For years, medical professionals have been prescribing people with ADD/ADHD with psychostimulants that improve concentration and reduce impulsivity. However, because of unwanted side effects, such as weight loss and reduction in appetite, the search is on for alternatives.
Researchers are now touting the benefits of neurofeedback to help treat ADD/ADHD. This non-pharmacological method may have similar performance in improving concentration and reducing inattention and impulsivity as conventional treatment.
What Is Neurofeedback?
Neurofeedback relies on the use of a brain-computer interface that provides patients with information about their current mental state. Systems measure participants’ brain activity, allowing them to see their current brain patterns directly and then make adjustments to accommodate them.
Most patients with ADD/ADHD have high levels of beta and gamma brain waves – those associated with peak focus, insight, and alertness – and too few alpha and theta brain waves – the more relaxed type. The goal of neurofeedback is to take advantage of the brain’s inherent neuroplasticity – its ability to change – so that it can move toward slower brain waves and better adapt to internal and external stimuli in the future.
How Does Neurofeedback Work?
Neurofeedback follows a series of steps.
Step 1: Set Treatment Goals
Medical professionals begin treatment by setting treatment goals, based on the patient’s condition and the type of neurofeedback system being used. For instance, the goal might be to regulate hyperactivity so that the patient feels calmer in the future.
Step 2: Measure Brainwave Activity
The next step is to measure the pattern of activity in the patient’s brain. Clinicians place electrodes on the patient’s scalp and then ask the patient to perform certain activities, such as listen to music or watch a video.
Step 3: Provide Positive Feedback
Once the neurofeedback equipment detects that the patient’s brain has reached a desirable state, the clinician provides positive, reinforcing feedback. For instance, neurofeedback systems might reward the patient with a higher score on a game they are playing, better music, or a larger movie screen.
Step 4: Repeat
Patients typically return for neurofeedback several times to reinforce earlier training. The hope is that patients will learn to “self-correct” by identifying their brain states in real time, and then modifying them so that they are healthier. In most ADD/ADHD cases, the goal is to transition away from faster brain waves to slower ones that facilitate greater attention, concentration and peacefulness.
Does Neurofeedback Work?
Evidence suggests that neurofeedback training can reduce hyperactivity, impulsivity and inattention in children. Moreover, research indicates that both of the most common forms of the therapy – theta/beta ratio (TBR) and sensori-motor rhythm (SMR) – are equally effective.
For example, Dutch researchers found that patients with ADHD undergoing SMR got to sleep faster and had higher sleep quality compared to controls. They hypothesized that improvements in sleep quality and duration resulted from reduced patient vigilance. People were able to go to sleep faster because they were not so concerned about the situation around them.
Many other researchers have also investigated the efficacy of neurofeedback. For instance, a 2002 study on a sample of one hundred children aged six to nineteen with ADHD found that those whose treatment plans included neurofeedback did better on measures of attention than those who did not. EEG scans showed that their brain waves were normalized compared to the control group on a combination of Ritalin and behavior therapy.
A 2009 study with an improved methodology investigated over one hundred eight to twelve-year-old children with ADHD and randomized them to either receive computerized attention training or neurofeedback. Over 18 weeks, researchers found that children in the neurofeedback group had lower ADHD ratings than those in the computer-training-only group.
Lastly, a 2013 study compared the effects of the drug methylphenidate to forty neurofeedback sessions over several weeks. At the two- and six-month follow-ups, teachers and parents rated both groups lower on standard ADHD symptom scores.
Whether neurofeedback works, however, primarily depends on whether the treatment is the right fit for the patient’s brain biology. Many individuals are able to change their brain structures, but some do not see benefits because they are not using the correct system for their needs. The specific type of neurofeedback patients receive matters.
The Bottom Line
In summary, the bulk of evidence suggests that neurofeedback is helpful in treating ADD/ADHD. Moreover, it may be as effective, perhaps more effective, than standard pharmacological options. For parents looking to avoid medications, this is welcome news.