Presented at the AAAS 2000 Conference, Washington DC

EEG Biofeedback Aids Impulse Control

BY MARY ANN MOON
Contributing Writer
appears in April issue of Clinical Psychiatry News

(Note: David Kaiser, Ph.D. was principal investigator of this research; the reporter fails to credit him. This research was just published in the Journal of Neurotherapy, Vol 4, No 1, 2000)

WASHINGTON - Impulse control and attentiveness improved after 20 sessions of EEG biofeedback in 85% of 1,089 children and adults with attention-deficit hyperactivity disorder and other attentional and behavioral disorders, Siegfried Othmer, Ph.D., said in a poster presentation at the annual meeting of the American Association for the Advancement of Science.

EEG biofeedback, also known as neurofeedback, "has shown great promise in clinical practice, but the lack of large trials has limited its acceptance within the medical community. This large study should help assuage this criticism," Dr. Othmer said in an interview at the meeting.

The subjects were 726 children aged 5-16 years and 363 adults aged 17-67 years. Approximately two-thirds of the subjects were male. A total of 186 subjects had been formally diagnosed with attention-deficit hyperactivity disorder (ADHD). The remainder had obvious behavioral problems and showed moderate to severe deficits in attentiveness and impulse control on the Tests of Variable Attention (TOVA). Some of the subjects also had been diagnosed with the comorbidities commonly seen with ADHD: oppositional-defiant disorder, conduct disorder, Tourette's syndrome, minor traumatic brain injury, epilepsy, anxiety disorders, and depression, said Dr. Othmer of EEG Spectrum Inc., Encino, Calif. Most had tried standard treatments for attentional disorders without success. None of the patients was taking stimulant medication or antidepressant medication during the study. The subjects participated in at least 20 EEG biofeedback sessions at 32 biofeedback and psychology clinics and private practices. "The process teaches people to train their brains to self-regulate. In a sense, they

'BIOFEEDBACK'S success in [refractory] cases shows how robust the intervention is in impacting attentional mechanisms.'' In a sense they learn to quiet their minds as well as their bodies," Dr. Othmer said. Subjective reports, clinical evaluations, and repeat TOVA testing after the intervention showed that 85% of subjects improved, regardless of whether they had received a formal diagnosis of ADHD. The greatest improvement occurred in those who had the worst scores at study entry. "In subjects who initially had poor TOVA scores in errors of omission, which measures attentiveness, and errors of commission, which measures impulse control, scores rose by 2 standard deviations," he said. A subset of 157 subjects who continued biofeedback therapy for at least 40 sessions showed continued improvement throughout the additional sessions, Dr. Othmer noted.

"Remember that these were people who had failed on traditional therapies like Ritalin, and that many of the adults had been symptomatic their whole lives. Biofeedback's success in such cases shows how robust the intervention is in impacting attentional mechanisms," he said. Dr. Othmer acknowledged that neurofeedback remains largely unrecognized as a viable option for treating ADHD and other attentional and behavioral disorders.

"Even though it has improved cognitive and psychological and physiologic function in an increasing number of mental health and neurologic conditions over the past 25 years, relatively few psychiatrists and neurologists realize that neurofeedback is an effective supplement or alternative to pharmacologic and surgical techniques," he said.

Future research will assess how the intervention influences subjects' physiologic, cognitive, and behavioral functions in the real world, he added.