EEG

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.

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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.

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Traumatic Brain Injury Task Force Congressional Briefing

St Joseph’s Regional Medical Center on behalf of the participants of the International Conference on Behavioral Health and Traumatic Brain Injury invites you on March 12, 2009 at 11:00am to a Congressional Briefing.

The participants of the International Conference on Behavioral Health and Traumatic Brain Injury will be holding a Congressional Briefing hosted by:

Congressman Bill Pascrell and  Congressman Todd Platts

Co-Chairs, Congressional Brain Injury Task Force presenting recommendations to improve the care of our wounded warriors NOW!

In October of 2008, St Joseph’s Regional Medical Center hosted the International Conference on Behavioral Health and Traumatic Brain Injury. 100 doctors, researchers and scientists from around the globe discussed issues facing our wounded warriors, identified the barriers to treatment and strategized on the improvements for continuum of care. This briefing will present their reccomendations.

The meeting will be held @ the Capitol Visitors Center- Congressional Meeting Room South

RSVP – rsvp@susandavis.com

Neurofeedback Impacts on Addiction

According to the U.S. Substance Abuse and Mental Health Services Administration, addiction is currently one of the most significant health and social problems in America, affecting ~12.5% of the population. Medical costs can be up to 300% higher for an untreated alcoholic than a treated alcoholic. Other costs to society have reached almost $500 billion, taking into account unemployment, lost productivity, increased crime and justice system/incarceration costs, health care system strain, increased insurance costs, child abuse/neglect and even workplace violence. It is estimated that every dollar spent on treatment saves $4–$7 in costs from drug-related crime and can help reduce the spread of infectious diseases.

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EEG Findings in Traumatic Brain Injury

This brief summary will discuss the various EEG findings seen in head injury when it results in a brain injury, though any given head injury may or may not result in traumatic brain injury.  When an injury is incurred by the brain there are a few varieties of findings seen in the EEG, ranging from spectral changes associated with either white or gray matter damage, to the changes in “connectivity”, seen as changes in coherence or correlation measured across the cortex, or between more distant functionally related areas.

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Introduction to Phenotypes

Identifying subtypes of specific disorders is an attractive exercise, as it expands our understanding of the individual’s response to therapy, but it remains attached to the approach based on the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is rooted in behavior and frequently does not predict therapeutic response by any individual within the DSM grouping. Phenotypes are an intermediate step between genetics and behavior. These proposed electroencephalography (EEG) phenotypes are semistable states of neurophysiological function. The author proposes a framework allowing one to describe much of the observed EEG variance with a small number of phenotypical categories. These groupings cut across the DSM categories, and unlike the DSM, the phenotypes predict the individual’s response to therapy, for neurofeedback as well as for medication.

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