Multimodal Interventions Are More Effective in Improving Core Symptoms in Children With ADHD

Objective: To investigate the effect of sensory integration training combined with EEG biofeedback on core symptoms in children with ADHD.Methods: Fifty-two children with attention-deficit, hyperactive-impulsive and combined ADHD were selected. They were randomly divided into control group, sensory integration training group, EEG biofeedback group, and sensory integration training + EEG biofeedback group, and after 4 months of intervention, concentration time and impulsive- hyperactivity and hyperactivity index scores on the PSQ scale were assessed.Results: Compared with that before the intervention, the attention time was significantly increased (P < 0.01), and the impulsive-hyperactivity and hyperactivity index scores were significantly decreased (P < 0.05, P < 0.01). After the intervention, the attention time was significantly higher than that of the control group (P < 0.05, P < 0.01), the attention time of the multimodal intervention group was significantly higher than that of the single intervention group (P < 0.01), and the impulsive-hyperactivity and hyperactivity index scores were significantly lower than those of the single intervention group (P < 0.05).Conclusion: Multimodal intervention can significantly improve the concentration level of children with ADHD, and significantly improve the behavioral symptoms of impulsive-hyperactivity and hyperactivity. Multimodal interventions were more effective than single interventions in improving core symptoms in children with ADHD. The results of this study provide a reference for related research and practical application.

The Peniston & Kulkosky Treatment for Chemical Dependence: a Replication, and Assessment of the Importance of the Electroencephalograph (EEG) Biofeedback Component of the Protocol

<p>This thesis is primarily a replication of Peniston and Kulkoskys' (1989; 1990) treatment (PKT) study which reported successful outcomes for alcoholics using an alpha/theta electroencephalograph (EEG) biofeedback protocol. The PKT protocol consists of 6 temperature biofeedback sessions of training increased hand temperature, followed by 30 sessions of training, via EEG biofeedback, increases in alpha/theta band amplitude. The latter sessions included visualizations of personality and physiology changes, and visualisations of scenes where alcohol is refused. Another aim of this study was to determine whether the EEG biofeedback element of the protocol was superior in outcomes to the subject simply listening to monotonous sounds. In addition to three months of therapeutic community treatment, one experimental group of 15 subjects received the PKT protocol, the other received a modified version excluding EEG biofeedback, and a control group of 14 subjects had no additional treatment. Post-treatment follow up revealed significant improvements for all three groups in key psychometric instruments. These were the Multiaxial Personality Inventory (MCMI-II), Situational Confidence Questionnaire (SCQ), Life Purpose Questionnaire (LPQ), and, at follow up, Addiction Severity Index (ASI). The control group changed in fewer MCMI-II scales, and had a higher treatment drop out rate. At follow up the groups' abstinence rates, using Peniston and Kulkoskys' measure, were also similar. However, when more sensitive relapse measures were applied, the PKT groups' relapse results were about twice those of the control group. This was significant for male subjects' mean number of days using substances, whereas female subjects' abstinence rates were high in all three groups. This therapeutic modality enhances therapeutic community treatment outcomes in a small sample of subjects, a result not common in the literature. It merits further investigation and implementation in a New Zealand setting.</p>

The Peniston & Kulkosky Treatment for Chemical Dependence: a Replication, and Assessment of the Importance of the Electroencephalograph (EEG) Biofeedback Component of the Protocol

<p>This thesis is primarily a replication of Peniston and Kulkoskys' (1989; 1990) treatment (PKT) study which reported successful outcomes for alcoholics using an alpha/theta electroencephalograph (EEG) biofeedback protocol. The PKT protocol consists of 6 temperature biofeedback sessions of training increased hand temperature, followed by 30 sessions of training, via EEG biofeedback, increases in alpha/theta band amplitude. The latter sessions included visualizations of personality and physiology changes, and visualisations of scenes where alcohol is refused. Another aim of this study was to determine whether the EEG biofeedback element of the protocol was superior in outcomes to the subject simply listening to monotonous sounds. In addition to three months of therapeutic community treatment, one experimental group of 15 subjects received the PKT protocol, the other received a modified version excluding EEG biofeedback, and a control group of 14 subjects had no additional treatment. Post-treatment follow up revealed significant improvements for all three groups in key psychometric instruments. These were the Multiaxial Personality Inventory (MCMI-II), Situational Confidence Questionnaire (SCQ), Life Purpose Questionnaire (LPQ), and, at follow up, Addiction Severity Index (ASI). The control group changed in fewer MCMI-II scales, and had a higher treatment drop out rate. At follow up the groups' abstinence rates, using Peniston and Kulkoskys' measure, were also similar. However, when more sensitive relapse measures were applied, the PKT groups' relapse results were about twice those of the control group. This was significant for male subjects' mean number of days using substances, whereas female subjects' abstinence rates were high in all three groups. This therapeutic modality enhances therapeutic community treatment outcomes in a small sample of subjects, a result not common in the literature. It merits further investigation and implementation in a New Zealand setting.</p>

Multimodal intervention improves core symptoms in preschool children with attention-deficit/hyperactivity disorder

I tested the effect of a psychobehavioral intervention combined with electroencephalographic (EEG) biofeedback on the core symptoms of preschool children with attention-deficit/hyperactivity disorder (ADHD). Participants were 42 preschool children with attention-deficit, hyperactive-impulsive, or compound-type ADHD. They were randomly divided into the control group, a psychobehavioral intervention group, an EEG biofeedback intervention group, or a psychobehavioral + EEG biofeedback intervention group (i. e., comprehensive). After 4 months of intervention, I assessed (a) attention concentration time and (b) impulsivity and hyperactivity scores using Conners Parent Symptom Questionnaire. Results show that the multimodal intervention significantly improved participants' concentration time and behavioral hyperactive-impulsive symptoms. The multimodal (vs. single-modal) intervention was more effective in improving core symptoms. My results provide a reference for related research and practical application.

