Concussions, also known as mild traumatic brain injury (mTBI), are often considered a temporary injury. However, many victims, especially veterans, suffer from chronic headaches, sleep disorders and cognitive impairment for years after the original event. Despite existing therapeutic approaches, the treatment of these symptoms remains a challenge.

A recently published randomised controlled trial by Carlson et al. investigated the efficacy of Infra-Low Frequency Neurofeedback (ILF NFB) as a potential non-invasive treatment method. Veterans with long-lasting post-concussive symptoms were treated with ILF NFB over several weeks. The results show significant improvements in several key areas.

What is Infra-Low Frequency Neurofeedback?
Neurofeedback is a form of biofeedback in which patients can improve their ability to self-regulate by visualising their brain activity in real time. Electrical signals from the brain are recorded via electrodes and played back in the form of sounds or visual elements. In this way, the activity of the brain and the symptoms of illnesses can be better regulated.
Infra-Low Frequency Neurofeedback (ILF NFB) focusses on extremely slow brain waves below 0.1 Hz.

The study: design and methodology
In order to investigate whether ILF NFB can actually help to alleviate post-commotion symptoms, researchers conducted a randomised controlled trial with 87 veterans suffering from persistent symptoms.

Participants and procedure
The participants in the study were randomly divided into two groups.
The intervention group received 20 sessions of ILF NFB, each lasting 30 minutes, over a period of 8 to 10 weeks.
The control group instead received eight short health talks covering general topics such as stress management and sleep hygiene.
During the study, all participants continued their regular medical treatments.

Measurement of symptoms
Various standardised test procedures were used to assess the effects of the treatment:

• Headache: Headache Impact Test (HIT-6)
• Sleep quality: Insomnia Severity Index (ISI)
• Cognitive performance: attention tests (QIK test)
• Mental stress: questionnaires on depression, PTSD and quality of life

Measurements were taken before treatment, after 4-6 weeks, after completion of therapy (after 8-10 weeks) and two months after the end of treatment.

Results: Clinically relevant improvements
At the end of the treatment, participants who received ILF NFB experienced significant improvements in several areas.

Headaches and pain perception
The ILF NFB group reported a noticeable reduction in headache intensity and frequency. The average score on the Headache Impact Test (HIT-6) decreased by 12.6 points, while the control group reported an improvement of only 1.9 points.

Sleep quality
Participants in the ILF NFB group fell asleep faster, had fewer waking phases at night and reported a higher quality of sleep.
The Insomnia Severity Index (ISI) improved by 11.7 points - a clear difference to the control group, which only showed an improvement of 1.4 points.

Cognitive performance
Participants in the ILF NFB group also performed significantly better than those in the control group in tests of attention and impulse control.

Mental stress and quality of life
The ILF NFB group recorded a noticeable improvement in depressive symptoms and post-traumatic stress disorder (PTSD).
The general quality of life increased significantly, which was reflected in better scores on the QOLIBRI test.

Conclusion
The results of the study suggest that ILF NFB may be a promising non-drug treatment option for post-concussive symptoms. Of particular note are the improvements in headache, sleep quality and cognitive performance, which remained stable over the study period. The secondary results of the present study also indicate that ILF neurofeedback may be an effective treatment option for symptoms associated with depression and PTSD. In addition, it has a significant positive impact on the subjective quality of life of veterans with mTBI.

The detailed explanation, the implementation and the results of the study can be found here.

Neurofeedback is an effective and evidence-based therapy method for the treatment of various mental illnesses. Neurofeedback devices for home use are increasingly available on the market. And we are also receiving more and more enquiries from private individuals.

Home-use neurofeedback equipment
BEE Medic is a leading manufacturer of neurofeedback equipment specifically designed for use in clinical and therapeutic environments. Our devices are certified to strict medical standards and undergo extensive quality assurance processes to ensure the highest levels of accuracy and safety.

However, devices sold for home use by individuals often do not achieve the diagnostic and therapeutic precision of professional systems. In addition, they are often not certified to medical standards. For effective and safe neurofeedback, we advise against non-certified home equipment.

Self application of neurofeedback
In addition, the use of neurofeedback should be in the hands of a healthcare professional - a doctor or therapist who has received appropriate training. Neurofeedback is a treatment that requires complex clinical decision-making and excellent clinical skills to be effective, so it is essential that neurofeedback is only administered by mental health professionals. A comprehensive training programme is required to ensure that practitioners are prepared to provide neurofeedback services.

Neurofeedback is a treatment that is largely free of side effects. In rare cases, however, side effects such as headaches, nausea or palpitations can occur. This is known as maladaptation. The effects are usually very short-lived and are controlled by the therapy - unless the incorrect exercise is continued for a longer period of time. Inappropriate training can make symptoms worse rather than better. Therefore, treatment should only be carried out by appropriately trained neurofeedback professionals who can adjust training protocols in the event of side effects.

Our approach: Professional neurofeedback equipment with therapeutic support 
To ensure safe and effective neurofeedback treatment, we strongly advise against the use of uncertified home-use equipment and recommend therapy with a trained provider.

Are you a patient interested in neurofeedback therapy?
Visit the Neurofeedback Network website for more information and a therapist locator to find neurofeedback providers in your area.
 

