Attention Deficit Hyperactivity, Disorder: Neurological Basis and Treatment Alternatives Arreed Barabasz, Ed.D., Ph.D., A.B.P.P., Marianne Barabasz Attentional Processes Laboratory, Cleveland Hall, Washington State University, Pullman, WA Recent research indicates a neurological basis for attention deficit disorder, specifically, right frontal lobe dysfunction. Traditional treatments for ADD/ADHD, such as stimulant drugs, behavior modification, and cognitive-behavior therapy have had limited, short-term success and many drawbacks. Neurotherapy (or EEG feedback) which addresses the frontal lobe dysfunction, has shown significant, long-term results, by teaching patients to normalize their brainwave responses to stimuli. (Complete article) Neurofeedback Treatment of Depression with the Roshi ISNR 2001 D. Corydon Hammond, Ph.D Introduction. A patient with severe, medication resistant depression was found to have the frontal alpha asymmetry described in Davidson's (1998a) research as demonstrating a predisposition to depression. Treatment. Initial sessions of EEG neurofeedback using Rosenfeld's (1997) protocol for correcting the alpha asymmetry were discouraging, actually producing slight negative change. Therefore, treatment shifted to using the Roshi, a two channel unit combining neurofeedback and photic stimulation, doing primarily left hemisphere beta training. Results. The very first Roshi session produced positive changes, and within five sessions the patient reported feeling less depressed and more energetic. At the conclusion of thirty training sessions, objective testing documented dramatic reductions in depression, somatic symptoms, overemotionality, anxiety, rumination, and fatigue. Discussion. In support of Henriques and Davidson's (1991) belief that hypoactivation of the left hemisphere results in an“approach deficit” and more withdrawal behavior, post-testing and interview data also documented that the patient had become less withdrawn, more active, sociable, and less distrustful. Eight and one-half month follow-up documented maintenance of changes. Continued exploration of left hemisphere beta protocols in treating depression, and of the combined use of neurofeedback with photic stimulation are encouraged. The effect of training distinct neurofeedback protocols on aspects of cognitive performance. 1: Int J Psychophysiol. 2003 Jan;47(1):75-85. Vernon D, Egner T, Cooper N, Compton T, Neilands C, Sheri A, Gruzelier J. Department of Cognitive Neuroscience and Behaviour, Imperial College London, The use of neurofeedback as an operant conditioning paradigm has disclosed that participants are able to gain some control over particular aspects of their electroencephalogram (EEG). Based on the association between theta activity (4-7 Hz) and working memory performance, and sensorimotor rhythm (SMR) activity (12-15 Hz) and attentional processing, we investigated the possibility that training healthy individuals to enhance either of these frequencies would specifically influence a particular aspect of cognitive performance, relative to a non-neurofeedback control-group. The results revealed that after eight sessions of neurofeedback the SMR-group were able to selectively enhance their SMR activity, as indexed by increased SMR/theta and SMR/beta ratios. In contrast, those trained to selectively enhance theta activity failed to exhibit any changes in their EEG. Furthermore, the SMR-group exhibited a significant and clear improvement in cued recall performance, using a semantic working memory task, and to a lesser extent showed improved accuracy of focused attentional processing using a 2-sequence continuous performance task. This suggests that normal healthy individuals can learn to increase a specific component of their EEG activity, and that such enhanced activity may facilitate semantic processing in a working memory task and to a lesser extent focused attention. We discuss possible mechanisms that could mediate such effects and indicate a number of directions for future research. A simple and a complex tic (Gilles de la Tourette's syndrome): their response to EEG sensorimotor rhythm biofeedback training. Int J Psychophysiol. 