This compendium of terms is provided to broaden the lay person’s understanding of some of the relative concepts and language related to the field of Neurofeedback. The term “Neurofeedback” can be used interchangeably with EEG Neurotherapy, EEG Neurofeedback, HEG Neurofeedback.

A specialized Neurofeedback protocol intended to address issues such as chronic trauma, addiction, pain and more. This process is also referred to as the “Peniston protocol,” so named after the work of researchers Peniston and Kulkosky, who successfully used alpha-theta brain-wave training to increase the amount and amplitude of subjects’ alpha and theta brain waves. Alpha-Theta is similar to hypnosis in that it provides a state of relaxation that can induce an altered state of awareness, allowing the subconscious mind to review issues and find apt resolutions, circumventing the need for rational analysis.

Arousal and Performance Curve
Brain activity can be considered in terms of states of arousal. Optimum performance can be achieved by maintaining a state of normalized arousal; a relaxed alertness sometimes described by peak performers as a “flow state.” Neurofeedback provides continuous feedback to the brain, conditioning it to operate at its ideal arousal peak.

Auditory/Visual Entrainment
Brainwaves change frequencies based on neural activity within the brain (vision, touch, smell, taste and hearing). Each of our senses responds to activity from the environment and transmits that information to the brain. The senses of sight and hearing, by their very nature, provide a favorable environment for affecting brainwaves. By presenting pulsed audio and visual stimulation to the brain, after a short period of time, the brain begins to resonate or entrain at the same frequency as the stimulus. This effect is commonly referred to as brainwave entrainment (BWE). In addition to entrainment, the imagery created by the visual and auditory stimulation provides a focus for the mind and quietens internal dialogue or chatter.

A technique in which an individual learns to consciously control involuntary physiological responses such as heart rate, brain waves, and muscle contractions. The process makes use of technology to relay information about normally unconscious processes to the patient as visual, auditory, or tactile signals. These responses are electronically monitored and noted through auditory beeps or visual graphs on a computer screen. These are seen and heard by the participant, and through repeated exposure over time, a person trains themselves to control their own physiological responses. Though all biofeedback technology makes use of electronic sensors of one kind or another, NO electricity ever goes into the subject. This is true of all types of biofeedback, including Neurofeedback.

The Biofeedback Certification Institute of America (BCIA) issues a credential (EEG) for Neurotherapy practitioners but certification is not currently a national requirement. According to BCIA “certification demonstrates professionalism and adherence to carefully developed standards as a health care provider. Procedures are consistent with Department of Health & Human Services Guidelines, giving credibility and evidence that practitioners maintain knowledge and skill levels. Health care professionals who achieve BCIA Certification demonstrate commitment to professionalism by completing basic degree and educational requirements, learning to apply clinical biofeedback skills during mentorship, and passing a written examination.” If an individual has completed advanced neurofeedback training with reputable institutions, if they hold a Master or PhD degree and have licensure in medical, psychological or other relevant fields, if they are under supervision with a certified Neurofeedback clinician, and if they have three years of experience under their belts, then certification may not be an issue. It is anticipated that within the next five years certification will become a national requirement.

Brain Cells
The brain is made up of two broad classes of cells: neurons and glial cells. Neurons are nerve cells and typically consist of dendrites that receive information, a cell body, and an axon used to transmit information throughout the nervous system. Glial cells have multiple functions, which include structurally supporting neurons, repairing the Central Nervous System, and regulating the biochemical balance of the brain. Pyramidal cells are neurons found in the cerebral cortex. These are responsible for the generation of EEG signals. The voltage volume generated by pyramidal cells is weak: only 20 to 100 microvolts after amplification on the order of ten thousand times.

