157th Annual Meeting, New York, NY
Saturday May 1, 2004 8:00AM to 12 noon

Course #3: Using Neurofeedback in Your Practice: Introduction
With Hands-On Experience

Educational Learning Objectives: At the conclusion of this course, the participant should be able to understand EEG basics, how training the EEG effects brain and mental function, recognize indications for EEG biofeedback (neurofeedback), understand how neurofeedback procedures are performed, and evaluate clinical neurofeedback research.

Course Description
How can a disregulated brain become better regulated? How do you train improved neuroregulation?

This is a solid, basic course about this powerful technology-based intervention. It's a basic introduction focused on how it works, the key concepts, and how it's applied clinically. You'll review: 1) EEG basics, 2) how training impacts both arousal, activation, and inhibition; 3) how the brain learns to change itself; 4) a review of the research 5) how much research supports the role of assessment, including titrating the feedback based on clinical response. You'll also get to watch (or participate) in live demonstrations.

XI. Target Audience: Adult and Child Psychiatrists in Clinical Practice
XII. Format: Workshop/Demonstration and Lecture

Using Neurofeedback in Your Practice: Introduction with
Hands-On Experience

Course Time Schedule:
4 hours, total

Thomas M. Brod, MD, Course Director
Michael Cohen, Course Co-Director
Laurence Hirshberg, Ph.D.
Henry Mann, MD

Introduction (Brod, Cohen) 20 minutes
Historical Overview, “Training” and the Self-Regulation Model (Brod) 10 minutes
EEG basics (Cohen) 15 minutes
Research Review including critique (Hirshberg) 30 minutes
Audience discussion 10 minutes
Training the EEG / brain behavior Part I. (Cohen) 20 minutes
break 20 minutes
Subtotal: 2:05 hrs
Arousal, Attention, and Neuroregulation. (Mann, with Hirshberg) 30 minutes
Audience discussion 10 minutes
“Training” the EEG / brain behavior ,Part II (Brod) 15 minutes
Audience discussion 10 minutes
EEG Neurofeedback Demonstration w/ audience (all faculty) 35 minutes
Closing: Audience discusson with faculty 15 minutes
Subtotal: 1:55 hrs

Outline of Each Faculty Member’s Presentation

Introduction (including introducing speakers, outline of the program, video demo)
(Brod, Cohen)

Historical Overview, “Training” and the Self-Regulation Model

EEG basics (Frequency/amplitude; beta, smr, alpha, delta, high beta; implication of state flexibility)

Research Review (from Sterman to Lubar to Gruzelier to Monastra, including critique) (Hirshberg)
Audience discussion

Training the EEG / brain behavior. (looking at EEGs, understanding spectral, inhibits, rewards, focusing on excessive slow and fast activity, relevance)


Arousal, Attention, and Neuroregulation [includes discussion of arousal and brain stem ascending systems Increasing and decreasing arousal with NF, impact on symptoms. How it relates to medications. The clinical role of arousal in attention, and task performance].
(Mann, with Hirshberg)

Audience discussion

“Training” the EEG / brain behavior (EEG Variability)

Audience discussion

EEG Neurofeedback Demonstration w/ audience
(all faculty

Closing: Audience discussion with faculty

Literature References

Barabasz A., & Barabasz M. Treating AD/HD with hypnosis and neurotherapy. Child Study Journal, 2000; 30(1), 25-42.

Brod TM: Notes On Brainwave Biofeedback For Young People: AD/HD and related issues. in Incorvia JA, Mark-Goldstein BS, and Tessmer D (eds): Understanding, Diagnosing And Treating AD/HD Children And Adolescents. Jason Aronson 1999

Chabot RJ, diMichele F, Prichep L, John ER:The clinical role of computerized EEG in the evaluation and treatment of learning and attention disorders in children and adolescents. J Neuropsychiatry and Clin Neuroscience, 2001; 13: 171-186

Egner T, Gruzelier JH Learned self-regulation of EEG frequency components affects attention and event-related brain potentials in humans. Neuroreport 2001, 12:411-415

