Doctors help children with ADHD train their brain

Madhav Bhardwaj at the EEG Neuro Feedback lab in the Nimhans.   | Photo Credit: G_P_Sampath Kumar

Several children who have attention deficit/hyperactivity disorder (ADHD) as well as interpersonal relationship problems with parents and teachers were found to have benefited from Electroencephalography (EEG) neuro feedback training (NFT). This was one of the findings of a study conducted by the National Institute of Mental Health and Neuro Sciences (NIMHANS) and published in Clinical EEG and Neuroscience Journal last year.

EEG Neurofeedback is a non-invasive process by which a person learns to self regulate his or her brain’s electrical activity. Jamuna Rajeswaran, Professor and Head, Clinical Neuropsychology and Cognitive Neuro Science Centre at NIMHANS, said that it involves a specific form of training that monitors a patient’s central nervous system via the measurement and regulation of brainwave activity from electrodes placed on the scalp.

Training with neuro feedback aims to enable an individual to modify patterns of cortical activity and normalise brain activity. “It trains the individual to control or modulate his or her brain activity, which leads to changes in cognition, emotion, and behaviour,” said Dr. Jamuna, adding that the aim is to enable conscious control of brainwave activity.

Normally, if brain activity changes in the direction as desired by the therapist, a positive reward or feedback is given to the individual, and if it regresses, no feedback is given. Faculty members at NIMHANS often club this therapy with behavioural interventions.

The study involved 30 children in the age group of 6-12 years, who were diagnosed with ADHD. Fifteen of these children received NFT — three to four sessions per week for 3.5 to five months. The research showed that the NFT method was an effective method to enhance cognitive deficits and helps reduce ADHD symptoms and behavioural problems.

One of the ways in which the results could be quantified was it was observed that the academic performance improved in children with ADHD.

“Improvement in academic success can be explained as a result of improved self-regulation learned in NFT, which would have enhanced cognitive functions and reduced behavioural problems. These improved cognitive and behavioural functions, which may have influenced the child’s ability to listen, learn quickly, recall better, and may have improved the overall quality of academic achievement,” the study pointed out.

The study also noted that while there was a significant improvement in children’s attention span as reported by their teacher, there was no improvement on parent-rated inattention symptoms. However, there was an improvement in hyperactivity symptoms reported by their parents. This could probably be because parents would have noticed and reported changes in more obvious behavioural problems manifested in the form of hyperactivity and impulsiveness and distraction rather than inattention, said the study.

The researchers have categorically pointed out that NFT can be considered as a long-term effective treatment for children with ADHD, and it could not only be an alternative treatment but also an adjunctive treatment to routine clinical management in ADHD.

How neuro feedback is helping trauma patients

Madhav Bhardwaj settles into a chair at the EEG Neuro Feedback lab in the National Institute of Mental Health and NeuroScience (Nimhans). He has to play a car racing game with two goals: keep the car on the track and reach the finish line. Except, there are no gadgets or commands that he can use. He has to use his mind, literally. He is expected to control or modulate his brain activity, which leads to changes in cognition, emotion, and behaviour.

The electrodes on the scalp relay his brain activities to doctors who are monitoring the session. This is part of his journey towards recovery after a car accident on May 11, 2018 in Delhi. He was in coma for two weeks, and the right side of his body was paralysed. He underwent three surgeries, and with the help of physiotherapy, his physical movement improved gradually in a few months.

But his speech and cognition abilities were a matter for concern. After visiting several doctors in various hospitals, his mother Preethi Bhardwaj finally found her way to the EEG Neuro Feedback lab at Nimhans.

Madhav, who started his treatment at Nimhans in October 2018, has completed 40 sessions, and has shown marked improvement. He concentrates on the race as doctors monitor the wave patterns in his brain.

“The alpha wave, which is indicative of relaxation, is supposed to be between 8 to 12 hertz. If the patient’s readings are not on par with this, then he is asked to relax in the next session,” said Dr. Jamuna Rajeswaran, Professor and Head, Clinical Neuropsychology and Cognitive Neuro Science Centre at Nimhans.

Each day, the patient is given a score based on his/her performance. The EEG readings also help the therapist understand the wave patterns in the brain.

Doctors say that this is similar to stimulated guided meditation. Madhav’s father Arvind has noticed a marked improvement in his son’s emotional stability since they started the sessions.

“With each session, his emotional outbursts were also getting addressed. It was an emotional moment for his family and friends when he was able to give a five-minute speech at a party in December.”

Since 2007, the lab has helped 3,000 patients like Madhav who are recovering from brain trauma. The lab has been funded by the Department of Science and Technology as well as the Department of Biotechnology.

They have recently started treating several international patients from the United States of America, UAE and Sri Lanka who chose to come to the lab as the treatment is relatively cheaper. The treatment costs ₹5,000 for 20 sessions, which takes place alternative days. Each session lasts about 40 minutes.

The department has a visual analog scale where they ask the patients and the caregivers to rate their behaviour, tasks they can do and their state of mind. These include their memory, concentration, ability to work, anger. tolerance and headache.

Mohd. Afsar, junior consultant, Department of Neuropsychology, said that the efficacy of neuro feedback training was found to be effective in various clinical conditions, such as ADHD, epilepsy, migraine, post traumatic stress disorder, substance use disorder and insomnia. They also provide sessions for family and friends of the patients, and also contact the employers if needed.

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Printable version | Jun 15, 2021 2:59:39 AM |

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