Approximately, 9.4% of children between the ages of 4 and 17 in the United State are diagnosed with Attention-Deficit Hyperactivity Disorder.
Common symptoms of ADHD include:
- Impulsive behavior
- Hyperactive movement
- Easy distractibility
Several clinical trials have found that neurofeedback effectively treats the symptoms of ADHD.
Improvements seen following neurofeedback have been described as:
- Improved attention
- Decreased hyperactivity and impulsivity
- Increased academic and social skills.
Neurofeedback Approaches For ADHD
There are several various neurofeedback approaches that have been developed for ADHD. The most frequently used frequencies increase beta (15-18 Hz) activity and decrease theta (4-7 Hz) brain activity particularly in frontal regions of the brain. The frontal lobe is often associated with executive functioning and problem solving such as motivation, attention, impulse-control, goal-directed behavior, and judgment.
Individuals with ADHD often exhibit frontal lobe dysfunction; which subsequently may be reason for perceived difficulties with inattention, impulsivity, and hyperactivity.
Other approaches are to target sensorimotor rhythm (SMR; 12-15 Hz). Protocols that enhance SMR activity, such as alpha and theta (8–11 Hz/4– 7 Hz) protocols that enhance alpha brain activity; and slow cortical potentials (SCP) responsible for regulating cortical excitability can also assist in reduction of symptoms.
Theta waves are involved in being withdrawn from the external world and being more focused on internal signals, often experienced as the twilight state when waking or drifting to sleep.
Beta waves are involved in typical wakefulness states and alertness and when attention is directed to cognitive tasks and the external world.
Neurofeedback for ADHD is based on data showing that many individuals with ADHD have more slow-wave (especially theta) power in their EEG than those without ADHD, and oppositely, less beta power. Therefore, neurofeedback helps to “wake up” the brain and keep it alert and focused while simultaneously decreasing the “sleepy” brain activity that is associated with inattention in individuals with ADHD.
ADHD Improvements with Neurofeedback
Neurofeedback has been found to produce a significant improvement in the core symptoms of ADHD that are equally as effective to the behavioral improvements produced by medication (e.g., methylphenidate), based on parental reports. This supports the use of neurofeedback as an alternative therapy for children and adolescents with ADHD. Children may also be on medication while completing neurofeedback treatment; but it may offer a healthy form of treatment to assist in waning off stimulants.
Neurofeedback can help individuals with ADHD focus better and improve executive functioning skills needed to improve daily functioning. Following neurofeedback therapy, children may show improvements in IQ scores and performance at school.
In addition, neurofeedback has been found to be effective in improving self-regulation skills in adults with ADHD demonstrated that compared to controls. Of the adults with ADHD who received neurofeedback, 14 out of 24 showed 25% symptom reduction after 30 sessions with 6 participants no longer meeting criteria for ADHD following treatment. Benefits were also maintained at a 6-month follow-up.
Overall, neurofeedback shows promising evidence for long-term improvement in ADHD symptoms.
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- Shue & Douglas, 1992; https://www.ncbi.nlm.nih.gov/pubmed/1389116
- Duric et al., 2012; https://bmcpsychiatry.biomedcentral.com/articles/10.1186/1471-244X-12-107
- Mayer et al., 2016; https://www-sciencedirect-com.mwu.idm.oclc.org/science/article/pii/S1388245715011037