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Hack RL, Aigner M, Musalek M, Crevenna R, Konicar L. Brain regulation training improves emotional competences in patients with alcohol use disorder. Soc Cogn Affect Neurosci 2024; 19:nsae048. [PMID: 38915188 PMCID: PMC11297497 DOI: 10.1093/scan/nsae048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 05/14/2024] [Accepted: 06/22/2024] [Indexed: 06/26/2024] Open
Abstract
Alcohol use disorder (AUD) is defined as the impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences and still represents one of the biggest challenges for society regarding health conditions, social consequences, and financial costs, including the high relapse rates after traditional alcohol rehabilitation treatment. Especially, the deficient emotional competence in AUD is said to play a key role in the development of AUD and hinders the interruption of substance compulsion, often leading to a viscous circle of relapse. Although the empirical evidence of a neurophysiological basis of AUD is solid and increases even further, clinical interventions based on neurophysiology are still rare for individuals with AUD. This randomized controlled trial investigates changes in emotional competences, alcohol-related cognitions, and drinking behavior before and after an established alcohol rehabilitation treatment (control group: nCG = 29) compared to before and after an optimized, add-on neurofeedback (NF) training (experimental group: nEG = 27). Improvements on the clinical-psychological level, i.e. increases in emotional competences as well as life satisfaction, were found after the experimental electroencephalography (EEG) NF training. Neurophysiological measurements via resting-state EEG indicate decreases in low beta frequency band, while alpha and theta bands remained unaffected.
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Affiliation(s)
- Ramona L Hack
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna 1090, Austria
- Anton-Proksch-Institute, Vienna, Vienna 1230, Austria
| | - Martin Aigner
- Clinical Department of Psychiatry and Psychotherapeutic Medicine, University Hospital Tulln, Tulln 3430, Austria
| | | | - Richard Crevenna
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Vienna 1090, Austria
| | - Lilian Konicar
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna 1090, Austria
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2
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Li JW, Gao K, Yang XY, Li ZF. Main focus of parents of children with attention deficit hyperactivity disorder and the effectiveness of early clinical screening. World J Clin Cases 2024; 12:3752-3759. [PMID: 38994321 PMCID: PMC11235449 DOI: 10.12998/wjcc.v12.i19.3752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/30/2024] [Accepted: 05/16/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is a common mental and behavioral disorder among children. AIM To explore the focus of attention deficit hyperactivity disorder parents and the effectiveness of early clinical screening. METHODS This study found that the main directions of parents seeking medical help were short attention time for children under 7 years old (16.6%) and poor academic performance for children over 7 years old (12.1%). We employed a two-stage experiment to diagnose ADHD. Among the 5683 children evaluated from 2018 to 2021, 360 met the DSM-5 criteria. Those diagnosed with ADHD underwent assessments for letter, number, and figure attention. Following the exclusion of ADHD-H diagnoses, the detection rate rose to 96.0%, with 310 out of 323 cases identified. RESULTS This study yielded insights into the primary concerns of parents regarding their children's symptoms and validated the efficacy of a straightforward diagnostic test, offering valuable guidance for directing ADHD treatment, facilitating early detection, and enabling timely intervention. Our research delved into the predominant worries of parents across various age groups. Furthermore, we showcased the precision of the simple exclusion experiment in discerning between ADHD-I and ADHD-C in children. CONCLUSION Our study will help diagnose and guide future treatment directions for ADHD.
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Affiliation(s)
- Jia-Wen Li
- Department of Paediatrics, The First Affiliated Hospital of Ningbo University, Ningbo 315021, Zhejiang Province, China
| | - Ke Gao
- Department of Paediatrics, The First Affiliated Hospital of Ningbo University, Ningbo 315021, Zhejiang Province, China
| | - Xiao-Yun Yang
- Department of Paediatrics, The First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, Anhui Province, China
| | - Zhi-Fei Li
- Department of Paediatrics, The First Affiliated Hospital of Ningbo University, Ningbo 315021, Zhejiang Province, China
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3
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Zhao L, Agazzi H, Du Y, Meng H, Maku R, Li K, Aspinall P, Garvan CW, Fang S. A Digital Cognitive-Physical Intervention for Attention-Deficit/Hyperactivity Disorder: Randomized Controlled Trial. J Med Internet Res 2024; 26:e55569. [PMID: 38728075 PMCID: PMC11127175 DOI: 10.2196/55569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/15/2024] [Accepted: 04/25/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders among children. Pharmacotherapy has been the primary treatment for ADHD, supplemented by behavioral interventions. Digital and exercise interventions are promising nonpharmacologic approaches for enhancing the physical and psychological health of children with ADHD. However, the combined impact of digital and exercise therapies remains unclear. OBJECTIVE The aim of this study was to determine whether BrainFit, a novel digital intervention combining gamified cognitive and exercise training, is efficacious in reducing ADHD symptoms and executive function (EF) among school-aged children with ADHD. METHODS This 4-week prospective randomized controlled trial included 90 children (6-12 years old) who visited the ADHD outpatient clinic and met the diagnostic criteria for ADHD. The participants were randomized (1:1) to the BrainFit intervention (n=44) or a waitlist control (n=46) between March and August 2022. The intervention consisted of 12 30-minute sessions delivered on an iPad over 4 weeks with 3 sessions per week (Monday, Wednesday, and Friday after school) under the supervision of trained staff. The primary outcomes were parent-rated symptoms of attention and hyperactivity assessed according to the Swanson, Nolan, and Pelham questionnaire (SNAP-IV) rating scale and EF skills assessed by the Behavior Rating Inventory of Executive Function (BRIEF) scale, evaluated pre and post intervention. Intention-to-treat analysis was performed on 80 children after attrition. A nonparametric resampling-based permutation test was used for hypothesis testing of intervention effects. RESULTS Among the 145 children who met the inclusion criteria, 90 consented and were randomized; ultimately, 80 (88.9%) children completed the study and were included in the analysis. The participants' average age was 8.4 (SD 1.3) years, including 63 (78.8%) male participants. The most common ADHD subtype was hyperactive/impulsive (54/80, 68%) and 23 (29%) children had severe symptoms. At the endpoint of the study, the BrainFit intervention group had a significantly larger improvement in total ADHD symptoms (SNAP-IV total score) as compared to those in the control group (β=-12.203, 95% CI -17.882 to -6.523; P<.001), owing to lower scores on the subscales Inattention (β=-3.966, 95% CI -6.285 to -1.647; P<.001), Hyperactivity/Impulsivity (β=-5.735, 95% CI -8.334 to -3.137; P<.001), and Oppositional Defiant Disorder (β=-2.995, 95% CI -4.857 to -1.132; P=.002). The intervention was associated with significant reduction in the Metacognition Index (β=-6.312, 95% CI -10.973 to -1.650; P=.006) and Global Executive Composite (β=-5.952, 95% CI -10.214 to -1.690; P=.003) on the BRIEF. No severe intervention-related adverse events were reported. CONCLUSIONS This novel digital cognitive-physical intervention was efficacious in school-age children with ADHD. A larger multicenter effectiveness trial with longer follow-up is warranted to confirm these findings and to assess the durability of treatment effects. TRIAL REGISTRATION Chinese Clinical Trial Register ChiCTR2300070521; https://www.chictr.org.cn/showproj.html?proj=177806.
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Affiliation(s)
- Licong Zhao
- Department of Child Healthcare, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Heather Agazzi
- Department of Pediatrics & Department of Psychiatry and Behavioral Neurosciences, College of Medicine, University of South Florida, Tampa, FL, United States
| | - Yasong Du
- Department of Child & Adolescent Psychiatry, Shanghai Mental Health Center, Shanghai Jiaotong University, Shanghai, China
| | - Hongdao Meng
- College of Behavioral & Community Sciences, University of South Florida, Tampa, FL, United States
| | - Renya Maku
- College of Public Health, University of South Florida, Tampa, FL, United States
| | - Ke Li
- Department of Child Healthcare, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | | | - Cynthia Wilson Garvan
- Department of Anesthesiology, College of Medicine, University of Florida, Tampa, FL, United States
| | - Shuanfeng Fang
- Department of Child Healthcare, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, China
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4
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Diotaiuti P, Corrado S, Tosti B, Spica G, Di Libero T, D’Oliveira A, Zanon A, Rodio A, Andrade A, Mancone S. Evaluating the effectiveness of neurofeedback in chronic pain management: a narrative review. Front Psychol 2024; 15:1369487. [PMID: 38770259 PMCID: PMC11104502 DOI: 10.3389/fpsyg.2024.1369487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 03/28/2024] [Indexed: 05/22/2024] Open
Abstract
The prevalence and impact of chronic pain in individuals worldwide necessitate effective management strategies. This narrative review specifically aims to assess the effectiveness of neurofeedback, an emerging non-pharmacological intervention, on the management of chronic pain. The methodology adopted for this review involves a meticulous search across various scientific databases. The search was designed to capture a broad range of studies related to neurofeedback and chronic pain management. To ensure the quality and relevance of the included studies, strict inclusion and exclusion criteria were applied. These criteria focused on the study design, population, intervention type, and reported outcomes. The review synthesizes the findings from a diverse array of studies, including randomized controlled trials, observational studies, and case reports. Key aspects evaluated include the types of neurofeedback used (such as EEG biofeedback), the various chronic pain conditions addressed (like fibromyalgia, neuropathic pain, and migraines), and the methodologies employed in these studies. The review highlights the underlying mechanisms by which neurofeedback may influence pain perception and management, exploring theories related to neural plasticity, pain modulation, and psychological factors. The results of the review reveal a positive correlation between neurofeedback interventions and improved pain management. Several studies report significant reductions on pain intensity, improved quality of life, and decreased reliance on medication following neurofeedback therapy. The review also notes variations in the effectiveness of different neurofeedback protocols and individual responses to treatment. Despite the promising results, the conclusion of the review emphasizes the need for further research. It calls for larger, well-designed clinical trials to validate the findings, to understand the long-term implications of neurofeedback therapy, and to optimize treatment protocols for individual patients.
