Neurofeedback & Attention Deficit Hyperactivity Disorder

By Kellie Lanktree and Denise Riewe (interns at RMPS)


In the late 1960s and 1970s, it was discovered that brainwaves could be retrained or reconditioned (Hammond, 2011). Neurofeedback Therapy (NFT) is a form of biofeedback which is aimed at developing skills for self-regulation of brain activity (Heinrich, Gevensleben and Strehl, 2007). A feedback electroencephalogram (EEG) is used to show the client current electrical patterns in their cortex. An EEG and a QEEG (quantitative electroencephalogram) are used to identify abnormal patterns. The abnormal patterns often accompany many medical and neurological disorders (La Vaque, 2003), including ADHD.

NFT is a non-invasive technique that can be utilized in a clinical setting with the purchase of relatively affordable hardware and software. As individuals continue to search for solutions to mental health and cognitive issues, NFT is gaining increased attention as a viable component of a treatment plan.

The term neurofeedback can be applied to multiple modalities, but most commonly in practice electroencephalography (EEG) measures are used. Sensors are placed on the head of the client, and the electrical data, or brainwaves, are then collected by a computer. This data is processed and presented to the participant in real-time. This feedback is usually provided using visual displays and/or sounds which are designed to encourage a targeted activity pattern.

Sensors are placed on the head of the client, and the electrical data, or brain waves, are then collected by a computer. This data is processed and presented to the participant in real-time. This feedback is usually provided using visual displays and/or sounds which are designed to encourage a targeted activity pattern. NFT is a non-invasive technique that can be utilized in a clinical setting with the purchase of relatively affordable hardware and software. As individuals continue to search for solutions to mental health and cognitive issues, NFT is gaining increased attention as a viable option as a component of the treatment plan for ADHD.

Research has shown that following a single neurofeedback training session, participants demonstrated lasting shifts in their electrocortical rhythms (Ros, Munneke, Ruge, Gruzelier, and Rothwell, 2010). NFT with children with ADHD has been found to improve their attention, decrease their hyperactivity, and increase their academic and social skills (Arns et al., 2009; Duric, Assmus, Gundersen, and Elgen, 2012; Lubar & Lubar, 1984; Monastra et al., 1998). Initially, the changes seen from NFT are short-lived, but with each session, the changes become more enduring. Depending on the individual, individuals with ADHD typically need between 30 and 50 sessions of NFT to see lasting effects (Hammond, 2011). NFT has been shown to be an effective alternative treatment to medication for ADHD, or an addition to medication, which is noninvasive and has minimal side effects (Duric, Assmus, Gundersen, and Elgen, 2012; Hammond, 2011). For those who have medical conditions that make traditional medication treatment for ADHD unsafe (e.g., individuals with heart conditions or conditions such as Tourette’s Disorder), NFT offers another option to consider for a treatment plan.

In comparison to other treatment methods, NFT has also been found to be very cost effective in the long run (Hammond, 2011). In Alberta, the cost of ADHD medication can range between $30 and $295 per every 90 days, depending on the specific medication and the individual’s insurance coverage (Alberta College of Family Physicians, 2017). However, medication accounts for only a small portion of the total costs associated with having an ADHD diagnosis. It has been found that non-ADHD specific costs of individuals with ADHD were more than double the costs of those without ADHD (Swensen et al., 2003). In addition, families, where at least one member has ADHD, have additional direct health care expenses and indirect costs (e.g. loss of work) over and above the cost of ADHD medication in comparison to other families (Swensen et al., 2003). These costs add up over time, and NFT may be one approach to preventatively lessen to the economic cost that is associated with ADHD.

Of note, is that NFT is approved by the U.S. Food and Drug Administration (FDA) for relaxation training and the American Pediatric Academy has endorsed neurofeedback as a “Level 1/Best Support” treatment for children with ADHD.

References


  • Alberta College of Family Physicians (2017).
    Price comparison of commonly prescribed pharmaceuticals in Alberta 2017.
    Retrieved from https://www.acfp.ca/wp-content/uploads/2017/03/ACFPPricingDoc2017.pdf
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    What is neurofeedback: An update. Journal of Neurotherapy, 15(4), 305 – 336.
    https://doi.org/10.1080/10874208.2011.623090
  • Heinrich, H., Gevensleben, H., & Strehl, U. (2007).
    Annotation: Neurofeedback – train your brain to train behaviour. Journal of Child Psychology & Psychiatry, 48(1), 3-16. doi:10.1111/j.1469-7610.2006.01665.x
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    Neurofeedback, neurotherapy, and QEEG. In D. Moss, A. McGrady, T. Davies, & I. Wickramasekera (Eds.), Handbook of mind body medicine for primary care (pp. 123-135). ThousandOaks, CA: Sage.
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    https://doi.org/10.15412/J.BCN.03070208
  • Ros, T., Munneke, M. A. M., Ruge, D., Gruzelier, J. H., & Rothwell, J. C. (2010).
    Endogenous control of waking brain rhythms induces neuroplasticity in humans. European Journal of Neuroscience, 31(4), 770–778.
    https://doi.org/10.1111/j.1460-9568.2010.07100.x
  • Swensen, A. R., Birnbaum, H. G., Secnik, K., Marynchenko, M., Greenberg, P., & Claxton, A. (2003).
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