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Those items marked (*) are required of all Certified Neurofeedback Technicians
(See Technicians) and need not be completed a second time.
A. Definition of Neurotherapy
C. Definition of Neurotherapy
Tom Budzynski:
• Budzynski’s research for the military in the 1960’s showed that people in
a theta state were “hypersuggestible,” as people are in a hypnotic
induction, and learned new information extremely rapidly and
uncritically, apparently because being near a state of sleep enabled
patients to bypass the conscious mind.
(SINB)
Elmer Green:
• In the last seven years of her life, Alyce had Alzheimer's. During these
years, Elmer and Alyce explored the realms of consciousness beyond
Alzheimer's and death, and in the process discovered how we, too, can
experience these mysterious and transformative realms.
Joe Kamiya:
Joel Lubar:
• Dr. Lubar was responsible for developing the use of EEG Biofeedback
(Neurofeedback) as a treatment modality for children, adolescents, and
adults with Attention Deficit Hyperactivity Disorder, starting with his
controlled studies in the mid-1970's. This application of Neurofeedback is
now becoming widespread in clinics and schools throughout the United
States, Canada, Australia, Israel, Europe and Mexico. Currently, more
than 1500 health care organizations are using the EEG biofeedback
protocols that Dr. Lubar has developed. Dr. Lubar is currently developing
databases for the assessment of individuals with ADD/ADHD, and is a
consulting in several controlled studies evaluating the effectiveness of
Neurofeedback. In a 1992 publication, in Pediatric Neurology, he and his
colleagues showed, for the first time, that children with the inattentive
form of ADD (without hyperactivity), differ significantly in terms of
quantitative EEG patterns, from matched control non-ADD children.
• Dr. Lubar is the past president of AABP(Association for Applied
Psychophysiology) He has been the president of the Academy of Certified
Neurotherapist which now offers specialty certifications in EEG
Biofeedback as part of the Biofeedback Certification Institute of America
(BCIA). He has also been the president of the EEG Division of the AAPB.
Siegfried Othmer:
• The initial impetus was the brain-training of their son Brian for his
seizure disorder. The training was life-transforming for their son, which
redirected their professional lives to the further development of
Neurofeedback as well as to the promotion of its public acceptance.
Gene Peniston:
Barbara B. Brown:
A. Neurophysiology
1. Know the bioelectric origin of Alpha, Beta, Delta, Gamma,
Lambda, Mu, SMR and Theta in the EEG
Alpha= is the frequency range from 8 Hz to 12 Hz. Hans Berger named the
first rhythmic EEG activity he saw, the "alpha wave." This is activity in the 8-
12 Hz range seen in the posterior regions of the head on both sides, being
higher in amplitude on the dominant side. It is brought out by closing the eyes
and by relaxation. It was noted to attenuate with eye opening or mental
exertion. This activity is now referred to as "posterior basic rhythm," the
"posterior dominant rhythm" or the "posterior alpha rhythm." The posterior
basic rhythm is actually slower than 8 Hz in young children (therefore
technically in the theta range). In addition to the posterior basic rhythm, there
are two other normal alpha rhythms that are typically discussed: the mu
rhythm and a temporal "third rhythm". Alpha can be abnormal; for example,
an EEG that has diffuse alpha occurring in coma and is not responsive to
external stimuli is referred to as "alpha coma".
Mu= rhythm is alpha-range activity that is seen over the sensorimotor cortex.
It characteristically attenuates with movement of the contralateral arm (or
mental imagery of movement of the contralateral arm).
Beta is the frequency range from 12 Hz to about 30 Hz. It is seen usually on
both sides in symmetrical distribution and is most evident frontally. Low
amplitude beta with multiple and varying frequencies is often associated with
active, busy or anxious thinking and active concentration. Rhythmic beta with
a dominant set of frequencies is associated with various pathologies and drug
effects, especially benzodiazepines. Activity over about 25 Hz seen in the scalp
EEG is rarely cerebral (i.e., it is most often artifactual). It may be absent or
reduced in areas of cortical damage. It is the dominant rhythm in patients who
are alert or anxious or who have their eyes open.
