ADHD – Page 2 – qEEGsupport.com

BRAINnet – Innovative Integration Analysis Challenge

From BRAINnet – Brain Research And Integrative Neuroscience Network

The purpose of this challenge is to promote a more integrative and innovative approach to Brain (EEG) – Body (Heart Rate) analysis. Brain Resource is sponsoring the challenge with the winner to receive $5,000USD.

The Challenge

Take 20 EEG and Heart Rate recordings from children diagnosed with ADHD and 20 recordings from a control population, and develop an analysis method that demonstrates any new insight relevant to ADHD using the data. The insight may have a basic science or applied clinical perspective.

Each dataset was recorded during a Go/NoGo paradigm and contains EEG, Heart Rate, respiration and Sweat Rate (skin conductance) channels, as well as stimulus and response information. The data sets are sourced from the Brain Resource International Database via BRAINnet.

Neurofeedback and the Brain

Neurofeedback is an emerging neuroscience based clinical application, and understanding the underlying principles of neurofeedback allows the therapist to provide referrals or treatment, and provides clients with a framework for understanding the process. The brain’s electrical patterns are a form of behavior, modifiable through “operant conditioning,” with the excessive brain frequencies reduced, and those with a deficit are increased. The learning curve for EEG has been described (Hardt, 1975).

Neurotherapy using slow cortical potentials also shows promise in the treatment of epilepsy (Kotchoubey et al., 2001; Birbaumer et al., 1981; Sterman, 2000). Neurotherapy has also been used for ADD/ADHD (Monastra, Monastra, & George, 2002) depression (Rosenfeld, 1997), anxiety (Vanathy, Sharma, & Kumar, 1998), fibromyalgia (Donaldson, 2002), and for cognitive enhancement (Budzynski, 2000; Klimesch, et al.). Commonly reported success rates of 60 to 90% are reported (Wright & Gunkelman, 1998).

Neurofeedback is an emerging neuroscience based clinical application based on the general principles of biofeedback or cybernetics. The Neurofeedback process involves training and learning self regulation of brain activity. Understanding the underlying principles of this process allows the therapist to provide referrals or treatment to their clients with some added understanding, and provides clients with a framework for understanding the neurofeedback process. The following short paper will provide a quick review of the brain’s function, and the underlying process involved in neurofeedback, a technique that will allow the client to better regulate and operate their brain.

The brain controls its own blood supply through the dilation and constriction of the blood vessels, and the blood flow is directed to areas that are more active through this self-regulation. The blood supply’s flow, along with the utilization of the oxygen and glucose the blood carries is measured as “perfusion,” a measure that is clearly seen in some of the modern imaging techniques, such as Positron Emission Tomography (PET) and SPECT technology. Though these techniques are invasive, requiring the injection of small amounts of very short half-life radioactive materials, they do give good resolution of the perfusion due to the emission of the positrons, which are emitted from where the brain utilizes the oxygen and burns the glucose carried by the blood flow.

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.

Is neurofeedback an efficacious treatment for ADHD? A randomized controlled clinical trial

Background:

For children with attention deficit/hyperactivity disorder (ADHD), a reduction of inattention, impulsivity and hyperactivity by neurofeedback (NF) has been reported in several studies. But so far, unspecific training effects have not been adequately controlled for and/or studies do not provide sufficient statistical power. To overcome these methodological shortcomings we evaluated the clinical efficacy of neurofeedback in children with ADHD in a multisite randomised controlled study using a computerised attention skills training as a control condition.

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.