Good vibrations: Whole Body Vibration as a new treatment for ADHD?

It is widely known that patients with attention deficit hyperactivity disorder (ADHD) suffer from a range of cognitive deficits that often affect various parts of their life. Think of social functioning, academic achievement, occupational attainment, and even quality of life. The most common intervention strategies for ADHD are cognitive behavioral therapy (CBT) and/or stimulant drug treatment. Unfortunately, several problems are associated with conventional treatment strategies. For example, pharmacological treatment may lead to uncomfortable side effects such as insomnia, dry mouth, decreased appetite, and headache. Also, although stimulant drug treatment improves cognitive functions, it does not normalize patients’ level of performance. Finally, CBT and drug therapy are expensive.

“So, we tried to address the need for alternative treatment options, but what shape could such a treatment take?”

Together with colleagues from the Departments of Molecular Neurobiology and Human Movement Science, we explored the potential value of a new method for the treatment of patients with ADHD – Whole Body Vibration (WBV). WBV is known to many people as a training method at fitness centers. WBV exposes a person’s whole body to low frequency vibration (usually 10 to 30 Hz) and is often used in combination with dynamic exercises. In our studies, however, we did not demand any physical activity from our participants, as we applied WBV treatment while they were sitting on a chair mounted on a vibrating platform. This approach is easy to apply to everyone, and does not exclude people whose physical activity is restricted.

In previous research on mice, positive effects of WBV treatment were shown on several functions and processes, such as maze learning and neuronal activity. Studies in humans also showed that WBV may be beneficial for various physiological measures, including balance, oxygen uptake, heart rate, blood pressure, and muscle strength. However, we still didn’t know the potential value of WBV in the treatment of cognitive impairments.

“Is this passive application of WBV also effective in improving cognitive deficits of patients with ADHD? We tried to find out.”

Our first study (Fuermaier et al. 2014a) explored acute effects of WBV treatment on attention. For this purpose, 83 healthy university students and 17 students diagnosed with ADHD were asked to perform short tests of attention repeatedly during an experimental session while sitting on our chair mounted on the platform. Directly before the performance of half of the attention tests, participants received short intervals (2 minutes) of WBV via the vibrating platform. Our results revealed that attention performance of both healthy students and students with ADHD was significantly improved after treatment with WBV! We then looked at the prolonged effects of WBV on cognitive functions and performed a case study on a student diagnosed with ADHD (Fuermaier et al. 2014b). The participant received WBV treatment on 10 consecutive days (three times a day for 15 minutes). Neuropsychological assessments were performed before the treatment, the day after the last WBV treatment, and at a follow-up assessment 10 days later. Our results were stunning as data clearly showed a large increase in the cognitive performance of our student with ADHD from the first to the second assessment! Cognitive performance at the follow-up assessment (with no WBV treatment 10 days before) dropped to a level similar to the first assessment, which shows that improvements from the first to the second assessment were unlikely to be caused by practice effects. These results indicate that beneficial effects of WBV are long-lasting up until at least one day after WBV treatment.

“Taken together, our two studies are very exciting as they clearly show that WBV may very well be of clinical relevance for the treatment of patients with ADHD.”

The obvious advantages of WBV support this notion; such as its easiness to apply, cost effectiveness, little or no interference with other interventions, and its possibility to be set up in private or institutional settings (e.g. at home, in school or at work). Only short periods of WBV treatment per day may be enough to cause clinically relevant effects. We also expect a high compliance rate as this approach requires little effort. Furthermore, our studies showed that the application of passive WBV is not associated with any problematic side effects.

We are delighted with these promising results. However, before we can establish WBV treatment, we need more group studies that show long lasting effects of WBV treatment. In addition, since little is known about the underlying mechanism of WBV induced cognitive enhancement, it should definitely be subject of future research. WBV may not only be interesting for the treatment of patients with ADHD, but also for many other purposes. It could be used as a cognitive enhancer for school children and university students, and even used for older people to maintain cognitive functioning.

“There are many applications imaginable, inviting a broad range of potential studies.”

References

Fuermaier, A.B.M., Tucha, L., Koerts, J., van Heuvelen, M.J.G., Van der Zee, E.A., Lange, K.W. & Tucha, O. (2014a). Good vibrations – Effects of Whole Body Vibration on attention in healthy individuals and individuals with attention deficit hyperactivity disorder. PLoS ONE, 9(2), e90747.

Fuermaier, A.B.M., Tucha, L., Koerts, J., van den Bos, M., Regterschot, G.R.H., Zeinstra, E.B., van Heuvelen, M.J.G., Van der Zee, E.A., Lange, K.W. & Tucha, O. (2014b). Whole Body Vibration improves cognitive functions of an adult with ADHD. ADHD Attention deficit and hyperactivity disorders, 6(3), 211-220.

NOTE: Image by insetto scoppiettante, licenced under CC BY 2.0

Anselm Fuermaier

Associate Professor

Anselm Fürmaier is associate professor at the Department of Clinical and Developmental Neuropsychology. He studied psychology at the Universities of Regensburg, Germany, and Keele, UK, with an emphasis on biological psychology and clinical neuropsychology (MSc in 2010). After graduation, he came to Groningen to work on his PhD project on cognitive functioning of adults with attention deficit hyperactivity disorder (ADHD). In 2014, he obtained his PhD and became assistant professor in the field of clinical neuropsychology. In 2020 he was promoted to associate professor. His research interests comprise the neuropsychological assessment of attention disorders in patients with psychiatric and neurological conditions, with an emphasis on everyday functioning. Large parts of his research are dedicated on the development and evaluation of tools for the assessment of symptom and performance validity.

Selected publications

Becke, M., Fuermaier, A.B.M., Buehren, J., Weisbrod, M., Aschenbrenner, S., Tucha, O., & Tucha, L. (2019). Utility of the Structured Interview of Reported Symptoms (SIRS-2) in detecting feigned adult attention-deficit/hyperactivity disorder. Journal of Clinical and Experimental Neuropsychology, 41(8), 786-802.

Fuermaier, A.B.M., Fricke, J.A., de Vries, S.M., Tucha, L., & Tucha, O. (2019). Neuropsychological assessment of adults with ADHD: A Delphi consensus study. Applied Neuropsychology: Adult, 26(4), 340-354.

Fuermaier, A.B.M., Tucha, O., Russ, D., Ehrenstein, J.K., Stanke, M., Heindorf, R., Buggenthin, R., Aschenbrenner, S., Koerts, J., & Tucha, L. (2020). Utility of an attention-based performance validity test for the detection of feigned cognitive dysfunction after acquired brain injury. Journal of Clinical and Experimental Neuropsychology, 42(3), 285-297.

Groen, Y., Fuermaier, A.B.M., Tucha, L., Weisbrod, M., Aschenbrenner, S., & Tucha, O. (2018). A situation-specific approach to measure attention in adults with ADHD: The everyday life attention scale (ELAS). Applied Neuropsychology: Adult. 26(5):411-440.