sample sizes are needed to support and replicate these findings.This research was supported by an equipment grant by Autogenics Systems. Portions of this paper were presented at the annual convention of the Association of Applied Psychophysiology and Biofeedback, March, 1993 in Los Angeles and at the annual meeting of the Biofeedback Society of California, November, 1992 in Monterey, California. The authors gratefully acknowledge Todd Fischer and Paul Clopton for their valuable assistance in statistical analysis for this article.     

The age-related features of influence biofeedback training on efficiency of functional state voluntary regulation in young schoolchildren

The aim of the study was to assess an impact of biofeedback training (5 sessions) onto the voluntary regulation of the brain functional state (relaxation) in two groups of children of 7-8 and 9-10 years old. EEG alpha-band spectral coherence and skin resistance were measured during pre-relaxation, relaxation and post-relaxation phases before and after training. Short-term memory test was used to evaluate behavioral changes in functional state regulation before and after training. The group of children of 9-10 y.o. was the only group that showed any significant relaxation-related changes of spectral coherence in alpha-band after training. Besides, that group showed a significant post-relaxation improvement in short-term memory volume. We found a number of individual psychophysiological indices that influenced an efficiency of the biofeedback training.     

Differential shaping of EEG theta rhythms

Heart rate, EEG, frontal EMG, and forearm EMG were recorded in 20 subjects for 3 baseline, 8 feedback, and 2 postbaseline sessions in order to compare two biofeedback methods of teaching subjects to increase theta EEG activity. Subjects were divided into high- and low-EMG groups. Five high-EMG subjects, and 5 low-EMG subjects then received 8 sessions of strictly theta feedback. The remaining 10 subjects, 5 from the high-EMG group, and 5 from the low-EMG group, received a “graduated” training which involved shaping the target response. This procedure consisted of 4 initial sessions of EMG feedback, followed by a second phase consisting of 4 sessions of theta feedback. Results showed a clear relationship between subjects' baseline frontal EMG levels and the effect of the training methods. Although subjects with high-EMG baseline increased their theta output only with the two-phase training, subjects with low-EMG baseline levels performed better when given theta feedback only. This result shows not only that amounts of theta can be reliably increased, but that training techniques should be adapted to the physiological characteristics of the individual—in this case, baseline levels of frontal EMG levels.     

Model analyses of visual biofeedback training for EEG-based brain-computer interface

The primary goal of this study was to construct a simulation model of a biofeedback brain-computer interface (BCI) system to analyze the effect of biofeedback training on BCI users. A mathematical model of a man-machine visual-biofeedback BCI system was constructed to simulate a subject using a BCI system to control cursor movements. The model consisted of a visual tracking system, a thalamo-cortical model for EEG generation, and a BCI system. The BCI system in the model was realized for real experiments of visual biofeedback training. Ten sessions of visual biofeedback training were performed in eight normal subjects during a 3-week period. The task was to move a cursor horizontally across a screen, or to hold it at the screen’s center. Experimental conditions and EEG data obtained from real experiments were then simulated with the model. Three model parameters, representing the adaptation rate of gain in the visual tracking system and the relative synaptic strength between the thalamic reticular and thalamo-cortical cells in the Rolandic areas, were estimated by optimization techniques so that the performance of the model best fitted the experimental results. The serial changes of these parameters over the ten sessions, reflecting the effects of biofeedback training, were analyzed. The model simulation could reproduce results similar to the experimental data. The group mean success rate and information transfer rate improved significantly after training (56.6 to 81.1% and 0.19 to 0.76 bits/trial, respectively). All three model parameters displayed similar and statistically significant increasing trends with time. Extensive simulation with systematic changes of these parameters also demonstrated that assigning larger values to the parameters improved the BCI performance. We constructed a model of a biofeedback BCI system that could simulate experimental data and the effect of training. The simulation results implied that the improvement was achieved through a quicker adaptation rate in visual tracking gain and a larger synaptic gain from the visual tracking system to the thalamic reticular cells. In addition to the purpose of this study, the constructed biofeedback BCI model can also be used both to investigate the effects of different biofeedback paradigms and to test, estimate, or predict the performances of other newly developed BCI signal processing algorithms.     

Respiratory Sinus Arrhythmia Feedback in a Stressed Population Exposed to a Brief Stressor Demonstrated by Quantitative EEG and sLORETA

Previous investigations of electroencephalograms during relaxation have identified increases in slow wave band power, correlations between increased levels of alpha activity with lower levels of anxiety, and autonomic changes characterized by otherwise documented decreased sympathetic activity. This study was carried out to determine the overall changes in quantitative electroencephalographic activity and the current source as a result of an acute session of respiratory sinus arrhythmia (RSA) biofeedback in a population of subjects experiencing stress. This study’s findings provide physiological evidence of RSA feedback effect and suggest that RSA training may decrease arousal by promoting an increase of alpha band frequencies and decrease in beta frequencies overall and in areas critical to the regulation of stress. It was of interest that novices could achieve these objective alterations in EEG activity after minimal training and intervention periods considering that the previous literature on EEG and meditative states involve experienced meditators or participants who had been given extensive training. Additionally, these effects were present immediately following the training suggesting that the intervention may have effects beyond the actual practice.     

Biofeedback treatments of generalized anxiety disorder: Preliminary results

Forty-five individuals with generalized anxiety (38 with GAD as defined by DSM-III) were randomized to 4 treatment conditions or a waiting list control. Patients received 8 sessions of either frontal EMG biofeedback, biofeedback to increase EEG alpha, biofeedback to decrease EEG alpha, or a pseudomeditation control condition. All treated subjects showed significant reductions in STAI-Trait Anxiety and psychophysiologic symptoms on the Psychosomatic Symptom Checklist. Only alpha-increase biofeedback subjects showed significant reductions in heart rate reactivity to stressors at a separate psychophysiological testing session. Decreased self-report of anxiety was maintained at 6 weeks posttreatment.     

Ten-year stability of EEG biofeedback results for a hyperactive boy who failed fourth grade perceptually impaired class

Ten years ago, the first successful application of a clinical,private-practice based, EEG 14-Hz biofeedback training regimen for the treatment of learning disorders was performed by the author. After the 10-year-old boy, with presenting symptomology including a developmental reading disorder, hyperactivity, and an educational classification of perceptually impaired, continued symptom free for a period oftwo years, his case was submitted for publication. Ten years after his termination from successful treatment, his ongoingly normal social and academic functioning is noted and his EEG brainwave signature examined and compared with a population of 24 used-to-be learning disabled, one-half of which had a pretreatment state including the educational classification of perceptually impaired. This 10-year follow-up confirms the long-term stability of the results of this EEG 14-Hz biofeedback regimen. Current findings on recent medical research identifying a major cerebral locus of dysfunction for hyperkinesis and how it supports the electrode placements of this clinical office setting regimen is also discussed.