Electroencephalograph

Some people who don’t believe ADHD exists argue that there is no physical signs or tests for it.  Such a claim, while popular, ignores the strong and compelling evidence from PET and fMRI scans that show things like smaller brain size in people with ADHD as well as dopamine irregularities.

But recent innovations in brain wave monitoring may put that claim to rest for good.  There is now a physical test that may be able to diagnose ADHD  up to 90% of the time, the qEEG.

Sounds too good to be true.  That said, the science behind this test does seem to be valid, and a recent test of qEEG ability to diagnose real people was breathtakingly impressive.  In a mix of 500 people, the qEEG tests diagnosed 96% of non-ADHD people correctly (as not having ADHD), and diagnosed correctly 86% of the people with ADHD.

Very impressive.  Let’s go a little more into the details.

What the heck is a qEEG?

A qEEG is the weird sounding abbreviation (“We’re going to have to run a queeg on your son”) for “quantitative electroenchalogram.”  Basically, a qEEG is an EEG that has been converted to a digital format – a computer stores the EEG data which is “quantified.” This is important because the computer can perform a higher level of analysis and check for minute differences that might not be noticed by a person alone.

And an EEG is that test when you wear a cap covered in electrodes.  What the test basically does is detect the electrical activity going on up in your skull.  The best thing about it is that it is non-invasive, not too expensive, and can be done fairly quickly.  That said, they are not yet very common and may be hard to obtain.

We’ve had EEGs for a while, but only recently have we improved our ability, especially by using computers, to analyze them.  With better analytical capabilities, we are increasingly able to develop a model of differences in brain wave behavior between people with ADHD and people without.

One analysis, for instance, showed that up to 80% of people diagnosed with ADHD and tested with an EEG show some signs of brain electrical difference.

Now, some electrical difference is not entirely uncommon. 24.6% of kids with learning disabilities may also have qEEG differences, but possibly of a different nature, and that’s not to mention that some of the kids used to get that number could have had ADHD as well.  After all, a great deal of kids with ADHD also have learning disabilities.  And in “normal” kids (who is really normal?), only 3.3% have EEG irregularities.

Lots of numbers.  What do they mean?

Recently, 176 people with inattentive ADD, 221 people with hyperactive ADHD and 85 people without ADHD were given qEEG tests.  The researchers didn’t have anything else to look at besides the data taken directly from measuring brain waves.

The result?  An astonishing 86% of the people with ADHD were diagnosed – and 96% of those without ADHD were correctly identified.

The next time someone tells you there isn’t a physical cause or aspect of ADHD, tell them that.

Do Medications “Fix” qEEG Differences?

To top it off – and this is like finding a $20 bill in the pockets of a returned pair of lost jeans – medications like Ritalin may actually change the very same brain patterns that can be used to blindly diagnose someone with ADHD!  Not only does the qEEG seem to show clearly that there are brain wave differences, it may also show that medications change those brain waves to something more normal.

It all makes an extremely compelling story.  That said, as always, healthy skepticism is called for, and the word is still out on this new method.

Now, it’s important to note that the research on the effects of stimulants on resting EEG behavior are mixed but generally show little effect.  Which goes against what we just said.  Emerging data, however, seems to show that stimulants do have a significant effect on the EEG behavior of people who aren’t resting – which is how we spend the vast majority of our waking time.

Using qEEG, for instance, Winsberg and his colleagues reported higher amplitude and peak on certain brain waves while performing a task in ADHD kids who took Ritalin as compared to ADHD kids who didn’t.  That activity could indicate better focus and concentration.  Another recent study of 20 kids showed similar positive effects of stimulant treatment, with a lowered theta and somewhat lowered delta brain wave activity.  Both the theta and delta areas seem to be elevated in ADHD people.

The models aren’t perfect, and the exact brain wave patterns that are different in ADHD people still not fully established.  The most consistent finding seems to be an elevation in delta and theta action, with lower levels of alpha and beta waves.  And some EEG studies have shown a decrease in activity in the frontal brain region, while others show an increase.

That the details aren’t worked out makes sense.  This is a revolutionary, break through idea.  And the inconsistencies may be due to different test situations, as well as possibly indicating different types of ADHD.  Amazingly enough, studies which measured brain activity of kids resting have been compared to the activity of kids watching television – which only makes sense that there would be a difference! (Probably for the worse.  I mean, they’re watching TV, right?)

There are other interesting findings from these tests.  2-3% of normal children have an abnormal wave pattern known as epileptiform, for instance, while a much higher 6% of ADHD do.  That specific pattern is important because it may hint at an underlying pattern that only overtly expresses itself in 6% of ADHD kids, but is really present behind the scenes in a much higher number.  Additionally, for those specific kids, it offers a potential drug target.

So far, the qEEG seems to be 80-90% accurate at diagnosing ADHD.  Which is pretty darn impressive for a test that doesn’t ask a single question – just looks at what’s going on in the brain.

We at Health and Life feel this article discusses a fascinating breakthrough – if you agree, please share this article and help fight the popular myth that there is no physical aspect to ADHD.

Sources:

Epileptiform abnormalities and quantitative EEG in children with attention-deficit / hyperactivity disorder
Effects of methylphenidate on quantitative eeg of boys with attention-deficit hyperactivity disorder in continous performance test
The Clinical Role of Computerized EEG in the Evaluation and Treatment of Learning and Attention Disorders in Children and Adolescents