EEG Biofeedback Therapy as an Adjunct Treatment for PTSD
| Status: | Completed |
|---|---|
| Conditions: | Anxiety, Insomnia Sleep Studies, Hospital, Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology, Other |
| Healthy: | No |
| Age Range: | 18 - 40 |
| Updated: | 4/21/2016 |
| Start Date: | May 2012 |
| End Date: | October 2013 |
Placebo-controlled Study of EEG Biofeedback Therapy as an Adjunct Treatment for PTSD, Evaluating Symptoms and EEG Dynamics
The proposed study, "Placebo-controlled study of EEG biofeedback therapy as an adjunct
treatment for PTSD, evaluating symptoms and EEG dynamics", will investigate the brain
dynamics associated with PTSD symptom reduction associated with EEG biofeedback therapy or
sham EEG biofeedback in addition to treatment as usual at the NMCSD OASIS program.
EEG biofeedback treatment protocols for PTSD and other disorders have been developed and
honed by private practice clinicians over the past 25 years, during which EEG biofeedback
has become an increasingly popular adjunct therapy.
The reported success of EEG biofeedback as a non-drug intervention with lasting efficacy
warrants a clinical study investigating not only symptom reduction, but also the underlying
neurobiological mechanism. To this end, we propose a study using high density EEG recordings
before and after treatment for PTSD symptoms to determine which brain activities correlate
with reported symptom changes.
The proposed study could expand treatment alternatives for servicemen with PTSD. If EEG
biofeedback is shown to improve symptom reduction over the placebo controlled condition, it
would offer a non-pharmacological intervention that would avoid undesirable side effects,
and accelerate recovery compared with the current standard of care.
treatment for PTSD, evaluating symptoms and EEG dynamics", will investigate the brain
dynamics associated with PTSD symptom reduction associated with EEG biofeedback therapy or
sham EEG biofeedback in addition to treatment as usual at the NMCSD OASIS program.
EEG biofeedback treatment protocols for PTSD and other disorders have been developed and
honed by private practice clinicians over the past 25 years, during which EEG biofeedback
has become an increasingly popular adjunct therapy.
The reported success of EEG biofeedback as a non-drug intervention with lasting efficacy
warrants a clinical study investigating not only symptom reduction, but also the underlying
neurobiological mechanism. To this end, we propose a study using high density EEG recordings
before and after treatment for PTSD symptoms to determine which brain activities correlate
with reported symptom changes.
The proposed study could expand treatment alternatives for servicemen with PTSD. If EEG
biofeedback is shown to improve symptom reduction over the placebo controlled condition, it
would offer a non-pharmacological intervention that would avoid undesirable side effects,
and accelerate recovery compared with the current standard of care.
EEG biofeedback is an emerging alternative approach to treating PTSD, for which there is
still insufficient evidence to assume unequivocal clinical utility. However, a 1991 report
showed PTSD symptom reduction in 14 subjects receiving EEG biofeedback, as compared to 13
subjects receiving traditional treatment (Peniston, 1991), and a recent case study of 2 PTSD
patients receiving EEG biofeedback therapy also showed reduce symptom severity using a newer
protocol and device (Othmer, 2009). Another recent study focused on the anxiety symptoms of
PTSD and showed that EEG biofeedback significantly reduced anxiety compared to subjects not
receiving treatment (Walker, 2009).
EEG biofeedback has also been explored as a treatment for non-PTSD related anxiety
disorders, with results showing significant changes in reported anxiety correlated with
increased or decreased alpha-frequency (~8-12 Hz) power (Hardt, 1978). Similarly,
alpha-frequency EEG biofeedback has been shown to reduce anxiety and to reduce heart rate
reactivity to a stressor after 8 sessions of EEG biofeedback training (Rice, 1993). While
EEG biofeedback has been shown to significantly change EEG power dynamics (Egner, 2004), it
is still unclear if and how EEG biofeedback can effect long-term and complex changes in
cognitive and/or emotional functioning.
