Children

EEG

An electroencephalogram (EEG) is a medical test performed to detect abnormal brain electrical activity. The EEG’s fundamental use is to monitor and record brain wave patterns, particularly in children with neurological impairment, as observed in ADHD patients.

While seated in a comfortable chair, an adhesive paste will be used to apply numerous electrodes to various locations on the scalp. These electrodes will be linked to an amplifier and EEG recording equipment.

The EEG detects the usual electrical activity of the brain wave, but aberrant patterns are detected in particular neurological conditions. However, it may also be utilized to determine the etiology of other chronic issues, such as behavioral changes or difficulty sleeping. The term “alpha wave activity” is generally used to refer to a specific frequency range (e.g., 8–12 Hz). Individual theta and beta ranges can be determined using individual alpha peak frequency (IAPF) and alpha bandwidth.

Our testing methods mirror that of our peer-reviewed study (Bazanova et al., 2018), which sought to replicate most of the previous findings regarding the electrophysiological profile of ADHD. We have found decreased alpha and beta powers in agreement with the literature. Alpha activity plays an important role in cognitive, psychomotor, psycho-emotional, and physiological aspects of human brain functions.

Forehead EMG

EMG is a measurement of the electrical activity created when muscles contract. A motor neuron receives an electrical action potential from the brain when we move. Acetylcholine released by motor neurons generates a calcium ion release by muscle. Muscle cells shorten and contract due to this calcium influx, which results in the gliding of motor filaments, actin, and myosin.

Using electrodes placed on the skin surface above the muscle fibers, we can observe this intricate electrical activity. We can determine when a muscle is stimulated and the intensity of that contraction by detecting electrical activity.

The inadequacy of inhibitory processes in sensorimotor coordination is reflected in redundant motoric components, which indicate hyperactivity. Because of their involvement in the top-down neural inhibitory process that they perform, the alpha oscillations significantly influence how well people do with cognitive tasks. EMG power decreases when redundant muscle action is inhibited, but EEG upper alpha and SMR power increase simultaneously.

Additionally, increased forehead muscle tone is regarded as a symptom of psycho-emotional strain or mental stress. Children with ADHD have poor control over muscular tension-relaxation and cannot relax their forehead muscles. Efficacy in the treatment of hyperactivity has been linked to training that reduces muscular tension across the central forehead.

EEG alpha power decreases because of an increase in forehead muscle tension. As a result of the strong correlation between task-relevant brain activity and EEG alpha power, the significance of EEG upper alpha activity in suppressing redundant motor action and decreasing excessive psycho-emotional strain seems to be well-established. Sensorimotor integration is essential for effective learning. A rise in alpha-2 activity accompanied by a decrease in forehead EMG is one of the most dependable indicators of effective learning.

qEEG

A qEEG (Quantitative Electroencephalogram) is a diagnostic technique that uses brain wave patterns to detect electrical activity. Brain mapping is an informal term for this practice. The millions of neurons in your brain interact with each other through regular electrical impulses known as brain waves. Stress levels, cognitive patterns, and emotions may all be revealed by analyzing brain waves. Many signs of impulsivity, cognitive inflexibility, and anxiety can be identified with a quantitative EEG (qEEG).

We demonstrated in our peer-reviewed scientific study that there is a shift of individual alpha peak frequency in ADHD compared to healthy controls (HC; individuals with no known symptoms of ADHD). Individual variations between ADHD and HC were shown to be predicted by alpha band characteristics measured near the back of the brain. Reduced alpha power and bandwidth in these posterior locations reveal ADHD children’s deficiencies in top-down inhibition used to inhibit distracting information.

Alpha oscillations have been highlighted in several studies as a top-down mechanism of neural inhibition and neuronal efficiency. Additionally, it has been demonstrated that children with ADHD had a greater theta/alpha ratio in addition to a higher theta/beta ratio (TBR).

