Martijn Arns

Drs. Martijn Arns studied Biological psychology at the Radboud University Nijmegen. After several projects in the Westmead Hospital, the Max Planck Institute in Munich and Organon Research in Newhouse, he started his own company Brain Resource Company Netherlands B.V. in 2001. He is specialized in applied neuroscience: bringing neuroscience out of the laboratory with the goal to improve diagnostics and treatments in mental health care. He is specialized in Personalized medicine, diagnostic services and treatment of brain related disorders (such as Neurofeedback for ADHD and rTMS for depression) using techniques such as QEEG, neuropsychological assessments (IntegNeuro) and rTMS. This applied brain research serves the purpose of personalizing treatment and diagnosis in order to get more targeted and efficacious treatment. Drs. Arns is director of Brainclinics Diagnostics B.V. (formerly known as Brain Resource Company Netherlands) and Brainclinics Treatment B.V., Chairman of the Applied Neuroscience Foundation, advisor for the Brain Resource Company and was founding director of Brainquiry B.V untill July 2007.

Historical Archives: The Beginning of Neurofeedback . . .

PART I – The Beginning – from the latest issue of the Journal of Neurotherapy introduces a new feature of the journal, the Historical Archives. In any profession it is important to be aware of the historical origins of the field. The field of neurofeedback was conceptualized a long time ago, and in this section we want to share some of the first works so the interested reader can get an idea of where our field came from and how it all started. As with most psychiatric treatments, the field of neurofeedback started as serendipity . . . .

In the early 1940s several studies already demonstrated that the human EEG could be classically conditioned (Jasper & Shagass, 1941a; Knott & Henry, 1941). These studies investigated in great detail the occipital alpha-blocking response and whether alpha blocking with visual stimulation could be conditioned to an auditory stimulus. In addition a range of classical conditioning principles have been successfully applied, and all of the Pavlovian types of conditioned responses could be demonstrated (Jasper & Shagass, 1941a). In a follow-up study, Jasper and Shagass (1941b) investigated further whether participants could also exert voluntary control over this alpha-blocking response. In this study they had participants press a button, which would turn the lights on and off, and use subvocal verbal commands when pressing the button (e.g., ‘‘Block’’ when pressing the button and ‘‘Stop’’ when releasing the button).

New research shows: Neurofeedback is an ‘Evidence-Based’ treatment for ADHD.

Nijmegen, July 16th 2009 – Neurofeedback – also called EEG Biofeedback – is a method used to train brain activity in order to normalize Brain function and treat psychiatric disorders. This treatment method has gained interest over the last 10 years, however the question whether this treatment should be regarded as an Evidence-Based treatment was unanswered until now. Tomorrow a study will be published in the scientific journal ‘EEG and Clinical Neuroscience’ demonstrating that Neurofeedback can indeed be regarded as an evidence-based treatment for Attention Deficit- / Hyperactivity Disorder (ADHD).

Neurofeedback is a treatment where real-time feedback is provided for specific brain activity (most often EEG) in order to learn the brain to suppress or produce specific brain activity. This method was initially discovered for the treatment of Epilepsy and from 1976 investigated further for the treatment of ADHD. This technique has become more popular by clinicians worldwide, and is currently provided for the treatment of several disorders. Critics have often questioned the efficacy of Neurofeedback and whether it can be considered an Evidence Based treatment or not.

In collaboration with researchers from Tübingen University (Germany), Radboud University (Nijmegen, the Netherlands), Brainclinics and EEG Resource Institute a so-called meta-analysis was conducted on all published research about Neurofeedback treatment in ADHD. This meta-analysis included 15 studies and 1194 ADHD patients. Based on this study – which will be published in the July issue of EEG and Clinical Neuroscience – it could be concluded that Neurofeedback can indeed be considered an Evidence-Based treatment for ADHD. The results show that neurofeedback treatment has large and clinically significant effects on Impulsivity and Inattention and a modest improvement of Hyperactivity.

EEG based Personalized Medicine in ADHD

Neurophysiological studies in ADHD have shown a relatively uniform picture with regards to EEG – QEEG data (based on group data). Most studies find excess slow brain activity (theta) (Hermens et al., 2004; Mann et al., 1992; Chabot and Serfontein, 1996; Clarke et al., 1998, 2001; Lazzaro et al., 1998, 1999) and a decreased fast brain activity (beta) (Hermens et al., 2004; Clarke et al., 1998; Mann et al., 1992; Lazzaro et al., 1998, 1999). Theta EEG activity is often associated with an “inattentive” or a dreamy state, and beta activity is often seen when the brain is very busy with for instance solving a cognitive task. Figure 1 shows an example of this based on the data of the Brain Resource International Brain Database of 275 patients with ADHD. In this example the increased theta and decreased beta can be clearly seen, with a frontal localization.

group data
Theta Absolute Beta Relative Beta

Figure 1: This figure shows the average brain activity (quantitative EEG – QEEG) of 275 children with ADHD, compared to a control group. On the left the increased theta EEG activity (p<.0001) can be seen, in the middle the absolute beta EEG activity (p<.0001) and on the left the decreased relative beta EEG activity (p<.0001). This deviant brain activity has a fronto-central localization. This pattern is found in almost all ADHD studies.