Neurofeedback

What is neurofeedback?

什麼是腦神經反饋？

  • Neurofeedback is an evidence-based brain training to improve self-regulation of unconscious processes without using medication. It’s also called EEG biofeedback, is a non-invasive procedure that allows brainwaves tracking and immediate feedback through various simulations, such as visual cues. This process helps our brains to learn and practise how to regulate brainwave activities in an optimal pattern such that related brain functions will also be in optimal and healthy states.
  • 腦神經反饋是一種以科研為基礎的的大腦訓練，可以在不使用藥物的情況下改善大腦潛意識的自我調節。它是一種非侵入性程序，實時跟踪腦電波的活動並即時作出各種回饋。透過不斷的練習令大腦學習以更健康的方式進行自我調節。從而令各大腦功能都以最佳的狀態呈現

How does Neurofeedback work?

腦神經回饋如何運作？

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  • Neurofeedback provides information to the brain about its own activity in real time, encouraging and allowing it to change based on this monitoring. A common example is when a brain makes too much of the theta frequency, which typically expresses as high impulsivity and distractibility in a person. Neurofeedback can train the brain to produce less theta, thus giving the person greater controlled focus.
  • Training the brain is similar to physical exercise such as swimming or riding a bicycle, only after practice regularly will you be able to pick up the skill. Once you learnt that, you brain and body remember it and it become part of your instinct.
  • 腦神經回饋向大腦實時提供有關其自身活動的信息，有助大腦根據這種監測進行改變。一個常見的例子是當大腦過度產生 Theta 頻率時，這通常代表一個人處於高度衝動和注意力分散狀態。腦神經回饋可以訓練大腦減少產生Theta，從而使人能夠更好地控制注意力。
  • 訓練大腦與體育鍛煉, 例如游泳和踏單車 其實很類似，只有經過定期鍛煉你才會學懂, 但學懂之後, 你的身體和大腦都會記得, 它會成為本能的一部分。

Types of Brain wave

腦電波的類型

  • Delta (1-3Hz) – Delta waves are the lowest frequencies which are amplified in deep meditation and dreamless/deep sleep, a state in which healing and regeneration occur. It decreases our awareness of the physical world and access information from our unconscious mind.
  • Theta (4-7Hz) – this is also classified as “slow” activity, Theta waves are strong during internal focus and meditation, often associated with creativity, intuition, daydreaming, and promotes behaviours such as learning and memory. It accesses information from our subconscious mind – the state between full awareness and the unconscious. People with ADHD tend to have more Theta activity, hence finding it difficult to concentrate.
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  • Alpha (8-12 Hz) – Alpha waves predominate whenever a person is alert but not actively processing information, it enhances overall sense of relaxation and good moods. It is the most important frequency to learn and use information taught in the classroom and in the job.
  • Beta(12-30 Hz) – Beta waves are classified as “fast” activity, they predominate in those who are alert, anxious or have their eyes open. It is most frequent when we are listening and thinking during analytical problem solving, judgement, decision making and processing information from the external environment,
  • Gamma (30 Hz or above) – Gamma waves is measured when the brain needs to simultaneously process information from different areas. Well regulated gamma waves is also associated with good memory, whereas a deficiency might contribute to learning disabilities.
  • Delta (1-3Hz) – Delta 波是在深度冥想和無夢/深度睡眠（一種癒合和再生的狀態）中發放的最低頻率。它降低了我們對外界世界的專注力並從我們的潛意識中獲取信息。
  • Theta (4-7Hz) – 這也被歸類為“慢”電波，Theta 波在內部聚焦和冥想期間很強，通常與創造力、直覺、白日夢相關，並促進學習和記憶等行為。它從我們的潛意識中獲取信息，患有過度活躍症的人往往有更多的 Theta 活動，因此很難集中註意力。
  • Alpha (8-12 Hz) – 當一個人保持警覺但沒有積極處理信息時，Alpha 波占主導位置，它增強了身體整體放鬆的感覺和良好心情。這在學習和工作吸收信息時有明顯的重要性。
  • Beta (12-30 Hz) – Beta 波被歸類為“快”電波，它在那些警覺、焦慮或睜開眼睛的人中占主導位置。當我們在分析問題、判斷、決策和處理來自外部環境的信息時進行傾聽和思考時，這種情況最為頻繁。
  • Gamma（30 Hz 或以上）- Gamma波在大腦需要同時處理多種信息時最為活躍。調節良好的Gamma波有助改善記憶力，而缺乏調節的Gamma波則有機會與學習障礙有關。

History and Development

歷史與發展

  • Neurofeedback was first explored and found effective by Dr. Joseph Kamiya at the University of Chicago in1950s. He was the first to train people through real-time feedback with the sound of a bell, based on EEG monitoring. In the 1960s, Dr. Barry Sterman at UCLA found that cats that were trained to produce low-beta EEG patterns become more resistant to seizures, he then found out that this technique works on epileptic patients as well, with long-lasting effects. In the 1970s, Dr. Joel Lubar started running controlled studies applying neurofeedback training to children and adults with Attention Deficit Hyperactivity Disorder (ADHD). Since then different researchers have applied neurofeedback for people with various conditions.
  • 腦神經反饋最初在50年代由芝加哥大學的 Joseph Kamiya 博士開始研究，他是第一個從腦電圖監測的鐘聲實時反饋來訓練腦電波的學者。在60年代時期，加州大學洛杉磯分校的 Barry Sterman博士發現，經過訓練產生低β腦電圖模式的貓對癲癇發作的抵抗力較強，隨後他發現這種技術也適用於癲癇患者，且效果持久。 於70 年代Joel Lubar 博士開始開展對照研究，將腦神經反饋訓練應用於患有專注力不足的兒童和成人。從此腦神經反饋訓練邊開始在患有不同病症的人身上實行。

Who is it for?

