Neurological indicators of Attention Deficit Disorder(ADD)

Evidence of the usefulness of neurological imaging methods for diagnosing and possibly
treating attention disorders is accumulating. Recent topographic quantitative electroencephalograph (EEG) findings show several distinct patterns of abnormality in children diagnosed as ADD, reports M. Barry Sterman, University of California/Los

He suggests that these findings can provide improved guidelines for drug treatment. He says that recent imaging techniques are also proving useful for neurofeedback, an alternative behavioral treatment for ADD.

The diagnostic criteria for ADD are purely behavioral, relying entirely on observed behavioral characteristics. Inattention, low frustration tolerance, impulsiveness, poor organization, distractibility, and hyperactivity are the characteristics used to define attention disorders. These symptoms are exhibited by all children at one time or another and are frequently seen in several other disorders as well. No laboratory tests or physical features have been established as diagnostic criteria for attention disorders.

Sterman states that evidence of EEG abnormality as a possible marker for ADD has existed for many years. Recent studies have shown that more than 90 percent of children behaviorally diagnosed with ADD show quantitative EEG findings that indicate disturbances
in neuropsychological regulation. The convergence of EEG findings with brain imaging is providing evidence that a more objective biological approach to the evaluation of ADD and its subtypes is possible. 

Studies comparing normal matched controls with clinically diagnosed ADD children reveal that analyzing quantitative EEG characteristics can correctly identify 88 percent of the children with ADD. Sterman believes that quantitative EEG findings can serve as a reliable biological marker for ADD.

He further suggests that these findings show that the disorder actually includes several distinct subtypes that are readily identifiable from EEGs. Recent studies have also shown improved therapeutic results when both clinical and EEG criteria are used to select the most effective stimulant medication.

Sterman goes on to report on a promising behavioral method that attempts to normalize EEG patterns through biofeedback. This new treatment, also referred to as neurofeedback, is comparable to the biofeedback that helps patients control other physiological functions. One study that compared the results of stimulant medication and neurofeedback showed similar therapeutic results.

Stimulant medications are currently the primary medical treatment for all ADD subtypes, but they only relieve the symptoms without curing the problem. Sterman suggests that while quantitative EEG analysis can help select the most appropriate medication for patients, neurofeedback offers some hope for a more permanent improvement in ADD symptoms without the risk of the negative side effects sometimes experienced with medication. He recommends continued study of the usefulness of quantitative EEG analysis and neurofeedback.

“EEG Markers for Attention Deficit Disorder: Pharmacological and Neurofeedback Application” Child Study Journal Volume 30, Number 1, 2000 Pp. 1-23.

Published in ERN December/January 2001 Volume 14 Number 1

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