Neu­ro­feed­back — also known as EEG Biofeed­back — is an approach for treat­ing ADHD in which indi­vid­u­als are pro­vided real-time feed­back on their brain­wave pat­terns and taught to alter their typ­i­cal EEG pat­tern to one that is con­sis­tent with a focused, atten­tive state. This is typ­i­cally done by col­lect­ing EEG data from indi­vid­u­als as they focus on stim­uli pre­sented on a com­puter screen. Their abil­ity to con­trol the stim­uli, for exam­ple, keep­ing the smile on a smi­ley face, is con­tin­gent on main­tain­ing the par­tic­u­lar EEG state being trained. Accord­ing to neu­ro­feed­back pro­po­nents, learn­ing how to do this dur­ing train­ing gen­er­al­izes to real world sit­u­a­tions and this results in improved atten­tion and reduced hyperactive/impulsive behavior.

Neu­ro­feed­back treat­ment for ADHD has been con­tro­ver­sial in the field for many years and remains so today. Although a num­ber of pub­lished stud­ies have reported pos­i­tive results many promi­nent ADHD researchers believe that prob­lems with the design of these stud­ies pre­clude con­clud­ing that neu­ro­feed­back is an effec­tive treat­ment. These lim­i­ta­tions have included the absence of ran­dom assign­ment, the lack of appro­pri­ate con­trol groups, raters who are not ‘blind’ to children’s treat­ment sta­tus, and small sam­ples. For addi­tional back­ground, you can find a recent review I wrote on exist­ing research sup­port for neu­ro­feed­back treat­ment of ADHD — along with links to exten­sive reviews of sev­eral recently pub­lished stud­ies -: How Strong is the Research Sup­port for Neu­ro­feed­back in Atten­tion Deficits?

- Results from a New Study of Neurofeedback -

Recently, a study of neu­ro­feed­back treat­ment for ADHD was pub­lished that addresses sev­eral lim­i­ta­tions that have under­mined prior research [Gevensleben, et al., (2009). Is neu­ro­feed­back an effi­ca­cious treat­ment for ADHD? A ran­dom­ized con­trolled clin­i­cal trial. Jour­nal of Child Psy­chol­ogy and Psychiatry.]

The study was con­ducted in Ger­many and began with 102 chil­dren aged 8 to 12. All had been care­fully diag­nosed with ADHD and approx­i­mately over 90% had never received med­ica­tion treat­ment. About 80% were boys. Chil­dren were ran­domly assigned to Read the rest of this entry »

Here you have the Feb­ru­ary edi­tion of our monthly newslet­ter cov­er­ing cog­ni­tive health and brain fit­ness top­ics. Please remem­ber that you can sub­scribe to receive this Newslet­ter by email, sim­ply by sub­mit­ting your email at the top of this page.

Cog­ni­tive train­ing (or struc­tured men­tal exer­cise) def­i­nitely seems to work — as long as we define prop­erly what “work” means, don’t expect magic cures, and help nav­i­gate options. Please keep reading…

Inter­view: Bay­crest

Inter­view with Baycrest’s CEO Dr. William Reich­man: Dis­cussing the recent Cen­tre for Brain Fit­ness at Bay­crest, Dr. Reich­man sug­gests that “we have an oppor­tu­nity to make major progress in Brain Health in the XXI cen­tury, sim­i­lar to what hap­pened with Car­dio­vas­cu­lar Health in the XXth, and tech­nol­ogy will play a cru­cial role.” A major obsta­cle? We need a con­sen­sus on “widely accepted stan­dards for out­come measures”.

Does It Work?

Does cog­ni­tive train­ing work? (For Whom? For What?): The grow­ing field of cog­ni­tive train­ing (one of the tools for brain fit­ness) can appear very con­fus­ing as the media keeps report­ing con­tra­dic­tory claims. These claims are often based on press releases, with­out a deeper under­stand­ing of the sci­en­tific evi­dence. Dr. Pas­cale Mich­e­lon, Sharp­Brains’ Research Man­ager for Edu­ca­tional Ini­tia­tives, ana­lyzes a cou­ple of recent stud­ies, clar­i­fy­ing what they mean — and what they don’t mean.

