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Specialized equipment translates brainwaves into sensory input the brain can use to self-regulate.
April 22, 2025
By Tristan Horrom
VA Research Communications
Our Veterans...gave so much for us, we need to find and offer non-invasive, non-pharmacological, safe, and effective interventions that can help them regain their health!
Researchers with the VA Pacific Islands Health Care System have developed a safe, non-invasive treatment that could help alleviate chronic headaches, sleep problems, and attention disorders in Veterans who have suffered concussions.
The procedure is called infra-low frequency neurofeedback, and it has been shown to help the brain self-regulate and recover after a head injury.
“This type of neurofeedback holds promise to be a safe and effective intervention for those who suffer with post-concussive symptoms,” explained study lead Dr. Judy Carlson. “Impact was also evident with PTSD, depression, and several additional physiological and psychological symptoms. While further validation is necessary, if VA were to widely offer this intervention to Veterans who can benefit from it, it would make a tremendous difference to those Veterans who receive it.”
Here’s how it works: neurofeedback is a sub-specialization of biofeedback, a method of treatment that assists people to become more aware of and self-regulate their own physiology. Using specialized equipment, clinicians show the patient images and other feedback that reflects in the patient’s brainwaves, at which point the brain begins to adapt and change its functioning. This helps the brain to interpret and correct various types of abnormal brain signaling, which in turn reduces or even eliminates the symptoms.
According to Carlson, the patient does not have to actively think about responding to the feedback; the subconscious brain takes care of that on its own. All the patient has to do is comfortably sit and look at the computer scenes being displayed, music played through headphones, and vibrations felt through a pillow, all of which provide the brain with the information it needs.
“It is actually a very active response by the brain in its attempts to self-regulate itself,” said Carlson. “The brain wants to communicate well among its billions of neuron cells so it can work at its best. Once the brain is able to receive information about how it is doing, it can then self-regulate itself better.”
The images and sensations are designed to provide information about a person’s brainwaves below a frequency of 0.1 Hz. The technique requires specialized equipment that can isolate this frequency of brainwave, because each person requires a special frequency in this low range to be effective at self-regulation. A highly skilled provider can home in on the specific frequency that will provide relief from headaches, insomnia, and other symptoms for each individual patient.
The science behind this new technique relies on resetting abnormal brainwave activity and improving functional connectivity. Previous research has shown that neurofeedback can influence neuroplasticity – the brain’s ability to adapt and respond to new experiences and situations – and improve connectivity between different regions of the brain.
In this study, 87 participants received either 20 sessions of infra-low frequency neurofeedback or eight weekly 15-minute health discussions as a control group. Each neurofeedback session was a half-hour, with three sessions per week over eight to ten weeks.
The researchers prompted participants every two to three minutes to describe their experience, such as shoulder tension, racing thoughts, and other reactions. The researchers could then carefully adjust the frequency based on the participant’s answers until they identified a unique, optimal response frequency.
Those who received the biofeedback had clinically meaningful improvements in headache, sleep, and attention, as well as improvements in quality of life, depression symptoms, and PTSD symptoms, when compared to the controls. At the end of the treatment, those in the neurofeedback group fell below the cutoff for probable PTSD. So far, the improvements even appear to be sustained over the long-term.
“Our Veterans gave so much to our nation, and by doing so their bodies and minds were greatly impacted,” Carlson said. “You see this with the number of Veterans with chronic pain, headaches, insomnia, gut issues, and mental health issues such as PTSD, depression, anxiety, and hypervigilance. They gave so much for us, we need to find and offer non-invasive, non-pharmacological, safe, and effective interventions that can help them regain their health!”
This was the first study to compare a group with unique optimal frequency neurofeedback to a control group, and also the first study to use this technique as an intervention for Veterans with traumatic brain injury (TBI), a group for which effective treatments have been difficult to identify.
Between 2001 and 2021, more than 440,000 Veterans suffered a TBI, most of them mild. Mild TBI, also called concussion, has been called the “signature injury” of recent military conflicts.
The most common causes of mild TBI in Veterans are blasts from improvised explosive devices, rocket-propelled grenades, and land mines. In addition to direct impacts, blasts cause a pressurized shock wave that can cause complex injuries to the brain involving stretch and twisting of the cells and blood vessels. Blasts can also alter the molecular and biochemical responses in the brain.
Abnormal brain signaling and inflammatory processes last much longer in the brain that direct impact injuries and can often lead to chronic and debilitating symptoms. Headaches, sleep problems, and attentional disorders are some of the most common symptoms of TBI.
While more testing with larger study groups is needed, infra-low frequency neurofeedback has great potential as a non-invasive, non-drug treatment for chronic TBI, a condition that can be hard to treat in Veterans.
The results appeared in Explore: The Journal of Science & Healing.
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