First study investigating personalized treatment in ADHD

NIJMEGEN, The Netherlands, Mar 28, 2012 (BUSINESS WIRE) — A personalized treatment approach, tailoring Neurofeedback treatment to the individual ADHD patient, almost doubled the effectiveness for attentional and hyperactivity/impulsivity problems. These results have just been published in the scientific journal ‘Applied Psychophysiology and Biofeedback’. This study is the first scientific study investigating whether personalizing Neurofeedback treatment, based on a so-called quantitative EEG or QEEG, results in a higher effectiveness of this treatment in ADHD.

Several scientific studies have already demonstrated that neurofeedback treatment has beneficial and lasting effects in the treatment of ADHD (Arns et al, 2009). A new development in psychiatry is that of ‘tailor-made treatments’ sometimes referred to as ‘personalized medicine’. This development is becoming more and more popular due to the fact that most ‘conventional’ treatments in psychiatry have demonstrated limited efficacy. The development of personalized medicine therefore focuses more on providing the right treatment for the right person in order to achieve a more effective treatment outcome. In a study conducted by Research Institute Brainclinics, neurofeedback protocols were tailored to the individual patient. On the basis of patients’ individual brain activity measured by quantitative EEG — also called a QEEG – it was determined which well-investigated neurofeedback protocol was applied to a specific patient. Sixty-seven percent of patients responded well to this treatment (more than 50% reduction in symptoms). The reported “effect-size” of 1.8 (a measure of the magnitude and clinical relevance of the treatment effect) in this study was found to be almost double the effect-size as compared to previously reported studies. These results were published today in the international scientific journal Applied Psychophysiology and Biofeedback (Arns et al, 2012).

Reference:

Arns, M., Drinkenburg, W. H. I. M., & Kenemans, J. L. (2012). The effects of QEEG-informed neurofeedback in ADHD: An open label pilot study. Applied Psychophysiology and Biofeedback. doi:10.1007/s10484-012-9191-4

This article is also available at:

http://www.springerlink.com/content/h5084x3642824r88/fulltext.pdf

When my son, was 11 yrs old, I had been remarried for a few years and my husband and I were preparing to start a college fund for him.  A few years earlier my son had been diagnosed with ADHD and was taking medications which were only moderately successful.  At this same time I was struggling with my son’s father’s lack of willingness to give ADHD medications during visitations and was being pushed for “alternative treatments”.  At the time I was a Professional Counselor doing home-based therapy for Devereux, and while attending  one of my regular continuing education seminars (on anger management of all things)  the speaker talked about this new “treatment” being used at the Menninger Clinic called “Neurofeedback” and how they were having good success using this treatment with ADHD.  Well, I went straight home, got on the internet, and started researching this new thing called Neurofeedback.  After extensively searching and reading, I found a practitioner to take may son to.  But there was one thing in the way:  the cost.  The ensuing conversation with my husband was pretty simple as we both quickly reasoned, regarding the proposed college fund, that if we didn’t go forward with the Neurofeedback treatment to resolve my son’s ADHD, then we weren’t going to have use for a college fund.  And so we made the decision to use what would have been the start of the college fund to fund the Neurofeedback.

While I may have been a Professional Counselor, Neurofeedback was still new to me; but I was eager to learn all I could – and learn I did. The clinician I took my son to used a model where the clinician does not stay in the room with the client at all times; and so I opted to stay with my son during sessions and figure out how best to keep him focused during the sessions to get the most from the experience.  Since this was traditional Neurofeedback, we had been prepared for the need for at least 40 sessions to gain success and sufficient symptom resolution, and that we might not see the start of improvement in symptoms until around 20 sessions.  Well, session 20 came and went, then session 21, and we really had not seen much of anything with a change in symptoms.  To be honest, I was beginning to wonder if we had wasted a lot of money and time; and I remember thinking, “Oh my, what have we done?”  But at exactly session number 23, suddenly it all started to click – we started seeing evidence of the treatment starting to work!   Then soon after we started reducing his medications, and before long my son was medication free.  We continued on to the 40 session point, and then opted for some additional training via a home-training platform.

At this point, I was next in line for consideration for Neurofeedback.  A long-standing post-partum and seasonal affective depression had not responded well to medication; and so it made since to consider Neurofeedback for myself as well.  However, since I was already a licensed clinician, I had the necessary foundation credentials to enter this field; and so I reasoned I could get the necessary training and equipment for the same cost as paying for my own treatment – and I might end up with an addition to my private practice.  Within a few months, I too was medication free; and after 12 years I’ve never looked back.  During the process of becoming a Board Certified Neurofeedback therapist, a requirement was to be a client for a specified number of sessions; and so I also have a personal understanding of what it means to be a Neurofeedback client.