Brain Hemispheres
Research has shown that specific functions of thought are allocated in two distinct hemispheres in the brain, respectively the right and left, separated by a thick fold extending from front to back. The hemispheres are joined at the base of the brain by a bundle of nerves called the corpus collosum. The left side of our body is “wired” to the right side of our brain, and vice versa. Specific aptitudes, traits and behaviors are associated with one hemisphere or the other. This is true for an estimated 70 to 95% of the population. Neurotherapy protocols are designed to train right and left hemispheres interhemispherically, unihemispherically, or both. The decision to use one protocol or another is indicated per behavioral and physiological symptoms, brain maps, and cognitive testing. Most researchers accept the following general hemispheric attributes:

Brain Lobes
Neurofeedback protocols take into account 4 distinct lobes of the brain in relation to their influences over emotional, cognitive and physiological states. The lobes and attributes are as follows:
The frontal lobe contains the pre-frontal, pre-motor and motor areas. The pre-frontal cortex is involved with decision-making and planning and has an inhibitory influence on impulses and actions. The pre-motor and motor cortices process and transmit body movement information.
The parietal lobe relays tactile sensations and/or pain, plays a key role in how we orient ourselves in space socially and physically, and is also involved with information processing.
The temporal lobe regulates auditory processing, memory, physiological processes and mood.
The occipital lobe is where visual information from the eyes is processed.

Brain Maps
Some clinicians provide an abbreviated qEEg or “mini” Brain Map using EEG measured at 6 to 8 or more sites. Brain Maps that are not analyzed in terms of a normative database provide very limited statistical information. See qEEG also.

Brainwave Frequencies
Frequency refers to the rate at which a brainwave or EEG signal is changing or vibrating. EEG frequency is measured in cycles per second. Exact frequency ranges used for EEG training vary with the practitioner and protocol. EEG signals have extremely low electrical voltage that can be recorded from the brain through the scalp. These electrical traces occur at varying frequencies and are measured in hertz (Hz). The span of frequencies considered most often in Neurofeedback protocols ranges in value from 0 to 35 Hz. Each bandwidth has a specific name as well as known attributes:
Delta (0-3 Hz) Sleepy, Foggy
Theta (4-7 Hz) Daydreaming
Alpha (8-11 Hz) Relaxed, Idling
SMR (12-15 Hz) Calm Focus
Beta (15-18 Hz) Alert Focus
High Beta (19-35 Hz) Anxiousness

CANS-MCI Testing software
The CANS-MCI is the only comprehensive test battery that is fully self-administered without needing staff training or administration time, yet it is a reliable, valid predictor of the need to refer people for full neuropsychological or imaging evaluations.
The CANS-MCI was developed over a seven-year period and subjected to rigorous usability, reliability, and validity research study, supported by grants from the Veterans Administration and the National Institute on Aging. The tests have already met high standards in both usability and concomitant validity.

Cerebral Cortex
The cortex is the outer-most layer of the brain, consisting of enfolded layers. The human neocortex is the most recent brain development, consisting of the frontal, temporal, parietal, and occipital lobes (see “Brain Lobes”). The cortex layer closest to the skull is where EEG signals are detected.

Cognitive Testing
Part of the Neurofeedback process involves assessment and measurement of brain and/or personality and emotional function. Continuous performance tests (see TOVA ®) are used to monitor and measure attention and performance. Other tests measure cognitive efficacy and memory. Screenings for obscure visual problems may be offered, as these can impact both cognition and mood when overlooked. Quantitative measurement of EEG that employs statistical analysis (see qEEG) may also be utilized. Cognitive testing may also be performed using valid or reliable instruments in the form of questionnaires. Such commonly used tests include, but are not limited to, Thompson’s Depression Scale, Amen’s AD/HD Scale, and MBTI, to name a few.

Electroencephalogram; a recording of brainwave activity using electrodes placed on the scalp to monitor electrical impulses generated by pyramidal brain cells found in the cerebral cortex. The resulting traces are known as an electroencephalogram (EEG) and represent so-called brainwaves. Electrical activity in the human brain was measured for the first time by an electroencephalogram more than 60 years ago. EEG also refers to the electrical signals emitted by neurons in the brain based on the International Ten-Twenty System for EEG electrode placement.

