Effect of HEG biofeedback on selected cognitive functions—Randomized study in children with ADHD and neurotypical children

Treating Executive Function in Youth With Attention Deficit Hyperactivity Disorder: A Review of Pharmacological and Non-Pharmacological Interventions

INTRODUCTION

Executive function (EF) deficits are common in youth with ADHD and pose significant functional impairments. The extent and effect of interventions addressing EF in youth with ADHD remain unclear.

METHODS

We conducted a systematic literature review using PRISMA guidelines. Included studies were randomized controlled trials of interventions to treat EF in youth with ADHD.

RESULTS

Our search returned 136 studies representing 11,443 study participants. We identified six intervention categories: nonstimulant pharmacological (N = 3,576 participants), neurological (N = 1,935), psychological (N = 2,387), digital (N = 2,416), physiological (N = 680), and combination (N = 366). The bulk of the evidence supported pharmacological interventions as most effective in mitigating EF, followed by psychological and digital interventions.

CONCLUSION

A breadth of treatments exists for EF in youth with ADHD. Pharmacological, psychotherapeutic, and digital interventions had the most favorable, replicable outcomes. A lack of outcome standardization across studies limited treatment comparison. More data on the persistence of intervention effects are necessary.

Enhancing Inhibitory Control in Older Adults: A Biofeedback Study

Multidomain interventions based on bio-/neurofeedback have proven useful in improving executive functions. The present study aimed to explore the potential efficacy and feasibility of an intervention that combined Heart Rate Variability Biofeedback (HRV-BF) and Near Infrared Hemoencephalography Neurofeedback (nirHEG-NF) on inhibitory control (IC) of healthy older adults. Thirty-four participants were randomly assigned to two groups: the biofeedback group (received a 10-week combined intervention of HRV-BF and nirHEG-NF) and the active control group (received a similar protocol without real-time biofeedback). Besides cognitive outcomes, the study examined pre- and post-changes in autonomic regulation and prefrontal blood oxygenation at rest and during training. Results revealed training-induced inhibitory control gains in one of the two interference tasks, whereas no effect was found on response inhibition. After the intervention, HRV increased in participants with the lowest levels of HRV at baseline. Although older adults increased blood oxygenation during training, no significant pre- and post-changes were found in blood flow oxygenation. These findings not only suggest that HRV-BF and nirHEG-NF potentially improve performance in certain subcomponents of inhibition (i.e., interference vs. response inhibition), but it may also be beneficial for parasympathetic activity in participants with low HRV and for increasing blood flow oxygenation on prefrontal areas during training.

Effects of hemoencephalographic biofeedback with virtual reality on selected aspects of attention in children with ADHD

For children with attention deficit/hyperactivity disorder (ADHD), a reduction of inattention by biofeedback has been shown in several studies. As evidenced by previous reports, biofeedback (BFB) with virtual reality (VR) allows for controlling distractors, providing an environment that captures participants' attention. The purpose of this study was to evaluate the effects of hemoencephalographic (HEG) BFB with VR in treating deficits in vigilance (assessed using the short form of the Mackworth Clock Task), visual search (the Visual Search Task), and divided attention (Multitasking Test) among children with ADHD. Data subjected to analysis were collected from 87 participants aged 9-15 years. Children were assigned to one of three groups (standard 2D BFB in the lab, VR BFB with a limited visual scene, VR BFB with a complex visual scene) and were subjected to ten HEG BFB sessions. Children in the VR BFB groups exhibited a bigger regional cerebral blood oxygenation slope during BFB and better performance in cognitive tests following the experiment compared to children in the 2D BFB group. The data obtained suggest that HEG BFB with VR may have a more beneficial effect in treating attention deficits compared to standard 2D HEG BFB. We believe that the strong effects of HEG BFB with VR stem from the increased commitment and motivation in individuals, rather than from manipulation with regard to visual scene complexity.