On Brain Injury and Neurofeedback

Modern biofeedback training has been shown to be extremely useful in healing, headaches, relaxation, control of blood pressure and heart rate, ADD, learning skills, and performance enhancement. Biofeedback has been shown to lower blood pressure even in persons who were taking as many as 3 blood pressure drugs simultaneously to no avail. Neurofeedback is biofeedback for the brain.

These claims may seem too good to be true, the mechanisms unclear and too simple to be so effective and to offer such profound benefits. Yet this approach is the body's way of healing itself. For many victims of head injury, ADD, fibromyalgia and other conditions, neurofeedback has been the only thing that has worked. For a review of why it works, see our Neurofeedback Brochure (which includes a short self-test).

Improvements and changes observed following neurofeedback training are often dismissed as "anecdotal" accompanied by the statement that "there just isn't any research," or what little does exist is sadly "lacking in scientific rigor." Both statements are wildly untrue. Laboratory work on bio-feedback (now familiar for relaxing muscles ) and neurofeedback (to control brain waves) both began at Minnesota's highly respected Menninger clinic in the late 1950s and 1960s. (This history is reported by researcher Elmer Green in his book Beyond Biofeedback, now out of print but still available from used book sources.) Research conducted at UCLA for NASA and the US Air Force led to great advances in treating seizures, brain injury and other conditions. Today there are thousands of research papers going back over 40 years and more, much of it published in highly respected medical journals. 


The Comprehensive Bibliography of EEG Neurofeedback contains over 1,000 articles culled from the general medical literature and from the Journal of Neurofeedback published by the International Society for Neurofeedback & Research (ISNR).

Research topics include: Academic Cognitive Enhancement, AD/HD and Learning Disabilities, Addiction, Adverse Reactions, Anger, Anxiety, Asthma, Autism, Autoimmune Disorders, Brain Injury, Cerebral Palsy, Creativity, Chronic Fatigue Syndrome, Cognitive Decline, Coma, Criminals & Juvenile Offenders, Depression, Developmental Disorders, Dissociative Disorders, Epilepsy, Fibromyalgia, Headache, Hemoencephalography, Hemispheric Assymmetry, Hypertension, LENS Neurofeedback, LORETA Neurofeedback, Medical Conditions (diabetes and allergies), Obsessive Compulsive Disorder, Optimal Functioning, Post Traumatic Stress Disorder, Pain Parkinson's Syndrome, Premenstrual Syndrome, Review Articles, Schizophrenia, Sleep, Slow Cortical Potentials, Spasticity, Standards, Stroke, Theoretical Treatises, Tinnitus, Tourette's Tourette's Syndrome, and Withdrawal.

Here are some websites with links to abstracts or complete articles with details below. Although much research in neurotherapy began with small clinical and case studies (as is true of any new field) research has spread to many prestigious scientific organizations and pubications.

The following list is an eclectic mix of information, intended to offer  sources to improve the understanding of brain injury and the scientific basis behind neurotherapy and healing.

General Information Resources

Materials range from accurate and informative websites, popular books / movies to clinical research studies. A large part of the problem is the lack of basic understanding of brain injury and its many consequences.


Brain Atlas -- Amen

A stunning atlas of SPECT images revealing what actually goes on in an injured (or healthy) brain. Before you go on a bender with alcohol, marijuana, or heroin, look here and consider the consequences.

Amen has also designed a school program on the effects of illegal drugs on the brain: Which Brain Do You Want? Here you will see the options. Your choice.

There are also pictures of brain injury from car and motorcycle accidents, falls from roofs, also ADD, PMS, obsessive compulsive disorder, violence, and sports injuries. The symptoms these people have suffered are not imaginary, not laziness, malingering or "failure to get a grip." They are the very real consequences of brain dysfunction.

In the two images of damaged brains (one from heroin, one from an auto accident) notice, in both, the breaks in the image of the cerebral cortex.

The main function of the cortex is inhibition plus the uniquely human abilities of planning, sequencing, and complex memory. Disruption of cortical systems alone (never mind trauma to deeper structures) will disrupt the ability to control temper and other emotions, appetites and indulgences, memory and learning, and other functions. Imaging can make the underlying reasons for many problems clearly visible. You will also find  on-line self-tests for ADD and general brain function. Amen's atlas of SPECT scans is available online and in book form (below). Highly recommended.

Note that severe ADD can be a direct result of head injury, whether from falling downstairs as a child or illness (especially accompanied by high fever). Contrary to popular belief, ADD is not a new diagnosis. It was first described in the 1930s as "minimal brain dysfunction" (MBD) based on clinical experience of the 1920s in turn attributed to the flu pandemic of 1918.

