z-score neurofeedback
Research Papers
Showing 6 of 819 Channel Z-Score and LORETA Neurofeedback: Does the Evidence Support the Hype?
Neurofeedback is a well-investigated treatment for ADHD and epilepsy, especially when restricted to standard protocols such as theta/beta, slow cortical potentials and sensori-motor rhythm neurofeedback. Advances in any field are welcome and other techniques are being pursued. Manufacturers and clinicians are marketing 'superior' neurofeedback approaches including 19 channel Z-score neurofeedback (ZNFB) and 3-D LORETA neurofeedback (with or without Z-scores; LNFB). We conducted a review of the empirical literature to determine if such claims were warranted. This review included the above search terms in Pubmed, Google scholar and any references that met our criteria from the ZNFB publication list and was restricted to group based studies examining improvement in a clinical population that underwent peer review (book chapters, magazine articles or conference presentations are not included since these are not peer reviewed). Fifteen relevant studies emerged with only six meeting our criterion. Based on review of these studies it was concluded that empirical validation of these approaches is sorely lacking. There is no empirical data that supports the notion that 19-channel z-score neurofeedback is effective or superior. The quality of studies for LNFB was better compared to ZNFB and some suggestion for efficacy was demonstrated for ADHD and Tinnitus distress. However, these findings need to be replicated, extended to other populations and have yet to show any "superiority." Our conclusions continue to emphasize the pervasive lack of evidence supporting these approaches to neurofeedback and the implications of this are discussed.
View Full Paper →Healing the Neurophysiological Roots of Trauma: A Controlled Study Examining LORETA Z-Score Neurofeedback and HRV Biofeedback for Chronic PTSD
Introduction: Posttraumatic stress disorder (PTSD) has been linked to abnormalities within three neural networks: default mode (DMN), salience (SN), and central executive (CEN). This study examined the effectiveness of LORETA z-score neurofeedback (LZNF) training for altering current source within these networks and reducing symptoms associated with PTSD. Methods: Twenty-three adults with chronic PTSD were randomly assigned to 15 sessions of either LZNF (n = 12) or heart rate variability biofeedback (HRVB; n = 11). Psychosocial and physiological assessments were completed at baseline and postintervention. Results: The LZNF group showed very large, statistically significant decreases in symptoms on the PTSD Checklist for DSM-V (PCL-5; p = .003, d = 2.09) and Beck Anxiety Inventory (BAI; p = .003, d = 2.13). The HRVB group also showed very large decreases on the PCL-5 (p = .006, d = 1.40) and medium effects on the BAI (p = .018, d = 0.76). Between-group comparisons showed medium to large effects of group type in favor of LZNF (PCL-5 d = 0.57; BAI d = 0.94), although not statistically significant. LZNF Responders (n = 9) demonstrated very large, statistically significant decreases in abnormal z-scores within all targeted networks (DMN p = .012, d = 0.96; SN p = .008, d = 1.32; CEN p = .008, d = 1.33). Conclusion: The positive outcomes of this study provide preliminary evidence to support LZNF training as a specific, effective, and tolerable intervention for adults with chronic PTSD
View Full Paper →Z-score LORETA Neurofeedback as a Potential Therapy for Patients with Seizures and Refractory Epilepsy
Approximately 30 % of epilepsy patients are resistant to conventional medical therapy. Therefore, alternative forms of treatment are needed to improve efficiency of these therapeutic regimens. Neurofeedback (NFB) has been becoming recognized as one of the promising therapies improving control of medically refractory epilepsy cases. This multi-case paper describes our experience with LORETA Z-score NFB as a tool for control of patients with seizures.
View Full Paper →QEEG and 19-Channel Neurofeedback as a Clinical Evaluation Tool for Children with Attention, Learning and Emotional Problems
Attention, learning and emotional problems can have different causes that cannot be easily and clearly distinguished by clinical testing methods. But, QEEG and, even more so, live 19-channel Z-score training under different task conditions can both give very detailed insights about the specific functioning and dysregulations of an individual’s brain. The clinical intake evaluation of the child is optimized by including a quantitative, neurometric analysis of an eyes open (EO) and eyes closed (EC) EEG acquisition combined with a real-time analysis of the child’s (in vivo) brain functioning during a specific set of conditions, as described below. This method was developed and refined with more than 300 children who were tested between June 2012 and April 2014. The goal is to get as much information as possible in only one session lasting 45 to 60 minutes. The different parts of the evaluation consist of: eyes open (EO) and eyes closed (EC) collection of data, display of the actual brain waves, listing of the Z-score values (also presented as plots or instant brain maps with different task conditions), followed by games to play with a challenge condition. In addition, current source density (CSD) sLORETA of the different wave frequencies (usually delta, theta, alpha, beta, and gamma bands), distribution and velocity are shown as they change, as well as when the brain evaluates emotions. The session ends with a brief, individual 19-channel training with video feedback. Because of the usefulness of the information obtained from using this QEEG method, the author recommends that QEEG and an interactive neurofeedback session be included as a standard component in the diagnosis of and treatment planning for children with attention, learning and emotional problems.
View Full Paper →Clinical Perspectives of 19-Channel Z-Score Neurofeedback: Benefits and Limitations
Z-Score neurofeedback has expanded to include 19-channel models (19ZNF) such that clinicians now have the option to use from 1 to 19 electrodes in a z-score neurofeedback protocol. Benefits and limitations of this new model are discussed from the clinical perspective of an early adopter of 19ZNF who has more than 4 years of experience with this modality after having several years of experience with QEEG-guided NF (QNF). Comparisons between QNF and 19ZNF are discussed. It has been suggested that 19ZNF can bring about positive clinical outcomes in fewer sessions than traditional NF, which matches the author's experience (average of 38 with QNF vs. an average of 11 with 19ZNF). Unique implications of 19ZNF that have not yet been discussed in the literature, such as the advantage of once-per-week sessions, or questions about whether there could be times when change can occur too fast, are introduced. Directions for future research to further evaluate 19ZNF are suggested.
View Full Paper →Latest Developments in Live Z-Score Training: Symptom Check List, Phase Reset, and Loreta Z-Score Biofeedback
Advances in neuroscience are applied to the clinical applications of EEG neurofeedback by linking symptoms to functional networks in the brain. This is achieved by reviews of the last 20 years of functional neuroimaging studies of brain networks related to clinical disorders based on positron emission tomography, functional MRI, diffusion tensor imaging, and EEG/MEG inverse solutions. Considerable consistency exists between different imaging modalities because of the property of functional localization and the existence of large clusters of connections in the brain representing network modules and hubs. Reviewed here is new method of EEG neurofeedback called Z-Score Neurofeedback, and it is demonstrated how real-time comparison to an age-matched population of healthy subjects simplifies protocol generation and allows clinicians to target modules and hubs that indicate dysregulation and instability in networks related to symptoms. Z-score neurofeedback, by measuring the distance from the center of the healthy age-matched population, increases specificity in operant conditioning and provides a guide by which extreme Z-score outliers are linked to symptoms and then reinforced toward states of greater homeostasis and stability. The goal is increased efficiency of information processing in brain networks related to the patient's symptoms. The unique advantage of EEG over other neuroimaging methods is high temporal resolution in which the fine temporal details of phase lock and phase shift between large masses of neurons is quantified and can be modified by Z-score neurofeedback to address the patient's symptoms. The latest developments in Z-score neurofeedback are a harbinger of a bright future for clinicians and, most important, patients that suffer from a variety of brain dysfunctions.
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