1986 Jul;4(2):91-7. Related Articles, Links Tansey MA. This study presents a clinical treatment regime for the treatment of tic manifestation, both simple and complex. The response of a case of simple tic and a case of complex tic (Gilles de la Tourette's syndrome) to EEG sensorimotor rhythm biofeedback training are presented. Specifically, the simple and the complex tic, both of long duration, were eliminated via this EEG biofeedback training procedure. It is hypothesized that this exercising of the sensorimotor cortex resulted in increased activation of this cerebrocortical subsystem and was reflected in increased voluntary muscle control and a heightened threshold for random motor discharge, resulting in the elimination of both tics as in the response of cases of epilepsy with motor involvement to EEG sensorimotor rhythm biofeedback training. The additional psychophysiologic sequelae of the complex tic--attention deficit disorder--remediated in the manner of the response of learning-disabled to EEG sensorimotor rhythm biofeedback training. Treatment of Chronic Anxiety Disorder with Neurotherapy: A Case Study Journal of Neurotherapy Joseph E. Thomas, Ph.D. and Elizabeth Sattlberger, B.A. The objective of the present case study is to report the effects of alpha-decrease biofeedback training on a patient diagnosed with Anxiety Disorder Three Minnesota Multiphasic Personality Inventories (MMPI and MMPI-2) were used as objective measures of treatment efficacy. Following 15 sessions of slow wave inhibit/fast wave increase EEG feedback training, the patient reported a significant reduction in anxiety-related symptoms. At three-year follow-up, results of an MMPI-2 showed all clinical scales within normal range. In addition, se!f-reports confirmed that the patient was symptom free. After treating the patient with several other clinical modalities, only the alpha-decrease feedback training produced effective, long-term improvement of symptoms.  (complete article) Neurofeedback Therapy for a Mild Head Injury Journal of Neurotherapy Alvah P. Byers The purpose of this study was to evaluate Neurofeedback Therapy (NFT) for a Mild Head Injury (MHI). The subject was a 58-year-old female who fell and struck her head in 1988. The NFT began in 1994 and was preceded and followed by neuropsychiatric and neuropsychological evaluations as well as quantified electroencephalograms (QEEG). The patient completed a symptom checklist and the Minnesota Multiphasic Personality Inventory 2 (MAPI- 2) before and after NFT. Treatment consisted of 31 sessions of NFT The NFT was designed to enhance the sensorimotor rhythm (SMR) of 12-15 Hertz (Hz) and the beta (15-18 Hz) frequency bands of the electroencephalogram (EEG) while at the same time suppressing the theta (4-7 Hz) frequency band. Twelve sessions were used for SMR NFT and 19 sessions for beta NFT. The comparison of the pre- and post-measures as well as the process measures suggests NFT is a promising intervention for the rehabilitation Of Patients wit MHI. (complete article) Fatty acid-rich diet may block Alzheimer's The Journal of Neuroscience, March 30, 2005 NEW YORK (Reuters Health) - Consuming a diet rich in the omega-3 fatty acid docosahexanoic acid (DHA) may help prevent or treat Alzheimer's disease, findings from an animal study suggest. In the study, which is reported in The Journal of Neuroscience, mice that ate DHA-enriched chow showed less beta-amyloid build-up in the brain than mice fed regular chow. Beta-amyloid is a protein that forms the characteristic brain plaques seen in patients with Alzheimer's disease. "These results suggest that dietary DHA could be protective against beta-amyloid production, accumulation, and potential downstream toxicity," senior author Dr. Greg M. Cole, from the University of California at Los Angeles, and colleagues note. Research has linked high levels of DHA in the diet with a reduced risk of Alzheimer's disease. Still, the studies have shown an association, but don't prove that eating a diet high in DHA actually reduces amyloid levels and prevents Alzheimer's disease. To show this, animal studies are often needed. Cole's team used a mouse model of Alzheimer's disease and fed the animals low- or high-DHA chow or regular chow. The animals were fed the assigned diet until 22.5 months of age, at which point brain tissue was obtained and tested for amyloid build-up. The high-DHA diet reduced total amyloid level by 70 percent compared with the other diets, the investigators report. Moreover, brain plaques were reduced by 40.3 percent. Several studies are currently underway to determine if fatty acids like DHA offer any benefits for patients with mild-to-moderate Alzheimer's disease, the authors add.