It Works, and It Doesn’t Work: the IMPACT study (a major, multi-site study on the Posit Sci­ence audi­tory pro­gram) will be pub­lished at the Jour­nal of the Amer­i­can Geri­atrics Soci­ety in April. Results sup­port that cog­ni­tive train­ing works — but doesn’t sup­port the grandiose “brain age” claims we see too often.

Cog­ni­tive Train­ing can Influ­ence Brain Bio­chem­istry: Dr. David Rabiner dis­cusses a recent sci­en­tific study that “shows that brain bio­chem­istry can be mod­i­fied by expe­ri­ence”, and that com­put­er­ized cog­ni­tive train­ing (Cogmed work­ing mem­ory train­ing) can pro­vide that experience.

The Big Picture

Mak­ing Healthy Choices — Pri­mare Care and Pre­ven­tion: a panel at the recent World Eco­nomic Forum explored why “New mar­kets and indus­tries are aris­ing sil­ver indus­tries such as finan­cial ser­vices, health, hous­ing and hos­pi­tal­ity geared to senior cit­i­zens. Longevity needs to be linked to health includ­ing cog­ni­tive health and lifestyle choices play a major role in health.”

Enrich your envi­ron­ment now and ben­e­fit your future off­spring: Dr. Robert Syl­wester reports that “all sorts of long held-beliefs about our brain and cog­ni­tion are being re– exam­ined by cog­ni­tive neu­ro­sci­en­tists” because of fas­ci­nat­ing stud­ies such as the one he reviews (with mice): “The study’s find­ings seemed to sug­gest that acquired char­ac­ter­is­tics can be genet­i­cally transmitted…long-term ben­e­fits accrue from a stim­u­lat­ing early envi­ron­ment that encour­ages curios­ity and exploration.”

Man­ag­ing Emotions

From Dis­tress to De-Stress: help­ing anx­ious, wor­ried kids: In a detailed 2-part arti­cle, (Part 1, Part 2), Dr. Jerome Schultz pro­vides great tips on how to help chil­dren learn to self-regulate emo­tions, adding that “Teach­ers, occu­pa­tional ther­a­pists, phys­i­cal edu­ca­tion teach­ers and par­ents need to actu­ally teach chil­dren (of all ages) how to get them­selves into a phys­i­cal state of being relaxed. This doesn’t hap­pen auto­mat­i­cally. If it did, there wouldn’t be so many adult yoga classes!”

Lie to Me, Paul Ekman and Biofeed­back: You may have watched the new series Lie To Me, with Tim Roth, based on the work of Paul Ekman. The intro­duc­tion to the sec­ond episode shows why what are called “lie detec­tors” are noth­ing but biofeed­back sys­tems that mea­sure phys­i­o­log­i­cal anxiety.

News

Brain Games for Baby Boomers: round-up of other recent news, cov­er­ing the effects of gam­ing, cog­ni­tive train­ing for dri­ving skills, and brain fit­ness classes.

Neu­rocog­ni­tive assess­ments and sports con­cus­sions: a new study and a new resource to under­stand and address the 1.6 to 3.8 mil­lion cases of sports-related con­cus­sions that occur annu­ally in the United States.

Brain Teaser

How will you, your orga­ni­za­tion, your neigh­bors, par­tic­i­pate in Brain Aware­ness Week, March 16th-22nd, orga­nized by the Dana Foun­da­tion with the par­tic­i­pa­tion of thou­sands of out­reach part­ners, includ­ing Sharp­Brains? You can find event ideas, excel­lent resources (yes, includ­ing puz­zles), and a cal­en­dar of events, Here.

Have a great month of March!

Like all psy­chi­atric dis­or­ders, ADHD is diag­nosed based on the pres­ence of par­tic­u­lar behav­ioral symp­toms that are judged to cause sig­nif­i­cant impair­ment in an individual’s func­tion­ing, and not on the results of a spe­cific test. In fact, recently pub­lished ADHD eval­u­a­tion guide­lines from the Amer­i­can Acad­emy of Pedi­atrics (AAP) explic­itly state that no par­tic­u­lar diag­nos­tic test should be rou­tinely used when eval­u­at­ing a child for ADHD.

