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ADHD and TM Practice


Table 3. Mean, Standard Error, t-Test and p-values for Likert Scale of Parent’s Observations Mean


Ability to focus on work Organizational abilities


Ability to work independently Happiness


Quality of Sleep


1.83 1.67 2.08 1.42 1.50


.43 .33 .37 .40


Note: There were significant improvements in these given areas after the children had practiced TM for 36 months.


Proposed Mechanism: Experience Related Cortical Plasticity The brain is a self-organizing system*repeated experience enhances brain circuits involved in that experience.34 During TM practice, one experiences a mantra as a thought, and then experiences that thought at more subtle levels*less clear, less distinct. This results in a style of attending characterized by low arousal with high attention. This is a new style of directing attention called ‘‘restful alertness.’’55,56 Typically high arousal goes with high attention and low arousal goes with low attention.58 This state of restful alertness corre- sponds to higher frontal and parietal cerebral metabolic rate*part of the attentional system*and lower thalamic metabolic rate,46 and to higher activity in the default mode network.48 Activity in the default mode network is higher during self-directed tasks and lower when attention is engaged with objects of attention.59,60


Repeated experiences of restful alertness during TM practice may change attentional processes during tasks. Heightened attention could lead to higher beta EEG leading to decreased theta/beta ratios. The percentage decrease in theta/beta ratios over the 6 months of this study was 48%* from 8.8 to 4.6 in the TM group and from 11.7 to 7.4 in the delayed-start group after they learned TM. This percentage decrease is more than that reported from use of methylphe- nidate, less than 3%,61 and more than that reported from neurofeedback*an average of 33% in three studies.40,62,63


Frontal executive circuits activate and sequence other brain areas. Subjects with greater success in a visuomotor tasks exhibit higher coherence across all frequency bands.64 With 3-month TM practice, frontal, parietal, and anterior/posterior theta, alpha, and beta1 coherence increased. These coherence changes were observed during a demanding computer task. Higher coherence could also explain previous findings of improved ability to concentrate and better emotion control in ADHD children with 3 months of TM practice.49


Phenomenologically, higher alpha and beta coherence are associated with a stable experience of inner self-awareness, posited to underlie thinking.56 With regular TM practice, this experience of inner self-awareness could begin to form a stable background for processing experiences.42 In ADHD children, this could provide a new foundation to organize experiences resulting in better behavior regulation and improved mental performance.


www.slm-psychiatry.com 79 Ability of D-KEFS to Discriminate ADHD Groups


After the study was conducted, Wodka and colleagues investigated D-KEFS’s ability to classifying ADHD (N54) and normal control subjects (N69).65 They reported that DKEF discriminated groups at a trend level (p.09). Their finding could reflect the fact that they used high functioning subjects. Future research could explore the relation of D-KEFS scores, brain scores, and behavioral measures in ADHD populations.


FUTURE RESEARCH


This random assignment study of brain and psychological measures supports the efficacy of TM practice as treatment for ADHD, replicating an earlier study using a single-group design. Future research is needed to replicate these findings in a larger subject population, to use other measures of executive functioning, and to compare effects of different meditation practices on enhancing brain functioning and promoting positive psychological and emotional well-being in ADHD populations.


Acknowledgements: We thank the David Lynch Foundation and anonymous donors for funding support. We also thank Rannie Boes, Peter Graham Bell, and Phyllis Greer for help with data acquisition.


Disclosure: Grosswald is a teacher of the TM technique.


REFERENCES 1. Prevalence of ADHD, Center for Disease Control and Prevention: prevalence of diagnosed and medicated Attention-Deficit/Hyperactivity Disorder. Morbidity and Mortality Weekly Rep. 2005;54(34):842847.


2. Biederman J. Attention-Deficit/Hyperactivity Disorder: a selective over- view. Biol Psychiatry. 2005;57(11):12151220.


3. Biederman J, Faraone SV, Mick E, et al. High risk for Attention Deficit Hyperactivity Disorder among children of parents with childhood onset of the disorder: a pilot study. Am J Psychiatry. 1995;152(3):431435.


4. Biederman J, Milberger S, Faraone SV, et al. Impact of adversity on functioning and comorbidity in children with Attention-Deficit Hyper- activity Disorder. J Am Acad Child Adoles Psychiatry. 1995;34(11):14951503.


5. Faraone SV. Genetics of adult Attention-Deficit/Hyperactivity Disorder. Psychiatry Clin North Am. 2004;27(2):303321.


6. Price TS, Simonoff E, Asherson P, et al. Continuity and change in preschool ADHD symptoms: longitudinal genetic analysis with contrast effects. Behav Gen. 2005;35(2):121132.


7. Burt SA. Rethinking environmental contributions to child and adolescent psychopathology: a meta-analysis of shared environmental influences. Psychol Bull. 2009;135(4):608637.


8. Cardinal RN, Winstanley CA, Robbins TW, et al. Limbic corticostriatal systems and delayed reinforcement. Ann N Y Acad Sci. 2004;1021:3350.


M&B 2011; 2:(1). July 2011


Standard Error Mean .36


t-Test (17) 5.16


3.89 6.33 3.87 3.75


p (Two-Tailed) .000


.002 .000 .002 .003


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