Differential effects of theta/beta and SMR neurofeedback in ADHD on sleep onset latency

Recent studies suggest a role for sleep and sleep problems in the etiology of attention deficit hyperactivity disorder (ADHD) and a recent model about the working mechanism of sensori-motor rhythm (SMR) neurofeedback, proposed that this intervention normalizes sleep and thus improves ADHD symptoms such as inattention and hyperactivity/impulsivity. In this study we compared adult ADHD patients (N = 19) to a control group (N = 28) and investigated if differences existed in sleep parameters such as Sleep Onset Latency (SOL), Sleep Duration (DUR) and overall reported sleep problems (PSQI) and if there is an association between sleep-parameters and ADHD symptoms. Secondly, in 37 ADHD patients we investigated the effects of SMR and Theta/Beta (TBR) neurofeedback on ADHD symptoms and sleep parameters and if these sleep parameters may mediate treatment outcome to SMR and TBR neurofeedback. In this study we found a clear continuous relationship between self-reported sleep problems (PSQI) and inattention in adults with- and without-ADHD. TBR neurofeedback resulted in a small reduction of SOL, this change in SOL did not correlate with the change in ADHD symptoms and the reduction in SOL only happened in the last half of treatment, suggesting this is an effect of symptom improvement not specifically related to TBR neurofeedback. SMR neurofeedback specifically reduced the SOL and PSQI score, and the change in SOL and change in PSQI correlated strongly with the change in inattention, and the reduction in SOL was achieved in the first half of treatment, suggesting the reduction in SOL mediated treatment response to SMR neurofeedback. Clinically, TBR and SMR neurofeedback had similar effects on symptom reduction in ADHD (inattention and hyperactivity/impulsivity). These results suggest differential effects and different working mechanisms for TBR and SMR neurofeedback in the treatment of ADHD.

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Congratulations Martijn Arns on your Phd

Dr Arns is a great friend of Bio-Medical & qEEGSupport.com and we would like to wish him congrats on his Phd!

Last Friday he defended his PhD titled: “Personalized Medicine in ADHD and Depression: A quest for EEG treatment predictors” with success!

For those of you interested, you can download a PDF of his 282 page PhD on http://www.brainclinics.com/page/5/course-calendar.html on the bottom of the page. You can also register under ‘Community’, where you can access all PDF’s of the articles and powerpoint presentations: http://www.brainclinics.com/page/11/community.html

Martijn’s dissertation far exceeds the quantity of work seen in PhD dissertations, covering a breadth and depth generally not seen from any less qualified than a full professor. His review of the literature, providing of a meta-analysis of the use of NF in ADHD lays the basis for the current level of acceptance NF in ADHD has achieved within the Neurosciences. His work also includes the prediction of medication response in ADHD and Depression, as well as the application of rTMS to depression, and an investigation into personalizing the rTMS stimulation paradigm. Seldom is such a breadth or depth of work seen in a PhD dissertation, as it generally would be too much work to finalize such an endeavor.

Martijn went back into the historic EEG literature far enough to gain insight into some of the reductionistic errors that the early days of qEEG created in our ability to understand the very nature of some of the pathologies we are currently studying. His dissertation disentangles the presence of slowed alpha from true theta rhythm, and also tests prospectively the EEG Phenotype model, integrating it with the European Vigilance model, and postulating biomarkers that predict clinical approaches.

It is easy to see why Martijn has gained such prominence in the neuromodulation field at such a young age (compared to me he is very young… but so is almost everyone else!)