Amplitude: The amplitude is the height of the wave. Its most general
definition is that the amplitude is the maximum positive displacement from the
undisturbed position of the medium to the top of a crest. This is shown in the
following diagram:
asymmetry: is the absence of, or a violation of, a symmetry or the lack of balance.
is the absence of, or a violation of, a symmetry.
Asymmetry in organisms
Due to how cells divide in organisms, asymmetry in organisms is fairly usual in at
least one dimension, with biological symmetry also being common in at least one
dimension.
Asymmetry in physics
Asymmetry arises in physics in a number of different realms.
Thermodynamics
Thermodynamics is asymmetrical in time: the entropy in a closed system
can only increase with time. A consequence of this is Clausius' Second
Law, which states that there is no thermodynamic process whose sole
effect is to extract a quantity of heat from a colder reservoir and deliver it
to a hotter reservoir.
Particle physics
Symmetry is one of the most powerful tools in particle physics, because it
has become evident that practically all laws of nature originate in
symmetries. Violations of symmetry therefore present theoretical and
experimental puzzles that lead to a deeper understanding of nature.
Asymmetries in experimental measurements also provide powerful handles
that are often relatively free from background or systematic uncertainties.
Frequency: Frequency refers to how many waves are made per time interval.
This is usually described as how many waves are made per second, or as cycles
per second
Frequency band: Or frequency range is a rand of wave frequencies. It most often
refers to either a range of frequencies in sound or a range of frequencies in
electromagnetic radiation, which includes light and radio waves.
Phase coherence: The state in which two signals maintain a fixed phase
relationship with each other or with a third signal that can serve as a reference
for each
Ratios are unitless when they relate quantities of the same dimension. When the
two quantities being compared are of different types, the units are the first
quantity "per" unit of the second — for example, a speed or velocity can be
expressed in "miles per hour". If the second unit is a measure of time, we call this
type of ratio a rate.
Spectra: Spectra (plural of spectrum) are conditions or values that vary over a
continuum.
Symmetry: Generally conveys two primary meanings. The first is an imprecise
sense of harmonious or aesthetically-pleasing proportionality and balance; such
that it reflects beauty or perfection. The second meaning is a precise and well-
defined concept of balance or "patterned self-similarity" that can be demonstrated
or proved according to the rules of a formal system: by geometry, through physics
or otherwise.
Frontal Poles: Anterior end of the frontal lobe is named the frontal pole.
Occipital Ploles: Posterior end of the occipital lobe is named the occipital
pole.
Temporal Poles: Anterior end of the temporal lobe is named the temporal
pole.
Brain stem = There are three main functions of the brainstem. The first is
its role in conduit functions. That is, all information related from the body
to the cerebrum and cerebellum and vice versa, must traverse the brain
stem. The ascending pathways coming from the body to the brain are the
sensory pathways. Descending tracts are upper motor neurons destined to
synapse on lower motor neurons. Third, the brain stem has integrative
functions (it is involved in cardiovascular system control, respiratory
control, pain sensitivity control, alertness, and consciousness).
Cortex = The cerebral cortex is a structure within the brain that plays a
key role in memory, attention, perceptual awareness, thought, language,
and consciousness.
Limbic system = The limbic system is a term for a set of brain structures
including the hippocampus and amygdala and anterior thalamic nuclei
and a limbic cortex that support a variety of functions including emotion,
behavior and long term memory. The limbic system operates by
influencing the endocrine system and the autonomic nervous system.
Medulla = The medulla oblongata is the lower portion of the brainstem. It
deals with autonomic functions, such as breathing and blood pressure.