We discovered that the a1/a2 ratio, alpha peak frequency, and alpha2 bandwidth are the strongest predictors of inattention, impulsivity, and hyperactivity, in addition to prior results indicating alpha activity is changed in ADHD. More crucially, TBR (theta/beta ratio) is a less accurate predictor of ADHD symptoms than (individualized) alpha activity measurements. Specific findings also suggest that proper identification of the alpha sub-bands enables an NFT (neurofeedback training) to target these alpha activity measurements selectively.

Qb Test

A Qb test is a computer-based exam that combines measures of attention with an activity analysis using a motion-tracking device. The test results are reviewed immediately and provided in a report that compares the patient’s findings to others of similar demographic characteristics who do not have ADHD.

Taking the test can help you figure out why your child might be having trouble concentrating, being hyperactive, or experiencing insomnia episodes. The Qb Test is a critical component of the ADHD assessment process. Its results are utilized in conjunction with other ADD/ADHD diagnostic instruments to support clinical decisions.

This exam should take between 15 and 20 minutes, depending on your child’s age. They will be required to sit in front of a computer screen and wear a soft, flexible headband with a reflective ball attached. This is what will be used to track their movement during the test. They will hold the responder button and respond to different shapes on the screen by clicking appropriately. The findings might assist in determining the form of help they may require in the future to support their well-being.

Go/no-go task

One of the most common types of attention tasks is when participants are required to keep their attention focused on a constant stream of stimuli. Participants complete a “go/no-go” activity known as a Sustained Attention to Response Task (SART), in which they must restrain behavioral responses until a single, infrequent target is displayed amid several frequent non-targets.

An inhibitory reaction is required when the participant’s attention is diverted to a non-target. When a target is seen, the person must overcome the predominant motor reaction and refrain from hitting the button. This is required for good performance. According to research, working memory sustained attention and impulse/inhibitory control are all shown to be influenced by the SART.

Delayed Gratification task

Self-regulation of affect-motivation-arousal (delayed gratification) is one of four executive neuropsychological functions affected by the presentation of ADHD. The final feature of inattention is postponing satisfaction. Above everything else, ADHD children pursue and engage in activities that provide rapid gratification. They necessitate near-constant expectation of an immediate reward. They usually prefer the immediate gratification, even if it is less valuable and will be enjoyed less in the long run.

The delayed gratification task can be completed at home, conducted by a guardian. A cake or preferred dessert is presented to the child with two options: eat the dessert now or wait until later to eat two. The amount of time that the child can resist the immediate reward is recorded.

Psychiatric and Psychological Evaluation

There are a variety of mental health conditions that might be confused for ADHD. Before determining if a patient has ADHD, professional psychiatrists and psychologists may do several additional assessments.

For example, your psychiatrist or psychologist might use a behavior rating scale or a list of symptoms. A learning disability might closely resemble the symptoms of ADHD; therefore, a psychiatric evaluation may include a test for it as well. For example, PTSD (post-traumatic stress disorder) and mood disorders can mirror the symptoms of ADHD.

Anxiety and depression are common co-occurring conditions with ADHD. Patients’ medical histories must be gathered, and physical examinations can help doctors rule out other possible causes, such as seizure disorders. Symptoms of any of these conditions might be similar to those of ADHD. A physician should conduct the complete medical history of each patient to make sure there aren’t any undiagnosed mental health issues.

You and your child will be asked about the symptoms and how they have affected their life by the doctor. As a result of their ADHD symptoms, children can face significant difficulties at home and school. Diagnosis of ADHD may occur from a significant or multiple adverse life events. Failing a class or forever losing an important belonging might fall under this category.

Hyperthyroidism and electrolyte imbalances are two medical diseases that can resemble the symptoms of ADHD and depression. Your medical team should take tests and vital signs (such as blood pressure and pulse) to ensure any adverse responses to potential medications. There should be a physical assessment and additional evaluation if there are any concerns about the patient’s physical health, if possible.

With this information, we can create a treatment plan that is most likely to assist patients in achieving full recovery and excellent quality of life. Medication, learning or behavioral techniques, and counseling might be used as part of the treatment plan.