Inflammatory bowel disease and irritable bowel syndrome: separate or unified? Bradesi, Sylvie PhD; McRoberts, James A. Ph.D; Anton, Peter A. MD; Mayer, Emeran A. MD Abstract: Both irritable bowel syndrome and inflammatory bowel diseases share symptoms of altered bowel habits associated with abdominal pain or discomfort. Irritable bowel syndrome has been referred to as a functional bowel disorder, which is diagnosed by a characteristic cluster of symptoms in the absence of detectable structural abnormalities. Inflammatory bowel disease is a heterogeneous group of disorders characterized by various forms of chronic mucosal and/or transmural inflammation of the intestine. In this review, the authors discuss recent evidence suggesting several potential mechanisms that might play a pathophysiologic role in both syndromes. Possible shared pathophysiologic mechanisms include altered mucosal permeability, an altered interaction of luminal flora with the mucosal immune system, persistent mucosal immune activation, alterations in gut motility, and a role of severe, sustained life stressors in symptom modulation. It is proposed that similarities and differences between the two syndromes can best be addressed within the framework of interactions between the central nervous system and the gut immune system. Based on recent reports of low-grade mucosal inflammation in subpopulations of patients meeting current diagnostic criteria for irritable bowel syndrome, therapeutic approaches shown to be effective in inflammatory bowel disease, such as probiotics, antibiotics, and antiinflammatory agents, have been suggested as possible therapies for certain patients with irritable bowel syndrome. Neonatal Signs After Late In Utero Exposure to Serotonin Reuptake Inhibitors Eydie L. Moses-Kolko, MD; Debra Bogen, MD; James Perel, PhD; Amy Bregar; Kathleen Uhl, MD; Bob Levin, MD; Katherine L. Wisner, MD, MS JAMA. 2005;293:2372-2383. Context A neonatal behavioral syndrome linked to in utero serotonin reuptake inhibitor (SRI) exposure during the last trimester of pregnancy has been identified. The US Food and Drug Administration (FDA) and drug manufacturers have recently agreed to a class labeling change for SRIs, which include selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs), to include information about potential adverse events in neonates exposed in utero. Integration of data about the neonatal behavioral syndrome into the management of pregnancy in women who take SRIs is a current challenge for physicians. Objectives To review evidence regarding the SRI-related neonatal syndrome and to help clinicians guide their patients in a risk-benefit decision-making process. Data Sources We searched MEDLINE (1966-February 2005) and PsycINFO (1974-February 2005). All articles related to neonatal signs after in utero SRI exposure were acquired, as well as unpublished data on this topic from the FDA advisory committee meeting of June 2004. References cited in case reports and studies were reviewed. Foreign-language literature was included and translated to English. Study Selection and Data Extraction Studies were included if they had clearly identified maternal SRI exposure for a minimum of the final trimester of pregnancy through delivery and assessed neonatal outcomes. We identified 13 case reports describing a total of 18 cases. Nine cohort studies met criteria. When not included in the published article, relative risks and 95% confidence intervals (CIs) were computed from raw data and summary risk ratios and 95% CIs were determined with Mantel-Haenszel estimates. Data Synthesis Compared with early gestational SRI exposure or no exposure, late SRI exposure carries an overall risk ratio of 3.0 (95% CI, 2.0-4.4) for a neonatal behavioral syndrome. The most SRI-related neonatal case reports involved fluoxetine and paroxetine exposures. Neonates primarily display central nervous system, motor, respiratory, and gastrointestinal signs that are usually mild and disappear by 2 weeks of age. Medical management has consisted primarily of supportive care in special care nurseries. A severe syndrome that consists of seizures, dehydration, excessive weight loss, hyperpyrexia, or intubation is rare in term infants (1/313 quantifiable cases). There have been no reported neonatal deaths attributable to neonatal SRI exposure. Conclusions Available evidence indicates that in utero exposure to SRIs during the last trimester through delivery may result in a self-limited neonatal behavioral syndrome that can be managed with supportive care. The risks and benefits of discontinuing an SRI during pregnancy need to be carefully weighed for each individual patient. Development and validation of assessment methods and clinical management strategies are critical to advancing this research. Lifetime exposure to environmental lead and children's intelligence at 11-13 years: the Port Pirie cohort study J Appl Toxicol. 