At the Center for Brain Training, we are passionate about helping people feel better.

We get a lot of questions these days about TMS (transcranial magnetic stimulation). These two technologies can seem so similar that identifying the differences can be confusing.

Here are common questions we hear with answers we hope will help you become more thoroughly informed:

TMS and neurofeedback are quite different methods employed to change brain activity.

TMS uses magnets and is primarily applied to treat depression. Neurofeedback employs feedback to help you learn to stimulate or change your brain and can be applied to a wider variety of brain-based conditions (see more below).

TMS
TMS (also known as rTMS) stimulates a targeted part of your brain using high-powered magnets placed above your head. Its magnetic field can change brain activity. In the U.S., TMS has been cleared by the FDA as a treatment for major depression and for pain associated with certain migraine headaches. Some TMS machines have been approved as an adjunct treatment in adults with OCD. These clearances and approval don’t mean that TMS works consistently, but it’s increasingly popular with psychiatrists and other providers because it’s often well reimbursed by health insurance.

Most centers that provide TMS require treatment sessions every weekday for 20 to 40 visits. Those benefitting often need ongoing maintenance for the benefits to continue. Many centers also recommend the continued use of anti-depressant medications.

Neurofeedback
Neurofeedback uses technology that provides instant feedback to the brain. This feedback helps your brain change its neuronal firing pattern. In other words, the brain resets itself to function better.

Rather than stimulating the brain as TMS does using magnets, neurofeedback employs feedback (typically in the form of auditory and visual stimulation) that helps you change your brain’s activity so that it operates with a more normal pattern. This approach is founded on the concept of neuroplasticity, the brain’s ability to change itself.

Neurofeedback training is used clinically to improve many conditions including depression, anxiety, OCD, sleep issues, chronic pain, ADHD, learning and attention problems, panic attacks, and autism. It’s increasingly used by psychologists, psychiatrists, and other mental health providers as an option to medications.

Insurance coverage is another way the two therapies differ. Because TMS has clearances and an acceptance from the FDA, it’s often covered by insurance. Insurance coverage for neurofeedback is not always covered. Many providers may be out of network, and reimbursement depends on the company, your particular plan, the codes chosen to submit, and whether your provider supports insurance filing.

Mike Cohen has been looking carefully at TMS for a number of years. (Mike is Director of Neurotechnology at the Center for Brain Training). Below are his thoughts on answering this question:

The benefits of TMS

“I’ve been investigating TMS off and on for the past 10 years (and used neurofeedback for 25+ years). I’ve looked into the different types of TMS and TMS equipment. I’ve visited several TMS centers and referred patients for TMS. I’ve asked psychiatrists who referred patients for TMS about their experiences and have talked to some of my clients who tried it. ”It turns out that TMS hasn’t lived up to its initial promise. Though it can work well for some people I had hoped we’d see a higher percentage of clients get clearly distinct benefits. My perception is that fewer than 50% of patients experience significant effects. Many require a lot of ongoing maintenance for them to hold, but some people do benefit.

“One psychiatrist I interviewed said she quit referring for TMS because too few of her patients did well. TMS protocols used in the U.S. are minimal compared to how they’re used in some other countries.

“TMS has promise, but the technology and methods for targeting the training need to evolve. It would make sense to have a detailed brain map to identify where to target the TMS. That’s often how we use neurofeedback, but currently, that’s not the standard for TMS. TMS primarily targets the same spots on the head for everyone – without knowing if the individual’s needs really match up.”

The benefits of neurofeedback

Neurofeedback has several advantages over TMS:

  • While TMS usually requires five 20–40-minute sessions per week for six to seven weeks, neurofeedback is usually done 1-3 times per week. The course of treatment depends on the individual.
  • TMS generally targets depression only. Neurofeedback can target a variety of symptoms in addition to depression, including anxiety and sleep.
  • About 70% of our neurofeedback clients experience clinical benefits, generally higher than those who benefit from TMS.
  • Neurofeedback often costs less than TMS if the TMS treatment isn’t covered by insurance.
  • Neurofeedback can take a more comprehensive approach for complex issues by being combined with other neurostimulation tools, other types of neurofeedback and lifestyle changes
  • Many people who do neurofeedback find that they can gradually reduce some of their medications, with the guidance of their physicians. TMS patients rarely adjust their medications during treatment.

