So, this week we have to make the “research question” and eliminate all the ambiguity that that entails.
My research question as of right now: Is neurofeedback therapy a viable, alternative treatment for both children and/or adults with ADHD in Arizona?
Scope
I tried to limit my scope to just focus on neurofeedback therapy as an alternative with the necessary context of ADHD medication. At first, I didn’t know if I wanted to put medication in the question itself, but I think neurofeedback therapy would not even be considered as an option if I didn’t. I think because it is such a new, emerging form of therapy, advertised and used as an alternative, it has to be mentioned in comparison to the most used and common form of treatment, which for ADHD is medication.
I am going to try to investigate the difference between therapy on adults and children in the United States, or specifically in Arizona. Is it necessary that I mention Arizona or does that make my question end up sounding too specific? My research is going to be conducted in Arizona, so I thought it was necessary to include in my question so the scope isn’t too unmanageable.
I am going to try to investigate the difference between therapy on adults and children in the United States, or specifically in Arizona. Is it necessary that I mention Arizona or does that make my question end up sounding too specific? My research is going to be conducted in Arizona, so I thought it was necessary to include in my question so the scope isn’t too unmanageable.
Key Terms
I have to define what neurofeedback therapy is, because even I had no idea about a year ago. Neurofeedback therapy is according to “A Symphony in The Brain”, "Neurofeedback helps guide the patient, but the brain does the rest". Essentially, neurofeedback therapy is using computer programming and electrodes placed on the brain, so a patient can see their own brain activity and “feedback” is perceived through a screen or speaker according to frequency parameters set by a clinician. According to author Jim Robbins, "physiological functions thought to be automatic can be brought under conscious control” with neurofeedback therapy. As a certain frequency is upregulated or downtrained, more blood will flow to that area of the brain, and thus neural connections are enhanced, strengthening certain areas of the brain.
In my literature review is where I will provide most of my definitions, which I get from the National Institute of Mental Health, esteemed neuroscientists (Russell Barkeley, the “ADHD expert”, and other publications. According to NIMH, is “Attention-deficit/hyperactivity disorder (ADHD) is a brain disorder marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development."
I also have to elaborate with what I mean by “viable, alternative option”. By viable I mean it will significantly reduce ADHD in patients, resulting in more concentrated individuals according to brain maps, logic/reasoning tests, and possible performance at school.
By treatment, I am referring to what the patient uses to mediate/reduce symptoms and the disorder itself. I will be comparing neurofeedback therapy loosely to medication, which is the most common form of treatment. ADHD medication is primarily amphetamine and methylphenidate (stimulants) ranging from short-acting Adderall to more longer-acting Ritalin LA, both common medication to treat ADHD and other mental disorders.
Children I would define as under 16 years old, which is how my clinic defines a “child” brain map, as at that point their brain has mature/change the most it will that will show up in a brain map by that time. I would define adults anywhere from 16-60, depending on how old the oldest patient I use in my study is.
I have to tackle the assumptions. I think by only mentioning neurofeedback therapy and medication, I imply that these are the only two options when a myriad of different behavioral therapies, lifestyle changes, and other medications may exist. I think I need to clarify that medication is the most common method, and neurofeedback therapy is the newest, least invasive method that exists as of yet. Neurofeedback can also be differentiated by the fact that it is permanent change without intake of any stimulants or lifelong changes to the way a person lives. In this way, neurofeedback is a temporary treatment that lasts a lifetime.
Variables
The variables would be different “success rates” of the neurofeedback session of a patient, the age of the patient, and possible change in brain map/reasoning test/education that results after. Because I am investigating neurofeedback therapy as an option, I need to prove it is viable or not viable by somehow mentioning medication success rates. I do not have the means to do a direct comparison, as I cannot see how well ADHD medication is working, but there needs to be some sort of link I can make here. I need some help with this? I know that I have to talk about medication, because if I do not I feel like it is a hole in my research, but does it have to be in my question? Or can I mention it in my literature review without making a direct comparison?
Hopefully sex of the patient is not a confounding variable that makes things confusing, but I will try to address it if it is.
Researchability
I think it is possible to hopefully find patients to agree to let me use their sessions and progress to see if neurofeedback therapy is helping them. I would try to get at least 5-10 patients of different ages and monitor their progress/look at their previous month’s progress to determine whether their success rate is going up an their brain maps are getting better. I think this is possible, as a previous student has conducted research at my clinic and was able to get patients to agree to his research. My backup plan if I cannot get patients to agree is to at least possibly due and interview patients to see if they mentally feel more focused and are academically doing better. And interview clinicians to see if they have seen improvement.
Gap
There are no in-depth studies showing if neurofeedback therapy works and is successful. There are papers and articles about its existence and how it works, but not anything that I have seen about how well it works or comparing how well it works in adults and children. Studies mainly attempt to compare it to medication.