The cardiac center is the part of the medulla oblongata responsible for
controlling the heart rate. The medulla oblongata controls autonomic
functions, and relays nerve signals between the brain and spinal cord. It is
also responsible for controlling several major points and autonomic
functions of the body: respiration (via dorsal respiratory group and
ventral respiratory group); blood pressure; swallowing; vomiting and
defecation.
Pineal = The pineal gland (also called the pineal body) is a small
endocrine gland in the brain. It produces melatonin, a hormone that may
modulate wake/sleep patterns. It is shaped like a tiny pine cone, and is
located near the center of the brain, between the two hemispheres, tucked
in a groove where the two rounded thalamic bodies join.
Thalamus = The thalamus is a pair and symmetric part of the brain. The
thalamus is known to have multiple functions. The thalamus is believed to
both process and relay sensory information selectively to various parts of
the cerebral cortex, as one thalamic point may reach one or several
regions in the cortex. The thalamus also plays an important role in
regulating states of sleep and wakefulness. The thalamus plays a major
role in regulating arousal, the level of awareness, and activity. Damage to
the thalamus can lead to permanent coma.
3. Know the fundamental elements of the central nervous system
such as:
cell nucleus = In cell biology, the nucleus (pl. nuclei; from Latin nucleus
or nuculeus, "little nut" or kernel) is an enclosed membrane found in most
cells. It contains most of the cell's genetic material. The function of the
nucleus is to maintain the integrity of these genes and to control the
activities of the cell by regulating gene expression.
COACHING REQUIREMENTS
B. Accredited Providers
0. The Biofeedback Coach
1. The Quantum Center of Excellence
C. Coaching Resources
0. What are Therapy and Coaching?
1. The Language of a Biofeedback Coach
14. Peak to peak – The amplitude (voltage) difference between the most
positive and the most negative excursions (peaks) of an electrical signal.
15. Root mean square – The effective value of an alternating voltage or
current.
Signal-to-noise ratio – The ratio between the received signal power and the noise at the receiver of a
communications system.
Volume conduction– Concept from physics and biology, the fact that the electrical potential generated by
the heart and as measured by an electrocardiograph can be recorded from any site on the body.
B. Sources of artifact
1. Know how to evaluate environmental noise
2. Know how to evaluate instrument noise
3. Know how to check electrode impedances
4. Know how to perform a continuity checks on electrodes
5. Know how to perform continuity checks on cables
6. Know how to identify short and open circuits.
C. Signal acquisition
1. Know how to attach electrodes to your clients (manual)
2. Know which ear to choose as a reference and why
3. Know when to use a reference other than one ear
4. Know when to use and apply a neutral reference
5. Know when to use and apply a scalp reference
6. Know which locations to use and why those locations were chosen
7. Know how electrode impedance affects the EEG
8. Know the potential effects of prescription, illicit and over-the-
counter drugs and remedies on EEG.
D. Signal processing
1. Know the sites on the l0-20 system (see manual)
2. Know the montages that derive from the 10-20 system (see manual)
3. Know how to explain offset voltages – When an electrode is placed in a
conducting solution and no current is flowing, an electrical potential
difference exists between the electrode and the bulk of the solution. This
electrode potential results from a difference between the electrical charge
caused by the flow of ions from the metallic surface of the electrode into
the solution and that caused by the flow of metallic ions from the solution
into the metallic surface of the electrodes. An excess of charge in the
solution causes the formation of an electrical double layer; in this way, an
equilibrium is established. The value of the electrode potential is a
function of the electrode material, the electrolyte composition, and the
temperature. It may have values ranging from millivolts to volts. When
scalp electrodes are used, depending on the electrolyte composition and
the condition of the skin, a similar DC potential is generated at the
skin/electrolyte junction. These steady potentials generated at the
electrodes, which cannot be eliminated, result in a DC offset voltage.