For most people, and for the benefits outlined above, neurofeedback is often the better choice for many people. Ultimately, however, it is up to your physician to help you decide how to proceed.

Neurofeedback as TMS maintenance

As a side note, we’ve worked with several patients who responded well to TMS who used neurofeedback training for their maintenance rather than using TMS for maintenance. The results were better in some cases when neurofeedback was paired with improved nutrition, exercise, and other lifestyle changes.

1.Contact us, or a neurofeedback provider near you, for information about how neurofeedback may be able to help you.

2. Click here to watch a short video that explains how neurofeedback works.

3. For an even more in-depth understanding read Mike Cohen’s Amazon bestselling book Neurofeedback 101: Rewiring the Brain for ADHD, Anxiety, Depression and Beyond (without medication).

Mike Cohen’s Take on Which Therapy is “Better”

Mike Cohen has been looking carefully at TMS for a number of years. (Mike is Director of the Center for Brain Training). Below are his thoughts on answering this question:

“I’ve been investigating TMS off and on for the past 10 years and used neurofeedback for 25+ years. I’ve looked into the different types of TMS and TMS equipment. I’ve visited several TMS centers and referred patients for TMS. I’ve asked psychiatrists who referred patients for TMS about their experiences and have talked to some of my clients who tried it. It turns out that TMS hasn’t lived up to its initial promise. Although it can work well for some people, I had hoped we’d see a higher percentage of clients get clearly distinct benefits. My perception is that fewer than 50% of patients experience significant effects, and many require a lot of ongoing maintenance for effects to hold.

One psychiatrist I interviewed said she quit referring for TMS because too few of her patients did well. TMS protocols used in the U.S. are minimal compared to how they’re used in some other countries.

TMS has promise, but the technology and methods for targeting the training need to evolve. It would make sense to employ a type of brain map called a qEEG to identify where to target specific brain areas, as we do when training with neurofeedback.

Although qEEG brain mapping is becoming more widespread among TMS providers, it isn’t standard among the vast majority of them. This means they must target the same spots on the head for everyone and are usually unable to adapt the TMS protocols to how any given individual’s brain is responding to the therapy. One reason only a limited number of providers do brain mapping is because it has a steep learning curve.

In my experience, neurofeedback is as effective, if not more effective, than the most common TMS technology, especially when combined with low-level neurostimulation technology. It may also be a help if paired with TMS. (Note: There’s a newer form of TMS called theta burst that seems promising.)

Neurofeedback can be very effective in helping anxiety and depression among people who did TMS and need maintenance or more help, and it’s almost certainly more effective, with more consistent results, among people with trauma and anxiety. In some cases, however, TMS may have an advantage when dealing with depression.

Another benefit of neurofeedback is that it is commonly used to help sleep. Sleep is often a problem for people considering doing TMS. Unfortunately, TMS doesn’t directly target sleep.

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Other Services

Body Biofeedback BRT Bioregulation therapy and body PEMF: A Cutting-Edge Approach to Nervous System Optimization

This innovative system combines biofeedback with PEMF (Pulsed Electromagnetic Field Therapy) to enhance cellular communication, allowing the nervous system to reset and function more efficiently. By promoting a stronger gut-brain connection and reducing inflammation, it helps the body recalibrate itself for improved overall performance.

Developed in Europe, this unique technology has been a game-changer for addressing issues that have not responded well to traditional medical interventions. It is particularly effective for chronic pain, gut-brain dysfunction, autoimmune conditions, tics, and a variety of metabolic and inflammatory challenges.

Additionally, it excels in calming the nervous system, making it an exceptional tool for managing anxiety, PTSD, and panic attacks. Its ability to settle the gut-brain axis is likely a key reason for its profound impact on emotional and physiological balance.

Cognitive Base Line Testing

Our neurocognitive baseline test is a comprehensive assessment designed to evaluate key cognitive functions, including attention, memory, processing speed, and executive function. This 40-minute series of 7 tests, based on gold-standard neurocognitive testing methods, provides a thorough measure of your cognitive strengths and weaknesses.

