Saturday, April 18, 2015

Identifying Disorders: ADHD

What is ADD/ADHD?

Attention Deficit Disorder is a neurological disorder which affects an individuals attention span, attentiveness, and ability to concentrate. People with ADD often find that focusing on tasks is very difficult, which can affect work/academic performance.

Symptoms:

1. Inattentiveness - Unable to focus on instructions
2. Hyperactivity - Unable to sit still, may seem very restless or fidgety
3. Short Attention Span - Unable to concentrate on tasks for a long period of time
4. Impulsiveness - Unable to control impulsive outbursts, emotions, or actions

ADHD in young children can often be mistaken for childish behavior, and may actually be late maturation. However, by age 5, most children have learned to sit quietly and respect instructions. At this stage, identifying ADD may be easier, as children affected by the disorder will still behave in a hyperactive/inattentive way.

What Causes ADD?

ADD is typically caused by irregular functioning of the frontal lobes, the executive action center of the brain. Abnormal blood flow to these regions, which correlate to certain brainmaps, cause behavioral problems. On the neural level: irregular electrical activity in the brain causes issues in the neurotransmission process: the proper amount of neurotransmitters are not fired across the synaptic gap. In ADD's case, the amount of dopamine (which is associated with sleep, mood, learning, and attention) is deficient. Medications that treat ADD force more dopamine to be produced to counteract the disorder. Acquisition of this disease is also hereditary. Children are very likely to get ADD if one or both parents have it.

Identifying ADD with Brainmaps

While brainmaps are not necessary for the identification of ADD, they can certainly be a helpful tool in both diagnosis and treatment. My internship adviser, Bob Gurney, participated in a research study with the creators of the NX Link Database (NYU Medical School). After analyzing the brainmaps of thousands of people with ADD, depression, obsessive compulsive disorder, etc., they created diagnosis tables containing the most common similarities between brainmaps of clients who had the same diseases. Each table contains subtypes, the most common different ways a disorder can manifest itself in the brainmaps. For example, ADD can be caused by both excessive Theta waves and Beta waves in the frontal lobes. On a brainmap, those two situations look completely different -- and yet, they result in the same disorder. These tables that were created became the NX Link discriminant database, which I described in the previous post. Clients brainwaves are compared against these norm tables for each disease, resulting in a very precise analysis/diagnosis. These tables have been tested in many countries on their native poplations, such as Japan, Nigeria, and Russia, and have proved their accuracy. Below are the subtypes for ADD, including a general symptoms list.

These are useful keys to identifying ADD in a map. If these signs are noticed, it is possible the patient has ADD.
a. New York University Medical School QEEG Normative Database Discriminant Analysis suggests the presence of Attention Deficit Hyperactivity Disorder (p<=0.025). This is merely the line printed on a QEEG if a patient is diagnosed with ADD with the NX Link.
b. Elevated frontal Theta, Alpha, and Beta (excessive Theta, Alpha, and Beta waves in the frontal lobes)
c. Reduced Delta (insufficient Delta waves in all regions of the brain)
d. Absence of expected ADHD Right frontal Theta and Alpha Asymmetry

Now these are the visual subtypes.
Normal Brain
This is what a completely normal brain with absolutely no problems should look like on the brainmap (0 standard deviations). While this is impossible, it gives the database a norm. 

Elevated Beta Subtype of ADD/ADHD
According to the key on the right, this patient has 3 standard deviations of Beta waves above the norm. As mentioned before,the fast Beta waves are produced when focusing on tasks or when concentration is necessary. However, too much blood flow, like above, can overclock the brain, causing a short attention span.

Elevated Theta Subtype of ADD/ADHD
ADD can also manifest itself in this subtype. The patient above has excessive Theta waves in the frontal regions (low blood flow there). The frontal lobes are in charge of completing tasks, executive action, and decisiveness. The excessive slow Theta waves (which are associated with drowsiness) cause sluggishness. This results in difficulty when focusing, and inattentiveness. Children with this subtype often can't pay attention because Theta is associated with daydreaming and relaxation. 

Elevated Alpha Subtype of ADD/ADHD
This patient has excessive Alpha waves in their frontal lobes. Alpha waves are the resting frequency of the brain. Imagine pulling up your car to a red light. The resting frequency of the car is analogous to the Alpha waves of the brain. If the resting frequency is too great, the brain will be working in overdrive -- the patient will tend to be more restless. This can also be a form of ADD. 


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