Galvanic Skin Response (GSR) biofeedback
Galvanic skin response (GSR), also known as electrodermal response (EDR) or psychogalvanic reflex (PGR), is a method of measuring the electrical resistance of the skin and interpreting it as an image of activity in certain parts of the body. Changes in the electrical properties of the skin in response to stress or anxiety can be measured either by recording the electrical resistance of the skin or by recording weak currents generated by the body. Stress thermometers are a less sophisticated version used to teach hand-warming technique. All of these yield feedback (information) used to teach individuals to better control stress.

Hearing vs. Listening
Do you think there is a difference between hearing and listening? You are right, there is! Hearing is simply the act of perceiving sound by the ear. If you are not hearing-impaired, hearing simply happens. Listening, however, is something you consciously choose to do. Listening requires concentration so that your brain processes meaning from words and sentences. Listening leads to learning. Most people tend to be “hard of listening” rather than “hard of hearing.”

Heart Rate Variability (HRV) biofeedback
The analysis of heart rate variability (HRV), or heart rhythms, is a noninvasive means of measuring heart–brain and autonomic nervous system dynamics as influenced by one’s emotional state. Clinical research indicates HRV as a primary indicator of neurocardiac fitness and overall health. Abnormally low HRV is a predictor of premature mortality and is associated with a wide range of health problems, many of which can be stress-related. By influencing shifts in heart rhythms, one can positively influence neural, hormonal and biochemical responses, yielding improvements in blood pressure and stress hormone levels, immune system function and so on. Effects are both immediate and long-lasting.

Hemoencephalography (HEG)
Neurofeedback procedure using infrared lights placed on the forehead that allows the user to modulate brain oxygenation and increase blood flow (perfusion) to the brain. Two types are currently in use: Near Infrared (nIR HEG) and Passive Infrared ( pIR HEG), and can be used in conjunction with other Neurofeedback treatments.
Hemoencephalography neurofeedback has been successfully utilized to improve function in patients with a wide range of diagnoses including Autism (Toomim, 2004, Limsila M.D., M.Sc. et al, 2003), ADHD. Both HEG systems have been used successfully with conditions that benefit from learning to increase activation of prefrontal areas, which are normally the most active areas of the brain. pIR has been particularly successful with migraines, and nIR was first used with attention issues.
The pIR or passive infrared headband measures the infrared temperature at the skull under the headband sensor, an infrared thermometer. It is passive in the same sense that EEG electrodes are. It measures but introduces no signals of its own to the brain.
The nIR or near infrared headband operates from the principle that more highly oxygenated blood is redder in color. It sends pulses of red and infrared light through the skull to the cortex beneath (the skull is not opaque, but rather, is translucent). By measuring the amount of red compared to infrared light that is reflected back by the cortex to the headband sensor, the headband can indicate how much oxygen is in an individual’s blood.

Irlen/Scotopic Syndrome
Irlen Scotopic Sensitivity Syndrome (IS) is a sensitivity to light, particularly fluorescent light, that can seriously interfere with reading and written language. It can lower test scores and significantly impact a person’s ability to function in school and work situations, and can co-exist with learning disabilities, attention deficit disorder, sensory processing disorders and some behavioral disorders. Individuals with Irlen Syndrome put more energy and effort into the reading process because they see the printed page differently from the proficient reader. Constant adaptation to distortions from the print or from the white background causes fatigue and discomfort and, more importantly, limits the length of time these individuals can read and maintain comprehension. Symptoms range from subtle to severe. Irlen Syndrome cannot be diagnosed using the standard educational, psycho-educational or speech and language testing or standard vision screening. Fortunately this syndrome is very easy to diagnose and treat using specific screening to determine colored overlays that can correct any deficits. Screening practitioners must be trained and certified. Irlen filters can be especially helpful for dyslexia and other reading and/or math deficits, and for sensory processing disorder. To learn more about this visit the Irlen Institute website.