Each test takes about 5 minutes, and results are compared to a standardized database of norms for your age group. This comparison helps identify areas where you excel and areas that may need improvement. This test has been administered millions of times and is widely used in both clinical and research settings. Over time, it can be valuable for tracking subtle cognitive changes and assessing overall brain health.

Nutrition and Brain Metabolism

Nutrition and Neurofeedback are closely interconnected, as the brain’s functioning is significantly influenced by what we eat. Proper nutrition can optimize neurofeedback results, while neurofeedback can help individuals develop healthier habits and better awareness of their body’s needs.

We offer a small number of brain and gut/brain supplements that have proven to work consistently with our clients. These were identified over a long time to show benefits for the brain and gut.

We recommend resources to help clients explore and understand other factors that impact their symptoms. There are many supplements highly recommended by health professionals. Yet they often don’t work consistently with our population (mental health, psychiatric, neurological). We constantly review the research and new products. We test products over time with clients to be sure they work well, are well tolerated, or they support physiological underpinnings that may drive symptoms. For example, there’s a strong link between blood sugar variability and anxiety or panic attacks. We guide clients to the appropriate resources to help support their brain, emotional well-being, and gut health. This works in tandem with neurofeedback and neurotechnology to enhance overall mental and physical performance.

Neuro-stimulation options

Brain Photobiomodulation (Pulsed Infrared Light)

This advanced technique uses pulsed infrared light to reduce inflammation, enhance blood flow, boost brain energy, and support repair processes. It’s especially beneficial for those concerned about aging or memory challenges. For concussions and brain injuries, it’s an invaluable tool for promoting recovery and brain health.

Light, Sound & CES entrainment- A Metronome for Your Brain

This is a powerful at-home tool that can be helpful for addressing ADHD, sleep challenges, mood regulation, and anxiety. It uses pulsing light, sound, and microcurrent stimulation to help the brain synchronize its timing, much like tapping along to a metronome. By encouraging better brain rhythm, it supports healing and improved function.

It offers a gentle and non-invasive way to enhance overall brain health.

Other Micro-Current Stimulation

Your brain functions like a complex battery, requiring stable electrical charge to operate optimally. When it’s over-firing or under-firing—creating low or high activity spots—it can impair performance. At our center, we use a unique, sophisticated system called Neurofield, which delivers very low-level micro-current stimulation to address these imbalances.

This system is particularly beneficial for clients recovering from strokes, concussions, memory issues, or other cognitive and neurological impairments. It’s highly customizable, with training tailored to each individual based on their detailed brain map and EEG analysis.

Neurofield enhances electrical signaling by targeting areas of both low and high brain activity, improving timing, activation, and overall function. It also offers a range of transcranial stimulation options, including TACS, TDCS, TRNS (random noise), and pink noise, which can be synchronized with PEMF and photobiomodulation as needed for optimal results.

Vagus Nerve Stimulation – CALMING tool for home use

Vagus nerve stimulation is an excellent, drug-free way to promote calm and relaxation anytime. Using low-level microcurrent stimulation, it enhances the gut-brain connection and activates the parasympathetic nervous system, helping the body shift into a state of rest and recovery.

Having tested six different devices, we’ve found a client favorite that consistently delivers results. This tool is highly effective for managing stress, anxiety, difficulty falling asleep, and even calming panic attacks. A simple yet powerful solution to support your emotional well-being.

PEMF – Pulsed Magnetic Field targeting the brain

PEMF therapy is a cutting-edge treatment that uses targeted pulsed electromagnetic fields to reduce brain inflammation, enhance blood flow, and boost metabolic activity. It’s a powerful tool for brain rehabilitation, particularly beneficial for those recovering from concussions or seeking to counteract the effects of aging. A “heavy-duty” solution for promoting optimal brain health and recovery.

Vibro-acoustic therapy

This vibrating sound chair cushion is remarkably popular in our office. It was developed to improve memory, and a study demonstrated that. But most people notice a rapid reduction in stress and an increased relaxation response. Some people have reported a reduction in back pain and other physical benefits, but that’s not its focus. The device was developed by a music professor and has been featured in a TED Talk, highlighting a study that demonstrates its effectiveness in enhancing memory.