Egner T, Gruzelier JH Ecological validity of neurofeedback: modulation of slow wave EEG enhances musical performance. Neuroreport 2003a, 14:1223-1228

Egner T, Gruzelier JH EEG biofeedback of low bnd beta components: frequency-specific effects of variables of attention and event-related brain potentials. Clinical Neurophysiology, 2003b, in press

Evans J, Abarbanel A (eds), Quantitative EEG and Neurofeedback, San Diego, Academic Press, 1999

Fuchs T, Birbaumer N, Lutzenberger W, Gruzielier JH, Kaiser J, Neurofeedback treatment for attention-deficit/hyperactivity disorder in children: a comparison with methylphenidate, Appl Psychophys Biofeedback 2003 Mar 28 (1):1-12

Hammond DH, Adverse reactions and potential iatrogenic effects in neurofeedback training (Clinical Corner), J of Neurotherapy, 2001; 4:57-69.

Hammond DC: Medical justification for neurofeedback with ADD/ADHD. Journal of Neurotherapy, 2000; 4(1), 90-93.

Kaiser DA, Othmer S: Effect of Neurofeedback on variables of attention in a large multi-center trial. Journal of Neurotherapy, 2000 4(1), 5-15.

Lantz D, & Sterman MB: Neuropsychological assessment of subjects with uncontrolled epilepsy: Effects of EEG biofeedback training. Epilepsia, 1988; 29(2), 163-171.

Loo SK, EEG and Neurofeedback Findings in ADHD The ADHD Report, 2003,. 11:3, 1-4

Lubar JF: Neocortical Dynamics: implications for understanding the role of neurofeedback and related techniques for the enhancement of attention. Applied Psychophysiology and Biofeedback, 1997 22: 111-25.

Lubar JF and Lubar JO: Neurofeedback Assessment And Treatment For Attention Deficit/Hyperactivity Disorders. in Evans JR and Abarbanel A (eds): Introduction to Quantitative EEG and Neurofeedback Academic Press 1999

Meyer-Lindenberg A, Ziemann U, Hajak G, et al:. Transitions between dynamical states of differing stability in the human brain. Proc Natl Acad Sci U S A. 2002; Aug 20;99(17):10948-53.

Monastra VJ, Lubar JF, Linden M: the development of a quantitative electroencephalographic scanning process for attention deficit hyperactivity disorder: reliability and validation studies. Neuropsychology, 2001 15: 136-144.

Monastra VJ., Monastra DM., & George,S. . The effects of stimulant therapy, EEG biofeedback, and parenting style on the primary symptoms of attention-deficit/hyperactivity disorder. Applied Psychophysiology & Biofeedback, 2002, 27(4), 231-249.

Nash JK, Treatment of attention-deficit hyperactivity disorder with neurotherapy. Clinical Electroencephalography 2000, 31(1), 30-37

Othmer S, Othmer SF, and Kaiser DA: EEG Biofeedback: an emerging model for its global efficacy. in Evans JR and Abarbanel A (eds): Introduction to Quantitative EEG and Neurofeedback Academic Press 1999

Peniston EG, Kulkosky PJ: Alpha-theta brainwave training and beta-endorphin levels in alcoholics. Alcohol: Clinical & Experimental Research, 1989; 13(2), 271-279.

Peniston EG, Marrinan DA, Deming WA, and Kulkosky PJ: EEG Alpha-Theta Brainwave Synchronization In Vietnam Theater Veterans With Combat-Related Post-Traumatic Stress Disorder And Alcohol Abuse. Adv Med Psychotherapy 1993 6: 37-30

Pizzagalli D, Pascual-Marqui R, Nitschke J, et al: Anterior cingulate activity as a predictor of degree of treatment response in major depression:Evidence from brain electrical tomography analysis. Amer J of Psychiatry, 2001; 158: 405-415

Pulvermuller F, Mohr, Schleichert H, Veit, R: Operant conditioning of left hemispheric slow cortical potentials and its effect on word processing. Biological Psychology, 2000; 53, 177-215.

Rosenfeld JP: An EEG Biofeedback Protocol for Affective Disorders. Clin Electroencephalography 2000:7-12

Scott W, & Kaiser D: Augmenting chemical dependency treatment with neurofeedback training. Journal of Neurotherapy, 1998;3(1), 66.

