Sarah Wyckoff

One size fits all? Slow cortical potentials neurofeedback: a review.

Objective: The intent of this manuscript was to review all published studies on slow cortical potentials (SCP) neurofeedback for the treatment of ADHD, with emphasis on neurophysiological rationale, study design, protocol, outcomes, and limitations. Method: For review, PubMed, MEDLINE, ERIC, and Google Scholar searches identified six studies and six subsequent publications. In addition to five studies focusing on children with Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV)–diagnosed ADHD, one study reports on adults. Results: SCP protocols utilize unipolar-electrode placement at Cz, randomized bidirectional signal regulation, feedback/transfer trials, and discrete feedback/rewards. Results demonstrated learning of SCP self-regulation, moderate to large within group effect sizes for core ADHD symptom reduction, and enhancement of event-related potentials/electroencephalogram components. Neurophysiological and session variables were predictive of treatment outcome, but open questions of specific and nonspecific effects remain. Study limitations and future directions are discussed. Conclusion: SCP is an efficacious and standardized neurofeedback protocol that addresses behavioral and neurophysiological deficits in ADHD.

Frontal alpha-asymmetry in adults with attention deficit hyperactivity disorder: Replication and specification

Recent findings suggest that adults suffering from attention deficit hyperactivity disorder (ADHD) display an atypical pattern of hemispheric asymmetry, assessed through the alpha band in resting-state electroencephalogram. In the context of the approach-withdrawal model of hemispheric asymmetry, this pattern has been identified as a correlate of approach-related behavior, particularly in anterior brain regions. The current study sought to replicate previous findings on alpha asymmetry in ADHD, and to specify them based on the assumption that ADHD represents a disorder of excessive approach tendencies. A group of ADHD patients (n=19) was compared to a group of healthy controls (n=19) on measures of alpha asymmetry and aggression, an approach-related trait. Observed region-specific group differences in alpha asymmetry approximated assumptions of the approach-withdrawal model. In addition ADHD subjects displayed elevated levels of a subcomponent of aggression. These results provide support for a conceptualization of ADHD as a disorder of excessive approach tendencies.

Neurofeedback as a nonpharmacological treatment for adults with attention-deficit/hyperactivity disorder (ADHD): study protocol for a randomized controlled trial

BackgroundNeurofeedback has been applied effectively in various areas, especially in the treatment of children with attention-deficit/hyperactivity disorder (ADHD). This study protocol is designed to investigate the effect of slow cortical potential (SCP) feedback and a new form of neurofeedback using near-infrared spectroscopy (NIRS) on symptomatology and neurophysiological parameters in an adult ADHD population. A comparison of SCP and NIRS feedback therapy methods has not been previously conducted and may yield valuable findings about alternative treatments for adult ADHD.Methods/DesignThe outcome of both neurofeedback techniques will be assessed over 30 treatment sessions and after a 6-month follow-up period, and then will be compared to a nonspecific biofeedback treatment. Furthermore, to investigate if treatment effects in this proof-of-principle study can be predicted by specific neurophysiological baseline parameters, regression models will be applied. Finally, a comparison with healthy controls will be conducted to evaluate deviant pretraining neurophysiological parameters, stability of assessment measures, and treatment outcome.DiscussionTo date, an investigation and comparison of SCP and NIRS feedback training to an active control has not been conducted; therefore, we hope to gain valuable insights in effects and differences of these types of treatment for ADHD in adults.Trial registrationThis study is registered with the German Registry of Clinical Trials: DRKS00006767, date of registration: 8 October 2014.

Neurofeedback for Adult Attention-Deficit/Hyperactivity Disorder: Investigation of Slow Cortical Potential Neurofeedback—Preliminary Results

Attention deficit/hyperactivity disorder (ADHD) is characterized by symptoms of inattention, impulsivity, and hyperactivity. Compared to ADHD in children, only a few studies have investigated ADHD in an adult population, and even less have investigated new forms of treatment such as neurofeedback. Neurofeedback has been applied effectively in various areas, especially in the treatment of children with ADHD, and symptom improvements were associated with increased amplitude of the contingent negative variation (CNV). This study investigated if any behavioral and electrophysiological changes reflected in the CNV can be observed after 15 sessions of SCP neurofeedback training. Furthermore, a comparison of CNV amplitude in adults with ADHD and a healthy control group was conducted. Continuous 22-channel EEG was acquired from 10 adults who met DSM–IV criteria for ADHD and 8 matched healthy controls. EEG recordings were collected pre/midtreatment and included resting EEG, P300, and CNV tasks as well as ADHD beha...