While most ADHD experts would agree that no sin­gle test could or should be used in iso­la­tion to diag­nose ADHD, there are sev­eral impor­tant rea­sons why the avail­abil­ity of an accu­rate objec­tive test would be useful.

First, many chil­dren do not receive a care­ful and com­pre­hen­sive assess­ment for ADHD but are instead diag­nosed with based on eval­u­a­tion pro­ce­dures that are far from optimal.

Sec­ond, although AAP guide­lines indi­cate that spe­cific diag­nos­tic tests should not be rou­tinely used, many par­ents are con­cerned about the lack of objec­tive pro­ce­dures in their child’s eval­u­a­tion. In fact, many fam­i­lies do not pur­sue treat­ment for ADHD because the the absence of objec­tive eval­u­a­tion pro­ce­dures leads them to ques­tion the diag­no­sis. You can read a review of an inter­est­ing study on this issue at www.helpforadd.com/2006/january.htm

For these rea­sons an accu­rate and objec­tive diag­nos­tic test for ADHD could be of value in many clin­i­cal sit­u­a­tions. Two impor­tant con­di­tions would have to be met for such a test to be useful.

First, it would have to be highly sen­si­tive to Read the rest of this entry »

As noted in our Mar­ket Report, we expect the field of cog­ni­tive train­ing (or “brain fit­ness”) soft­ware to grow in a vari­ety of edu­ca­tion and health-related areas over the next years. One of the most promis­ing areas in our view: help­ing chil­dren and adults with atten­tion deficits improve brain func­tion to reduce ADHD symptoms.

I am glad to present this in-depth dis­cus­sion on the results of two recent high-quality sci­en­tific stud­ies. Let me start with Dr. Rabiner’s conclusion:

“Results from these two cog­ni­tive train­ing stud­ies high­light that cog­ni­tive train­ing inter­ven­tions may pro­vide an impor­tant com­ple­ment to tra­di­tional med­ica­tion treat­ment and behav­ior ther­apy. Both stud­ies included appro­pri­ate con­trol groups, employed ran­dom assign­ment, and had out­come mea­sures pro­vided by indi­vid­u­als who were “blind” to which con­di­tion chil­dren were assigned to. They are thus well-designed stud­ies from which sci­en­tif­i­cally sound con­clu­sions can be drawn. They add to the grow­ing research base that inten­sive prac­tice and train­ing focused of key cog­ni­tive skills can have pos­i­tive effects that extend beyond the train­ing sit­u­a­tion itself.”

With­out futher ado…enjoy the article!

- Alvaro

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Two New Cog­ni­tive Train­ing Stud­ies for ADHD Yield Promis­ing Findings

– By Dr. David Rabiner

Although med­ica­tion treat­ment is effec­tive for many chil­dren with ADHD, there remains an impor­tant need to explore and develop inter­ven­tions that can com­ple­ment or even sub­sti­tute for med­ica­tion. This is true for a vari­ety of rea­sons including:

Read the rest of this entry »

We have talked about the value of med­i­ta­tion before (see Mind­ful­ness and Med­i­ta­tion in Schools), as a form of well-directed men­tal exer­cise than can help train atten­tion and emo­tional self-regulation.  Which other stud­ies have shown how it strength­ens spe­cific parts of the brain, mainly in the frontal lobe.

Dr. Rabiner shares with us, below, an excel­lent review of a new study that ana­lyzes the ben­e­fits of mind­ful­ness for ado­les­cents and adults with atten­tion deficits. He writes that “although this is clearly a pre­lim­i­nary study, the results are both inter­est­ing and encouraging.”

- Alvaro

Does Mind­ful­ness Med­i­ta­tion Help Adults & Teens with ADHD

– By Dr. David Rabiner

Although med­ica­tion treat­ment is effec­tive for many indi­vid­u­als with ADHD, includ­ing ado­les­cents adults, there remains an under­stand­able need to explore and develop inter­ven­tions that can com­ple­ment or even sub­sti­tute for med­ica­tion. This is true for a vari­ety of rea­sons includ­ing:
1) Not all adults with ADHD ben­e­fit from med­ica­tion.
2) Among those who ben­e­fit, many have resid­ual dif­fi­cul­ties that need to be addressed via other means.
3) Some adults with ADHD expe­ri­ence adverse effects that pre­vent them from remain­ing on medication.