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Affiliation(s)
- Pierluigi Diotaiuti
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, Cassino, Lazio, Italy
| | - Stefano Corrado
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, Cassino, Lazio, Italy
| | - Beatrice Tosti
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, Cassino, Lazio, Italy
| | - Giuseppe Spica
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, Cassino, Lazio, Italy
| | - Tommaso Di Libero
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, Cassino, Lazio, Italy
| | - Anderson D’Oliveira
- Department of Physical Education, CEFID, Santa Catarina State University, Florianopolis, Santa Catarina, Brazil
| | - Alessandra Zanon
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, Cassino, Lazio, Italy
| | - Angelo Rodio
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, Cassino, Lazio, Italy
| | - Alexandro Andrade
- Department of Physical Education, CEFID, Santa Catarina State University, Florianopolis, Santa Catarina, Brazil
| | - Stefania Mancone
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, Cassino, Lazio, Italy
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Geffen R, Braun C. Effects of Geometric Sound on Brainwave Activity Patterns, Autonomic Nervous System Markers, Emotional Response, and Faraday Wave Pattern Morphology. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2024; 2024:9844809. [PMID: 38586300 PMCID: PMC10997421 DOI: 10.1155/2024/9844809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 12/28/2023] [Accepted: 01/31/2024] [Indexed: 04/09/2024]
Abstract
This study introduces Geometric Sound as a subfield of spatial sound featuring audio stimuli which are sonic holograms of mathematically defined 3D shapes. The effects of Geometric Sound on human physiology were investigated through EEG, heart rate, blood pressure, and a combination of questionnaires monitoring 50 healthy participants in two separate experiments. The impact of Geometric Sound on Faraday wave pattern morphology was further studied. The shapes examined, pyramid, cube, and sphere, exhibited varying significant effects on autonomic nervous system markers, brainwave power amplitude, topology, and connectivity patterns, in comparison to both the control (traditional stereo), and recorded baseline where no sound was presented. Brain activity in the Alpha band exhibited the most significant results, additional noteworthy results were observed across analysis paradigms in all frequency bands. Geometric Sound was found to significantly reduce heart rate and blood pressure and enhance relaxation and general well-being. Changes in EEG, heart rate, and blood pressure were primarily shape-dependent, and to a lesser extent sex-dependent. Pyramid Geometric Sound yielded the most significant results in most analysis paradigms. Faraday Waves patterns morphology analysis indicated that identical frequencies result in patterns that correlate with the excitation Geometric Sound shape. We suggest that Geometric Sound shows promise as a noninvasive therapeutic approach for physical and psychological conditions, stress-related disorders, depression, anxiety, and neurotrauma. Further research is warranted to elucidate underlying mechanisms and expand its applications.
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Affiliation(s)
| | - Christoph Braun
- Tübingen University, MEG-Center, Tübingen 72074, Germany
- HIH Hertie Institute for Clinical Brain Research, Tübingen, Germany
- CIMeC Center for Mind/Brain Sciences, University of Trento, Trento, Italy
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6
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Öğütlü H, Kütük ÖM, Tufan AE, Akay AP, Gündoğdu ÖY, Ercan ES. The detect consensus report on Attention Deficit/Hyperactivity Disorder and its management among Turkish children and adolescents (Detect: consensus report on ADHD among Turkish youth). Front Psychiatry 2024; 15:1372341. [PMID: 38577402 PMCID: PMC10993048 DOI: 10.3389/fpsyt.2024.1372341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 03/01/2024] [Indexed: 04/06/2024] Open
Abstract
Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common and heritable neurodevelopmental disorders which may last through the life-span. A consensus report on diagnosis and management of ADHD among Turkish youth was prepared previously. However, the participants as well as the management options were rather limited and developments in the past decade necessitated a revision and update of the consensus. Therefore, this review aims to summarize the consensus among Child and Adolescent Psychiatrists from Türkiye on the nature and management of pediatric ADHD. For those aims, the etiology of ADHD, diagnostic and evaluation process, epidemiology, developmental presentations, differential diagnoses and comorbidities, course/outcome and pharmacological as well as non-pharmacological management options were reviewed and suggestions for clinical practice are presented. Since ADHD is a chronic disorder with wide-ranging effects on functionality that is frequently accompanied by other mental disorders, a multidimensional therapeutic approach is recommended. However, since the disorder has neurobiological basis, pharmacotherapy represents the mainstay of treatment. Additional therapies may include psychosocial therapy, behavioral therapy, school-based therapeutic approaches, and family education. This review provides recommendations for ADHD at the national and global levels. It contains information about ADHD that will contribute to and facilitate clinicians' decision-making processes. It is advisable to consider this guideline in clinical practice.