誰適合腦神經反饋訓練？

  • Neurofeedback is found to be helpful in alleviating symptoms of various conditions. Including:
  • Attention Deficit (Hyperactivity) Disorder (ADD/ADHD)
  • Neurofeedback is rated at the highest efficacy level (Level 1 for Best Support) for ADD/ADHD by the American Academy of Pediatrics in 2013.
  • A widely researched method aims to decrease theta power in central and frontal locations, in order to reduce the high theta-beta rations (TBR).
  • Research found that TBR neurofeedback are as effective as methylphenidate medication in alleviating inattentive and hyperactivity symptoms (Duric et al., 2012)
  • Research showed that neurofeedback can have long-lasting effect post-training from 2-month and 6-month follow up assessments (Meisel et al 2013).
  • 研究發現神經反饋有助緩解各種症狀，其中包括：
  • 專注力不足/過度活躍症 （ADD/ADHD)
  • 腦神經反饋在2013年被美國兒科學會評為 ADD/ADHD 的最高療效級別（最佳輔助 1 級）。
  • 其中一種方法為降低中央和額葉位置的θ功率，以減少高θβ比例（high theta-beta rations；TBR）。
  • 研究發現，TBR 神經反饋在緩解注意力不集中和多動症狀方面與哌甲酯藥物一樣有效（Duric 等，2012）
  • 研究亦指出腦神經反饋可以在訓練後 2 個月和 6 個月的隨訪評估中產生持久的效果（Meisel 等，2013 ）。

Autism Spectrum Disorders (ASD)

自閉症障礙 (ASD)

  • Research showed that people with ASD usually have underactivated activity in the anterior cingulate cortex. Neurofeedback training aims to inhibit theta activity and reward SMR activity in the right hemisphere. This can alleviate ASD symptoms such as difficulties in social interaction and impaired communication.
  • Research showed that improvements in executive functions could be maintained or increased 12 months post-training
  • 研究指出自閉症患者的前扣帶皮層通常活動不足，腦神經反饋訓練可以訓練抑制右半球的 theta 活動並鼓勵SMR 活動，這可以緩解自閉症症狀，例如在社交互動和溝通上的障礙。
  • 研究表示培訓後 12 個月仍可以維持或增強執行功能的改善。
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Anxiety  

焦慮症

  • Anxiety disorder is often associated with decreased alpha waves and increased beta waves. Neurofeedback training that reduces arousal can be used to reduce anxiety and create a generally relaxed state of wellbeing.
  • Anxiety might also weaken the connections between amygdala and the ventrolateral prefrontal cortex. Research showed that neurofeedback can strengthen the connection between the two, leading to the ventrolateral prefrontal cortex can effectively provide suitable response to potential threats, reducing impulsive, hyperactive reactions commonly seen in anxiety patients.
  • For anxiety disorders, neurofeedback qualifies for the evidence-based designation of efficacious treatment, with evidence for an anxiety reduction that endures over 18 months post-training (Watson et al., 1978).
  • 焦慮症通常與缺乏α波和過多β波有關。腦神經反饋訓練可用於減少焦慮並增強普遍放鬆的健康狀態。
  • 焦慮還可能削弱杏仁核和腹外側前額葉皮層之間的聯繫。研究表明，腦神經反饋可以加强两者之間的聯繫，導致腹外側前額葉皮層能夠有效地對潛在威脅提供適當的反應，減少焦慮症患者常見的衝動反應。
  • 有證據表明訓練後焦慮症狀減少可持續超過 18 個月（Watson 等，1978）。

Depression

抑鬱症

  • EEG research indicated that left frontal area is more associated with positive emotions, while right frontal area is more involved with negative emotions
  • A neurofeedback method is to modify the left-right alpha balance, with research showing improvements in depressive symptoms endure 1 and 5 years post-training (Baehr et al 2001).
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  • 腦電圖研究表明，左額葉區域與積極情緒更多相關，而右額葉區域則與消極情緒更有關聯
  • 腦神經反饋方法可以協助改變左右 alpha 平衡，研究表明抑鬱症狀在訓練後 1 到 5 年內可達到持續改善（Baehr et al 2001）。

Peak Performance

峰值性能？

  • Neurofeedback training can also be used to enhance brain activity in healthy individuals to attain maximum brain functioning (e.g. attention and control arousal) and memory improvement.
  • Training aims to improve overall cognitive performance instead of alleviate specific symptoms, specifically neurofeedback aims to modify white and grey matter pathways in order to achieve faster conduction of neural networks.
  • There is no “one size fit all” protocol, however common methods include alpha training which improves decision making ability; and sensori-motor rhythm (SMR) training which improves focus, attention, motor precision and balance, and ability to relax.
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  • 腦神經反饋訓練還可用於增強健康個體的大腦活動（例如注意力和控制喚醒）和記憶力改善。
  • 訓練旨在提高整體認知表現，而不是緩解特定症狀，特別是腦神經反饋旨在修改白質和灰質通路，以加快神經網絡傳導。
  • 雖然沒有一個人人通用的方案，但常見的方法包括提高決策能力的阿爾法訓練；sensori-motor rhythm (SMR) 感覺運動節律）訓練可提高注意力、運動精確度和平衡性以及放鬆能力。
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