Some attention has been given to other types of biofeedback for the treatment for PTSD, such
as heart rate variability (HRV) biofeedback, which may be relevant in understanding the
background of biofeedback with respect to PTSD treatment. While one study reported no
difference in symptom reduction between treatment as usual and treatment as usual plus HRV
biofeedback (Lande, 2010), a handful of other studies have reported significant associations
between HRV changes and PTSD symptoms. Specifically, increased HRV was significantly
correlated with PTSD symptom reduction, which was more effective with respiratory sinus
arrhythmia (RSA) (which affects HRV) biofeedback than with progressive muscle relaxation
(Zucker, 2009). Furthermore, combat-related PTSD subjects showed lower resting HRV than
controls, but training with HRV biofeedback increased PTSD subjects' HRV and simultaneously
decreased their PTSD symptoms (Tan, 2011). Finally, a quantitative EEG study showed that an
acute session of RSA biofeedback was associated with an increase in alpha-band power and
reduced higher frequency beta-band power, suggesting a neural impact of RSA training and HRV
regulation (Sherlin, 2010).
Summary The proposed study of EEG biofeedback at the OASIS program will not only address the
clinical efficacy, but also the brain activations associated with specific symptoms of PTSD
through collection of high-density EEG data before and after EEG biofeedback treatment.
These data will help elucidate the neural correlates of PTSD symptom expression as well as
address the potential efficacy of EEG biofeedback therapy as an adjunct treatment for
PTSD-like symptoms.
still insufficient evidence to assume unequivocal clinical utility. However, a 1991 report
showed PTSD symptom reduction in 14 subjects receiving EEG biofeedback, as compared to 13
subjects receiving traditional treatment (Peniston, 1991), and a recent case study of 2 PTSD
patients receiving EEG biofeedback therapy also showed reduce symptom severity using a newer
protocol and device (Othmer, 2009). Another recent study focused on the anxiety symptoms of
PTSD and showed that EEG biofeedback significantly reduced anxiety compared to subjects not
receiving treatment (Walker, 2009).
EEG biofeedback has also been explored as a treatment for non-PTSD related anxiety
disorders, with results showing significant changes in reported anxiety correlated with
increased or decreased alpha-frequency (~8-12 Hz) power (Hardt, 1978). Similarly,
alpha-frequency EEG biofeedback has been shown to reduce anxiety and to reduce heart rate
reactivity to a stressor after 8 sessions of EEG biofeedback training (Rice, 1993). While
EEG biofeedback has been shown to significantly change EEG power dynamics (Egner, 2004), it
is still unclear if and how EEG biofeedback can effect long-term and complex changes in
cognitive and/or emotional functioning.
Some attention has been given to other types of biofeedback for the treatment for PTSD, such
as heart rate variability (HRV) biofeedback, which may be relevant in understanding the
background of biofeedback with respect to PTSD treatment. While one study reported no
difference in symptom reduction between treatment as usual and treatment as usual plus HRV
biofeedback (Lande, 2010), a handful of other studies have reported significant associations
between HRV changes and PTSD symptoms. Specifically, increased HRV was significantly
correlated with PTSD symptom reduction, which was more effective with respiratory sinus
arrhythmia (RSA) (which affects HRV) biofeedback than with progressive muscle relaxation
(Zucker, 2009). Furthermore, combat-related PTSD subjects showed lower resting HRV than
controls, but training with HRV biofeedback increased PTSD subjects' HRV and simultaneously
decreased their PTSD symptoms (Tan, 2011). Finally, a quantitative EEG study showed that an
acute session of RSA biofeedback was associated with an increase in alpha-band power and
reduced higher frequency beta-band power, suggesting a neural impact of RSA training and HRV
regulation (Sherlin, 2010).
Summary The proposed study of EEG biofeedback at the OASIS program will not only address the
clinical efficacy, but also the brain activations associated with specific symptoms of PTSD
through collection of high-density EEG data before and after EEG biofeedback treatment.
These data will help elucidate the neural correlates of PTSD symptom expression as well as
address the potential efficacy of EEG biofeedback therapy as an adjunct treatment for
PTSD-like symptoms.
Inclusion Criteria:
- Male,
- active military,
- participating in PTSD program at NMCSD
Exclusion Criteria:
- Seizure disorder.
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