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Affiliation(s)
- Hakan Öğütlü
- Child and Adolescent Psychiatry Department, Cognitive Behavioral Psychotherapies Association, Ankara, Türkiye
| | - Özlem Meryem Kütük
- Child and Adolescent Psychiatry Department, Medical Faculty, Baskent University, Adana, Türkiye
| | - Ali Evren Tufan
- Child and Adolescent Psychiatry Department, Medical Faculty, Bolu Abant Izzet Baysal University, Bolu, Türkiye
| | - Aynur Pekcanlar Akay
- Child and Adolescent Psychiatry Department, Medical Faculty, Dokuz Eylul University, Izmir, Türkiye
| | - Özlem Yildiz Gündoğdu
- Child and Adolescent Psychiatry Department, Medical Faculty, Kocaeli University, Kocaeli, Türkiye
| | - Eyüp Sabri Ercan
- Child and Adolescent Psychiatry Department, Medical Faculty, Ege University, Izmir, Türkiye
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7
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Tosti B, Corrado S, Mancone S, Di Libero T, Rodio A, Andrade A, Diotaiuti P. Integrated use of biofeedback and neurofeedback techniques in treating pathological conditions and improving performance: a narrative review. Front Neurosci 2024; 18:1358481. [PMID: 38567285 PMCID: PMC10985214 DOI: 10.3389/fnins.2024.1358481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/01/2024] [Indexed: 04/04/2024] Open
Abstract
In recent years, the scientific community has begun tо explore the efficacy оf an integrated neurofeedback + biofeedback approach іn various conditions, both pathological and non-pathological. Although several studies have contributed valuable insights into its potential benefits, this review aims tо further investigate its effectiveness by synthesizing current findings and identifying areas for future research. Our goal іs tо provide a comprehensive overview that may highlight gaps іn the existing literature and propose directions for subsequent studies. The search for articles was conducted on the digital databases PubMed, Scopus, and Web of Science. Studies to have used the integrated neurofeedback + biofeedback approach published between 2014 and 2023 and reviews to have analyzed the efficacy of neurofeedback and biofeedback, separately, related to the same time interval and topics were selected. The search identified five studies compatible with the objectives of the review, related to several conditions: nicotine addiction, sports performance, Autism Spectrum Disorder (ASD), and Attention Deficit Hyperactivity Disorder (ADHD). The integrated neurofeedback + biofeedback approach has been shown to be effective in improving several aspects of these conditions, such as a reduction in the presence of psychiatric symptoms, anxiety, depression, and withdrawal symptoms and an increase in self-esteem in smokers; improvements in communication, imitation, social/cognitive awareness, and social behavior in ASD subjects; improvements in attention, alertness, and reaction time in sports champions; and improvements in attention and inhibitory control in ADHD subjects. Further research, characterized by greater methodological rigor, is therefore needed to determine the effectiveness of this method and the superiority, if any, of this type of training over the single administration of either. This review іs intended tо serve as a catalyst for future research, signaling promising directions for the advancement оf biofeedback and neurofeedback methodologies.
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Affiliation(s)
- Beatrice Tosti
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Lazio, Italy
| | - Stefano Corrado
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Lazio, Italy
| | - Stefania Mancone
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Lazio, Italy
| | - Tommaso Di Libero
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Lazio, Italy
| | - Angelo Rodio
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Lazio, Italy
| | - Alexandro Andrade
- Department of Physical Education, CEFID, Santa Catarina State University, Florianopolis, Santa Catarina, Brazil
| | - Pierluigi Diotaiuti
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Lazio, Italy
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8
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Hyde LW, Bezek JL, Michael C. The future of neuroscience in developmental psychopathology. Dev Psychopathol 2024:1-16. [PMID: 38444150 DOI: 10.1017/s0954579424000233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
Developmental psychopathology started as an intersection of fields and is now a field itself. As we contemplate the future of this field, we consider the ways in which a newer, interdisciplinary field - human developmental neuroscience - can inform, and be informed by, developmental psychopathology. To do so, we outline principles of developmental psychopathology and how they are and/or can be implemented in developmental neuroscience. In turn, we highlight how the collaboration between these fields can lead to richer models and more impactful translation. In doing so, we describe the ways in which models from developmental psychopathology can enrich developmental neuroscience and future directions for developmental psychopathology.
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Affiliation(s)
- Luke W Hyde
- Department of Psychology, Survey Research Center at the Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Jessica L Bezek
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Cleanthis Michael
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
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9
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Xiong K, Wan M, Cai D, Nan W. Down-regulation of theta amplitude through neurofeedback improves executive control network efficiency in healthy children. Int J Psychophysiol 2024; 197:112301. [PMID: 38218562 DOI: 10.1016/j.ijpsycho.2024.112301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/21/2023] [Accepted: 01/08/2024] [Indexed: 01/15/2024]
Abstract
Despite extensive clinical research on neurofeedback (NF) in attention-deficit/hyperactivity disorder (ADHD), few studies targeted the optimization of attention performance in healthy children. As a crucial component of attention networks, the executive control network, involved in resolving response conflicts and allocating cognitive resources, is closely linked to theta activity. Here, we aimed to answer whether theta down-regulating NF can enhance healthy children's attention performance, especially the executive control network. Sixty children aged 6-12 years were randomly assigned to the NF and waitlist control groups. The NF group received theta down-regulation NF training for five days (a total of 100 mins), and the attention performance of both groups was measured by the attention network test (ANT) in the pre, post-NF, and 7-day follow-up. The electroencephalographic (EEG) results demonstrated a significant decrease in resting-state theta amplitude within sessions. For the behavioral results, the NF group exhibited significant improvements in overall attention performance and the efficiency of the executive control network relative to the control group in the post-NF and follow-up assessment, whereas the alerting and orienting networks remained unchanged. These findings proved the feasibility of theta down-regulating NF and its positive effect on attention in the healthy children population. In particular, the facilitation of the efficiency of the executive control network and the unaltered performance of the other two attention networks in the NF group may support the causality between theta rhythm and the executive control network.
