Skip to main content

Advertisement

Log in

The Need for Individualization in Neurofeedback: Heterogeneity in QEEG Patterns Associated with Diagnoses and Symptoms

  • Published:
Applied Psychophysiology and Biofeedback Aims and scope Submit manuscript

Abstract

Very diverse assessment procedures are utilized by neurofeedback practitioners, many of which are not based on careful examination of raw EEG data followed by scientifically objective quantitative EEG (QEEG) database comparisons. Research is reviewed demonstrating the great heterogeneity in the EEG patterns associated with various diagnoses and symptoms. The fact that most patients qualify for dual diagnoses, with co-morbid psychiatric and medical conditions present, complicates the ability of clinicians to estimate what electrophysiological patterns may be associated with symptoms. In such cases treatment planning is characterized by a great deal of guesswork and experimentation. Peer reviewed publications have documented that neurofeedback treatment can sometimes be associated with both transient side effects as well as more serious negative effects. It is believed that the lack of comprehensive and objective assessment of brain functioning may increase the risk of neurofeedback either being ineffective or causing iatrogenic harm. QEEG provides reliable, non-invasive, objective, culture-free and relatively low cost evaluation of brain functioning, permitting individualization of treatment and added liability protection.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Ahn, H., Prichep, L. S., John, E. R., Baird, H., Trepetin, M., & Kaye, H. (1980). Developmental equations reflect brain dysfunction. Science, 210, 1980.

    Article  Google Scholar 

  • Arruda, J. E., Weiler, M. D., Valentino, D., Willis, W. G., Rossi, J. S., Stern, R. A., et al. (1996). A guide for applying principal-components analysis and confirmatory factor analysis to quantitative electroencephalogram data. International Journal of Psychophysiology, 23(1–2), 63–81.

    Article  PubMed  Google Scholar 

  • Ayers, M. E. (1999). Assessing and treating open head trauma, coma, and stroke using real-time digital EEG neurofeedback. In J. R. Evans & A. Abarbanel (Eds.), Introduction to quantitative EEG and neurofeedback (pp. 203–222). New York: Academic Press.

    Chapter  Google Scholar 

  • Barkley, R. A. (1998). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment (2nd ed.). New York: Guilford.

    Google Scholar 

  • Bergin, A. E., & Lambert, M. J. (1978). The evaluation of therapeutic outcomes. In S. L. Garfield & A. E. Bergin (Eds.), Handbook of psychotherapy and behavior change: An empirical analysis (pp. 139–189). New York: John Wiley & Sons.

    Google Scholar 

  • Boutros, N. N., Torello, M., & McGlashan, T. H. (2003). Electrophysiological aberrations in borderline personality disorder: State of the evidence. Journal of Neuropsychiatry and Clinical Neurosciences, 15, 145–154.

    PubMed  Google Scholar 

  • Burgess, A., & Gruzelier, J. (1993). Individual reliability of amplitude distribution in topographical mapping of EEG. Electroencephalography and Clinical Neurophysiology, 86(4), 219–223.

    Article  PubMed  Google Scholar 

  • Chabot, R. J., Merkin, H., Wood, L. M., Davenport, T. L., & Serfontein, G. (1996). Sensitivity and specificity in children with attention deficit or specific developmental learning disorders. Clinical Electroencephalography, 27(1), 26–34.

    PubMed  Google Scholar 

  • Chabot, R. J., Orgill, A. A., Crawford, G., Harris, M. J., & Serfontein, G. (1999). Behavioral and electrophysiological predictors of treatment response to stimulants in children with attention disorders. Journal of Child Neurology, 14(6), 343–351.

    Article  PubMed  Google Scholar 

  • Chabot, R. J., & Serfontein, G. (1996). Quantitative electroencephalographic profiles of children with attention deficit disorder. Biological Psychiatry, 40, 951–963.

    Article  PubMed  Google Scholar 

  • Chartier, D. (2001). An adverse neurofeedback reaction, or, there is no such thing as a neurofeedback “demo”. Journal of Neurotherapy, 5(3), 68–69.

    Google Scholar 

  • Clarke, A., Barry, R., McCarthy, R., & Selikowitz, M. (1998). EEG analysis in attention-deficit/hyperactivity disorder: a comparative study of two subtypes. Psychiatry Research, 81, 19–29.

