ADHD & Attention Deficits
The QEEG Phenotypes of ADHD
Attention-Deficit/Hyperactivity Disorder (ADHD) is not a single electrophysiological entity. While the DSM groups behavioral symptoms, QEEG analysis reveals several distinct subtypes that require entirely different neurofeedback approaches.
Phenotype 1: Frontal Slow-Wave Excess
The most common subtype (approx. 60%). Characterized by excessive Theta (4-8 Hz) in the frontal lobes (Fz, F3, F4) and a high Theta/Beta Ratio (TBR > 3.0). Presents as inattentive, daydreaming, and easily distracted.
Phenotype 2: Spindle / Beta Excess
Less common. Characterized by excessive High Beta (20+ Hz) or excessive fast Alpha. Often misdiagnosed. These individuals are physically hyperactive but internally anxious and over-aroused.
The Theta/Beta Ratio (TBR)
The FDA approved the NEBA system (Neuropsychiatric EEG-Based Assessment Aid) based on the Theta/Beta Ratio. A TBR measured at vertex (Cz) that is significantly higher than age-matched norms is a strong biomarker for classic ADHD.
Indicated Protocols
| Protocol | Target Phenotype | Clinical Goal |
|---|---|---|
| SMR Enhancement | Motor Hyperactivity | Increase sensory gating, reduce physical restlessness. |
| Theta Suppression / Beta Reward | Frontal Slow-Wave Excess | Decrease Theta at Fz, increase Beta (15-18 Hz) to improve executive function. |