Neurofeedback training aimed to improve focused attention and alertness in children with ADHD: a study of relative power of EEG rhythms using custom-made software application.

Neurofeedback is a nonpharmacological treatment for attention-deficit hyperactivity disorder (ADHD). We propose that operant conditioning of electroencephalogram (EEG) in neurofeedback training aimed to mitigate inattention and low arousal in ADHD, will be accompanied by changes in EEG bands' relative power. Patients were 18 children diagnosed with ADHD. The neurofeedback protocol (Focus/Alertness by Peak Achievement Trainer) has a focused attention and alertness training mode. The neurofeedback protocol provides one for Focus and one for Alertness. This does not allow for collecting information regarding changes in specific EEG bands (delta, theta, alpha, low and high beta, and gamma) power within the 2 to 45 Hz range. Quantitative EEG analysis was completed on each of twelve 25-minute-long sessions using a custom-made MatLab application to determine the relative power of each of the aforementioned EEG bands throughout each session, and from the first session to the last session. Additional statistical analysis determined significant changes in relative power within sessions (from minute 1 to minute 25) and between sessions (from session 1 to session 12). Analysis was of relative power of theta, alpha, low and high beta, theta/alpha, theta/beta, and theta/low beta and theta/high beta ratios. Additional secondary measures of patients' post-neurofeedback outcomes were assessed, using an audiovisual selective attention test (IVA + Plus) and behavioral evaluation scores from the Aberrant Behavior Checklist. Analysis of data computed in the MatLab application, determined that theta/low beta and theta/alpha ratios decreased significantly from session 1 to session 12, and from minute 1 to minute 25 within sessions. The findings regarding EEG changes resulting from brain wave self-regulation training, along with behavioral evaluations, will help elucidate neural mechanisms of neurofeedback aimed to improve focused attention and alertness in ADHD.