    Article  PubMed  Google Scholar 

  • Clarke, A., Barry, R., McCarthy, R., & Selkowitz, M. (2001a). EEG differences in two subtypes of attention-deficit/hyperactivity disorder. Psychophysiology, 38, 212–221.

    Article  PubMed  Google Scholar 

  • Clarke, A., Barry, R., McCarthy, R., & Selikowitz, M. (2001b). Excess beta in children with attention-deficit/hyperactivity disorder: an atypical electrophysiological group. Psychiatry Research, 103, 205–218.

    Article  PubMed  Google Scholar 

  • Corsi-Cabrera, M., Solis-Ortiz, S., & Guevara, M. A. (1997). Stability of EEG inter-and intrahemispheric correlation in women. Electroencephalography and Clinical Neurophysiology, 201(3), 248–255.

    Article  Google Scholar 

  • Donaldson, M., & Donaldson, S. (2006). The assessment of brain wave activity in fibromyalgia using quantitative electroencephalography techniques. Biofeedback, 34(3), 114–120.

    Google Scholar 

  • Donaldson, S., Sella, G., & Mueller, H. (1998). Fibromyalgia: A retrospective study of 252 consecutive referrals. Canadian Journal of Clinical Medicine, 5(6), 116–127.

    Google Scholar 

  • Fein, G., Galin, D., Yingling, C. D., Johnstone, J., & Nelson, M. A. (1984). EEG spectra in 9–13-year-old boys are stable over 1–3 years. Electroencephalography and Clinical Neurophysiology, 58, 517–518.

    Article  PubMed  Google Scholar 

  • Gasser, T., Bacher, P., & Steinberg, H. (1985). Test-retest reliability of spectral parameters of the EEG. Electroencephalography and Clinical Neurophysiology, 60(4), 312–319.

    Article  PubMed  Google Scholar 

  • Gruzelier, J. (2000). Self regulation of electrocortical activity in schizophrenia and schizotypy: A review. Clinical Electroencephalography, 31(1), 23–29.

    PubMed  Google Scholar 

  • Gruzelier, J., Hardman, E., Wild, J., Zaman, R., Nagy, A., & Hirsch, S. (1999). Learned control of interhemispheric slow potential negativity in schizophrenia. International Journal of Psychophysiology, 34, 341–348.

    Article  PubMed  Google Scholar 

  • Hamilton-Bruce, M. A., Boundy, K. L., & Purdie, G. H. (1991). Interoperator variability in quantitative electroencephalography. Clinical & Experimental Neurology, 28, 219–224.

    Google Scholar 

  • Hammond, D. C. (2006). Quantitative electroencephalography patterns associated with medical conditions. Biofeedback, 34(3), 87–94.

    Google Scholar 

  • Hammond, D. C., & Kirk, L. (2008). First, do no harm: Adverse effects and the need for practice standards in neurofeedback. Journal of Neurotherapy, 12(1), 79–88.

    Article  Google Scholar 

  • Hammond, D. C., Walker, J., Hoffman, D., Lubar, J. F., Trudeau, D., Gurnee, R., et al. (2004). Standards for the use of QEEG in neurofeedback: A position paper of the International Society for Neuronal Regulation. Journal of Neurotherapy, 8(1), 5–26.

    Article  Google Scholar 

  • Harmony, T., Fernandez, T., Rodriguez, M., Reyes, A., Marosi, E., & Bernal, J. (1993). Test-retest reliability of EEG spectral parameters during cognitive tasks: II. Coherence. International Journal of Neuroscience, 68(3–4), 263–271.

    Article  PubMed  Google Scholar 

  • Hoffman, D. A. (2006). “First, do no harm”—A basic tenet in jeopardy. Journal of Neurotherapy, 10(4), 53–61.

    Article  Google Scholar 

  • Howorka, K., Pumpria, J., Saletu, B., Anderer, P., Krieger, M., & Schabmann, A. (2000). Decrease of vigilance assessed by EEG-mapping in Type I diabetic patients with history of recurrent severe hypoglycaemia. Psychoneuroendocrinology, 25, 85–105.

    Article  PubMed  Google Scholar 

  • Hughes, J. R., & John, E. R. (1999). Conventional and quantitative electroencephalography in psychiatry. Journal of Neuropsychiatry & Clinical Neuroscience, 11, 190–208.

