Neurofeedback in ADHD and insomnia: Vigilance stabilization through sleep spindles and circadian networks

In this review article an overview of the history and current status of neurofeedback for the treatment of ADHD and insomnia is provided. Recent insights suggest a central role of circadian phase delay, resulting in sleep onset insomnia (SOI) in a sub-group of ADHD patients. Chronobiological treatments, such as melatonin and early morning bright light, affect the suprachiasmatic nucleus. This nucleus has been shown to project to the noradrenergic locus coeruleus (LC) thereby explaining the vigilance stabilizing effects of such treatments in ADHD. It is hypothesized that both Sensori-Motor Rhythm (SMR) and Slow- Cortical Potential (SCP) neurofeedback impact on the sleep spindle circuitry resulting in increased sleep spindle density, normalization of SOI and thereby affect the noradrenergic LC, resulting in vigilance stabilization. After SOI is normalized, improvements on ADHD symptoms will occur with a delayed onset of effect. Therefore, clinical trials investigating new treatments in ADHD should include assessments at follow-up as their primary endpoint rather than assessments at outtake. Furthermore, an implication requiring further study is that neurofeedback could be stopped when SOI is normalized, which might result in fewer sessions.

Research Institute Brainclinics: Doubling of Neurofeedback Efficacy in ADHD Treatment

A personalized treatment approach, tailoring Neurofeedback treatment to the individual ADHD patient, almost doubled the effectiveness for attentional and hyperactivity/impulsivity problems. These results have just been published in the scientific journal ‘Applied Psychophysiology and Biofeedback’. This study is the first scientific study investigating whether personalizing Neurofeedback treatment, based on a so-called quantitative EEG or QEEG, results in a higher effectiveness of this treatment in ADHD. 

Instrumental Conditioning of Human Sensorimotor Rhythm (12-15 Hz) and Its Impact on Sleep as Well as Declarative Learning

Relative SMR amplitude increased over 10 instrumental conditioning sessions (in the experimental group only) and this “shaping of one's own brain activity” improved subsequent declarative learning and facilitated the expression of 12–15 Hz spindle oscillations during sleep. Most interestingly, these electrophysiological changes were accompanied by a shortened sleep onset latency.