Accelerated Summer Treatment Program for ADHD and Autism, with remote treatment options for CA patients. To learn more,
click here >>Accelerated Summer Treatment Program for ADHD and Autism, with remote treatment options for CA patients. To learn more,
click here >>ADHD isn’t a one size fits all condition. It affects each person differently, can present with unique symptoms, and ranges in severity from one person to the next. Similarly, manifestation of ADHD in children varies in comparison to adult ADHD.
To evaluate and treat ADHD, doctors use a variety of tools like simple behavioral observation, diagnostic checklists, questionnaires, and medical exams. But sometimes, a more in-depth tool is needed to get a clearer picture of the condition and how it affects each person individually.
Today, a high-tech approach is available. Brains scans can aid in the diagnosis and treatment of neurological and psychiatric conditions like ADHD as they measure brain activity. People with ADHD often have different patterns of brainwave activity and blood flow in certain areas of the brain, so these scans are useful for evaluating related symptoms and behaviors.
Brain scans are not diagnostic of ADHD by themselves, but they provide useful insights into brain function that can help with differential diagnosis and creating a more specialized or targeted treatment plan specific to each patient, especially for qEEG-directed neurofeedback.
Here are the common brain scans used in specialized clinical settings:
Also known as a quantitative electroencephalography scan (qEEG), this advanced scan is used to analyze and measure electrical activity in the brain and identify patterns related to symptoms. A qEEG is a painless, noninvasive scan performed with sensors applied to the surface of the head. During the scan, electrical brainwave activity is recorded under relaxed conditions.
The data received from a qEEG scan forms a visual brain map of the electric activity of the brain, highlighting areas that are overactive or underactive, as compared to an FDA registered normative database. This helps clinicians link symptoms to the relevant areas of the brain that are dysregulated and can be improved through treatment. A qEEG can also help measure functional connectivity between regions of the brain that are essential for normal cognitive and emotional processing.
Research shows that qEEG methodology can help to better understand what ADHD is and its neurophysiology, characterize its subtypes, and therefore move towards treatments and interventions that are as personalized and effective as possible.
The Drake Institute has used qEEG brain mapping for over 30 years as an important diagnostic test to evaluate patients with ADHD/ADD, Autism Spectrum Disorder, PTSD, Anxiety, Insomnia, and other stress-related disorders. To learn more about the Drake Institute’s Brain Mapping process or to schedule a free consultation, call 800-700-4233.
The Single Photon Emission Computed Tomography scan, or SPECT scan, is a nuclear imaging test that provides three-dimensional images of how the blood flows in the brain. In a SPECT scan, the patient is injected with a radioactive substance known as a tracer. This allows blood flow to be detected by the scanner.
Once the tracer is absorbed, the patient lies on a table while the scanner rotates around them taking images of the brain. These images show blood flow and metabolic activity in different areas of the brain. Generally, areas with higher levels of the tracer indicate increased brain activity, while lower levels of the tracer indicate lower activity levels.
SPECT scan test duration can vary. Patients will wait at least 30 minutes for the tracer to be absorbed and the SPECT scan takes about thirty minutes. In some cases, length can be extended up to two hours depending on how long it takes for tracer absorption and the depth of evaluation required.
SPECT scans provide functional imaging of how the brain is working and the small amount of exposure to radiation is generally considered safe. While it is sometimes used in clinical settings as a diagnostic tool for ADHD and can provide insights into neurological conditions, it is not as commonly used as qEEG scans.
Functional Magnetic Resonance Imaging scans (fMRI) are a non-invasive imaging method that maps brain activity by detecting blood flow and blood oxygenation utilization. While other MRIs focus on detailed images of brain structure, fMRIs focus on functional activity and help us understand localization of specific brain functions.
A functional MRI maps brain activity and shows which areas are active during specific tasks. They can thus help neurosurgeons better determine what parts of the brain they should leave alone that are involved in functions such as language and motor control.
fMRIs are performed with the patient lying in an MRI scanner using magnetic fields and radio waves to create images of the brain while performing a variety of tasks over the course of about an hour. During the tasks, the fMRI detects changes in blood flow, showing activity levels in the brain.
Much like the qEEG, the data provides a series of images of brain activity that are a visual representation of the patients’ brain activity. These images may help pinpoint dysregulation in regions of the brain that are responsible for attention and executive function.
While fMRI scans offer detailed images of brain activity with excellent spatial resolution, they do not track instantaneous brain activity, focusing rather on blood flow, which follows changes in the electrical activity of the brain. Data distortion is also a potential issue for understanding localization of specific brain functions.
