<p></p><p>Thousands of research
articles on neurotherapy and neurofeedback have been conducted, a very thorough
list of studies conducted can be found at: <a href="https://isnr.org/isnr-comprehensive-bibliography">https://isnr.org/isnr-comprehensive-bibliography</a></p>

<h3>ADHD Studies</h3>

<p>ADHD is one of the most
common and most researched disorder: a prevalent, chronic, and impairing
disorder occurs in 3% to 7% of school-aged populations (Angold et al., 2000;
Jensen et al., 1999; Cormier, 2008) and compromises as much as 50% of America’s
child psychiatry clinic populations (Cantwell, 1996).ADHD is a highly heritable
disease, with estimated heritability rates of up to 80 % (Faraone et al., 2010).
It is more common in males (James and Taylor, 1990), with relative rates of up
to 9:1 in clinical samples, and 4:1 in epidemiological studies (APA, 1994),
although community-based studies have found ratios as low as 2:1 (Szatmari,
1992; Taylor et al., 1998). </p>

<h3>ADHD History</h3>

<p>In 1947, Lehtinen termed what
we now call ADHD the ‘minimal brain dysfunction’ (MBD) syndrome. In 1957, this
term was followed by ‘hyperkinetic impulse disorder,’ with symptoms of hyperactivity,
short attention span, variability, impulsiveness, irritability, explosive anger
fits, and poor school work (Laufer and Denhoff, 1957). In 1962, Clements and Peters (1962) re-introduced the Minimal Brain
Dysfunction terminology, including:</p>

<p></p><ul><li>specific learning deficits</li><li>perceptual motor deficits</li><li>general coordination deficits</li><li>hyperkinesis</li><li>impulsivity</li><li>emotional lability</li><li>short attention span and/or distractibility</li><li>In 1968, the DSM-II (APA, 1968) dubbed the disorder ‘hyperkinetic
reaction of childhood,’ emphasizing inattention, impulsivity and motor
activity. In 1980, the DSM-III (APA, 1980) renamed it ‘Attention Deficit
Disorder’ (ADD), shifting emphasis from motor activity to attention, with two
types: with hyperactivity (ADDh) and without hyperactivity (ADDwo). DSM-III-R (APA, 1987) renamed
it ‘Attention Deficit Hyperactivity Disorder’ (ADHD), and considered
unidimensional in nature, with a single diagnostic checklist. A second
category, ‘Undifferentiated Attention Deficit Disorder’ (UADD), featured marked
inattention without specific diagnostic criteria. In the DSM-IV (APA, 1994), the criteria changed again to reflect
these findings, with 3 main types:<br>&nbsp;• Predominantly Inattentive (AD/HDin)<br>&nbsp;• Predominantly Hyperactive-Impulsive (AD/HDhyp)<br>&nbsp;• Combined Type (AD/HDcom)</li></ul>

<h3>ADHD Symptoms</h3>

<p>In adults, the disorder is
typified by poor concentration, explosive outbursts, impulsivity, restlessness,
carelessness, ack of attention to detail, poor organizational skills, inability
to focus or concentrate, mood swings, extreme impatience, difficulty keeping
quiet and speaking out of turn, continually losing or misplacing things, as
well as non-medical drug use, court referrals, incarceration, and personality
disorders (Hechtman et al., 1984, 1979; Loney et al., 1983; Wender, 1994). </p>

<p>Symptoms in children and
teens include the following:</p>

<p><b>Inattentiveness</b></p>

<p><ul><li>having a short attention span and being easily distracted</li><li>making careless mistakes&nbsp;–&nbsp;for example, in schoolwork</li><li>appearing forgetful or losing things</li><li>being unable to stick to tasks that are tedious or time-consuming</li><li>appearing to be unable to listen to or carry out instructions</li><li>constantly changing activities or task</li><li><!--[endif]-->having difficulty organizing tasks</li></ul><!--[if !supportLists]--></p>













<p><b>Hyperactivity
and&nbsp;impulsiveness</b></p>

<p><ul><li>being unable to sit still, especially in calm or quiet
surroundings</li><li>constantly fidgeting</li><li>being unable to concentrate on tasks</li><li>excessive physical movement</li><li>excessive talking</li><li>being unable to wait their turn</li><li>acting without thinking</li><li>interrupting conversations</li><li>little or no sense of danger</li></ul><!--[if !supportLists]--></p>

















<p>&nbsp;</p>

<h3>Brain Research and ADHD</h3>

<p>ADHD subjects clearly show a different maturation profile
comparative to neurotypical populations (Poli et al., 2014). Feinberg, De Bie,
Davis, &amp; Campbell (2011) suggest a decline in EEG power for neurotypicals
is likely a reflective of brain reorganization, which is driven by synaptic pruning,
further postulating that slower waves decreased by up to 60% in ages 11 to 17
years.</p>

