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High effectiveness of LORETA Z-score Neurofeedback in the treatment of headaches.

By Dr. Koberda and his students

Introduction: Z-score LORETA Neurofeedback (NFB) is a new form of EEG-biofeedback which has been a promising tool in the treatment of several neuropsychiatric symptoms. Prior published papers with quantitative electroencephalography (QEEG) reports indicated elevated beta power in patients suffering from chronic headaches. Previously 1-2 electrodes NFB was shown to be an effective treatment of patients suffering from chronic pharmaco-resistant migraines (Stokes, 2010; Walker, 2011). EEG-biofeedback uses scalp recordings and delivers biofeedback based on feedback from the brain as well as surrounding tissue including scalp muscles. The aim of this study was to evaluate effectiveness of this form of therapy in the treatment of chronic headaches.

Materials and methods: Patients enrolled in this study included those with frequent migraines, chronic tension headaches and other head pains. The design of this study was to complete a QEEG before beginning NFB in order to conduct QEEG-guided biofeedback treatment. A QEEG was also completed after 10 sessions of NFB therapy to see if any objective improvement in reduction of over expressed beta power was noted. Most of the patients completed at least 10 sessions of NFB and the degree of subjective improvement (if any) was recorded. 

Results: Twenty-one patients began this therapy, 2 dropped out before the study was completed. Eighty percent of patients reported subjective improvement and 70% of subjects had objective improvement (reduction of beta activity on QEEG). One patient diagnosed with chronic trigeminal neuralgia on chronic pregabalin (Lyrica) therapy was able to discontinue medication completely after just a few sessions due to pain resolution. Improvements in headaches lasting longer than 3 months were usually observed. An additional “refresher” NFB therapy was completed for those patients who subsequently experienced reoccurrence of headaches.

Conclusions: This study indicates high effectiveness of Z-score LORETA NFB in pain reduction of chronic headaches sufferers. Further, a randomized double blinded study may be beneficial for further investigation of effectiveness of this type of therapy.

Stokes, D. A., & Lappin, M. S. (2010). Neurofeedback and biofeedback with 37 migraineurs: A clinical outcome study. Behav Brain Funct, 6, 9.
Walker, J. E. (2011). QEEG-guided neurofeedback for recurrent migraine headaches. Clin EEG Neurosci, 42 (1), 59-61.