The first key difference between brain scans used for ADHD evaluation is that qEEG is a direct measurement of instantaneous or real-time brain activity. In contrast, SPECT scans and fMRIs are indirect measurements of brain activity, using blood flow as an indication of brain activity levels.
When neurons fire, the EEG immediately records that activity. In contrast, an fMRI measures blood oxygenation level-dependent response, which is a secondary response to the neurons firing. As a result, fMRI is a delayed measurement of brain activity, making qEEG a superior modality for using in neurofeedback. SPECT scans have the lowest temporal resolution of the three scans discussed here. SPECT scans measure activity averaged over a few minutes, rather than real-time, instantaneous activity.
Next, how accurately brain regions are localized, or spatial resolution, varies from test to test. In this area, fMRI is excellent for pinpointing specific regions of the brain with ADHD-related dysfunctions. qEEG scans offer slightly lower specificity.
Finally, as mentioned above, there are variations of invasiveness. qEEG is noninvasive, requiring only the application of electrodes to the scalp. SPECT scans require a small radioactive tracer injection and restriction to a table while a machine completes the scan. The fMRI is noninvasive, with no injections required, but the patient is confined to a scanner for the duration of the test.
Over the last 40 years, the Drake Institute has clinically pioneered the use of advanced treatment technologies to treat ADHD and other brain-based medical disorders. Using a combination of brain map-guided neurofeedback and sometimes neurostimulation, we develop customized treatment protocols to address each patient's needs.
Drugs are never administered during ADHD treatment at Drake and we do not perform invasive procedures. Instead, the patient improves their own brain function, guided by visual and auditory feedback.
Individualized treatment plans are developed by first completing a qEEG brain map analysis for each patient. This non-invasive test uses sensors placed on the scalp to identify specific regions or networks of the brain that are dysregulated and linked to symptoms.
During neurofeedback sessions, sensors are again placed on the scalp to record and display instantaneous brainwave activity in real-time. The activity is visually displayed on a computer screen with simultaneous auditory feedback.
During neurofeedback therapy, the patient can see how their brain is working and learn to improve their brainwave activity by guiding it toward healthier, more functional brainwave patterns.
As an adjunct to neurofeedback, we sometimes use neurostimulation guided by qEEG brain map findings to gently stimulate the brain into healthier functional patterns. It is our experience that some patients benefit even more from neurofeedback when combined with neurostimulation. We find this to be particularly helpful for lower-functioning children on the Autism Spectrum.
For the last forty years, the Drake Institute has helped thousands of patients with ADHD and other brain-based disorders such as autism, PTSD, anxiety, panic disorder, and depression. Our patients reduce or resolve their symptoms and achieve a better quality of life. Call us at 1-800-700-4233 or fill out the free consultation form to get more information or to schedule a free consultation.
If you or a family member need help, please fill out our confidential online form
Interview with Dr. David Velkoff
Seth's Story
Interview with Dr. David Velkoff
Spanish News Feature
“David F. Velkoff, M.D., our Medical Director and co-founder, supervises all evaluation procedures and treatment programs. He is recognized as a physician pioneer in using biofeedback, qEEG brain mapping, neurofeedback, and neuromodulation in the treatment of ADHD, Autism Spectrum Disorders, and stress related illnesses including anxiety, depression, insomnia, and high blood pressure. Dr. David Velkoff earned his Master’s degree in Psychology from the California State University at Los Angeles in 1975, and his Doctor of Medicine degree from Emory University School of Medicine in Atlanta in 1976. This was followed by Dr. Velkoff completing his internship in Obstetrics and Gynecology with an elective in Neurology at the University of California Medical Center in Irvine. He then shifted his specialty to Neurophysical Medicine and received his initial training in biofeedback/neurofeedback in Neurophysical Medicine from the leading doctors in the world in biofeedback at the renown Menninger Clinic in Topeka, Kansas. In 1980, he co-founded the Drake Institute of Neurophysical Medicine. Seeking to better understand the link between illness and the mind, Dr. Velkoff served as the clinical director of an international research study on psychoneuroimmunology with the UCLA School of Medicine, Department of Microbiology and Immunology, and the Pasteur Institute in Paris. This was a follow-up study to an earlier clinical collaborative effort with UCLA School of Medicine demonstrating how the Drake Institute's stress treatment resulted in improved immune functioning of natural killer cell activity. Dr. Velkoff served as one of the founding associate editors of the scientific publication, Journal of Neurotherapy. He has been an invited guest lecturer at Los Angeles Children's Hospital, UCLA, Cedars Sinai Medical Center-Thalians Mental Health Center, St. John's Hospital in Santa Monica, California, and CHADD. He has been a medical consultant in Neurophysical Medicine to CNN, National Geographic Channel, Discovery Channel, Univision, and PBS.”