Neurofeedback

QEEG / Brain Map Guided Training

We use the QEEG, EEG and ERP analysis to tailor a personalized neurofeedback training plan to target individual goals. Depending on the map and analysis, we create a plan that may include a variety of options, including neurofeedback, other neurotechnology, biofeedback and other approaches. The recommendations can vary widely depending on the reports and history. We work to provide practical solutions that can fit each client’s circumstances.

Infra - Slow Training ISF​

Infra -Slow Neurofeedback (ISF), developed by Mark Smith for BrainMaster neurofeedback systems, focuses on enhancing ultra-slow brainwave frequencies, typically below 0.1 Hz. These slow waves are believed to play a vital role in regulating overall brain stability, core bodily rhythms, emotional balance, and the body’s resting state.

By targeting these frequencies, ISF promotes relaxation and balance, making it particularly effective for addressing chronic stress, anxiety, sleep disorders and migraines. This approach supports improved self-regulation, emotional stability, and resilience, benefiting individuals managing trauma, and mood disorders.

During ISF training, clients receive subtle visual or auditory feedback when their brain achieves the desired slow-wave frequency. This feedback encourages the brain to naturally adopt these calming oscillations over time, fostering long-term improvements in well-being.

HEG training (both NIR and PIR) -Hemoencephalography

Our center offers two types of HEG (Hemoencephalography) neurofeedback:

1. Near-Infrared (NIR) Neurofeedback
NIR neurofeedback uses near-infrared light to measure blood flow and oxygenation levels in the frontal lobe, providing real-time feedback. Unlike traditional EEG neurofeedback, it focuses on metabolic activity rather than electrical brain activity. NIR neurofeedback is particularly beneficial for conditions involving impaired blood flow and metabolic regulation, such as traumatic brain injury (TBI), depression, anxiety, and cognitive decline.

2. Passive Infrared (PIR) Neurofeedback
PIR neurofeedback measures the brain’s passive infrared (thermal) energy, which reflects blood flow and temperature in the brain. This approach provides valuable insights into cerebral blood flow patterns, especially in the prefrontal cortex, a region critical for emotional regulation, attention, and executive functioning.

Both methods offer non-invasive ways to support improved brain function and self-regulation, tailored to individual needs.

Mulitvariate Coherence Training (Dr. Robert Coben)

Developed by Dr. Robert Coben, this specialized neurofeedback approach has been successfully applied to hundreds of children with learning disabilities, processing challenges, autism, and seizures, as well as adults with concussions and other cognitive issues. In one study, children with processing difficulties improved by a full grade level after just 15 sessions.

This method focuses on assessing and training the relationships between different brain regions, rather than isolating individual areas. It emphasizes coherence—the real-time communication between various brain regions. Disruptions in this communication can profoundly affect functions such as learning, attention, emotional regulation, and visual processing.

Traditional Amplitude and SMR/Beta training

Beta-SMR neurofeedback is designed to help individuals achieve a calm, alert state by training specific brainwave patterns. This type of training is applied across the brain to support improvements in focus, mood, anxiety, sleep, and attention. It was the basis for a lot of early published research in the field of neurofeedback.

Using real-time feedback, individuals practice increasing SMR and beta brainwaves learning to modulate stable arousal (how well your brain maintains an alert, awake state). As a result, it can enhance focus, impulse control, and emotional stability, making it an effective approach for addressing conditions such as ADHD, anxiety, and sleep disturbances.

Infra- Low Training ILF

Infralow training targets ultra-slow brainwave frequencies (below 0.01 Hz) using specialized hardware and software designed to optimize this unique training model. This approach is rooted in growing evidence linking slow brain activity fluctuations to key neurophysiological processes, including heart rate variability, blood pressure regulation, oxygenation, and cortical excitability.

Research suggests that infralow frequency rhythms (ILF) play a crucial role in the self-organization and regulation of the central nervous system. According to Dr. Yuri Kropotov, PhD, these frequencies are fundamental for maintaining balance within the brain’s networks, which is critical for emotional regulation, attention, and resilience to stress. They also support the brain’s underlying stability and self-regulation, influencing core aspects of neural functioning and overall arousal.