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Affiliation(s)
- Kaiwen Xiong
- School of Psychology, Shanghai Normal University, Shanghai, China
| | - Mengqi Wan
- School of Psychology, Shanghai Normal University, Shanghai, China
| | - Dan Cai
- School of Psychology, Shanghai Normal University, Shanghai, China.
| | - Wenya Nan
- School of Psychology, Shanghai Normal University, Shanghai, China.
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10
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Tazaki M. A review: effects of neurofeedback on patients with mild cognitive impairment (MCI), and Alzheimer's disease (AD). Front Hum Neurosci 2024; 17:1331436. [PMID: 38420112 PMCID: PMC10899454 DOI: 10.3389/fnhum.2023.1331436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 11/29/2023] [Indexed: 03/02/2024] Open
Abstract
Neurofeedback training (NFT) is a non-invasive method and has been shown to be effective for attention deficit/hyperactivity disorder (ADHD) and various psychiatric disorders. The aim of this paper is to evaluate the effectiveness of NFT for patients with Mild Cognitive Impairment (MCI) and Alzheimer's disease (AD) or Vascular Diseases (VD), so that we searched research articles from four databases, using the keywords neurofeedback, elderly, MCI, AD, VD, and dementia. As a result, 13 articles were identified regarding the effectiveness of NFT in patients with MCI and AD. Although each study differed in study design, training protocol, electroencephalogram (EEG) electrode placement, and reward and inhibition frequency bands, all were shown to enhance memory, attention, and other cognitive abilities. Additional well-designed, randomized studies with sufficient power are needed to further confirm the effectiveness of NFT.
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Affiliation(s)
- Miyako Tazaki
- Department of Psychology, Faculty of Medicine, Toho University, Tokyo, Japan
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11
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Zhang DW, Johnstone SJ, Sauce B, Arns M, Sun L, Jiang H. Remote neurocognitive interventions for attention-deficit/hyperactivity disorder - Opportunities and challenges. Prog Neuropsychopharmacol Biol Psychiatry 2023; 127:110802. [PMID: 37257770 DOI: 10.1016/j.pnpbp.2023.110802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 05/23/2023] [Accepted: 05/24/2023] [Indexed: 06/02/2023]
Abstract
Improving neurocognitive functions through remote interventions has been a promising approach to developing new treatments for attention-deficit/hyperactivity disorder (AD/HD). Remote neurocognitive interventions may address the shortcomings of the current prevailing pharmacological therapies for AD/HD, e.g., side effects and access barriers. Here we review the current options for remote neurocognitive interventions to reduce AD/HD symptoms, including cognitive training, EEG neurofeedback training, transcranial electrical stimulation, and external cranial nerve stimulation. We begin with an overview of the neurocognitive deficits in AD/HD to identify the targets for developing interventions. The role of neuroplasticity in each intervention is then highlighted due to its essential role in facilitating neuropsychological adaptations. Following this, each intervention type is discussed in terms of the critical details of the intervention protocols, the role of neuroplasticity, and the available evidence. Finally, we offer suggestions for future directions in terms of optimizing the existing intervention protocols and developing novel protocols.
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Affiliation(s)
- Da-Wei Zhang
- Department of Psychology/Center for Place-Based Education, Yangzhou University, Yangzhou, China; Department of Psychology, Monash University Malaysia, Bandar Sunway, Malaysia.
| | - Stuart J Johnstone
- School of Psychology, University of Wollongong, Wollongong, Australia; Brain & Behaviour Research Institute, University of Wollongong, Australia
| | - Bruno Sauce
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Martijn Arns
- Research Institute Brainclinics, Brainclinics Foundation, Nijmegen, Netherlands; Department of Experimental Psychology, Utrecht University, Utrecht, Netherlands; NeuroCare Group, Nijmegen, Netherlands
| | - Li Sun
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China; National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | - Han Jiang
- College of Special Education, Zhejiang Normal University, Hangzhou, China
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Lee CSC, Chen TT, Gao Q, Hua C, Song R, Huang XP. The Effects of Theta/Beta-based Neurofeedback Training on Attention in Children with Attention Deficit Hyperactivity Disorder: A Systematic Review and Meta-analysis. Child Psychiatry Hum Dev 2023; 54:1577-1606. [PMID: 35471754 DOI: 10.1007/s10578-022-01361-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/01/2022] [Indexed: 11/25/2022]
Abstract
Neurofeedback training is a common treatment option for attention deficit hyperactivity disorder (ADHD). Given theta/beta-based neurofeedback (T/B NF) training targets at the electrophysiological characteristics of children with ADHD, benefits for attention may be expected. PsycINFO, PubMed, ScienceDirect, Scopus, and Web of Science were searched through December 31, 2020. Studies were evaluated with Risk of Bias tools. Within-group effects based on Pre- and Post-treatment comparisons of the Intervention Group, and Between-group effects based on the between-group differences from Pre-treatment to Post-treatment were calculated. Nineteen studies met selection criteria for systematic review, 12 of them were included in meta-analysis. Within-group effects were medium at Post-treatment and large at Follow-up. Between-group analyses revealed that T/B NF was superior to waitlist control and physical activities, but not stimulant medication. Results showed that T/B NF has benefits for attention in children with ADHD, however, cautions should be taken when interpreting the findings.
