The Neurofeedback Results: How 20 Sessions Transformed One Brain's Performance
After 20 sessions of neurofeedback training, we had the rare opportunity to see exactly what changed in a human brain. Not just subjective improvements, but objective, measurable differences in cognitive performance and neural activity patterns. The results reveal both the remarkable potential of neurofeedback and the specific mechanisms through which it works.
The Testing Protocol: Measuring Attention and Response Control
To understand what changed, we need to understand what we measured. The attention performance test is deliberately boring—a 20-minute task where you click on ones but not twos, presented either visually or auditorily. This isn't about intelligence or skill; it's about cognitive stamina and resource allocation under monotonous conditions.
The scoring uses a bell curve where 100 is average for your age group, with about 15 points encompassing two-thirds of the population. The test measures two key domains:
Attention: How well you can activate and sustain focus on target stimuli Response Control: How well you can inhibit automatic responses to distractors
Each domain breaks down further into specific components like vigilance (catching novel changes), focus (maintaining on boring repetition), and speed (processing efficiency).
The Baseline: A Specific Bottleneck Revealed
Before neurofeedback, the data revealed a fascinating pattern. Response control was normal—around 100 in both visual and auditory domains. The ability to pump the brakes and not click on distractors was intact.
But attention showed a different story. Overall attention scored 79, about one and a half standard deviations below average. More telling was the specificity of this deficit.
Visual attention was completely normal—right in the middle of the bell curve. But auditory attention showed a severe bottleneck at 56, two and a half standard deviations below average.
Drilling down further revealed the exact mechanism: vigilance in the auditory domain scored just 58. This represents the precise moment of catching auditory information when things change—when your brain needs to dynamically shift attention to new auditory input.
This wasn't a general attention problem. It was a highly specific deficit in auditory vigilance—the cognitive moment of grabbing novel auditory information as it emerges.
The Transformation: Eliminating the Bottleneck
After 20 sessions of neurofeedback, the results were dramatic. Overall attention improved from 79 to 107—nearly two full standard deviations of improvement. But the real story lies in the specifics.
That auditory vigilance bottleneck? It went from 58 to 105—a 47-point improvement representing more than three standard deviations of change. To put this in perspective, typical neurofeedback produces about one standard deviation of change every 20-25 sessions. This was triple that expected improvement.
The auditory attention system as a whole improved from 56 to 113, moving from the corner of the bell curve to above average performance. Auditory focus improved from 79 to 97, eliminating the tendency to burn out during boring auditory tasks. Processing speed jumped from 89 to 123.
Interestingly, visual attention also improved despite not being the target. Visual processing speed increased, and vigilance remained rock solid, though some efficiency measures dipped slightly—likely due to test-day fatigue rather than true regression.
The Neuroscience: Understanding the Mechanism
These changes weren't random. They reflect specific alterations in neural circuit function that neurofeedback can reliably produce.
The auditory vigilance bottleneck likely involved dysfunction in the temporoparietal attention networks—brain circuits that coordinate the moment-to-moment allocation of attention to auditory input. When these circuits underfunction, you get exactly what we saw: difficulty with the dynamic aspect of auditory attention while static auditory processing remains intact.
Neurofeedback protocols targeting these regions typically involve training specific brainwave patterns that enhance thalamocortical regulation. The thalamus acts as the brain's relay station, and when its rhythmic activity becomes better regulated, it can more effectively coordinate cortical attention networks.
The improvement in processing speed suggests enhanced neural efficiency—the same cognitive work now requires fewer neural resources, freeing up capacity for other functions. This is consistent with neurofeedback's ability to optimize the signal-to-noise ratio in neural circuits (Ghaziri et al., 2013).
The Efficiency Question: Power vs. Optimization
The post-training results revealed an interesting pattern. While the bottleneck was eliminated and overall function improved dramatically, some efficiency measures suggested compensatory strategies were still in play.
The high processing speed (123) and excellent vigilance, combined with slight dips in sustained focus measures, suggested the brain was now using a "quick and alert" strategy. Rather than smoothly maintaining attention, it was rapidly catching information it might otherwise miss.
