Frequently asked questions.
What is the difference between neurofeedback and LORETA neurofeedback (LNF)
Standard neurofeedback trains only a couple or a few areas on the surface of the brain. LNF can train multiple specific 3 dimensional areas. The areas are chosen from the 3 dimensional areas defined by a GPS-like computer program that converts your digital EEG with 19 active leads, 2 reference leads, and ground into 88 areas. This allows LNF to target functional areas of the brain (Brodmann areas). As well LNF trains your abnormal brain areas towards the normal areas for your sex and age (Z score).
How can LNF help my well-being?
LNF acts the way physiotherapy or exercise act on your muscles, bones and joints. Neurofeedback can strengthen weak areas, shift things that are out of place, and provide a calmness to your brain.
What brain issues has LNF been proven to help?
LNF can help:
- Mood disorders like anxiety and depression
- Attention deficit disorder and certain other learning disorders
- Certain causes of cognitive dysfunction
- Traumatic brain injury (Head injury)
- Chronic pain
- Addiction (including substance use, shoplifting and gambling),
- Stroke rehabilitation
- Post-traumatic stress disorder (PTSD) including torture.
- Prevention of migraine headaches
- Autonomic dysfunction
Dr. Birmingham has found LNF can also help:
- Anorexia Nervosa where operant conditioning of those areas of the brain involved reduces anorexic thinking
- Bulimia Nervosa & Binge Eating Disorder to reduce binging and binging/purging
- Some causes obesity
- Obsessive compulsive thinking or compulsive behaviours
- Tics due to Tourette’s syndrome
LNF doesn’t help (in Dr. Birmingham’s opinion)
- Bipolar affective disorder (antidepressants or LNF can precipitate hypomania or mania). If the hypomania or mania are under control on medications LNF may be tried while you are being followed by your psychiatrist or physician.
- Seizures (however, vagal stimulation may help reduce the incidence of seizures). There is strong evidence that vagus nerve stimulation reduces the frequency of some seizures.Dr. Birmingham does use vagus nerve stimulation.
Are you a psychiatrist or a psychologist?
I am neither. I am a medical doctor licensed to practice as a specialist in Internal Medicine. Academically I am a Professor of Psychiatry at UBC. I am also a medical researcher with a Masters Degree in Epidemiology and Biostatistics. I have about 280 publications.
How long is your wait list?
My wait list is typically between 2 – 3 weeks depending on the time of year. My wait list is short because my patients only need 10 sessions on average.
How many sessions will I need and how frequent should they be?
Many patients need 10 sessions but this has ranged from 1 to 70 sessions. If you have more than one major issue, like PTSD and severe depression, it may take 20 sessions.
Can I see my GP and therapist?
Yes, you should continue seeing your other health care professionals. I can keep them up to date if you wish or give you information to share with them. I will not send information to anyone without your consent.
How is Dr. Birmingham’s use of neurofeedback different from other practitioners of neurofeedback?
First, I am a licensed medical doctor who is a specialist in internal medicine. I have the ability to diagnose disease and complications based on your symptoms, signs, and tests.
Second, my use of the principles of biofeedback and medicine.
A Toronto psychiatrist specialized in biofeedback taught me the principles of biofeedback 40 years ago. Neurofeedback is one type of biofeedback (a biological function changed into something the patient can quantify and change). For example, the reward or the negative feedback must occur as soon as possible after the patient’s behavior. For this reason I don’t use videos that delay the process of the neurofeedback decision. Importantly, I monitor the EEG during the entire training session to make certain the patient’s brain is not being trained wrongly because of artefacts like loss of lead contact.
Third, my medical knowledge helps me use adjunctive treatments like AC stimulation and vagus nerve stimulation.
Fourth, I use a full digital EEG of the highest quality (Nexus 32 and Biotrace) and analyse the information using 3-D technology (Neuroguide and LPR).