Advances in Electrical Neuroimaging, Brain Networks and Neurofeedback Protocols

Human EEG biofeedback (neurofeedback) started in the 1940s using 1 EEG recording channel, then to 4 channels in the 1990s. New advancements in electrical neuroimaging expanded EEG biofeedback to 19 channels using Low Resolution Electromagnetic Tomography (LORETA) three-dimensional current sources of the EEG. In 2004–2006 the concept of a “real-time” comparison of the EEG to a healthy reference database was developed and tested using surface EEG z-score neurofeedback based on a statistical bell curve called “real-time” z-scores. The “real-time” or “live” normative reference database comparison was developed to help reduce the uncertainty of what threshold to select to activate a feedback signal and to unify all EEG measures to a single value, i.e., the distance from the mean of an age matched reference sample. In 2009 LORETA z-score neurofeedback further increased the specificity by targeting brain network hubs referred to as Brodmann areas. A symptom check list program to help link symptoms to dysregulation of brain networks based on fMRI and PET and neurology was created in 2009. The symptom checklist and NIH based networks linking symptoms to brain networks grew out of the human brain mapping program starting in 1990 which is continuing today. A goal is to increase specificity of EEG biofeedback by targeting brain network hubs and connections between hubs likely linked to the patient’s symptoms. New advancements in electrical neuroimaging introduced in 2017 provide increased resolution of three-dimensional source localization with 12,700 voxels using swLORETA with the capacity to conduct cerebellar neurofeedback and neurofeedback of subcortical brain hubs such as the thalamus, amygdala and habenula. Future applications of swLORETA z-score neurofeedback represents another example of the transfer of knowledge gained by the human brain mapping initiatives to further aid in helping people with cognition problems as well as balance problems and parkinsonism. A brief review of the past, present and future predictions of z-score neurofeedback are discussed with special emphasis on new developments that point toward a bright and enlightened future in the field of EEG biofeedback.

Neuromeditation: The Science and Practice of Combining Neurofeedback and Meditation for Improved Mental Health

Beginning meditators often complain that they do not know if they are “doing it right” or give up before realizing significant benefits. Advanced meditators often reach a plateau and struggle to reach “the next level” of their practice. Modern researchers and practitioners are finding a possible new solution to these challenges by using EEG biofeedback to increase awareness of subtle states of consciousness and speed the learning process. By tracking brainwave activity in specific regions of the brain, we can tell if someone is focused or relaxed. We can tell if the mind is wandering, if they are engaged in body-based emotions, or if they have entered a space of internal quiet. By monitoring this activity and connecting it directly to the intent of the meditation, it is possible to help meditators learn to quickly enter a desired state of consciousness and maintain this state for increasing periods of time. This chapter will describe the early research conducted in this area along with an original case study conducted by the author. In addition, the author will describe the way this technology is being used as a treatment intervention for ADHD, anxiety, depression, and PTSD.

Changes in the Total Power of Beta and Theta Bands When Using EEG Biofeedback in Primary School-Age Children Having Difficulties with Voluntary Regulation

This article presents the results of the study on spectral electroencephalogram (EEG) characteristics in 7–10-year-old children (8 girls and 22 boys) having difficulties with voluntary regulation of activity after 10 and 20 neurofeedback sessions using beta-activating training. Brain bioelectric activity was recorded in 16 standard leads using the Neuron-Spectrum-4/VPM complex. The dynamics was assessed by EEG beta and theta bands during neurofeedback. An increase in the total power of beta band oscillations was established both after 10 and after 20 sessions of EEG biofeedback in the frontal (p ≤ 0.001), left parietal (p ≤ 0.036), and temporal (p ≤ 0.003) areas of the brain. A decrease in the spectral characteristics of theta band oscillations was detected: after 10 neurofeedback sessions in the frontal (p ≤ 0.008) and temporal (p ≤ 0.006) areas of both hemispheres, as well as in the parietal area of the left hemisphere (p ≤ 0.005); after 20 sessions, in the central (p ≤ 0.004), frontal (p ≤ 0.001) and temporal (p ≤ 0.001) areas of both hemispheres, as well as in the occipital (p ≤ 0.047) and parietal (p ≤ 0.001) areas of the left hemisphere. The study into the dynamics of bioelectric activity during biofeedback using EEG parameters in 7–10-year-old children with impaired voluntary regulation of higher mental functions allowed us to prove the advisability of 20 sessions, as the increase in high-frequency activity and decrease in low-frequency activity do not stop with the 10th session. Changes in these parameters after 10 EEG biofeedback sessions are expressed mainly in the frontotemporal areas of both hemispheres, while after a course of 20 sessions, in both the frontotemporal and central parietal areas of the brain.