Biofeedback

Biofeedback vs. Neurofeedback: What’s the Difference?

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Neurofeedback is one kind of biofeedback. Biofeedback is the broad method of measuring a body signal and showing it to you so you can learn to change it; neurofeedback applies that method to brain activity, measured through sensors on the scalp. The evidence for the two is not the same: biofeedback has high-confidence evidence for headaches, while Wikipedia describes the benefits of neurofeedback as unproven.

As a family and one of its members. The Wikipedia article on neurofeedback defines it as a form of biofeedback that uses electrical potentials in the brain to reinforce desired brain states through operant conditioning, a form of learning shaped by the consequences of behavior. It is non-invasive, and brain activity is typically recorded with electroencephalography (EEG).

Other forms of biofeedback work with signals from the rest of the body: muscle tension, skin temperature, sweat gland activity, heart rhythm and breathing.

What does a neurofeedback session measure?

The electrical activity of the brain, picked up by electrodes on the scalp. The same article describes several training protocols, some of which use a detailed brain map, called quantitative EEG, to decide what to train. Related technologies use other measures of brain activity, including functional MRI and near-infrared light.

The practical difference for you: in a general biofeedback session, you may be able to feel what you are changing, such as a tight shoulder or a fast breath. In neurofeedback, the target is a pattern of brain activity, and the screen is how you know whether it is changing.

Where did neurofeedback come from?

From early brainwave research. The article’s history includes 1924, when Hans Berger detected a small current through electrodes on a patient’s scalp, and dates the first study to demonstrate neurofeedback to Joe Kamiya in 1962, who asked people to judge whether they were producing alpha waves when a tone sounded. In 1967, M. Barry Sterman published research training cats to produce more of a brain rhythm called the sensorimotor rhythm.

How does the evidence compare?

Unevenly. For headaches, the authors of a 2019 evidence map of systematic reviews rated the evidence as high-confidence: biofeedback reduced how often migraine and tension-type headaches occurred, how long they lasted and how intense they were. Where the map compared the two directly, in fibromyalgia, it found that muscle (EMG) biofeedback had the potential to improve pain and brainwave (EEG) biofeedback did not.

For neurofeedback in general, the Wikipedia article states that its benefits are unproven and that improvements may stem more from placebo effects than from direct brain regulation. It describes neurofeedback for ADHD as controversial, with a mixed literature.

Which one fits your goal?

Start with the symptom. If it is a problem such as migraine or tension-type headache, ask about general biofeedback first, since that is where the 2019 map found high-confidence evidence. If someone proposes brain training instead, ask what condition it targets, what research supports it for that condition, and how the result will be measured.

One question that tells them apart

Ask the practitioner: “What signal will we train, and where is the evidence that training it helps my condition?” A clear answer names the signal, the condition and the study. A vague one is a reason to wait before you pay for a course.

This article is general information, not medical or psychological advice; talk with a licensed clinician about your own situation.

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