Meet Dr. Andrea Durand & Durand Healing and Wellness Center in Phoenix, AZ!
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For Dr. Andrea Durand, DBH, LCSW, integrating neurofeedback was a natural step in her mission to provide comprehensive mental health care. With a strong background in behavioral health and trauma-focused therapy, she sought training with EEG Info and introduced neurofeedback into her practice last year. Since then, she has witnessed remarkable transformations in her patients.

“I have seen some incredible progress in my patients while using ILF and NeuroAmp II,” she shares. Many have experienced improved sleep, enhanced focus, better memory, and overall well-being. She has also observed patients reducing or even discontinuing certain medications as their symptoms improve.

The integration of neurofeedback was both exciting and challenging, but with the support from BEE Medic and EEG Info, the process became much smoother. From the start, she had access to valuable resources and guidance at every step of the way. “Gary from BEE Medic was always quick to respond and answer any questions I had.”

Clients have been enjoying neurofeedback sessions, and as interest grew, Dr. Durand added a second NeuroAmp II in less than a year. One feature clients especially appreciate is the Advanced Browser, with Dr. Durand noting, "Patients love being able to watch their favorite show while improving their health at the same time."

We love seeing practices like hers thrive and make a difference in their communities—thank you for sharing your story!

About Durand Healing & Wellness Center

We are a private mental health practice in Phoenix, AZ, founded in 2020. We offer individual, couples, group, and family therapy, as well as onsite medication management and neurofeedback services. Our practice is built on the belief that mind and body are deeply connected, and we take this into account in every aspect of treatment.

Get In Touch

Phone: 480-690-8941

Email: [email protected]

Website: durandhwc.com

The second part of the article ‘Clinical ILF neurofeedback with children and adolescents’ has now been published in the current issue (1/2025) of the forum für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie (forum for child and adolescent psychiatry, psychosomatics and psychotherapy) of the bkjpp  (Professional Association for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy in Germany e.V.).

Building on part 1 of the article, which deals with the scientific foundations of (ILF) neurofeedback, our lecturers Ute Bolduan (occupational therapist), Andrea Icking (qualified psychologist), Horst Schneider (qualified biologist and doctor of neurophysiology) and Gernot Wührer (qualified psychologist) shed light on the current study situation and various case studies on the use of ILF neurofeedback in occupational therapy practice in this second part of the article. The article presents a detailed case study of an 11-year-old boy with post-traumatic stress disorder and explains in detail both the individual training plan and the course of therapy. It also describes the treatment of two 17-year-old girls with anxiety disorder. Finally, the article provides an overview of the options for prescribing and reimbursing neurofeedback as part of occupational and behavioural therapy in ther German health system.

You can read the full article on the website of the forum for paediatric and adolescent psychiatry, psychosomatics and psychotherapy: 

https://www.kinder-psychiatrie.de/wp-content/uploads/2025/01/web_forum_1-25_.pdf

Please note: the article is in German language.
 

Meet Dr Divya Kakaiya and Healthy Within in San Diego, CA!

For over a decade, Dr Divya Kakaiya, Ph.D., M.S. (PsyPharm) and her team at Healthy Within have been providing integrative neurofeedback treatments. With neurofeedback at the heart of their approach, they focus on working with the whole person - addressing lifestyle, brain function and the microbiome to promote stability and overall wellbeing.

Dr Kakaiya has been using BEE Medic's Cygnet neurofeedback system since 2012 and considers it essential to her practice. ‘With an activity as intense as mine, I could do with another BEE Medic device,’ she says. She mainly uses infra-low frequency (ILF) neurofeedback and the single channel protocol, praising Cygnet's user-friendly interface compared to other systems.

She has seen first-hand how neurofeedback helps individuals to significantly improve their well-being. One patient said: ‘Within a few weeks of starting treatment, I was no longer depressed and was able to stop psychotherapy. Another client explained, ‘Neurofeedback gave me the results I wanted without any unwanted side effects.’

Dr Kakaiya credits neurofeedback with reinvigorating her career: ‘The addition of neurofeedback gave me enormous enthusiasm in my mid-fifties. Today, I can see myself working into my 90s! I get immense satisfaction and the patients get better and better. She also appreciates our support team: ‘The BEE Medic team is fantastic. They are VERY reactive and respond immediately to all my needs. They have such a solid understanding of how equipment needs to be in top condition every day!

At Healthy Within, Inner Tube and Particle World are patient favorites, with teenagers particularly enjoying the opportunity to watch films during sessions. Dr Kakaiya hopes that neurofeedback will become a more widely recognized treatment option and stresses the need for greater awareness and support, in line with the progress made with other therapies.

We are proud to present Dr Divya Kakaiya and Healthy Within as a dedicated provider of neurofeedback and an inspiration to clinicians looking to transform their practices.

About Healthy Within

We are an integrative psychological center whose main offering is neurofeedback. Dr Kakaiya's post-doctoral master's degree enabled her to opt for a much more integrative modality. We work with the whole person on lifestyle issues and provide education on how to stabilize the whole body, brain and microbiome.

Contact

Phone: 858-622-0221

Email: [email protected]

Website: healthywithin.com