Neurofeedback of slow cortical potentials as a treatment for adults with Attention Deficit-/Hyperactivity Disorder

OBJECTIVE Attention Deficit-/Hyperactivity Disorder (ADHD) has been treated successfully in children with neurofeedback (NF). In this study, for the first time NF is investigated in adults with ADHD. To answer the question of specificity the relationship between treatment outcome and self-regulation ability is assessed. METHODS Twenty-four participants underwent 30 sessions of slow cortical potential NF. Measurements of ADHD and comorbid symptoms, as well as neurophysiological data (reaction time (RT) and RT variability (RTV) and contingent negative variation (CNV)) were performed before and after treatment, and again six months after sessions were completed. Participants were categorized into self-regulation learners and non-learners. RESULTS Significant improvements on all symptom scales were observed with medium to large effect sizes after treatment and six months post treatment. RT and RTV decreased significantly and there was a trend for an increased CNV. Half of the participants successfully learned to regulate their brain activity. In the long-term, symptoms in the group of learners improved more than in non-learners with large effect sizes. CONCLUSION NF is effective in treating adult ADHD long-term. The impact of self-regulation ability and possible unspecific effects still require further investigation. SIGNIFICANCE This study is the first to investigate the effects of NF in adults with ADHD, relating clinical outcome to self-regulation performance.

Underarousal in Adult ADHD: How Are Peripheral and Cortical Arousal Related?

In children and adults with attention deficit/hyperactivity disorder (ADHD), a general slowing of spontaneous electroencephalographic (EEG) brain activity and a decrease of event-related potential amplitudes such as the contingent negative variation (CNV) are observed. Additionally, some studies have reported decreased skin conductance level (SCL) in this clinical population leading to the hypothesis of a peripheral hypoarousal, which may be a target of biofeedback treatment in addition to or instead of neurofeedback. To our knowledge, the relationship between SCL and CNV has not been simultaneously investigated in one experiment. Using the theoretical background of the hypoarousal model, this article aims to gain more insight into the differences and correlations of cortical (CNV) and peripheral (SCL) arousal in adults with ADHD. A sample of 23 adults with ADHD and 22 healthy controls underwent an auditory Go-NoGo task with simultaneous 22-channel EEG and SCL recordings. Reaction time (RT) and reaction time variability (RTV) were also measured to assess task performance. Significantly decreased CNV amplitude and significantly higher RTV were observed in the ADHD group, reflecting cortical underarousal and problems with sustained attention. No significant correlation between peripheral underarousal and cortical underarousal was observed in the ADHD group or the control group. The observed cortical underarousal reflected in the decreased CNV supports the notion of a reduced CNV amplitude as a possible biomarker for ADHD. However, the connection between cortical and peripheral arousal is not as clear as is suggested in previous research investigating both separately. Implications of these results for new treatment options for ADHD such as biofeedback are discussed.

Feedback of Slow Cortical Potentials: Basics, Application, and Evidence

Publisher Summary This chapter discusses the origins of slow cortical potentials (SCP) activity, followed by a description of the technical requirements. Feedback, diagnosis, and evaluation requirements are also addressed. SCPs belong to the family of event-related potentials (ERPs). The common feature of brain potentials subsumed under this category is that they are time-locked to a specific event. These events may be external or internal and include physical stimuli, behavioral responses, and cognitive and emotional processes. To detect these deflections within the raw electroencephalography (EEG), averaging techniques are required. The timing of these responses reflects diverse aspects of brain communication and information processing. ERPs can be observed from ∼50 to 1000 msec after the onset of a stimulus, and subdivided into early and late components on the basis of their latency and direction of deviance. Finally, the chapter concludes with a review of the published research of SCP feedback and epilepsy, attention deficit/ hyperactivity disorder (ADHD), and migraines.Publisher Summary This chapter discusses the origins of slow cortical potentials (SCP) activity, followed by a description of the technical requirements. Feedback, diagnosis, and evaluation requirements are also addressed. SCPs belong to the family of event-related potentials (ERPs). The common feature of brain potentials subsumed under this category is that they are time-locked to a specific event. These events may be external or internal and include physical stimuli, behavioral responses, and cognitive and emotional processes. To detect these deflections within the raw electroencephalography (EEG), averaging techniques are required. The timing of these responses reflects diverse aspects of brain communication and information processing. ERPs can be observed from ∼50 to 1000 msec after the onset of a stimulus, and subdivided into early and late components on the basis of their latency and direction of deviance. Finally, the chapter concludes with a review of the published research of SCP feedback and epilepsy, attention deficit/ hyperactivity disorder (ADHD), and migraines.