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Affiliation(s)
- Clara S C Lee
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
| | - Ting-Ting Chen
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Qingwen Gao
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Chunzhuo Hua
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Rui Song
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Xiu-Ping Huang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
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Esmaeilzadeh Kanafgourabi SN, Shabani M, Mirchi Z, Aliyari H, Mahdavi P. The impact of ILF neurofeedback on inhibitory control in high-functioning adolescents with autism spectrum disorder: Preliminary evidence of a randomized controlled trial. APPLIED NEUROPSYCHOLOGY. CHILD 2023:1-19. [PMID: 37930738 DOI: 10.1080/21622965.2023.2258247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
BACKGROUND Individuals with Autism Spectrum Disorder (ASD) often exhibit impairments in inhibitory control, which can impact their cognitive functioning. This study aimed to investigate the effectiveness of Infra-Low Frequency (ILF) neurofeedback in improving inhibitory control among high-functioning adolescents with ASD. METHODS A single-blind, two-armed randomized controlled trial was conducted with 24 adolescents with ASD randomly divided into two groups (active and sham; n = 12 per group). Both groups participated in 15 sessions of one-hour ILF neurofeedback, three times per week. The ILF neurofeedback protocol was applied to the active group, while the sham group received an inactive intervention. Outcomes were measured at the pretest, post-test, and follow-up stages. RESULTS ILF neurofeedback significantly improved inhibitory control in adolescents with ASD, as indicated by improvements in behavioral measures and absolute power analysis. The most significant differences were observed in alpha, theta, and gamma waves located in the central areas of the left gyrus. However, no significant effect was observed at the follow-up level on either behavioral measures or absolute power. CONCLUSION The results suggest that ILF neurofeedback is effective in improving inhibitory control in high-functioning adolescents with ASD. This non-invasive intervention has the potential to improve inhibitory control in this population. However, future research is needed to determine the long-term effects of ILF neurofeedback.
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Affiliation(s)
| | - Mohsen Shabani
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Zahra Mirchi
- Faculty of Education and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Hamed Aliyari
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Parisa Mahdavi
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
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Herrera-Morales WV, Reyes-López JV, Tuz-Castellanos KNH, Ortegón-Abud D, Ramírez-Lugo L, Santiago-Rodríguez E, Núñez-Jaramillo L. Variations in Theta/Beta Ratio and Cognitive Performance in Subpopulations of Subjects with ADHD Symptoms: Towards Neuropsychological Profiling for Patient Subgrouping. J Pers Med 2023; 13:1361. [PMID: 37763129 PMCID: PMC10533160 DOI: 10.3390/jpm13091361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 09/01/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
ADHD is a neurodevelopmental disorder appearing in childhood but remaining in many cases in adults. There are both pharmacological and non-pharmacological approaches to treating ADHD, but they do not have the same efficacy in all subjects. Better knowledge of the neurophysiological basis of this disorder will allow for the design of more effective treatments. Studies performing qEEG analysis in children suggest the existence of subgroups of ADHD patients with different neurophysiological traits. There are fewer studies in adults, who might have undergone plastic changes allowing them to cope with ADHD symptoms along with brain maturation. Herein, we study cognitive performance and the theta/beta ratio in young adults with ADHD symptoms. We found that subjects with ADHD symptoms and low working memory performance (n = 30) present higher theta/beta ratios than controls (n = 40) at O2 and T6 in the eyes-closed condition, as well as a tendency toward a higher theta/beta ratio at O1 and Cz. Subjects with ADHD and high working memory performance (n = 50) do not differ from the controls in their theta/beta ratios at any derivation. Our results suggest that neuropsychological profiling could be useful for patient subgrouping. Further research will allow for the distinction of neuropsychological profiles and their neurophysiological correlates, leading to a better classification of ADHD subtypes, thus improving treatment selection.
