An Inside Look into the Brain of Attention Disorders

Attention disorders affect about 5% -10%of school aged children. Combined that with learning disabilities and developmental delays, and it accounts for about 1 in 6 children. These problems present differently in each child, but can have overlapping similarities on diagnostic imaging.

A new type of brain imaging called Quantitative Electroencephalography (QEEG) reads the electrical activity of the brain and can tell us which areas of the brain are functioning properly and which are not. Typically in these disorders, there are areas of hypo function, or in QEEG terms, excess theta and delta waves. The analogy I often use to describe the brain waves is to driving. There are 4 main types of brainwaves. Beta (fastest) waves are the ones we produce when we are driving fast and weaving in and out of traffic in a hurry. Alpha (next fastest) waves are the ones we produce while we are sitting at the light with the clutch pushed in and waiting in anticipation for the light to change, in other words a relaxed focus. Theta (slow) waves are the ones we produce when we are driving down the freeway and not paying attention causing us to miss the exit which are the waves often in excess in an ADHD brain. Lastly, Delta (slowest) waves are produced when we sleep.

In real life, ADHD can look like several other disorders including learning disabilities. QEEG imaging of the brain can help us distinguish that and pin-point the exact area of disease, allowing us to focus treatment. A new research article I came across on the medical research website Medscape, discusses the similar symptom- appearance of bipolar disorder and ADHD. Had this patient been given a QEEG from the beginning, a physician trained in EEG analysis might have seen the typical frontal slowing (in other words excess theta) if the diagnosis was ADHD which would discern it from bipolar disorder which has an entirely different QEEG finding. Head injuries or traumatic brain injuries (TBI) can present similarly to ADHD in a classroom setting with weak memory and poor focus.

However, after looking at a QEEG of a brain injured patient, a trained clinician would typically see excess delta waves in the area damaged, as in temporal lobe injuries producing poor focus and attention. Oftentimes doctors will call these co-morbidities. Having ADHD along with depression and anxiety, a doctor may contribute the ADHD to the other problems, and treat with medications for each of the symptoms. However, what is more likely to be happening is an imbalanced brain wave pattern producing all these symptoms and when the brain waves are normalized with a therapy called neurofeedback or EEG biofeedback, the symptoms resolve. Much new research is coming to the spotlight to support what we have been doing for years using QEEG-guided neurofeedback to treat these conditions. This usually occurs without the use of medication resulting in permanent and lasting changes, often times with improved IQ and school performance.

Conventional treatment for ADHD is almost exclusively done with stimulant medication. Improvements can temporarily be made, but are not as good as actually fixing the problem. This is apparent by the concluding sentence in the August 2009 study stating, “treated kids (with stimulant medication) still lagged peers without ADHD”, supporting my view that we need to get to the root cause of the problem and fix the brainwave imbalance.

So what does the QEEG tell us? It may seem counterintuitive, however the problem in attention deficit-hyper activity disorder is often and under arousal seen as excess theta or delta waves on a QEEG which explains partially why stimulant medication can work at times with some of the symptoms of ADD/ADHD. However, as any parent who has given their child stimulant medication knows, once the medication is removed the symptoms come back. Besides stimulants not fixing the root cause of the problem, side effects of the medications are the parent’s biggest concerns. Several reports have linked the stimulant medication methyphenidate (Ritalin) to sudden death in children as well as Adderall XR being linked to heart attacks (Myocardial Infarction). Other concerns tend to be about stunted growth, lack of appetite, and insomnia in adults and children on these medications.

A simplified version of how neurofeedback works is as follows. Once the QEEG pattern is recognized changes can be made using sophisticated computer software. Essentially, the patient believes they are playing a game or watching a movie but they are actually retraining or rewiring the way their brain functions using a computer and their brain’s own abilities. This technology has been used in research for over 25 years and was originally developed for NASA and pilots but is now used for people looking for improvement that haven’t gotten any with medications or supplementation. It is also used by people looking for permanent changes without requiring daily medications. Treatment is typically done twice per week for about 3-4 months to sustain permanent changes.

Several factors need to be addressed before considering neurofeedback for you or your child. The clinicians credentials (ND,MD,PhD, etc.) , their experience with your disorder, their certification (BCIA – EEG) and their ability or willingness to address other underlining issues that have not yet been addressed such as food allergies, immune dysfunctions, nutritional deficiencies and other foundational health issues. We are excited to be able to provide neurofeedback in our office as a service for our patients. Call to schedule a free 15 minute consult with Dr. Rondeau NMD, BCIA-EEG, to discuss neurofeedback for your condition.
For more information read “A Symphony In the Brain” by Jim Robbins or go to www.thebrainlabs.com