For the SPECT scan, the patient is immobilized and given an IV of glucose with a radioactive contrast material. Actively working brain cells take up glucose (and its accompanying contrast material) at a faster rate than slower or poorly functioning areas. (Unless brain tissue is actually missing or dead, the "breaks" appearing in the images above are not actual physical breaks. They are areas of slowed cell activity.) There are far less invasive test procedures, such as LENS mapping or QEEG. But thanks to SPECT studies, a wealth of information on brain function vs. behavior is now available.

Biofeedback Certification Institute of America is the certifying organization of the biofeedback / neurofeedback community. It has an extensive list of providers trained in traditional neurofeedback.

An extensive site by the Othmers who work in traditional neurofeedback. They have also written on the use of the LENS system. At the bottom of the opening page is a search box. Enter keywords of interest to find articles on specific topics. Bibliographic citations often with full articles are available in the research section. The Othmers went into this field to save their son, Brian, from seizures and other problems with phenomenal results. To this day, much of their practice is dedicated to children.

Since the Gulf War, however, they have been working with veterans through their Brian Othmer Foundation. EEG4VETERANS is a national outreach program to provide free Neurofeedback training for veterans for the rehabilitation of Post-Traumatic Stress Disorder and issues of brain performance resulting from traumatic brain injury, blast injury, concussion, whiplash, and chemical exposure. Incidentally, it has been found that concussion / blast injury is much more likely to result in PTSD and other brain dysfunctions than experience alone. Apparently there is good reason why this condition was originally dubbed "shell shock."

Home site of the International Society for Neurofeedback and Research and the  Comprehensive Bibliography of EEG Neurofeedback compiled by D. Corydon Hammond, Ph.D., editor of ISNR's Journal of Neurotherapy.

Neurotherapy Centers of Washington is headed by neurofeedback pioneer Mary Lee Esty, Ph.D. Dr. Esty is the therapist gave me back my life after my own severe traumatic brain injury. Esty is featured in "The Healing Power of Neurofeedback," by S. Larsen (below). One of the highlights of her interview is the difficulty people have with accepting the possibility that a brain injury could have occurred. People will deny ever having had a head injury but eventually admit to having fallen out of a 2nd story window, or having been hit in the head with a baseball bat hard enough to knock out 7 teeth. "Is that a head injury? Does that count?" It does.

Resistance to acknowledging even the possibility of brain injury is extremely common. We have no model for what actually happens. We mistake TV and movie effects, The Three Stooges and Loony Toons for reality. This carries over even into "reality" TV. "I can no longer bear to watch America's Funniest Home Videos, Dr. Esty once told me. "It is mostly about children getting head injuries."

The website contains a wealth of client stories and articles. Be sure to read Pumping Neurons by Jody Jaffe.

This is the home site for the LENS (Low Energy Neurofeedback System). Note that LENS was previously known (and appears in the research literature) as the Flexyx Neurotherapy System. Under Resources, look for the CNS_Questionnaire and other documents for evaluation of brain function and fascinating video showing changes in brain frequencies with treatment. Clinical Providers are listed by State.

This is the online publications database of the U. S. National Institutes of Health. Basically, in the SEARCH box, select PUBMED; in the "for" box, enter a keyword or a keyword plus another keyword. For example, the search below for BIOFEEDBACK returns thousands of articles dating back to the 1970s.

PubMed Biofeedback

Or you can narrow your search. If you want to see research on biofeedback for fibromyalgia (a common side effect of brain injury), type the keywords with a plus (+) sign as shown:


This returned citations for 41 articles. Click the link (here, it is the authors' names) to see the abstract of the article. (Older articles may not have abstracts associated with them).


Note that Neurofeedback is a newer term; currently there are only about 100 entries dating back only to 1994 when it was called simply Biofeedback or EEG Biofeedback. But whatever you call it, there is a world of research at your fingertips and you can see it for yourself.

This website contains a good fact sheet on QEEG linked to brain function and various personality and functional problems. The main site discusses neurofeedback in general. Even very mild brain injuries commonly cause problems with concentration, memory, reading, multi-tasking, and profound fatigue (strangely accompanied by severe problems falling asleep). 

Many patients are told they are "fine" when nothing obviously wrong appears on an MRI or X-ray. Microscopic injury resulting from the shearing and tearing of neurons can produce profound brain injury but the damage is microscopic and cannot be seen by X-ray or MRI with just a quick visual review.

QEEG Sample

The best test for brain function is a Quantitative EEG (QEEG) which measures the Quantity, power, and distribution of electrical signals at the surface of the scalp. These signals (coming from the cortex of the brain) are compared with a database which determines "normal" and deviations from normal for the patient's age.

In the sample shown here, each circle maps the behavior of an individual brainwave across the patient's head. Green indicates normal levels. Blues indicate too little of a particular brainwave. Yellow, orange, and red indicate too much. The brightest reds and blues indicate 3 standard deviations from normal. Consider Robbins' (Symphony in the Brain) analogy of music. Brain music that is slow and blue (nothing but tubas and string bass) is not very energizing. Brain music that is hot and fast and screechy (nothing but the strident high notes on violins) is not going to leave you feeling very relaxed. For your brain to make beautiful music, you need all the instruments and notes in balance.