E. EEG
1. Be able to recognize normal EEG patterns for the frequency
ranges traditionally called delta, theta, alpha, smr, beta, gamma,
deltha, thalpha, mu, and lambda in the raw EEG and QEEG.
2. Be able to recognize common artifacts in the raw EEG such as
drowsiness, eye blink, eye movement both vertically and
laterally, muscle activity such as EMG, EOG, TMJ, frontalis, jaw
and neck tension, sleep spindles, sweat, loose or poorly attached
electrodes, heart pulse (EKG), electrode wire movement, skin
potentials and static electricity, and electromagnetic noise.
3. Be able to identify abnormal EEG patterns, such as those
associated with seizure disorders, stroke, memory loss and
dementia, attention and learning disorders, addiction, mood
disorders, and closed head injuries
F. QEEG
1. Be able to explain the clinical uses of spectral arrays.
2. Be able to explain the clinical uses of compressed spectral arrays.
3. Be able to explain the clinical uses of topographic brain maps.
4. Be able to explain the clinical uses of databases and discriminant
functions -
http://books.google.com/books?id=3CuM6MviwMAC&pg=PA146&lpg=
PA146&dq=clinical+use+of+databases+and+discriminant+functions&s
ource=web&ots=PBhmkAscSv&sig=vgpBJ7y0w4Dq4YLQm1Utf77_Y-
A&hl=en&sa=X&oi=book_result&resnum=1&ct=result
G. Computers in Neurotherapy
1. Know how to use a computer with at least one computerized EEG
system (see manual)
2. Know how to use at least one neurotherapy software package with
a computer (see manual)
3. Know how computer speed affects the speed of neurotherapy.
The computer is a non-invasive tool, and it makes no changes to
your brain--it simply provides feedback about the activity in your
brain. For neurofeedback, you train your own brainwaves based on
that feedback signal. Newer computer chips allow you to see your
brainwaves on a computer screen a few thousandths of a second
after they occur, and gives you the ability to influence and change
them. Before now, computer processors were too slow to effectively
measure brainwaves and provide the feedback fast enough to the
brain.
4. Know how FFT and digital filtering delays neurotherapy.
http://www.dsprelated.com/showarticle/26.php
http://www.elisanet.fi/mnentwig/webroot/FFT_smoothness_cycl
ic/index.html
http://cnx.org/content/m10250/latest/
http://www.elisanet.fi/mnentwig/webroot/FFT_bin_frequencies
/index.html
http://www.elisanet.fi/mnentwig/webroot/FFT_filter_example/
index.html
Physiology and Anatomy* (40 CEU required)
A. Physiology
1. Recognize the names of the major muscle groups which generally
respond to biofeedback training
2. Recognize the names of the major bones associated with these
muscles
3. Know the names and be able to describe the disorders which are
generally expected to respond to biofeedback training
4. Know the clinical applications for EMG, SEMG, temperature
training, heart rate variability and EDR/GSR as they relate to
biofeedback training and be able to identify when each is
appropriate and inappropriate
5. Know the clinical signs for hypertension, stress, pain and be able
to describe how to handle each in a clinical setting
B. Basic Anatomy
1. Know the location and function of the major components of the
skeletal and muscle system, endocrine glands and the immune
system
2. Know the fundamental elements of the major body systems
including the digestive, circulatory, respiratory, excretory,
nervous, lymphatic, urinary and hormonal systems
Organs that make up the digestive tract are the mouth, esophagus,
stomach, small intestine, large intestine—also called the colon—rectum,
and anus. Inside these hollow organs is a lining called the mucosa. In the
mouth, stomach, and small intestine, the mucosa contains tiny glands that
produce juices to help digest food. The digestive tract also contains a
layer of smooth muscle that helps break down food and move it along the
tract.
Two “solid” digestive organs, the liver and the pancreas, produce
digestive juices that reach the intestine through small tubes called ducts.
The gallbladder stores the liver’s digestive juices until they are needed in
the intestine. Parts of the nervous and circulatory systems also play major
roles in the digestive system.