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Affiliation(s)
- Wendy Verónica Herrera-Morales
- Laboratorio de Neurofisiología, Departamento de Ciencias Médicas, División de Ciencias de la Salud, Universidad Autónoma del Estado de Quintana Roo, Chetumal 77039, Mexico; (W.V.H.-M.); (K.N.-H.T.-C.)
| | - Julián Valeriano Reyes-López
- Unidad de Neurodiagnóstico y Rehabilitación “Dr. Moisés López Gonzáles” Secretaria de Vinculación y Servicios Universitarios, Facultad de Ciencias Naturales, Universidad Autónoma de Querétaro, Querétaro 76000, Mexico;
| | - Karen Nicte-Ha Tuz-Castellanos
- Laboratorio de Neurofisiología, Departamento de Ciencias Médicas, División de Ciencias de la Salud, Universidad Autónoma del Estado de Quintana Roo, Chetumal 77039, Mexico; (W.V.H.-M.); (K.N.-H.T.-C.)
| | - Desiree Ortegón-Abud
- Universidad Santander, Montañas Rocallosas 409, Lomas de Chapultepec, Ciudad de México 11000, Mexico;
| | - Leticia Ramírez-Lugo
- División de Neurociencias, Instituto de Fisiología Celular, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico;
| | - Efraín Santiago-Rodríguez
- Diagnóstico, Tratamiento e Investigación Neurológica, S.C. Querétaro, Santiago de Queretaro 76177, Mexico;
| | - Luis Núñez-Jaramillo
- Laboratorio de Neurofisiología, Departamento de Ciencias Médicas, División de Ciencias de la Salud, Universidad Autónoma del Estado de Quintana Roo, Chetumal 77039, Mexico; (W.V.H.-M.); (K.N.-H.T.-C.)
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Neuhäußer AM, Bluschke A, Roessner V, Beste C. Distinct effects of different neurofeedback protocols on the neural mechanisms of response inhibition in ADHD. Clin Neurophysiol 2023; 153:111-122. [PMID: 37478508 DOI: 10.1016/j.clinph.2023.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 07/23/2023]
Abstract
OBJECTIVE In attention deficit/hyperactivity disorder (ADHD), impaired response inhibition is frequently observed. A promising non-pharmacological treatment is electroencephalography (EEG)-neurofeedback (NF) training. However, the widely used theta-down/beta-up regulation (↓θ↑β) NF protocol may not be optimal for targeting these deficits. We examined how neurofeedback protocols training the upregulation of theta and/or beta power affect inhibitory control in children and adolescents with ADHD. METHODS 64 patients with ADHD took part in the three NF trainings. Aside from parent-reported ADHD symptoms and behavioural performance data, neurophysiological parameters collected via a Go/Nogo task and corrected to account for intraindividual variability were compared in a pre-post design and to an ADHD (n = 20) as well as a typically developing control group (n = 24). RESULTS The examined NF protocols resulted in similar improvements in response inhibition with the neurophysiological mechanisms differing substantially. The upregulation of theta led to a specific Nogo-P3 increase, while training beta upregulation as well as the combined protocol resulted in less specific effects. CONCLUSIONS This study shows distinct effects of different theta/beta-neurofeedback protocols on the neural mechanisms underlying improvements in response inhibition in patients with ADHD. SIGNIFICANCE These effects shed further light on the oscillatory dynamics underlying cognitive control in ADHD and how these may be targeted in neurofeedback treatments.
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Affiliation(s)
- Anna Marie Neuhäußer
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
| | - Annet Bluschke
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany.
| | - Veit Roessner
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
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Kober SE, Buchrieser F, Wood G. Neurofeedback on twitter: Evaluation of the scientific credibility and communication about the technique. Heliyon 2023; 9:e18931. [PMID: 37600360 PMCID: PMC10432958 DOI: 10.1016/j.heliyon.2023.e18931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 08/22/2023] Open
Abstract
Neurofeedback is a popular technique to induce neuroplasticity with a controversial reputation. The public discourse on neurofeedback, as a therapeutic and neuroenhancement technique, encompasses scientific communication, therapeutic expectations and outcomes, as well as complementary and alternative practices. We investigated twitter publications from 2010 to 2022 on the keyword "neurofeedback". A total of over 138 k tweets were obtained, which originated from over 42 k different users. The communication flow in the neurofeedback community is mainly unidirectional and non-interactive. Analysis of hashtags revealed application fields, therapy provider and neuroenhancement to be the most popular contents in neurofeedback communication. A group of 1221 productive users was identified, in which clinicians, entrepreneurs, broadcasters, and scientists contribute. We identified reactions to critical publications in the twitter traffic and an increase in the number of tweets by academic users which suggest an increase in the interest on the scientific credibility of neurofeedback. More intense scientific communication on neurofeedback in twitter may contribute to promote a more realistic view on challenges and advances regarding good scientific practice of neurofeedback.