    Google Scholar 

  • Jensen, P. S., Hinshaw, S. P., Swanson, J. M., Greenhill, L. L., Conners, C. K., Arnold, L. E., et al. (2001). Findings from the multimodal treatment study of ADHD (MTA): Implications and applications for primary care providers. Developmental & Behavioral Pediatrics, 22(1), 60–73.

    Google Scholar 

  • John, E. R., Prichep, L. S., Ahn, H., Easton, P., Fridman, J., & Kaye, H. (1983). Neurometric evaluation of cognitive dysfunctions and neurological disorders in children. Progress in Neurobiology, 21, 239–290.

    Article  PubMed  Google Scholar 

  • John, E. R., Prichep, L. S., Alper, K. R., et al. (1994). Quantitative electroencephalogical characteristics and subtyping of schizophrenia. Biological Psychiatry, 36, 801–826.

    Article  PubMed  Google Scholar 

  • John, E. R., Prichep, L., & Easton, P. (1987). Normative data banks and neurometrics. Basic concepts. Methods and results of norm constructions. In A. S. Gevins & A. Redmonds (Eds.), Methods of analysis of brain electrical and magnetic signals (pp. 449–495). Amsterdam: Elsevier.

    Google Scholar 

  • John, E. R., Prichep, L. S., Friedman, J., & Easton, P. (1988). Neurometrics: Computer-assisted differential diagnosis of brain dysfunctions. Science, 293, 162–169.

    Article  Google Scholar 

  • John, E. R., Prichep, L. S., Winterer, G., Herrmann, W. M., diMichelle, F., Halper, J., et al. (2007). Electrophysiological subtypes of psychotic states. Acta Psychiatrica Scandinavia, 116, 17–35.

    Article  Google Scholar 

  • Jonkman, E. J., Poortvliet, D. C. J., Veering, M. M., deWeerd, A. W., & John, E. R. (1985). The use of neurometrics in the study of patients with cerebral ischemia. Electroencephalography & Cliinical Neurophysiology, 61, 333–341.

    Article  Google Scholar 

  • Kaye, H., John, E. R., Ahn, J., & Prichep, L. S. (1981). Neurometric evaluation of learning disabled children. International Journal of Neuroscience, 13, 15–25.

    Article  PubMed  Google Scholar 

  • Kondacs, A., & Szabo, M. (1999). Long-term intra-individual variability of the background EEG in normals. Clinical Neurophysiology, 110, 1708–1716.

    Article  PubMed  Google Scholar 

  • Korzekwa, M., Links, P., & Steiner, M. (1993). Biological markers in borderline personality disorder: New perspectives. Canadian Journal of Psychiatry, 38(suppl 1), S11–S15.

    Google Scholar 

  • Lahmeyer, H. W., Reynolds, C. F., Kupfer, D. J., et al. (1989). Biologic markers in personality disorder: A review. Journal of Clinical Psychiatry, 50, 217–225.

    PubMed  Google Scholar 

  • Lubar, J. F. (1995). Neurofeedback for the management of attention-deficit/hyperactivity disorders. In M. S. Schwartz (Ed.), Biofeedback: A practitioner's guide (pp. 493–522). New York: Guilford.

    Google Scholar 

  • Lubar, J. F., Shabsin, H. S., Natelson, S. E., et al. (1981). EEG operant conditioning in intractible epileptics. Archives of Neurology, 38, 700–704.

    PubMed  Google Scholar 

  • Lubar, J. F., & Shouse, M. N. (1976). EEG and behavioral changes in a hyperactive child concurrent with training of the sensorimotor rhythm (SMR): A preliminary report. Biofeedback & Self-Regulation, 1(3), 293–306.

    Article  Google Scholar 

  • Lubar, J. F., & Shouse, M. N. (1977). Use of biofeedback in the treatment of seizure disorders and hyperactivity. Advances in Clinical Child Psychology, 1, 204–251.

    Google Scholar 

  • Lund, T. R., Sponheim, S. R., Iacono, W. G., & Clementz, B. A. (1995). Internal consistency reliability of resting EEG power spectra in schizophrenic and normal subjects. Psychophysiology, 32(1), 66–71.

    Article  PubMed  Google Scholar 

  • McEvoy, L. K., Smith, M. E., & Gevins, A. (2000). Test-retest reliability in cognitive EEG. Clinical Neurophysiology, 111(3), 457–463.

