In recent years, the consequences of brain injuries have been recognized.  Usually, persons with a head injury have CAT scans or MRI’s, which often don’t reveal organic damage since they look at the structure of the brain and not how the brain functions.

As a result, accident victims were often not taken seriously and accused of fabricating their symptoms.  However, more recently, tests of brain function have found a basis for the symptoms.  These tests include quantitative EEG (qEEG) brain mapping, radioactive PET and SPECT scans, and evoked potential response measurements.

These functional tests reveal changes in cortical activation and abnormal EEG activity traceable to brain injury, stroke, epilepsy, and mental decline.

Symptoms which accompany brain injuries like this can include impairment in short-term memory; difficulty concentrating; loss of energy; irritability, temper outbursts; impulsiveness; mood swings; depression headaches and chronic pain; dizziness; anxiety; aphasia; sleep disturbance; visual perception problems and reversal of letters or words; oversensitivity to light and sound; tremor, spasticity; problems with coordination and balance; decreased libido; and seizures or seizure-like activity such as auras.

Persons with difficulties such as attention deficit disorder, migraines, or sleep problems may find these symptoms exacerbated by the brain injury. The apparent severity of the injury, including the length of them being unconscious (if they were), is not always correlated with symptom severity. Changes in the EEG are usually seen in post-concussion patients and may persist for years unless treated.  Usually, there is a slowing of the brainwave activity, especially in the area where damage occurred.

This is shown in the illustration below of a coup-contracoup injury where a woman’s head was hit on the back left side, causing a slowing of brainwave activity into the 6-8 Hz range both there and in the right frontal area where her brain rebounded from the impact.

Over the last two decades, various clinicians have published articles and obtained considerable clinical evidence of the effectiveness of EEG neurofeedback (brainwave training) as a modality to assist in the rehabilitation of brain injuries.

The training appears to often be helpful in relieving many of the symptoms listed above, even years post-injury when spontaneous improvements are no longer expected. Many traditional rehabilitation modalities (for example, medication, PT, speech therapy, OT) provide some relief, but such methods do not deal directly with the results of the brain injury.  And, in fact, sedatives can sometimes slow brainwave activity further, intensifying problems with concentration and depression. 

Neurofeedback allows us to directly intervene with the central nervous system damage, inhibiting the abnormal activity associated with symptoms of difficulty concentrating, learning/memory problems, headache, depression, sensitivity to light/sound, spasticity, seizures, imbalance and incontinence. One large neurofeedback study with head injuries found that some of the earliest improvements from training were an increase in energy and decrease in depression, mood swings, anxiety, and anger.  A decrease in sensitivity to sound/light and an increase in attention span often improved next, followed by a reduction of dizziness and headaches, and finally, an improvement in libido and less reversal of letters or words.

In this study, about 60% of patients reported significant improvement in short-term memory.  The improvements in quality of life and skills following neurofeedback which has been reported in case studies and in our work is encouraging, but because of the absence of large, controlled studies, it may still be regarded as experimental by many people. 

However, in working with somewhat similar cortical problems of abnormal slow brainwave activity with ADD/ADHD and uncontrolled epilepsy (including placebo controlled, blinded studies), research conducted over the past 25 years has documented that neurofeedback training can effectively bring about significant improvements more than 80% of the time.

There are reports of people after neurofeedback who have become much more productive in their lives after being disabled for years due to their brain injuries.  The training will not always be able to assist in overcoming all of the damage that has been done, but it may often bring improvement in the quality of life and at least partial alleviation of some symptoms.  Reports thus far suggest that a large proportion of patients who undertake neurofeedback training for brain injuries seem to derive some benefits.

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