Headaches and tinnitus
Headaches and tinnitus
Neurofeedback for headaches and tinnitus
Who is Neuroflex suitable for?
For people who suffer from recurring migraine attacks, tension headaches or troublesome ringing in the ears and are looking for lasting help to supplement their medication.
Do you know that?
A pulsating pain that makes it impossible to concentrate? A constant whistling or humming that accompanies you even in quiet moments? Headaches and tinnitus often have a common cause in overactive pain and auditory processing pathways.
What is neurofeedback?
With the help of vasoconstriction training and EEG feedback, clients learn to reduce excessive cortical activity in the temporal and parietal regions and build up regulating alpha patterns. At the same time, the perception of pain and sound is rebalanced.
How does neurofeedback help?
Numerous studies have reported a significant decrease in the frequency of migraine attacks and a reduction in the subjective loudness of tinnitus. The targeted build-up of SMR activity calms the thalamus-cortex network, which is considered to be overexcited in both disorders.
When will I notice something?
The first improvements are often noticeable after 6-8 sessions. For a stable long-term effect, we recommend 20-30 sessions.
What makes Neuroflex special?
We use frequency-specific protocols (e.g. alpha/delta ratio) and integrate relaxation and mindfulness techniques where necessary to positively influence the overall experience.
Procedure of the training, which combines mobile neurofeedback and in-practice training
Start - initial consultation, trial training, qEEG
Phase 1 - Initial phase
(10-12 sessions)
Phase 2 - In-depth phase
(further 15-20 sessions)
Phase 3 - Transfer phase and self-application
Studies on neurofeedback for headaches or tinnitus
Neurofeedback (NF) is being researched in the areas of chronic pain and tinnitus. The aim here is to modulate pathologically altered brain rhythms that are associated with the perception of pain or tinnitus. Below is a brief overview of the literature and key studies:
Overview and central questions
Aim: Regulation of certain frequency bands (e.g. reduced alpha, increased theta or beta) in brain areas involved in pain perception or tinnitus generation (e.g. somatosensory cortex, auditory cortex).
Expectation: Normalization of this brain activity could reduce the subjective intensity of pain and tinnitus and thus improve quality of life.
Variety of protocols: Depending on the indication, different training frequencies (e.g. SMR, theta-down, alpha-up) and feedback modalities are used.
Main results and trends
Pain relief: Most NF studies on chronic pain report a reduction in pain intensity and, in some cases, improved quality of life.
Tinnitus reduction: Alpha training or beta/gamma down was used for tinnitus, in some cases with subjective relief of the tinnitus. However, the strength of the effect varied greatly in the studies.
Individual protocols: The training scheme is often adapted to the EEG findings of the individual patient (so-called “assessment-guided AF”). However, this makes standardized comparisons difficult.
Study situation: As in other clinical areas, there are mainly case series and small pilot studies. High-quality, randomized controlled trials (RCTs) with large samples are still pending.
Important studies and reviews
Chronic Pain Jensen MP, Grierson C, Tracy-Smith V, Bacigalupi SC, Othmer S. (2007). Neurofeedback treatment for pain associated with complex regional pain syndrome type I. J Neurother, 11(1), 45-53.
Content: Case series of patients with CRPS (complex regional pain syndrome).
Result: Reduction in pain intensity and improvements in everyday function after NF training (e.g. theta-down, alpha-up).
Limitation: Small sample, no RCT.
Jensen MP et al. (2013). Neurofeedback and Biofeedback for Pain Conditions. Am Psychol, 68(2), 135-144.
Content: Overview of biofeedback methods for chronic pain syndromes (e.g. back pain, neuropathic pain).
Result: Moderate positive effects in several pilot studies; need for larger studies with controls.
Tinnitus Dohrmann K, Elbert T, Schlee W, Weisz N. (2007). Neurofeedback for treating tinnitus. Prog Brain Res, 166, 473-485.
Content: Description of tinnitus as a maladaptation of auditory circuits, which can be accompanied by deviating alpha/beta activity.
Result: Alpha band increase or reduction of excessive beta/gamma activity leads in part to a reduction in tinnitus perception.
Weisz N, Moratti S, Meinzer M, Dohrmann K, Elbert T. (2005). Tinnitus perception and distress is related to abnormal spontaneous brain activity as measured by magnetoencephalography. PLoS Med, 2(6), e153.
Content: No direct NF study, but basis for NF protocols (e.g. beta-gamma-down).
Result: Abnormally high gamma oscillations (approx. 40 Hz) in auditory areas correlate with tinnitus severity; NF therefore often aims to reduce this activity.
Schulz-Stübner S. (2008). Neurofeedback in chronic pain syndromes. The Pain, 22(4), 423-429.
Content: German review article on NF in pain patients, including migraine and back pain.
Result: Initial studies indicate a reduction in subjective pain ratings, but control groups and long-term follow-ups are often lacking.
Do you have any questions? I am here for you.
Wolfgang Maier
MA in Special Education HfH
MAS in Neuropsychology UZH
Wolfgang Maier
MA in Special Education HfH
MAS in Neuropsychology UZH
Areas of application of neurofeedback
Conclusion
The use of neurofeedback for chronic pain and tinnitus has shown promising effects in small studies. Both the intensity of pain and the perception of tinnitus can often be reduced when dysfunctional EEG patterns are regulated. However, the lack of methodological robustness (small number of subjects, short follow-ups, unclear placebo controls) is often criticized. Future research should therefore implement larger RCTs, longer observation periods and standardized protocols in order to more clearly demonstrate the clinical relevance and long-term efficacy of neurofeedback in these indication areas.