The body's circulatory system really has three distinct parts: pulmonary
circulation (lungs), coronary circulation (heart), and systemic
circulation(the rest of the system). Each part must be working
independently in order for them to all work together.
The diaphragm's job is to help pump the carbon dioxide out of the lungs
and pull the oxygen into the lungs. The diaphragm is a sheet of muscles
that lies across the bottom of the chest cavity. As the diaphragm contracts
and relaxes, breathing takes place. When the diaphragm contracts, oxygen
is pulled into the lungs. When the diaphragm relaxes, carbon dioxide is
pumped out of the lungs.
Central nervous system: The brain keeps the body in order. It helps to
control all of the body systems and organs, keeping them working like they
should. The brain also allows us to think, feel, remember and imagine. In
general, the brain is what makes us behave as human beings.
The brain communicates with the rest of the body through the spinal cord
and the nerves. They tell the brain what is going on in the body at all
times. This system also gives instructions to all parts of the body about
what to do and when to do it.
Urinary System: The urinary system includes the kidneys, bladder and
tubes. These organs control the amount of water and salts that are
absorbed back into the blood and what is taken out as waste. This system
also acts as a filtering mechanism for the blood.
Your body takes nutrients from food and uses them to maintain all bodily
functions including energy and self-repair. After your body has taken what
it needs from the food, waste products are left behind in the blood and in
the bowel. The urinary system works with the lungs, skin, and intestines—
all of which also excrete wastes—to keep the chemicals and water in your
body balanced.
The urinary system removes a type of waste called urea from your blood.
Urea is produced when foods containing protein, such as meat, poultry,
and certain vegetables, are broken down in the body. Urea is carried in
the bloodstream to the kidneys. Urea, together with water and other waste
substances, forms the urine as it passes down the renal tubules of the
kidney.
From the kidneys, urine travels down two thin tubes called ureters to the
bladder. The bladder is a hollow muscular organ shaped like a balloon. It
sits in your pelvis and is held in place by ligaments attached to other
organs and the pelvic bones.
Circular muscles called sphincters help keep urine from leaking. The
sphincter muscles close tightly like a rubber band around the opening of
the bladder into the urethra, the tube that allows urine to pass outside the
body.
Nerves in the bladder tell you when it is time to urinate, or empty your
bladder. When you urinate, the brain signals the bladder muscles to
tighten, squeezing urine out of the bladder. At the same time, the brain
signals the sphincter muscles to relax. As these muscles relax, urine exits
the bladder through the urethra. When all the signals occur in the correct
order, normal urination occurs.
Some of the roles of the endocrine system include: Growth, Repair, Sexual
reproduction, Digestion, Homeostasis (constant internal balance). A
hormone will only act on a part of the body if it ‘fits’. A hormone can be
thought of as a ‘key’, and its target site (such as an organ) has specially
shaped ‘locks’ on the cell walls. If the key (hormone) fits the lock (on the
cell wall), then the hormone will work. The endocrine glands get feedback
from the body so they can adjust the hormones and keep them at the right
levels.
• Pituitary gland - is inside the brain. It oversees the other glands and
keeps hormone levels in check. It can bring about a change in hormone
production somewhere else in the system by releasing its own
‘stimulating’ hormones. The pituitary gland is also connected to the
nervous system via part of the brain called the hypothalamus.
• Ovaries - are inside the female pelvis. They make female sex hormones
like oestrogen.
• Testes - they hang in the male scrotal sack. They make male sex
hormones like testosterone.
Glands that secrete straight to a target site via ducts or tubes are called
exocrine glands. Some examples include: Salivary glands: Sweat glands
and Sebaceous glands.
Biofeedback
While there is no requirement for learning biofeedback theory and practice to be certified
as a neurotherapy specialist or technician, it is suggested that candidates also meet the
requirements of the Biofeedback Blueprint.