This represents an intermediate stage in neurofeedback training. The resources that were previously "pinched up and flagging" had been brought up to typical levels, but the system hadn't yet achieved optimal efficiency. The brain was working harder than necessary, using powerful but not yet perfectly refined strategies.
This pattern is common in neurofeedback training. Initial sessions often eliminate bottlenecks and restore function. Later sessions refine efficiency and reduce compensatory effort. It's the difference between getting the job done and getting it done elegantly.
Clinical Implications: Specificity and Personalization
These results highlight neurofeedback's remarkable specificity. The training didn't produce broad, non-specific improvements. It targeted exactly the bottleneck identified in the initial assessment—auditory vigilance—while leaving intact systems largely unchanged.
This specificity emerges from neurofeedback's ability to train individual brain circuits based on their unique activity patterns. Unlike medications that affect neurotransmitter systems broadly throughout the brain, neurofeedback can target the specific neural networks that need optimization.
The persistence of some compensatory patterns also demonstrates why neurofeedback typically requires multiple rounds of training. Each 20-25 session round addresses different aspects of circuit function: first eliminating bottlenecks, then refining efficiency, then building resilience under stress.
The Broader Picture: Neuroplasticity in Action
What we're seeing here is neuroplasticity—the brain's ability to reorganize and optimize its function—guided by real-time feedback. The magnitude of change (three standard deviations in 20 sessions) demonstrates that adult brains retain remarkable capacity for functional improvement when given appropriate training signals.
This challenges older models of brain development that suggested critical periods beyond which significant change becomes impossible. Neurofeedback research consistently shows that targeted training can produce substantial improvements in cognitive function even in fully mature brains.
The structural brain imaging studies support this functional data. Ghaziri et al. (2013) found that intensive neurofeedback training produces measurable increases in gray matter volume in trained regions. These aren't just temporary functional changes—they represent actual structural reorganization of neural tissue.
Practical Takeaways: What This Means for Training
For clinicians and individuals considering neurofeedback, these results offer several key insights:
Assessment specificity matters: Generic brain training is less effective than targeted training based on individual assessment. The dramatic improvement here resulted from identifying and specifically addressing the auditory vigilance bottleneck.
Expect staged improvements: Initial rounds eliminate bottlenecks and restore function. Later rounds refine efficiency. Don't expect perfect optimization immediately.
Objective measurement is valuable: Subjective improvements often precede objective measurements, but having both provides crucial feedback about training effectiveness and remaining areas for optimization.
Individual variation is normal: Not everyone will show three standard deviations of improvement in their primary bottleneck. Factors like age, overall brain health, consistency of training, and specific protocol selection all influence outcomes.
The Road Ahead: Optimization vs. Function
The results after 20 sessions represent a major milestone but not the endpoint. The elimination of the primary bottleneck and restoration to above-average function in the target domain is significant. However, the persistence of compensatory patterns suggests additional training could yield further refinement.
This mirrors what we see clinically. Individuals often report substantial subjective improvements after their first round of training as bottlenecks are eliminated. Subsequent rounds tend to produce more subtle but important gains in efficiency, resilience, and automaticity of improved function.
The brain that struggled with auditory vigilance is now performing above average in that domain. The next question becomes: can that performance become more efficient and automatic? The data suggests yes, with continued targeted training.
Conclusion: The Precision of Neurofeedback
These results demonstrate neurofeedback's unique position in the landscape of cognitive enhancement. Rather than broad, non-specific effects, we see precise targeting of identified deficits with measurable, substantial improvements in exactly the predicted domains.
The three standard deviations of improvement in auditory vigilance—the specific bottleneck identified pre-training—represents the kind of targeted neuroplasticity that makes neurofeedback particularly valuable for addressing cognitive limitations that don't respond well to other interventions.
More broadly, these data illustrate the remarkable plasticity that remains available in adult brains. With appropriate assessment, targeted protocols, and consistent training, substantial improvements in cognitive function are not only possible but measurable and predictable.
The brain's capacity for optimization extends well beyond what most people experience in their daily lives. Neurofeedback provides one precise method for accessing and developing that capacity.
For a complete understanding of the initial assessment and training approach that produced these results, see the companion article covering the baseline brain mapping and protocol selection process.