LENS Neurotherapy,LENS, or Low Energy Neurofeedback System
A type of neurofeedback that uses a very low power electromagnetic field, like the ones that surround digital watches and wires in the wall, to carry feedback to the person receiving it. It can be used in conjunction with other Neurofeedback interventions.

Microcurrent Electrotherapy Stimulation
Referred to as MENS; a pocket-sized technology that emits a sub-sensory current that acts on the body’s naturally occurring electrical impulses to decrease pain and facilitate the healing process. An example of a microcurrent electrical stimulation device is the Alpha-Stim, used to treat anxiety, depression, insomnia, headaches, and acute, chronic, and postoperative pain. This is an affordable technology that works well with Neurofeedback.

Music-Based Brain Stimulation
The auditory nerve travels from the brain through every major organ in the body. Therefore, auditory perception greatly influences emotional and physiological functioning. Advanced technologies such as The Listening Program ® can provide individuals with solutions to many auditory based challenges. Authorized providers administer a customized program, monitor progress and offer listening guidance.

Neurofeedback is synonymous with a number of terms: EEG Neurotherapy, EEG Neurofeedback, HEG Neurofeedback, EEG Biofeedback (EBF), and Baud Assisted Neurofeedback.
Basic premises of Neurofeedback:
1. The brain has measurable electrical activity known as EEG
2. Excessively high or low EEG or brainwave activity can be correlated with pathology
3. EEG can be changed using operant conditioning
4. Changing EEG to improve self-regulation produces a healthier overall brain state
5. When the brain works better, the Central Nervous System functions better

Neurotransmitters are chemicals that relay, amplify and modulate electrical signals between a neuron and another cell. Some neurotransmitters generally impact the Central Nervous System, others have specialized effects on the Autonomic Nervous System, and still others are used in brain regions by particular classes of nerve cells. Neurofeedback influences the activity between neurotransmitters and their destinations, as do pharmaceutical medications. Some common neurotransmitters include dopamine, acetylcholine, serotonin and norepinephrine.

The term “nutraceutical” was coined from the terms “nutrition” and “pharmaceutical” in 1989 by Stephen DeFelice. Also referred to as “phytochemicals” (functional foods), neutraceuticals are natural, bioactive chemical compounds that have health promoting, disease preventing or medicinal properties; are pharmacy-grade nutritional supplements. These can be used under medical supervision in conjunction with Neurotherapy for maximum benefit, especially when pharmaceuticals are contraindicated or are otherwise not a desirable choice.

Operant Conditioning Operant conditioning, so named by psychologist B. F. Skinner, is a term referring to learning that occurs when an association between behavior and its consequences is made. Another explanation is based on the concept that learning is a function of change in behavior as the result of a reinforcing and conditioning stimulus-response pattern in a step-by-step procedure to affect changes over time. It is also known as response-stimulus or RS conditioning.

Peak Performance Training
See Arousal and Performance Curve. Athletes, musicians, performers, writers, scholars and executives have all benefited from this unique form of training. Protocols for developing performance output vary among clinicians and include Neurofeedback training plus any or all of the following: coaching, hypnosis, visualization, meditative techniques and other technological reinforcements. These all add up to improved performance, increased endurance and the ability to experience a state of “flow” on demand — a heightened sense of concentration and focus with complete relaxation.

