How can new technology like brain-mapping help to improve our healthcare?
Let us have a look at the attention deficit-hyperactivity disorder (ADHD)
Different types of brain dysfunction may cause the same behavioural and cognitive problems. For example a child that is being extremely inattentive, hyperactive, very impulsive and is showing poor results at school, could be diagnosed with the attention deficit-hyperactivity disorder (ADHD). However recent research showed that all these symptoms could be explained by many different brain dysfunctions, and thus would require completely different measures. And whereas for one child a dopamine re-uptake inhibitor (such as Ritalin) could work, for others a medication using a noradrenaline re-uptake inhibitor would be better. The patient could also respond well to neurofeedback or to transcranial direct current stimulation.
So how can we know what treatment is best for which child if they all show the same symptoms?
What we need is a way to distinguish between the sources of different brain dysfunctions. Recent research showed specific patterns in the electrical activity of the brain and proved that these patterns could provide reliable brain markers of normal brain functioning and also show brain dysfunctions. In figure 1. you can see an example of three very distinctive EEG frequency rhythms with different topographical distributions for three ADHD subtypes who probably have many symptoms in common, but require a completely different treatment when we look at their brain-activity.
J. D. Kropotov, M. Pąchalska and A. Mueller (2014) New neurotechnologies for the diagnosis and modulation of brain dysfunction health psychology report · volume 4
Neurofeedback aplication in ADHD cases: an effective treatment without side effects.
What is ADHD?
ADHD is a behavioural disorder characterized by a moderated to severe distraction, brief attention periods, motor restlessness, emotional instability and impulsive conducts.
This disorder was firstly identified in childhood. However, over time, it was recognized its chronic character since it persists and manifests beyond adolescence. The long-terms monitoring studies have demonstrated that between 60 and 75 per cent of the children with ADHD manifests the symptoms until adulthood.
ADHD is typically diagnosed when children are 7 years old, although in some cases, this diagnose can be done earlier. It appears as an increasing in physical activity, impulsiveness and difficulty keeping attention in an activity during a continued time. In addition, many children develop self-esteem issues linked to ADHD symptoms which are not typically associated with this disorder by parents.
Also, ADHD may be associated frequently with other problems, and its consequences are seen in different environments of the child’s life, not only the school. It also affects their interpersonal relationships, with family, with other children and with their teachers, being all these ones key relationships in child development.
According to the North American classification of psychiatric diseases DSM-IV, not all people with ADHD have the same clinical features. In some of them, they predominate the inattention symptoms, in others hyperactivity and impulsiveness, and in others there are both attentional and hyperactivity and impulsiveness problems (what is known as ADHD combined or mixed). Therefore, ADHD can be divided into several subtypes, depending on which group of symptoms predominate. These variants are known as “ADHD subtypes”. Of all these variants the most common is the combined, followed by the predominantly hyperactive-impulsive. The inattentive subtype is the least common of them and is more common in girls than in boys. This contrasts with the other medical conditions that are found more in boys. In consequence, as the inattentive symptoms are more subtle, are detected less and cause the diagnosis of ADHD in girls / adolescents take longer and, in many cases, go unnoticed.
Population affected by ADHD
Who are more likely to have ADHD, boys or girls?
In the pediatric population, ADHD is identified more in men than in women. Most experts believe that the much lower ADHD incidence in girls and young women is due to girls tend to suffer the subtype predominantly inattentive. In contrast, the hyperactive subtype, more frequent in boys, attracts the attention of adults precipitating the patient evaluation. Therefore, in general population, the ratio of boys vs. girls diagnosed of ADHD is about 4:1.
In adults, it is estimated that 4 per cent of population suffers the disorder, but just a few of them are detected. In general, hyperactivity disappears leaving a restlessness, a continuous feeling of needing something. The impulsiveness and inattention do not appear as in childhood.
Evolution of TDAH in adults
Overall, patients with ADHD achieve an academic training less compared to the control groups, even with similar levels of intelligence. Only 5 per cent of patients with ADHD achieve their access to college. Studies report that people with ADHD have a worse work adaptation. In addition, it is demonstrated that labour discontinuity in patients with ADHD is caused by lack of social skills. For example, some symptoms, as hyperactivity, impulse control or lability can leads them to see monotone and boring their jobs. This emotional and labour instability also affects to their families and the couple. There are publications where they are described these relationship difficulties as well as social adaptation issues which can persist in adults with ADHD.
Neurofeedback application in ADHD cases
– Improvement in body awareness and the environment.
– Developement of social skills.
– Enhancement of emotional management.
– Increase of communication skills.
– Improvement of impulse control: rage and anger.
– Development of the capacity for analysis and decision making.
– Benefits concentration and attention.
Neurofeedback: recommeded treatment for the American Academy of Pediatrics