ADHD and Neurofeedback
Neurofeedback is a form of biofeedback which uses either electroencephalograms or fMRIs to measure brain activity. Sensors are placed on the scalp in a noninvasive way to determine which types of waves the brain is producing and the ratio between the types of waves. There are many techniques of neurofeedback, also known as neurobiofeedback, neurotherapy, and EEG biofeedback. The basic structure is that brain activity is measured and displayed on a monitor. The patient is given tasks such as simple games or concentration challenges which affect the kinds of waves being produced. When brain waves change favorably, the patient hears a pleasing tone or other sensory reward.
Because only 60-75 % of ADHD cases respond to Ritalin treatment, and some parents and patients find the use of pharmaceutical treatment objectionable, it is important to study and develop alternative treatments of this common condition. Neurofeedback has been shown to have an effect comparable to Ritalin. 1 Neurofeedback has been studied for the treatment of ADHD, epilepsy, autism, headaches, insomnia, anxiety, substance abuse, pain disorders, obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD), concussion and other illnesses and disorders of the mind and body.
Effect of Neurofeedback on ADHD
ADHD is a disorder of neural regulation. Neurofeedback training assumes that neural deficiencies are amenable to change using behavioral methods.
The information gathered by the therapist and the patient during neurofeedback sessions supports understanding of how emotions, thoughts, and behavior affect physiological wellbeing. This allows the patient to exercise, strengthen, and regulate the central nervous system.
Research Evidence on Neurofeedback
A 2011 study compared the efficacy of methylphenidate (commonly known as Ritalin) and neurofeedback in the treatment of ADD/ADHD. Participants studied were 39 children with ADD/ADHD in three groups – one receiving methylphenidate, one receiving neurofeedback, and one receiving no treatment.
- Inattention and hyperactivity were improved by both treatments.
- Ritalin was found to be more effective than neurofeedback in improving the behavioral measures reported by parents in the SNAP IV behavioral questionnaire, one of the outcome measures of this study.
- Response inhibition, i.e. the suppression of behavior that is inappropriate to the environment, was improved in this study only in the group receiving neurofeedback.
- The average magnitude of the effect of treatment by all measures was greater in the methylphenidate group, but to such a slight degree that it was not statistically significant. 1
A series of six case studies found that of the six patients, five measurably improved in parent/teacher report and/or objective data in congruence with neurofeedback treatment. This improvement seemed to be related to the ratio between theta and beta waves.
After 7-10 neurofeedback sessions,
- One student was able to discontinue medication
- Four students reduced medication to half the original dosage.
- Of these four, two maintained consistent success in stabilization of medication reductions,
- Two with severe theta/beta ratios were inconsistent in measures and returned to two-thirds and original dosage levels. 2
1 Nazari, Mohammad et al. “Effectiveness of EEG Biofeedback as Compared with Methylphenidate in the treatment of Attention-Deficit/Hyperactivity Disorder: A Clinical Outcome Study,” Neuroscience & Medicine 2, (2011): 78-86. doi:10.4236/nm.2011.22012 .
2Warwick, Shannon. “Six Case Studies Examining the Effectiveness of a Comprehensive Adaptive Approach to Neurofeedback for Attention Deficit in an Educational Setting,” www.zengar.com, 2000-2011, http://www.zengar.com/research.