Feedback of Slow Cortical Potentials

Publisher Summary This chapter discusses the origins of slow cortical potentials (SCP) activity, followed by a description of the technical requirements. Feedback, diagnosis, and evaluation requirements are also addressed. SCPs belong to the family of event-related potentials (ERPs). The common feature of brain potentials subsumed under this category is that they are time-locked to a specific event. These events may be external or internal and include physical stimuli, behavioral responses, and cognitive and emotional processes. To detect these deflections within the raw electroencephalography (EEG), averaging techniques are required. The timing of these responses reflects diverse aspects of brain communication and information processing. ERPs can be observed from ∼50 to 1000 msec after the onset of a stimulus, and subdivided into early and late components on the basis of their latency and direction of deviance. Finally, the chapter concludes with a review of the published research of SCP feedback and epilepsy, attention deficit/ hyperactivity disorder (ADHD), and migraines.Publisher Summary This chapter discusses the origins of slow cortical potentials (SCP) activity, followed by a description of the technical requirements. Feedback, diagnosis, and evaluation requirements are also addressed. SCPs belong to the family of event-related potentials (ERPs). The common feature of brain potentials subsumed under this category is that they are time-locked to a specific event. These events may be external or internal and include physical stimuli, behavioral responses, and cognitive and emotional processes. To detect these deflections within the raw electroencephalography (EEG), averaging techniques are required. The timing of these responses reflects diverse aspects of brain communication and information processing. ERPs can be observed from ∼50 to 1000 msec after the onset of a stimulus, and subdivided into early and late components on the basis of their latency and direction of deviance. Finally, the chapter concludes with a review of the published research of SCP feedback and epilepsy, attention deficit/ hyperactivity disorder (ADHD), and migraines.

Chapter 8 – Feedback of Slow Cortical Potentials: Basics, Application, and Evidence

Publisher Summary This chapter discusses the origins of slow cortical potentials (SCP) activity, followed by a description of the technical requirements. Feedback, diagnosis, and evaluation requirements are also addressed. SCPs belong to the family of event-related potentials (ERPs). The common feature of brain potentials subsumed under this category is that they are time-locked to a specific event. These events may be external or internal and include physical stimuli, behavioral responses, and cognitive and emotional processes. To detect these deflections within the raw electroencephalography (EEG), averaging techniques are required. The timing of these responses reflects diverse aspects of brain communication and information processing. ERPs can be observed from ∼50 to 1000 msec after the onset of a stimulus, and subdivided into early and late components on the basis of their latency and direction of deviance. Finally, the chapter concludes with a review of the published research of SCP feedback and epilepsy, attention deficit/ hyperactivity disorder (ADHD), and migraines.Publisher Summary This chapter discusses the origins of slow cortical potentials (SCP) activity, followed by a description of the technical requirements. Feedback, diagnosis, and evaluation requirements are also addressed. SCPs belong to the family of event-related potentials (ERPs). The common feature of brain potentials subsumed under this category is that they are time-locked to a specific event. These events may be external or internal and include physical stimuli, behavioral responses, and cognitive and emotional processes. To detect these deflections within the raw electroencephalography (EEG), averaging techniques are required. The timing of these responses reflects diverse aspects of brain communication and information processing. ERPs can be observed from ∼50 to 1000 msec after the onset of a stimulus, and subdivided into early and late components on the basis of their latency and direction of deviance. Finally, the chapter concludes with a review of the published research of SCP feedback and epilepsy, attention deficit/ hyperactivity disorder (ADHD), and migraines.