May 19

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​Achievement, Productivity & Behavior


As early as 1937, stimulants were found to have calming effects on

disruptive behavior. Although this ultimately led to the widespread use of medications such as Ritalin to treat hyperactivity (ADHD), it did not explain the paradox of stimulants slowing down children who were constantly in motion. The advent of brain imaging technologies in the 1980s began to make sense of the mystery with a surprising discovery.

The frontal cortex (surface) of brains of people with Attention Deficit Disorder (ADD) and ADHD were found to have more difficulty using glucose (blood sugar) and to have less blood flow than the frontal region of people without ADD.

PHYSICAL CLUES LEAD TO CURES

The above finding gives new meaning to other well-known facts. Thoroughly understanding these helps make sense of treatments for ADD and strategies that minimize it:

The prefrontal cortex (a) inhibits impulses, (b) initiates behavior, and (c) controls working memory. Underactivity in the cortex would reduce the ability to:

Dopamine and norepinephrine, the body’s natural stimulants, are abundant in the prefrontal area of the brain. An underactive cortex may (a) be less able to use these chemical messengers, or (b) have fewer dopamine neurons that connect the lower brain to prefrontal cortex. It may be a lack of input from the brain stem that decreases energy in the frontal cortex. Therefore:

Slow brain waves seen in deep sleep (when less energy is being used) dominate the waking states of people with ADD. As children age, low-
frequency (slow) brain waves decrease and the cortex becomes better regulated. “Low-energy” brainwaves (measured by EEG) in people with ADD may be further evidence of decreased blood flow and glucose use in the cortex. EEG biofeedback training claims to help people eliminate problems with ADD by increasing higher frequency (alert) brain waves.

Decreased blood flow in the right hemisphere is also detected by brain imaging in some people with ADD. This side of the brain manages cause-
and-effect relationships, spatial perception, and decision making. An underactive right hemisphere may cause trouble with seeing the whole picture, poor spelling, getting lost or losing things, and difficulty adapting to unexpected situations.

Heredity appears to account for some of the physiological and maturation differences between people with and without ADD. A particular combination of genes creating the full syndrome is strongly suggested by statistics. At least 30% of parents of ADD children have (or had) the disorder themselves. Only 4% to 6% of the general population has ADD. Fetal exposure to lead, alcohol, cocaine, or nicotine could also be factors.

TREATMENT FOR ADD

In mild cases, people can learn to manage ADD symptoms by learning behavioral strategies. However, failing to consider medication for people who may have an energy shortage in the brain cortex can handicap school or work performance. Stimulants reduce symptoms in 75% to 80% of people with correct diagnoses. Although their effects are immediate, it can take months of trial and error to determine the right dose. Certain antidepressants help approximately 70% of those who do not respond to stimulants. Other drugs also help ADD or increase the effectiveness of medication:

MEDICATION GUIDELINES

References

Statistics and information on the physiology of ADD from Driven to Distraction by Edward Hallowell and John Rately (Simon & Schuster, 1994).

For further information on EEG training, contact EEG Spectrum, 16100 Ventura Boulevard, Suite 10, Encino, CA 91436-2595, www.eegspectrum.com.


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