Adverse Reactions and Potential Iatrogenic Effects in Neurofeedback Training

Neurofeedback as a Treatment for ADHD: A Methodological Review with Implications for Future Research

“…However, a reversal of the neurofeedback training contingencies, from inhibiting theta and enhancing SMR activity to enhancing theta and inhibiting the production of SMR activity, resulted in a reversal of EEG baseline activity to pre-training levels and a concomitant deterioration in behaviour. This led some to suggest that it may be possible for neurofeedback training to have a negative effect, highlighting the importance of training the correct component of the EEG (Ayers, 2001;Chartier, 2001;Hammond, 2001a;Nash, 2001;Stockdale, 2001).…”

“…However, clinicians have voiced some concerns. Hammond (2001a) commented that the potential negative effects could include the possibility that individuals may feel anxious and experience difficulty sleeping following training to increase beta activity. In addition, Stockdale (2001) commented that on several occasions training to increase SMR resulted in increased levels of agitation for one patient.…”

EEG Findings in ADHD and the Application of EEG Biofeedback in Treatment of ADHD

“…On the other words, the power in being able to define deviations of brain's electrical patterns within a normally distributed measurement set is that one can target deviant measures to "normalize" by a variety of intervention modalities. In fact, the EEG (as a physiological measure) is considered a form of behavior, which is subject to behavior modification through basic "operant conditioning" and "shaping" principles within (Hammond et al, 2001;p.55). For detailed information about neurofeedback see the website of the ISNR (http://www.isnr.org).…”

“…Side effect can sometimes occur during neurofeedback and practitioners should be aware that occasionally negative effects may occur (Hammond & Kirk, 2008;Hammond et al, 2001;Lubar & Shouse, 1976;Todder et al, 2010) if training is not being supervised by a knowledgeable and certified professional. Adverse effects that have been reported by some clinicians include increased anxiety and agitation, headaches, fatigue, sleep disturbance, anger and irritability, crying and emotional lability, enuresis, an increase in depression, increase in somatic symptoms (including tics and twitches), seizures, and temporary disorientation.…”

Standards of Practice for Neurofeedback and Neurotherapy: A Position Paper of the International Society for Neurofeedback & Research

“…They perform appropriate history taking and assessments prior to providing neurofeedback treatment, and they regularly assess the effectiveness of the services provided. Practitioners are aware that occasionally side effects or negative effects may occur (Hammond & Kirk, 2008;Hammond, Stockdale, Hoffman, Ayers, & Nash, 2001;Lubar & Shouse, 1976, 1977Todder, Levine, Dwolatzky, & Kaplan, 2010), and they inquire frequently about any side effects or adverse reactions.…”