Infralow neurofeedback has been successfully applied to address conditions such as anxiety, PTSD, emotional dysregulation, ADHD, addiction, and migraines, offering a powerful tool for enhancing brain stability and well-being.

LENS (Low Energy Neurofeedback)

We refer to LENS (Low Energy Neurofeedback System) as a “homeopathic” type of neurofeedback due to its light, subtle approach. Sessions are much shorter than traditional neurofeedback and are often combined with our body biofeedback system. Together, these methods create a complementary resonance response in the brain and body, amplifying their benefits.

LENS is a non-traditional, highly effective neurofeedback method that embodies the principle of “less is more.” For years, we’ve used it in our center, particularly to support clients recovering from post-concussion syndrome and traumatic brain injury (TBI). It is also an excellent option for individuals with highly sensitive nervous systems.

Using ultra-low energy—thousands of times weaker than a cell phone signal—LENS gently influences brain activity. This facilitates the brain’s spontaneous reorganization, encouraging more balanced and efficient functioning.

Alpha Theta Training : Unlocking Deep States for Healing and Growth

Alpha-Theta neurofeedback, often referred to as “deep state training,” is a transformative tool for accessing deeper emotional states and fostering mindfulness, self-awareness and creativity. This approach can help individuals process unresolved trauma and emotional pain, offering a pathway to healing.

Research has demonstrated its effectiveness in significantly reducing addictive behaviors and relapse. It is also widely used to enhance creativity, deepen meditation, and quiet the mind. Many participants report feeling more at peace with themselves and others after training.

By increasing theta brainwaves during eyes-closed sessions, Alpha-Theta training acts as a gateway to the subconscious, where profound healing and personal growth can occur. This underutilized yet powerful tool is often described as highly enjoyable and rewarding once experienced. However, professional guidance is essential to unlock its full potential and ensure safe, meaningful outcomes.

Brain mapping

qEEG Brain Map

A quantitative EEG (qEEG) creates a detailed brain map by recording electrical activity. It compares it to age-matched normative data (other people in your area range) . This helps identify areas that are out of balance. It provides insight into individual brain function. This is used as part of a comprehensive brain analysis to help create personalized neurofeedback training.

In-Depth EEG Analysis​

We offer significant expertise and experience in the EEG analysis that provides important information that goes beyond the qEEG assessment. That helps us identify important features, intermittent events and patterns within the EEG that are often missed in the averaging that occurs with the qEEG. We have a board-certified neurologist who can review the EEG as needed to assess abnormal EEG patterns or events. This information can provide clues about brain metabolic function that may provide a better understanding of the root problems.

Specialized Coherence Map (Dr. Robert Coben’s Work)

Connectivity measures timing comparing how different parts of the brain communicate. The advanced method Dr Coben developed analyzes a term called effective connectivity using a specialized type of analysis between different brain regions. It provides a basis for a specialized type of neurofeedback training using multivariate coherence. Dr. Coben’s research has pointed to benefits in this approach for autism, learning disabilities, concussions, seizures and more, as a method for increasing overall brain integration.

These mapping options guide the development of personalized plans to improve cognitive function, attention, emotional regulation, and overall brain health.

ERP (Event-Related Potentials) Report

This report goes well beyond a qEEG. The ERP analysis compares how your brain processes information with other people your age range during a simple 20 minute visual/auditory task. This analysis helps identify issues with processing speed, how your brain processes details and emotions, stays on task, manages attention, and makes decisions.

The report provides a stable consistent pre- and post-measure that helps identify whether progress is being made and what changes in training may be needed.

The report helps clients more clearly see issues. The ERP report looks at 8 different systems. All these areas must work together with exquisite timing in milliseconds to function efficiently. It helps fine tune the training recommendations made for our clients and to have greater insights into what is striving the problem.

qEEG Analysis Compared to a Large ADHD Database

This specialized analysis compares your brain’s electrical activity to a large, established ADHD database. It helps identify patterns typical of ADHD, allowing for targeted neurofeedback protocols to address attention, impulsivity, and other related challenges.