From Aberrant Brainwaves to Altered Plasticity: A Review of QEEG Biomarkers and Neurofeedback in the Neurobiological Landscape of ADHD

This critical review synthesizes findings from quantitative electroencephalography (QEEG) to bridge the gap between systems-level neurophysiology and the underlying cellular pathology of Attention-Deficit/Hyperactivity Disorder (ADHD). As a prevalent neurodevelopmental disorder, ADHD diagnosis is challenged by symptomatic heterogeneity, creating an urgent need for objective biological indicators. Analysis of QEEG data reveals consistent neurophysiological patterns in ADHD, primarily an excess of Theta-band activity and a deficit in Beta-band activity. These findings have led to the proposal of specific biomarkers, such as the Theta/Beta Ratio (TBR), and serve as the basis for neurofeedback interventions aimed at modulating brainwave activity. While not a standalone diagnostic tool, this review posits that QEEG-based biomarkers and Neurofeedback responses are systems-level manifestations of putative cellular and synaptic dysfunctions. By outlining these robust macro-scale patterns, this work provides a conceptual framework intended to guide future molecular and cellular research into the fundamental biology of ADHD.