    Article  PubMed  Google Scholar 

  • Monastra, V. J. (2005). Electroencephalographic biofeedback (neurotherapy) as a treatment for attention deficit hyperactivity disorder: Rationale and empirical foundation. Child & Adolescent Psychiatric Clinics of North America, 14(1), 55–82.

    Google Scholar 

  • Monastra, V. J., Lubar, J. F., Linden, H., VanDeusen, P., Green, G., Wing, W., et al. (1999). Assessing attention deficit disorder via quantitative electroencephalography: An initial validation study. Neuropsychology, 13(3), 424–433.

    Google Scholar 

  • Mueller, H., Donaldson, S., Nelson, D., & Layman, M. (2001). Treatment of fibromyalgia incorporating EEG-driven stimulation: A clinical outcomes study. Journal of Clinical Psychology, 57(7), 933–952.

    Article  PubMed  Google Scholar 

  • Othmer, S. (2005). Interhemispheric EEG training. Journal of Neurotherapy, 9(2), 87–96.

    Article  Google Scholar 

  • Pollock, V. E., Schneider, L. S., & Lyness, S. A. (1991). Reliability of topographic quantitative EEG amplitude in healthy late-middle-aged and elderly subjects. Electroencephalography and Clinical Neurophysiology, 79(1), 20–26.

    Article  PubMed  Google Scholar 

  • Prichep, L. S., Mas, F., Hollander, E., Liebowitz, M., John, E. R., Almas, M., et al. (1993). Quantitative electroencephalography (QEEG) subtyping of obsessive compulsive disorder. Psychiatry Research, 50(1), 25–32.

    PubMed  Google Scholar 

  • Ritchlin, C. T., Chabot, R. J., Alper, K., Buyon, J., Belmont, H. M., Roubey, R., et al. (1992). Quantitative electroencephalography: A new approach to the diagnosis of cerebral dysfunction in systemic lupus erythematosus. Arthritis and Rheumatism, 35(11), 1330–1342.

    PubMed  Google Scholar 

  • Salinsky, M. C., Oken, B. S., & Morehead, L. (1991). Test-retest reliability in EEG frequency analysis. Electroencephalography and Clinical Neurophysiology, 79(5), 382–392.

    Article  PubMed  Google Scholar 

  • Satterfield, J. H., & Cantwell, D. P. (1974). CNS function and response to methylphenidate in hyperactive children. Psychopharmacology Bulletin, 10, 36–37.

    PubMed  Google Scholar 

  • Schneider, F., Rockstroh, B., Heimann, H., et al. (1992). Self-regulation of slow cortical potentials in psychiatric patients: Schizophrenia. Biofeedback & Self-Regulation, 17, 277–292.

    Article  Google Scholar 

  • Suffin, S. C., & Emory, W. (1995). Neurometric subgroups in attentional and affective disorders and their association with pharmacotherapeutic outcome. Clinical Electroencephalography, 26(2), 76–83.

    PubMed  Google Scholar 

  • Swets, J. A. (1988). Measuring the accuracy of diagnostic systems. Science, 240, 1285–1293.

    Article  PubMed  Google Scholar 

  • Van Dis, H., Corner, M., Dapper, R., Hanewald, G., & Kok, H. (1979). Individual differences in the human electroencephalogram during quiet wakefulness. Electroencephalography & Clinical Neurophysiology, 47, 87–94.

    Google Scholar 

  • Van Huffelen, A. C., Poortvliet, D. C., & Van der Wulp, C. J. (1984). Quantitative electroencephalography in cerebral ischemia. Detection of abnormalities in "normal" EEGs. Progress in Brain Research, 62, 3–28.

    Google Scholar 

  • Westmorland, B. (1993). The EEG in cerebral inflammatory processes. In E. Niedermeyer & F. Da Silva (Eds.), Electroencephalography: Basic principles, clinical applications, and related fields (pp. 291–304). New York: Williams & Wilkins.

    Google Scholar 

  • Yalom, I., & Lieberman, M. A. (1971). A study of encounter group casualties. Archives of General Psychiatry, 25, 16–30.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to D. Corydon Hammond.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hammond, D.C. The Need for Individualization in Neurofeedback: Heterogeneity in QEEG Patterns Associated with Diagnoses and Symptoms. Appl Psychophysiol Biofeedback 35, 31–36 (2010). https://doi.org/10.1007/s10484-009-9106-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10484-009-9106-1

Keywords

Navigation