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Research Papers

Can the Brain be Trained? Comparing the Literature on the Use of EEG Biofeedback/Neurofeedback as an Alternative or Complementary Therapy for Attention Deficit Hyperactivity Disorder (ADHD)

Stankus, Tony (2008) · Behavioral & Social Sciences Librarian

Psychologists, social workers, and school counselors are increasingly adding neurofeedback (NFT), a controversial alternative or complementary therapy to their treatment plans for patients with Attention Deficit Hyperactivity Disorder. NFT involves training the patient in self-regulation of brain wave patterns, employing a standard diagnostic tool, the EEG, in an interactive operant conditioning mode not often used by neurologists or psychiatrists. Some NFT therapists claim in their books that they have sufficient expertise to advise parents against the use of Ritalin™ and amphetamines, which are part of the conventional multimodal therapy strongly endorsed in a wide variety of clinical publications. In return, some of the leading conventional physicians and Ph.D. researchers in the field of ADHD have traditionally ignored or disparaged the literature of NFT as being insufficiently scientific and appearing largely in obscure journals or books published outside the mainstream medical presses. While most librarians are unlikely to have sufficient scientific or clinical credentials to pass judgment, one way or another, on NFT as a treatment for ADHD, an examination of the credentials of authors, their books, book reviews, journals, and the publishers in which opponents and proponents make their case is entirely within our purview, and such an analysis is provided.

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Neurofeedback: An Alternative and Efficacious Treatment for Attention Deficit Hyperactivity Disorder

Fox, Daniel J., Tharp, David F., Fox, Lydia C. (2005) · Applied Psychophysiology and Biofeedback

Current research has shown that neurofeedback, or EEG biofeedback as it is sometimes called, is a viable alternative treatment for Attention Deficit Hyperactivity Disorder (ADHD). The aim of this article is to illustrate current treatment modalities(s), compare them to neurofeedback, and present the benefits of utilizing this method of treatment to control and potentially alleviate the symptoms of ADHD. In addition, this article examines the prevalence rates and possible etiology of ADHD, the factors associated with ADHD and brain dysfunction, the current pharmacological treatments of ADHD, Ritalin, and the potential risks and side effects. Behavior modification and cognitive behavioral treatment for ADHD is discussed as well. Lastly, a brief history of the study of neurofeedback, treatment successes and clinical benefits, comparisons to medication, and limitations are presented.

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EEG biofeedback: A new treatment option for ADD/ADHD

Alhambra, Marabella A., Fowler, Timothy P., Alhambra, Antonio A. (1995) · Journal of Neurotherapy

Attention Deficit Disorder is commonly treated with stimulant medications such as Ritalin (methylphenidate). However, this medication has short-term effects and numerous undesirable side effects including insomnia and loss of appetite. This study explores using EEG biofeedback, with its minimal side effects and long-term results, as an alternative to pharmacological treatments for ADD

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EMG and EEG biofeedback training in the treatment of a 10-year-old hyperactive boy with a developmental reading disorder

Tansey, Michael A., Bruner, Richard L. (1983) · Biofeedback and Self-Regulation

The serial application of electromyographic (EMG) and sensorimotor (SMR) biofeedback training was attempted with a 10-year-old boy presenting a triad of symptoms: an attention deficit disorder with hyperactivity, developmental reading disorder, and ocular instability. Symptom elimination was achieved, for all three aspects of the triad, following the procedure of first conditioning a decrease in EMG-monitored muscle tension and then conditioning increases in the amplitude of sensorimotor rhythm over the Rolandic cortex. The learned reduction of monitored EMG levels was accompanied by a reduction in the child's motoric activity level to below that which had been achieved by past administration of Ritalin. In addition, the attention deficit disorder with hyperactivity was no longer diagnosable following the EMG biofeedback training. The learned increase in the amplitude of monitored SMR was accompanied by remediation of the developmental reading disorder and the ocular instability. These results remained unchanged, as ascertained by follow-ups conducted over a 24-month period subsequent to the termination of biofeedback training

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Operant conditioning of EEG rhythms and ritalin in the treatment of hyperkinesis

Shouse, M. N., Lubar, J. F. (1979) · Biofeedback and Self-regulation

Enhanced voluntary motor inhibition regularly accompanies conditioned increases in the sensorimotor rhythm (SMR), a 12–14-Hz Rolandic EEG rhythm in cats. A similar rhythm, presumably SMR, has also been identified in the human EEG. The clinical effectiveness of SMR operant conditioning has been claimed for epilepsy, insomnia, and hyperkinesis concurrent with seizure disorders. The present report attempts to follow up and replicate preliminary findings that suggested the technique's successful application to hyperkinesis uncomplicated by a history of epilepsy. SMR was defined as 12–14-Hz EEG activity in the absence of high-voltage slow-wave activity between 4 and 7 Hz. Anticipated treatment effects were indexed by systematic behavioral assessments of undirected motor activity and short attention span in the classroom. EEG and behavioral indices were monitored in four hyperkinetic children under the following six conditions: (1) No Drug, (2) Drug Only, (3) Drug and SMR Training I, (4) Drug and SMR Reversal Training, (5) Drug and SMR Training II, (6) No Drug and SMR Training. All hyperkinetic subjects were maintained on a constant drug regimen throughout the phases employing chemotherapy. Contingent increases and decreases in SMR occurred in three of four training subjects and were associated with similar changes in classroom assessments of motor inactivity. Combining medication and SMR training resulted in substantial improvements that exceeded the effects of drugs alone and were sustained with SMR training after medication was withdrawn. In contrast, these physiological and behavioral changes were absent in one highly distractible subject who failed to acquire the SMR task. Finally, pretraining levels of SMR accurately reflected both the severity of original motor deficits and the susceptibility of hyperkinetic subjects to both treatments. Although the procedure clearly reduced hyperkinetic behavior, a salient, specific therapeutic factor could not be identified due to the dual EEG contingency imposed combined with associated changes in EMG. Despite these and other qualifying factors, the findings suggested the prognostic and diagnostic value of the SMR in the disorder when overactivity rather than distractibility is the predominant behavioral deficit.

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