Significance
If neurofeedback therapy is a viable option that leaves permanent effects, then people with ADHD would not have to resort to ADHD medication. Through my research I have found that medication, especially stimulants for ADHD, are abused, used inappropriately and over the needed amount. Furthermore, using ADHD medication can lead to dependency on other stimulants. Medication can be expensive and are a means of not curing the disorder, but rather limiting and reducing severity of symptoms. With neurofeedback therapy, I am proposing that people can be cured and be affected not just temporarily. Medication has to be ingested, altering your biochemical levels, while neurofeedback therapy can be seen as a noninvasive treatment, a means of training the brain but not adding additional chemicals to your system. Oftentimes college students are misdiagnosed and abuse ADHD medication to stay up later and study more, but that may be out of my scope to discuss. Basically, neurofeedback therapy is a new type of treatment that is not researched enough, because it has real potential to change the way we treat mental disorders, not just ADHD. If its possible to actually train our brain to re-cement certain connections between neurons, its amazing how many possibilities this opens humans up to. This can lead the way to unlocking the full potential of the brain to becoming the best versions of ourselves possibly, enhancing our mood, concentration, cognitive skills, and even motor skills in the future. I think this is the most exciting field in medicine today, and if this method of neurofeedback therapy is more researched, made better, and more widely available/applicable it truly is the future of neuroscience.
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ReplyDeleteHi Sunskruthi! Nice blog post this week!
ReplyDeleteIs it feasible to research on both children and adults? I understand how it would be interesting to examine the effects on these two groups, although I think it would be more feasible to look at the effects of the treatment on just one age group in your third trimester.
I also think that you should include “in Arizona” in your question so that it would add specificity but not too many words to your particular research topic.
Additionally, in order to address the assumptions in your question, I would make sure to explain in your literature review that neurofeedback therapy is the newest form of therapy and that medication is the most common form.
Since you’re concerned about not being able to research the effects of ADHD medication, I would be wary of including it in your research question. However, I think that it is necessary to address it since it is the most common form of therapy. You could address it in your literature review and expand on it more in your discussion, if you don’t include it in your question (But I like your question better with the medication part in it). You mention that studies attempt to compare neurofeedback therapy to medication when discussing the gap, so I think you can use these to back up your research.
Regarding your significance, it would be important to address the costs of neurofeedback therapy, since you say that medication is expensive. Other than that, I really like how focused you are in your area of inquiry and the amount of research you have done so far has helped you narrow down your topic! Good luck with your literature review!
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Hi Sunskruthi!
ReplyDeleteFirst of all, I think you are biting off too much to chew when you in your question you ask if neuro-feedback is useful for adults and children. I think you should focus on children or adults, which ever one your clinic research gives you the most exposure too.
Secondly, I think you need to quantify "useful". Something being "useful" is very ambiguous. How is it useful? I think here, your question can get a lot more specific. I think you can delve into the characteristics of the options that neurofeedback provides and I think you could ask the question of which method/version of neurofeedback do ADHD children or adults (not both) feel the most comfortable with and feel is the method that is helping them the most. Also, if you phrase a question like this, not only does it allow you a easily testable set of trials and variables, but it also allows you to possibly conclude that none of the methods/trials that you studied in neurotherapy were found to be useful. So, instead of focusing your question on whether neurofeedback therapy is useful, I think you should specify it to say something like "Which method of neurofeeback therapy, ____, ___, or ____, is more successful in creating an optimistic and enthusiastic outlook in children/adults (not both).
Also, I have a few concerns about feasibility. How are you going to measure if the neurofeedback therapy is actually successful. I feel as though conducting your methodology over a period of "months" is not very feasible. Instead, I feel like your immediate results could look at whether the patient is even motivated to do the neurofeedback therapy or if they feel like it will help them. I think looking at what form of neurofeedback therapy is liked most by the patient is crucial because w/o patient consent, are you even allowed to give neurofeedback therapy? And if a patient doesn't like it mid way through your months of testing, then you are losing valuable results :(.
Overall, I find your project very interesting!
Peace,
Swaggy V
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Today in AP Research we discussed how to refine our research question based on inputs from our classmates. I realize I did not explain somethings clearly. When I refer to neurofedeback therapy I am talking about a type of biofeedback therapy, but there are no different types of neurofeedback therapy. There is just the one I described. I will be using patient's clinical records who have been participating in neurofeedback therapy for a while, if one month is two short of a span to measure. If I could get consent to even look at their records, I could possibly still conduct my research.
ReplyDeleteMy new, improved question: Is neurofeedback therapy a viable, alternative treatment for children and/or adults with ADHD in Arizona?
"By viable I mean it will significantly reduce" -- so I think "viable" is subjective and "significantly reduce" is still objective. What constitutes "significantly"? Also, how will you measure success?
ReplyDeleteI don't think you've given me a compelling reason to look at children versus adults, so if you're making the distinction in your question, it's important to make it clear.
As for the comparison to medication, I don't think you'd need to prove that it's more effective than medication, I think you'd just need to prove why medication is problematic to justify why we need to look at alternative methods. As in, you're not trying to see if it's more effective than medicine, you're just trying to see if it offers an alternative that would free people from medicine.