1999 May-Jun;19(3):167-72. Shilu Tong,Peter Baghurst, Anthony McMichael, Michael Sawyer, Jane Mudge, Division of Human Nutrition, Commonwealth Scientific Industrial Research Organisation, Australia, Department of Epidemiology and Population Sciences, London School of Hygiene and Tropical Medicine, London Women's and Children's Hospital, Adelaide, Australia Abstract Objective: To examine the association between environmental exposure to lead and children's intelligence at age 11-13 years, and to assess the implications of exposure in the first seven years of life for later childhood development. Design: Prospective cohort study. Subjects: 375 children born in or around the lead smelting town of Port Pirie, Australia, between 1979 and 1982. Main outcome measure: Children's intelligence quotient (IQ) measured at 11-13 years of age. Results: IQ was inversely associated with both antenatal and postnatal blood lead concentrations. Verbal, performance, and full scale IQ were inversely related to blood lead concentration with no apparent threshold. Multivariate analyses indicated that after adjustment for a wide range of confounders, the postnatal blood lead concentrations (particularly within the age range 15 months to 7 years) exhibited inverse associations with IQ. Strong associations with IQ were observed for lifetime average blood lead concentrations at various ages. The expected mean full scale IQ declined by 3.0 points (95% confidence interval 0.07 to 5.93) for an increase in lifetime average blood lead concentration from 0.48 to 0.96 µmol/l (10 to 20 µg/dl). Conclusions: Exposure to environmental lead during the first seven years of life is associated with cognitive deficits that seem to persist into later childhood. Neurodevelopmental evaluation of 9-month-old infants exposed to low levels of lead in utero: involvement of monoamine neurotransmitters. Tang HW, Huel G, Campagna D, Hellier G, Boissinot C, Blot P. French National Institute of Medical Research and Health, Unit of Epidemiological Research The objective of this work is to investigate the neurotoxicty of low-level lead exposure in utero on infants and the possible involvement of dopaminergic and serotonergic neurotransmitters. The correlation analysis for cord blood lead level, the concentrations of dopamine metabolite homovanillic acid (HVA) and serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA) in cord plasma and the neurodevelopmental scales of infants were conducted on 244 9-month-old children. Both score of sociability subscale and 5-HIAA concentration were correlated with cord blood lead level. When taking 5-HIAA into account, the scores of all the neurodevelopmental subscales except the language subscale were significantly negatively correlated with lead level in cord blood. The results indicated that low-level lead exposure in utero could produce a neurotoxic effect on the developing serotonergic system in infants. The neurotoxicity of low-level lead exposure in utero may affect the sociability of infants. Serotonergic activity was shown to have a potential effect on neurodevelopmental assessment. It may interfere with the association between low-level lead exposure in utero and other neurodevelopmental performances of 9-month-old children. Men Find Health Benefits with Acupuncture 5/20/2005 National Men's Health Week (June 13-19, 2005) serves as a proactive measure to encourage men and boys to seek regular medical advice and early treatment for disease and injury. It has become increasingly important for men to become aware of preventable health problems, and seek out early detection of treatment and disease, as men are at a high risk for health problems such as high blood pressure, prostate, diabetes, cancer, and obesity. According to the U.S. Census Bureau, 190,000 more men are diagnosed with a cancer than women each year, and cancer kills men 18 percent more often than women. Furthermore, 4.4 million men in the United States have already had a heart attack, and men between the ages 29-44 have a 40 percent higher chance of having a heart attack than women. As recent studies show that men's health has been steadily declining, acupuncture and Oriental medicine can help many of the common ailments that men face. Acupuncture has been cited by the World Health Organization to treat over 43 conditions, including those previously mentioned. Using acupuncture to treat health problems of concern to men has been growing in popularity; a Kaiser study conducted in 2002 found that 57.2 percent of primary care physicians in Northern California used or recommended acupuncture in the previous year. And according to the National Certification Commission for Acupuncture & Oriental Medicine, nearly one out of every 10 adults in the United States has tried acupuncture.

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