Oh, and if you’re wondering what ever happened to that college fund?  As it turns out we didn’t need it after all, but for a good reason; when he’s ready, college will be paid for by the new GI Bill.  My son decided during high school that he wanted to serve in the military and after graduation enlisted in the US Navy.  And so today, thanks to Neurofeedback, I am very proud Navy-mom.  Why do I say “thanks to Neurofeedback”?  That will have to be the topic for another blog post…….

But in summary, the main point of this post is to share how I have been where all of my clients start and how I am a “mom” as much as I am a Neurofeedback clinician.  I know what it’s like to be the client and/or the mother of a child client.  My early experience is something I will never forget and in turn underlies all that I do for my clients.  It drives my unyielding commitment to personal, caring, and honest treatment, to provide the highest quality service in the fewest amount of sessions, and my promise of financial value.  In short, I have a unique perspective to walk with you through this process, because I’ve been there too.

Recently there have been many news stories in the media about a growing issue with a shortage of ADHD medication availability.  One recent blog post on a CHADD related site discusses the causes of this issue of ADHD medication shortages.  According to the author, Ruth Hughes, PhD, “the shortages began last spring and all parties thought it would be a short-term problem. But now it is six months later and the problem is getting bigger, not smaller.”  She goes on to explain, “If the shortage continues for a while, as it has for ADHD medications, then other things begin to happen. Over time, physicians begin to change prescribing habits to other medications that are more readily available, such as the short-acting methylphenidate medications.”  However, one significant problem with this, as I see it, is that not all medications work the same for all ADD/ADHD patients.  One size does NOT fit all.  Unfortunately it can take going thru several different types/combinations of medications to find the “goldie locks” just right “fit” for ADHD medications.  And so if you or your child’s “just right” medication is in short supply, simply switching to something else that a doctor or pharmacist believes is “just as good” might not be.

But there is an alternative to medications for ADD/ADHD.  In a fairly recent research article where close to 1200 research cases were reviewed (i.e. a Meta Analysis) Neurofeedback for ADD/ADHD was found to have the highest level of effectiveness (Level 5) as measured by the American Psychological Association. (Click here to read article).  One of the biggest benefits of Neurofeedback, when it is appropriately used in place of medications, is that you don’t have to worry about medication shortages.  Visit our FAQ page for more information about Neurofeedback and our “We’re Different” page to find out what sets Applied Neurotherapy Center apart from other providers in the area

Researchers are investigating the use of brain mapping technology to examine the connections between different regions in the brain of stroke patients.

In her 2010 review of this study led by Alexandre Carter, MD, PhD , a neurologist at Washington University, in St. Louis , Emily Singer states, “Stroke patients typically undergo an MRI to identify the precise location of their stroke. But these brain scans don’t show how the damaged part of the brain fits into the larger network–the neural connections that feed into and out of this spot. Just as a delay at one station of a subway system can affect service at numerous stops and subway lines, dysfunction in a localized part of the brain disrupts activity in several different parts.  In the new study, researchers assessed this disruption by creating a functional connectivity map of the brain in people who had recently suffered a stroke.”  Also according to Singer, “Mapping brain connectivity and recovery may give scientists a better measure of which treatments most effectively enhance the brain’s innate plasticity–its ability to rewire–and when the brain is best primed for repair.”

Here at ANC, measuring the brain’s connectivity measures with a QEEG is a standard part of the assessment process for all clients.

This is a 2005 video interview with Linda Thompson, PhD, one of the foremost experts in the Neurofeedback field.  In this interview she discusses the role of medication vs. Neurofeedback, and then she goes on to discuss Neurofeedback for ADHD & Autistic spectrum disorders.
Thompson Interview

Earlier this month, at the 8th annual International Oncology Conference, Dr. Jean Alvarez presented results of her research study using Neurofeedback to improve the symptoms of cognitive impairment from Chemo therapy.

For those who undergo chemotherapy a condition that is frequently referred to as “chemo-brain” or “chemo-fog” can develop. This is where patients report a kind of mental “fogginess” and this can result in measurable declines in cognitive function during treatment, and the condition can continue after chemo treatment is completed.

In the Medscape Medical News review of the presentation, Dr Alvarez reports, “Neurofeedback, also known as EEG biofeedback or neurotherapy, has the potential to reduce or even reverse the cognitive impairment associated with chemotherapy, according to the results of a pilot study.”

In this study they found significant improvement in cognitive function, perceived impairment, quality of life, depression, and sleep medication use. Dr Alvarez reported that 91% (21 of 23) of the study participants improved at a statistically significant level (p<.001) in all four cognitive measures assessed.

This is ground-breaking work in the field of Neurofeedback; and this may well be the first study of its kind evaluating the effectiveness of Neurofeedback for improvement of chemo-fog with cancer patients.

To read the full review click here