The patterns of colors on a QEEG are the electrical fields of the brain (responsible for function and behavior) made clearly visible. They can be used to direct and target neurofeedback treatment or to select appropriate drug therapy. See the website for Dr. Nash's clear explanation of why an ADD adult responded badly to medication, why the teenager (shown in this picture) had difficulty listening and how that information helped to direct effective treatment. 

Information on the research behind QEEG and the normative database on which it is based, work done primarily by Dr. Robert Thatcher, can be found at>. Thatcher's database is FDA approved and accepted in court cases. One of the fascinating applications of QEEG data is the Loreta program which reconfigures the data into a deep image of the brain revealing the area of dysfunction.


This capability is available with Thatcher's NeuroGuide and others. Again, damage due to shearing and tearing of individual neurons, the changes in timing and disorganization of brain rhythms following trauma do not show up on X-ray, and are not detected by visual examination of a standard MRI. QEEG is standard EEG data run through the computer program to tease out more information than would be visible to the eye. It shows where abnormalities exist, their nature and severity, and allows the therapist to link brain injury to brain behavior.

There are two approaches to QEEG:

  1. Direct testing. This is the QEEG recording process with immediate results. For Pittsburghers, the closest practitioner I have been able to locate is:
    Dr. Harold Schaus, 1655 W Market St, Akron OH 44313 / 330-836-7223

    A list of equipment is available at Dr. Thatcher can also provide names of practitioners who own the software.

  2. Derived from a standard EEG. To do this you must know the EEG equipment manufacturer; for best results the software must be calibrated to the particular equipment that gathers the data. The resulting data file can then be sent for analysis and recommendations to any specialist who owns the software.

    Two standard questions arise:

    1. Will insurance pay for it?
      Rarely. Insurance will usually pay for a standard EEG if it is ordered and read by a neurologist. Insurance rarely covers the QEEG interpretation of the data which may run $450 or more out of pocket. In contrast, insurance is likely to pay for any number of MRIs which will show "nothing" leading to the conclusion that the patient is "fine." The patient who is not "fine" but wants to get better must be willing to address a hard question:
      • Which is more important: Getting Better? - or - Getting Someone Else to pay for treatment?
        Of course this brings up related questions:
      • Is QEEG really better?
        Better for what? MRI is best at revealing gross tissue damage. QEEG shows microscopic damage to neurons and connections via changes in normal electrical signals. And . . .
      • If QEEG is really better than MRI for brain injury why haven't I heard of it?
        For the usual reasons: custom and the usual turf wars. And that goes back to the original issue: insurance doesn't pay for it. Its rarity is not a lack of Good Science -- it's Economics. You must decide which is most important to you.
        On this point you need not trust an unknown Internet Source; QEEG is thoroughly documented in the medical and legal literature. Numerous examples (many dealing specifically with admissibility in court) are available at: Thousands more documenting or using QEEG or quantitative EEG are available at:"

Books, Articles, and Videos

I'll Carry the Fork

— by Kara L. Swanson

The curious thing about the auto accident that ended my life was that I lived through it."

In the aftermath of "mild traumatic brain injury," Swanson suffered memory problems, frightening logical disconnects (such as finding herself pouring kitty litter into the washing machine), limbs that wouldn't respond to the confused directions of an injured brain, and burned food. The only way to remember food left cooking in the oven was to "carry the fork" as a reminder.  The author states that she has never read her own book in its entirety; her short term memory is too poor to retain the words that she herself has written.

Like other books on traumatic brain injury, it may be most valuable for caregivers. I remember buying this book after my own injury. I remember weeping at some of the all-too-familiar stories but I have no memory of what those stories were. And, like Swanson, I was unable to read the book through. Now that I can read again, I am astonished at the detail of information. Read it to a damaged friend who cannot read for himself, so that you may both learn and understand what you're dealing with.

Guilty by Reason of Insanity

— by Dorothy Lewis

We met no Jimmy Cagneys or Robert Mitchums among the inmates in the prisons we visited. We found ourselves, rather, in the company of a pathetic crew of intelllectually limited, dysfunctional, half-mad, occasionally explosive losers. Long before these men wound up on death row, their similarly limited, primitive, impulsive parents had raised them in the only fashion they knew...had set the stage on which our condemned subjects now found themselves playing out the final act. It was a drama generations in the making.

Psychologist Dorothy Lewis and neurologist Jonathan H. Pincus did extensive psychological and neurological evaluations of murderers on Death Row. Originally, Pincus was strongly in favor of the death penalty. Lewis was strongly against. After their studies, they both moved to the middle in favor of life lockup to keep them — and the rest of society — safe. What brought them to this conclusion was the discovery that every murderer they have examined has a three-part history of . . .