Read the rest of this entry »

Here you are have the bi-monthly update with our 10 most Pop­u­lar blog posts. (Also, remem­ber that you can sub­scribe to receive our RSS feed, or to our newslet­ter, at the top of this page, if you want to receive this digest by email).

The Neu­ron, The Brain, and Think­ing Smarter

Read the rest of this entry »

A very promis­ing cog­ni­tive train­ing study was pre­sented last week by Helena West­er­berg at the annual meet­ing of the CNS: Cog­ni­tive Neu­ro­science Soci­ety held in San Fran­cisco, and Dr. David Rabiner brings us the highlights.

- Alvaro

———————

The study was con­ducted with a gen­eral adult pop­u­la­tion, rather than adults diag­nosed with ADHD, as was the case in pre­vi­ous pub­lished work­ing mem­ory train­ing studies,

The study was a ran­dom­ized, con­trolled trial of work­ing mem­ory train­ing con­ducted with 55 younger (20–30 years old) and 45 older (60–70 years old) adults. Par­tic­i­pants were ran­domly assigned to receive 5 weeks of active Cogmed Work­ing Mem­ory Train­ing or a placebo train­ing inter­ven­tion. In the active train­ing group, the dif­fi­culty of the work­ing mem­ory train­ing tasks con­tin­u­ally adjusted to match the individual’s per­for­mance. As a result, indi­vid­u­als were con­sis­tently chal­lenged to per­form at their high­est pos­si­ble level. In the placebo train­ing group, the dif­fi­culty level remained con­stant across the train­ing period such that improve­ments in work­ing mem­ory were not expected to occur.

Read the rest of this entry »

(Note: neu­ro­feed­back is a form of biofeed­back that mea­sures brain waves and that, accord­ing to prac­ti­tion­ers, pro­vides good “brain train­ing” for spe­cific clin­i­cal con­di­tions).
A few weeks ago Dr. David Rabiner wrote a great post on How Strong is the Research Sup­port for Neu­ro­feed­back in Atten­tion Deficits?, con­clud­ing that

- “It is for these rea­sons that neu­ro­feed­back is under­stand­ably regarded as an unproven treat­ment approach for ADHD at this time by many ADHD researchers.

- How­ever, these stud­ies do pro­vide a solid basis for sug­gest­ing that if par­ents choose to pur­sue neu­ro­feed­back for their child, there is a rea­son­able chance that their child will ben­e­fit even though we can’t be sure that it is the spe­cific EEG train­ing that is respon­si­ble for the ben­e­fits. Thus, although the effi­cacy of neu­ro­feed­back has yet to be con­clu­sively con­firmed in a ran­dom­ized, placebo-controlled trial, it is impor­tant to place this lim­i­ta­tion in the con­text of the sup­port­ive research evi­dence that has been accumulated.

Read the rest of this entry »

A CDC report esti­mated that, in 2003, 4.4 mil­lion youth ages 4–17 lived with diag­nosed ADHD, and 2.5 mil­lion of them were receiv­ing med­ica­tion treat­ment. Now, which is the core deficit under­ly­ing ADHD-so that treat­ments really address it? and how are ADHD and brain devel­op­ment related? Keep reading…

ADHD & the Nature of Self-Control — Revis­it­ing Barkley’s The­ory of ADHD

— By David Rabiner, Ph.D

As implied in the title of his book, ADHD and the Nature of Self-Control, Dr. Barkley argues that the fun­da­men­tal deficit in indi­vid­u­als with ADHD is one of self-control, and that prob­lems with atten­tion are a sec­ondary char­ac­ter­is­tic of the disorder.

Dr. Barkley empha­sizes that dur­ing the course of devel­op­ment, con­trol over a child’s behav­ior grad­u­ally shifts from exter­nal sources to being increas­ingly gov­erned by inter­nal rules and stan­dards. Con­trol­ling one’s behav­ior by inter­nal rules and stan­dards is what is meant by the term “self-control”.

Read the rest of this entry »

As we have been doing for the last 6 months, here you are have the Monthly Digest of our Most Pop­u­lar Blog Posts. You can con­sider it your monthly Brain Fitness/ Train­ing Newsletter.