<p>&nbsp;</p>

<h3>Profiles</h3><h4>Excessive Theta</h4>

<p>Attention deficit’s relation to EEG has been ever since
the first description of <b>“fronto-central slow EEG activity at frequencies of
5-6/sec”</b> in <b>“behavioral problem children” </b>in 1938 (Jasper, Solomon,
&amp; Bradley, 1938). Early accounts described <u>defects in moral control</u>,
<u>mischievousness</u> and <u>destructive behavior</u> (Hoffman, 1844; Still,
1902), regarded as resulting from <b>traumatic brain injury </b>(e.g.
Goldstein, 1936; Meyer, 1904), <b>influenza-related encephalitis </b>(e.g.
Hohman, 1922; Kennedy, 1924), or <b>various childhood central nervous system
(CNS) infections </b>(e.g. Bender, 1942). </p>

<p>There are many different ways in which ADHD symptoms
manifest, as can be seen in EEG. Poil et al. (2014) found that in adults with
ADHD there was slowing of alpha frequency along with increased power in alpha-1
(8–10 Hz) when eyes were closed for resting.</p>

<p>The finding of increased absolute power in the theta EEG
band in ADHD is the most consistently reported finding <i>(Bresnahan, Anderson,
&amp; Barry, 1999; Chabot &amp; Serfontein, 1996; Clarke, Barry, McCarthy,
&amp; Selikowitz, 1998; Clarke, Barry, McCarthy, &amp; Selikowitz, 2001b;
DeFrance, Smith, Schweitzer, Ginsberg, &amp; Sands, 1996; Janzen, Graap,
Stephanson, Marshall, &amp; Fitzsimmons, 1995; Lazzaro et al., 1999; Lazzaro et
al., 1998; Mann, Lubar, Zimmerman, Miller, &amp; Muenchen, 1992; Matsuura et
al., 1993).</i> This increase in theta was observed in children and not adults
(<i>Markovska-Simoska &amp; Pop-Jordanova, 2017)</i></p><p><i><img src="@@PLUGINFILE@@/Excessive%20theta.png" alt="Excessive Theta" width="571" height="362" class="img-responsive atto_image_button_left"><br></i></p><br><br><br><br><br><br><br><br><br><br><br><br><br><br><br>&nbsp;<video controls="true"><source src="@@PLUGINFILE@@/Excessive%20theta%20vid.mp4">@@PLUGINFILE@@/Excessive%20theta%20vid.mp4</video>&nbsp;<h3>Slow Alpha Peak</h3>

<p>There are many different
ways in which ADHD symptoms manifest, as can be seen in EEG. Poil et al. (2014)
found that in adults with ADHD there was slowing of alpha frequency along with
increased power in alpha-1 (8–10 Hz) when eyes were closed for resting.</p>

<h3><img src="@@PLUGINFILE@@/Slow%20ALpha.png" alt="Slow ALpha" width="696" height="601" class="img-responsive atto_image_button_text-bottom"><br></h3><p>&nbsp;<video controls="true"><source src="@@PLUGINFILE@@/Slow%20ALpha%20Video.mp4">@@PLUGINFILE@@/Slow%20ALpha%20Video.mp4</video>&nbsp;<br></p><h3>Theta – Beta Ratio</h3>

<p>Lubar (1991) laid the
foundation for the concept of the theta/beta power ratio as a measure that
could discriminate “normal” children from children with ADD, learning disorders
and ADHD (Lubar, 1991). Based on the initial
findings of increased theta and decreased beta, in 1991, Lubar suggested the
Theta/Beta power ratio (TBR) as a measure for discriminating “normal” children
from children with ADD, learning disorders, and ADHD (Lubar, 1991). </p>

<p>Excess theta and elevated
TBR have been found favorable predictors for treatment outcome to stimulant
medication (Arns, Gunkelman, Breteler, &amp; Spronk, 2008; Clarke, Barry,
McCarthy, Selikowitz, &amp; Croft, 2002; Suffin &amp; Emory, 1995) and neurofeedback
(Arns et al., 2012; Monastra, Monastra, &amp; George, 2002), thereby
demonstrating the prognostic value of this measure (assuming a slow alpha peak
frequency is ruled out (Arns et al., 2008; Lansbergen, Arns, van Dongen, Boomsma,
Spronk, &amp; Buitelaar, 2011). Based on studies, the excess theta and TBR is
found in a substantial subgroup of patients with ADHD (25%-40%) and has been
demonstrated to be of prognostic value in predicting treatment outcome to
stimulant medication and neurofeedback.</p><img src="@@PLUGINFILE@@/theta%20beta%20atio.jpg" alt="Theta Beta Ratio" width="500" height="592" class="img-responsive atto_image_button_left"><h3>Other Profile Types</h3>While these profiles are some of the most widely researched and written about, there are a few others that occur in clinic that the well-versed clinician should know about. They are:<br>* Mu Rhythm<br>* Frontal Beta Spindles<br>*Excessive Delta<br>* Complex Types (composed of one or more of the subtypes)<br>* Paroxysms&nbsp;<br>*Epileptiform Content (An ADHD Impostor)&nbsp;<br><p></p>