Sterman MB, Howe RD, Macdonald LR: Facilitation of spindle-burst sleep by conditioning of electroencephalographic activity while awake. Science, 167, 1970; 1146-1148.

Sterman MB: Basic concepts and clinical findings in the treatment of seizure disorders with EEG operant conditioning. Clinical Electroencephalography, 2000;31(1), 45-55.

Sterman MB: Physiological Origins And Functional Correlates Of EEG Rhythmic Activities: implications for self-regulation. Biofeedback and Self-Regulation 1996 21:3-34

Tinius TP, Tinius KA: Changes after EEG biofeedback and cognitive retraining in adults with mild traumatic brain injury and attention deficit disorder. Journal of Neurotherapy, 2001; 4(2), 27-44.

Uhlmann C, Froscher W. Biofeedback treatment in patients with refractory epilepsy: Changes in depression and control orientation. Seizure 2001, 10(1), 34-38.

Vernon D, Egner T, Cooper N, Compton T, Neilands C, Sheri A, Gruzielier J, The effect of training distinct neurofeedback protocols on aspects of cognitive performance. Intl J Psychophys, 2003, 47: 75-86

Yoo SS, Jolesz FA: Functional MRI for neurofeedback: feasibility study on a hand motor task. Neuroreport. 2002 Aug 7;13(11):1377-81.

List of Relevant Web Sites, Faculty E-mail Addresses:

T.M. Brod, MD:

M. Cohen:

V Brown PhD

Laurence Hirshberg, PhD

H Mann, MD

Int’l Society for Neuronal Regulation

Assoc. for Applied Psychophysioolgy and Biofeedback


Pubmed - abstacts of medical and other journals
(search for Neurofeedback or EEG Biofeedback)

Self-Assessment Questions

1. EEG represents the complex summation of

a) action potentials
b) spikes
c) ERPs
d) post-synaptic potentials (psp’s)

2. When you see excessive delta in the EEG while the patient is trying hard to do a task, the patient:

a. is thinking
b. didn't have enough sleep last night
c. it highly agitated
d. cannot perform the task at an optimum level

3. Depression has been typically associated with

a) right frontal hypoactivation
b) left frontal hypoactivation
c) right parietal hypoactivation
d) left parietal hypoactivation

4. Frequency bands take information from the raw EEG and:

a. filter it and display it
b. average it over the total spectrum
c. always uses 4-7, 12-15, and 22-30 hz
d. analyze emergent variability

5. The Sensorimotor Rhythm is deemed to reflect the following:

a) The state of vigilance of the subject
b) The cortical stability of the subject
c) Motor system excitability
d) Sensory acuity

6. The EEG neurofeedback training promotes higher EEG amplitudes for the following reasons:

a) Higher amplitudes are associated with the desired higher activation
b) Higher amplitudes trains the activation-relaxation dynamics
c) Higher amplitudes in the EEG are associated with greater cortical stability
d) Higher amplitudes are associated with improved signal-to-noise ratio.

7. M. Barry Sterman’s initial research with EEG biofeedback was with:

a. seizure disorders
b. human sleep disorders
d. substance abuse

8. Controlled studies of EEG conditioning have been performed for the following conditions (Name the exception):

a) Seizures
b) Attention Deficit Hyperactivity Disorder
c) Alcoholism
d) Tourette Syndrome

Self-Assessment Answers

1. D
2. B
3. B
4. A
5. C
6. B
7. A
8. D

Background Articles

1. Brod TM: Notes On Brainwave Biofeedback For Young People: AD/HD and related issues. in Incorvia JA, Mark-Goldstein BS, and Tessmer D (eds): Understanding, Diagnosing And Treating AD/HD Children And Adolescents. Jason Aronson 1999

2. Hammond DH, Adverse reactions and potential iatrogenic effects in neurofeedback training (Clinical Corner), J of Neurotherapy, 2001; 4:57-69

3. Loo SK, EEG and Neurofeedback Findings, in ADHD The ADHD Report, 2003,. 11:3, 1-4