Neurofeedback is a biofeedback method based on the rationale that there is a relationship

between surface EEG and the underlying thalamocortical mechanisms responsible for its

rhythms and frequency modulations. Variations in alertness and behavioral control are directly

related to thalamocortical generator mechanisms. The principle of neurofeedback is that over

time, participants learn operant control of their EEG and change from an “ADHD” state to one

resembling that of typically developing children. This process has been shown to eventually

remediate the symptoms associated with ADHD.

In the case of children with attentional difficulties, e.g. ADHD, brain research has documented

an excess amount of slow-wave activity, called theta waves, in the pre-frontal cortex.

Illustration below of EEG patterns.

Theta waves are especially predominant when children with ADHD try to engage in an active

concentration task, which makes it very difficult for them to focus and sustain their attention on

the task over a prolonged period of time. This is illustrated in the brain maps below. Through

neurofeedback training, children are taught to decrease their amount of theta activity and

increase faster beta frequencies, which enable them to sustain attention and focus on the task at

hand.

Findings from EEG studies provide the rationale for applying the neurofeedback paradigm in

ADHD. In the resting EEG (relaxed awake state), increased slow wave activity (theta, 4–8 Hz)

and/or reduced alpha (8–13 Hz) and beta (13–30 Hz) activity, especially in central and frontal

regions, might be associated with ADHD. This indicates cortical under arousal. Thus, it seems

plausible that in a paradigm often applied in ADHD, the goal is to decrease activity in the theta

band and to increase activity in the beta at the vertex (electrode Cz), i.e., activating and

maintaining a state of cortical arousal.

In individuals with ADHD, there is second pattern of excessive “beta” activity or “hyperarousal”

over frontal regions. EEG analysis has revealed increased relative beta power, decreased relative

alpha power and in the frontal regions compared to healthy peers.

Below is a typical setup for a neurofeedback session. The helmet is set up with the EEG leads

internally. There are special programs that help “train” the child to increase desired EEG patters.

More traditional EEG scalp applications can be used so that the US probe could be applied for

neuromodulation purposes. One concern is the possibility that the US device will create 60-cycle

interference. 60-cycle is an electrical field produce by most electrical devices.

An experimental design to assess the effects USNM on EEG is a sound approach to begin to

understand the effect US has on the brains electrical activity, and eventually attentional abilities.