EEG Biofeedback for Addictive Disorders—The State of the Art in 2004

Abstract

This paper reviews studies of brainwave biofeedback as a therapeutic technique for substance use disorder. This modality is attractive as a medication free, neurophysiologic, and self actualizing treatment for a substance based, brain impaired and self-defeating disorder. Three approaches are described and the literature for each reviewed. Alpha-theta occipital feedback was originally employed to facilitate autosuggestion in hypnagogic states to augment standard therapy approaches in substance abuse treatment programs and appears most suited for chronic treatment resistant alcoholics. Beta augmentation feedback in conjunction with alpha/theta feedback has been employed in mixed substance abuse and stimulant abuse with good results. Individualized brainwave biofeedback based on correcting EEG abnormalities, or based on addressing comorbid conditions is a third approach that has been described, and may be most appropriate where confounding comorbid conditions are present. Although effectiveness in certain hard to treat populations (conventional treatment resistant alcoholics, crack cocaine addicts, cognitively impaired substance abusers) is promising, better-designed controlled studies are needed.

EEG Biofeedback as a Treatment for Substance Use Disorders: Review, Rating of Efficacy and Recommendations for Further Research

“…A critical analysis of the Peniston Protocol is discussed at length in the previous reviews (Trudeau, 2000(Trudeau, , 2005a(Trudeau, , 2005b). Several controlled studies of the Peniston protocol for addictions, completed by Lowe (1999), Moore and Trudeau (1998), and Taub and Rosenfeld (1994), suggest that alpha-theta training for addictions may be nonspecific in terms of effect when compared to suggestion, sham or controlled treatment, or meditational techniques.…”

“…However the Scott et al (2005) To be considered Level 5 (''efficacious and specific''), modified alpha-theta training would need to be shown to be superior to sham or bona fide treatment. It has not been demonstrated that the Peniston type alpha-theta feedback is more efficacious than sham treatment (Lowe, 1999;Moore & Trudeau, 1998;Trudeau, 2000Trudeau, , 2005aTrudeau, , 2005b or alternative treatment that involves meditation (Taub & Rosenfeld, 1994).…”

“…ADHD has been found to be associated with an earlier onset of SUD (Horner & Scheibe, 1997). It is generally assumed that untreated ADHD is a risk factor for SUD development (Biederman, Wilens, Mick, Faraone, & Spenser, 1998;Biederman et al, 1997;Mannuzza et al, 1989Mannuzza et al, , 1998Trudeau, 2005aTrudeau, , 2005b.…”

“…This article represents an update of earlier reviews (Trudeau, 2000(Trudeau, , 2005a(Trudeau, , 2005b of EEG biofeedback for addictive disorders extended with a review on qEEG in SUD. This review is presented as one of a series of articles in both the Journal of Neurotherapy and the Journal of Applied Psychophysiology & Biofeedback describing and reviewing biofeedback applications for adult populations.…”

“…Most, if not all of the recommendations previously made regarding further research (Trudeau, 2000(Trudeau, , 2005b) have yet to be implemented. These recommendations are summarized as follows.…”