This article presents a review of work that my colleagues and I have been doing during the past 15 years developing a rationale for the diagnosis of attention-deficit/hyperactivity disorder (ADHD) and treatment of ADHD employing EEG biofeedback techniques. The article first briefly reviews the history of research and theory for understanding ADHD and then deals with the development of EEG and event-related potential (ERP) assessment paradigms and treatment protocols for this disorder, including our work and that of others who have replicated our results. Illustrative material from our current research and child case studies is included. Suggestions for future experimental and clinical work in this area are presented and theoretical issues involving the understanding of the neurophysiological and neurological basis of ADHD are discussed.
Spectral analysis of the electrophysiological output at a single, midline prefrontal location (the vertex) was conducted in 482 individuals, ages 6-30 years old, to test the hypothesis that cortical slowing in the prefrontal region can serve as a basis for differentiating patients with attention deficit hyperactivity disorder (ADHD) from nonclinical control groups. Participants were classified into 3 groups (ADHD, inattentive; ADHD, combined; and control) on the basis of the results of a standardized clinical interview, behavioral rating scales, and a continuous performance test. Quantitative electroencephalographic (QEEG) findings indicated significant maturational effects in cortical arousal in the prefrontal cortex as well as evidence of cortical slowing in both ADHD groups, regardless of age or sex. Sensitivity of the QEEG-derived attentional index was 86%; specificity was 98%. These findings constituted a positive initial test of a QEEG-based neurometric test for use in the assessment of ADHD.
Neurofeedback has begun to attract the attention and scrutiny of the scientific and medical mainstream. Here, neurofeedback researchers present a consensus-derived checklist that aims to improve the reporting and experimental design standards in the field.
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