A known regimen that guides how Neurofeedback training is done. Each person is treated with a specific set of customized protocols. An individual’s unique physiological, cognitive and emotional profile and their brainwave activities guide decisions about which protocols are best suited for a particular desired outcome. Protocols are also referred to as “montages”.
Pulsed Magnetic Field Therapy
Also referred to as PEMF and repetitive Transcranial Magnetic Simulation or rTMS, when applied to the cranium. The use of magnetic fields (MF) produced by both static (permanent) and time-varied (most commonly, pulsed) magnetic fields are a related technology. Various instruments are available, and all induce extremely low frequency currents that can depolarize, re-polarize, and hyperpolarize neurons. This reportedly promotes healing mechanisms that may provide beneficial neuroendocrine, neurological and psychological effects, in addition to promoting bone, tissue and nerve regeneration. The technology shows promise for treating conditions such as Fibromyalgia, rheumatic conditions, migraine headaches and other pain conditions, as well as for enhancement of meditation, sleep, more positive emotional states, and improved ability to focus mentally and to concentrate, create or learn.

Quantitative Electroencephalograph (qEEG) is the measurement of electrical patterns at the surface of the scalp, which primarily reflect cortical activity or “brainwaves.” qEEG uses multiple electrodes at 22 or more sites to yield a comprehensive recording of brainwave activity that is analyzed relative to a normative database and converted by a computer to a color brain map. The qEEG is not intended to be a “stand alone” diagnostic. While it is not needed to effectively treat conditions with Neurofeedback, no other brain imaging technique is as fast or non-invasive, and it is often recommended for clients with brain injury or developmental disorders to assist in determining an optimum protocol for treatment. Some clinicians require a quantitative analysis of clinical EEG or qEEG, with a written report and interpretation before administering Neurofeedback treatments, while others do not. No data exists indicating traditional q-EEG based training is any more or less efficacious then other clinical protocols. Some clinicians provide an abbreviated qEEg or “mini” Brain Map using EEG measured at 6 to 10 or more sites. A mini Brain Map is only valid if compared with a normative database.

Roshi is a form of EDF (Electroencephalographic Disentrainment Feedback); a type of brainwave entrainment utilizing variable light and/or magnetic stimulation to disentrain or “reset” the brain’s activity to a more desired state. The technology makes use of complex adaptive audio visual stimulation (AVS) or electro magnetic stimulation (EMS) coupled with EEG neurofeedback that can be set so that the frequency varies according to the trainee’s existing dominant brainwaves. Although traditional neurofeedback and AVS devices evoke similar changes in brain functioning, with Roshi this rate of change is greatly accelerated. Roshi is used for stress and performance management.

Also referred to as electrodes. These are manufactured in a variety of shapes, materials and sizes. Neurofeedback clinicians tend to use tiny (approximately 10 mm in diameter) silver discs that have a thin layer of gold -plate for maximum conductivity of EEG. The disc looks somewhat like a miniature flat frying pan that is attached to a very thin wire. The wire conveys the brain’s EEG signals to an EEG amplifier (the voltage volume generated from the neurons in the cortical layer are too weak to use otherwise; amounting to only 20 to 100 microvolts even after amplification on the order of ten thousand times). The sensors are appended to the scalp using an a somewhat sticky, thick, water-soluble saline paste that can be easily wiped away with a quick dab at the end of the treatment. Usually only 3 to 5 sensors are used at any one time when administering Neurofeedback.

Ten -Twenty (10-20) System
A standardized international system developed to describe locations for placement of electrodes on the human skull in order to perform consistent testing for EEG recordings. Each point indicates a possible electrode position. Each site has a letter (to identify the lobe) and a number or another letter to identify the hemisphere location. The letters F, T, C, P, and O stand for Frontal, Temporal, Central, Parietal and Occipital.

The T.O.V.A.® (Test of Variables of Attention or TOVA) is the most extensively used valid continuous performance test available and provides accurate, objective and cost-effective data for screening, diagnostic and treatment monitoring of ADHD, OCD and other conditions. The tool was originally developed to help psychiatrists determine readiness for cessation of prescribed medications. In relation to Neurofeedback training, a TOVA typically is administered at the beginning of training to establish a baseline from which to develop a diagnosis, monitor performance improvement and to titrate medications (with prescribing physician oversight) when appropriate. A second TOVA is administered after 20 or 40 training sessions.