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Research finds that chronic fatigue syndrome (CFS) and fibromyalgia (FM) appear to frequently be accompanied by a generalized slowing of brainwave activity. The brain map below is from a patient with CFS and FM who has excessive slow brainwave activity in the theta and alpha frequency bands, and deficient beta brainwaves. The brown and yellow colors in the brain map indicate areas of excessive slow activity, and the lighter and lighter colors of blue indicate the areas of an increasingly greater deficiency of healthy beta brainwaves.

This disturbance in brain function appears to be related to the cognitive impairments referred to as “fibro fog”, along with generalized fatigue, pain, and sleep disturbance that is associated with these conditions. It has been found that an excess of alpha brainwaves is present even during sleep. This “alpha intrusion” into sleep seems responsible for sleeping shallowly, so that even little noises can awaken a person, resulting in awakening feeling tired and un-refreshed. Research has documented that with improved, restful sleep, FM people feel less fatigue and pain. Research has suggested that cognitive impairments and brain dysfunction are most likely to be found in CFS patients who have had a more abrupt, rather than a gradual onset, of chronic fatigue, and those who have not previously struggledfor a long time with psychiatric conditions such as depression.
During the past several years in working with CFS and FM, various clinicians have observed considerable evidence for the effectiveness of EEG neurofeedback training as a modality for assisting in the remediation of these symptoms. In Canada for example, Dr. Stuart Donaldson and his colleagues have found that neurofeedback (followed by a small amount of physical therapy or EMG [muscle] biofeedback) produced substantial improvement in 77% of FM people on long term follow-ups. Neurofeedback training for CFS and FM appears to usually increase energy levels, to assist in alleviating cognitive deficits (memory and concentration), and restless and non-restorative sleep. As these things improve in FM, the pain generally decreases and becomes localized to small areas, rather than being diffuse over the entire body. Physical therapy, trigger-point work, or muscle biofeedback may then assist in reducing the limited pain that remains. When used with people who are not entirely disabled by the condition, it has allowed many to return to full-time productive activity within a few months. In severe cases, the impact of training has generally been very helpful, although full remediation may not always occur.
No claim is made that the training directly addresses the fundamental cause of CFS or FM, although it might assist in overcoming deficits resulting from a viral influence. The improvements in the quality of life in reported cases, and in the preliminary research, is encouraging. But given the absence of large, carefully controlled studies, this procedure would still be regarded by many people as experimental. However, in doing work for more than 25 years with somewhat similar and abnormally slow brainwave activity in attention deficit disorder and epilepsy, Dr. Joel Lubar and Dr. Barry Sterman, and others have verified that neurofeedback training can be effective in improving symptoms and reconditioning brainwave activity. These changes are usually maintained as documented on long-term follow-up research studies.
Initially, a person is evaluated with a quantitative EEG brain map, looking at brain function to determine if abnormal brainwave patterns are present which may benefit from neurofeedback. The procedure takes about 1 to 2 hours and consists of placing 20 EEG electrodes on the head that measure the electrical patterns coming from the brain. It is non-invasive, and the brainwave patterns are relayed to the computer and recorded. The person’s brainwave patterns are then compared to those of very normal individuals of the same age in a very sophisticated normative database. The results of the brain map then allow a determination to be made as to how an individual’s brain map patterns are significantly different from what they should normally be. This then increases the ability of the brain waves to be normalized by the process of doing neurofeedback sessions.
If there is an abnormal color pattern in the brain map, indicating a problem in a person with CFS or FM, that person will want to undertake an initial sequence of 15-20 sessions. If the training is likely to be of benefit by reducing the problems associated with CFS and FM, usually there will be early signs of improvement within that time frame. A decision can then be made about continuing with the neurofeedback sessions and how often the sessions should be to obtain maximum benefit from the process. The first sessions should be conducted in close succession, at a minimum of three if not four sessions per week. Under these conditions, the gains from neurofeedback training sessions are more cumulative, and the changes induced by it can be more readily distinguished. Completion of neurofeedback training may take about four months, at a rate of three training sessions per week. Cumulatively, some forty to sixty training sessions may be required, depending upon severity of the initial condition.
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