ADHD Overview

Attention Deficit Hyperactivity Disorder (ADHD) is a neuro-behavioral condition marked by persistent patterns of inattention and/or hyperactivity-impulsivity. These symptoms can significantly impact daily functioning and development.

The Neural Imbalance in ADHD

Individuals with ADHD typically exhibit increased theta activity and reduced beta activity compared to their peers. This brainwave imbalance manifests differently depending on the type of ADHD:

Hyperactive/Impulsive Type: Characterized by a constant need for movement, fidgeting, squirming, and difficulty remaining seated.

Inattentive Type: Marked by challenges in sustaining attention, following detailed instructions, and organizing tasks and activities.

Irregularities in theta and alpha waves- Inattentive Type: contribute to symptoms such as distractibility, daydreaming, difficulty sustaining attention, disorganization, forgetfulness, and challenges in completing tasks requiring sustained mental effort.

Excessive theta and beta - Hyperactivity Type: Symptoms include impulsivity, restlessness, fidgeting, difficulty staying seated, excessive talking, interrupting others, and a constant need for movement or stimulation.

Alterations in the prefrontal cortex, basal ganglia, and dopamine neurotransmission: These differences contribute to difficulties in attention regulation, impulse control, and executive functioning observed in individuals with ADHD.

Neurofeedback aids ADHD by training individuals to regulate brain waves, enhancing attention and impulse control. It targets specific neural circuits, normalizing brain wave patterns and improving the physiological functioning of regions implicated in ADHD symptoms, promoting better cognitive performance and behavioral outcomes.

Evidence Supporting Neurofeedback

RCTs have shown that 30–40 sessions of TBR neurofeedback can be as effective as methylphenidate (a common stimulant medication) in reducing inattentiveness and hyperactivity symptoms. Moreover, neurofeedback has been linked to superior post-treatment academic performance (studies by Duric et al., and Meisel et al.).

A recent meta-analysis highlighted that the benefits of neurofeedback persist and even improve over time, unlike medication, whose efficacy often diminishes. Six months after completing neurofeedback treatment, the positive effects were found to surpass those of semi-active control groups and methylphenidate (Jessica Van Doren et al., 2018).

The most robust evidence for neurofeedback’s efficacy comes from double-blind placebo-controlled RCTs. One of the largest and most comprehensive trials, the International Collaborative ADHD Neurofeedback (ICAN) study, is currently underway, with conclusive results expected soon (Arnold et al., 2013; 2018; 2019).

Conclusion

Neurofeedback therapy offers a promising alternative or complement to traditional ADHD treatments. By addressing the neural imbalances associated with ADHD, neurofeedback can improve attention and reduce hyperactivity and impulsivity, with lasting benefits that surpass those of medication alone.