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Jensen M, Alanis JCG, Hüttenrauch E, Winther-Jensen M, Chavanon ML, Andersson G, Weise C. Does it matter what is trained? A randomized controlled trial evaluating the specificity of alpha/delta ratio neurofeedback in reducing tinnitus symptoms. Brain Commun 2023; 5:fcad185. [PMID: 37680692 PMCID: PMC10481778 DOI: 10.1093/braincomms/fcad185] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 05/18/2023] [Accepted: 06/22/2023] [Indexed: 09/09/2023] Open
Abstract
Previous studies showed that alpha/delta ratio neurofeedback was effective in reducing unpleasant psychological, emotional and perceptual consequences of tinnitus. The main goal of the present study was to investigate, whether the specific combination of enhancing alpha frequency band activity and reducing delta frequency band activity was necessary, or merely sufficient, to obtain a positive treatment outcome regarding tinnitus distress and intensity. A second research aim was to assess the relative contribution of neurofeedback-related non-specific and general non-specific effects in neurofeedback treatment. In a three-arm, randomized controlled trial, 94 chronic tinnitus patients were randomly assigned to one of three conditions: alpha/delta ratio neurofeedback (n = 31), beta/theta ratio neurofeedback (n = 28) and non-neurofeedback minimal treatment intervention (n = 35). Neurofeedback participants underwent 10 treatment sessions over a 4-week period. Outcome measures were collected pre-, mid- and post-interventions and at 3-months follow-up. The Tinnitus Handicap Inventory and the Tinnitus Magnitude Index were used as primary outcome measures for tinnitus distress and tinnitus intensity. EEG data recorded during training supplemented primary outcomes. Since data were repeated measures, the analyses used a two-level mixed effects model approach including by-subject random effects (random intercept). For the Tinnitus Handicap Inventory, the results showed no interaction effect. For the Tinnitus Magnitude Index, the analysis showed a significant time × group interaction, indicating that both alpha/delta ratio neurofeedback and beta/theta ratio neurofeedback reported reduced tinnitus intensity. Analysis of EEG data showed a consistent pattern for the alpha/delta ratio over the course of training. Compared to beta/theta ratio neurofeedback, alpha/delta ratio neurofeedback showed an elevated response. Conversely, for the beta ratio to theta ratio, the pattern was more inconsistent, with no clear indication of superiority for beta/theta ratio neurofeedback over alpha/delta ratio neurofeedback. The main question of this piece of research was whether alpha/delta ratio neurofeedback demonstrated frequency band specificity in the alleviation of tinnitus distress and perceived intensity. Results showed that alpha/delta ratio neurofeedback was sufficient but importantly 'not' necessary to achieve a positive outcome on both the Tinnitus Handicap Inventory and Tinnitus Magnitude Index, when compared to beta/theta ratio neurofeedback. Still, the data suggest a trend towards specificity for alpha/delta ratio neurofeedback. Because of this, it may be too premature to discard alpha/delta ratio neurofeedback in the treatment of tinnitus. Recommendations for future studies are outlined.
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Affiliation(s)
- Martin Jensen
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps University Marburg, 35032 Marburg, Germany
- Eriksholm Research Centre, 3070 Snekkersten, Denmark
- Copenhagen Hearing and Balance Center, Department of Otorhinolaryngology and Audiology, Rigshospitalet, 2100 Copenhagen, Denmark
| | - Jose Carlos Garcia Alanis
- Division of Clinical Child and Adolescent Psychology, Department of Psychology, Philipps University Marburg, 35032 Marburg, Germany
| | - Eva Hüttenrauch
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps University Marburg, 35032 Marburg, Germany
| | - Matilde Winther-Jensen
- Department of Data, Biostatistics and Pharmacoepidemiology, Centre for Clinical Research and Prevention, Copenhagen University Hospital Bispebjerg-Frederiksberg, 2000 Copenhagen, Denmark
| | - Mira-Lynn Chavanon
- Division of Clinical Child and Adolescent Psychology, Department of Psychology, Philipps University Marburg, 35032 Marburg, Germany
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, 58183 Linkoping, Sweden
| | - Cornelia Weise
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps University Marburg, 35032 Marburg, Germany
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Schmidt K, Barac-Dammeyer D, Kowalski A, Teigelack P, Pfeiffer C, Robitzsch A, Dörrie N, Skoda EM, Bäuerle A, Fink M, Teufel M. Implementing biofeedback treatment in a psychosomatic-psychotherapeutic inpatient unit: a mixed methods evaluation of acceptance, satisfaction, and feasibility. Front Psychiatry 2023; 14:1140880. [PMID: 37293401 PMCID: PMC10244572 DOI: 10.3389/fpsyt.2023.1140880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 05/03/2023] [Indexed: 06/10/2023] Open
Abstract
Introduction Feedback-based therapies such as biofeedback have a benefit in patients with mental health disorders. While biofeedback is heavily researched in outpatient settings, it has been rarely investigated in psychosomatic inpatient settings. The implementation of an additional treatment option in inpatient settings holds special requirements. The aim of this pilot study is the evaluation of additional biofeedback treatment in an inpatient psychosomatic-psychotherapeutic unit to derive clinical implications and recommendations for the future implementation of biofeedback offers. Methods The evaluation of the implementation process was investigated using a convergent parallel mixed methods approach (following MMARS guidelines). Quantitative questionnaires measured patients' acceptance and satisfaction with biofeedback treatment after receiving 10 sessions in addition to treatment as usual. After 6 months during implementation, qualitative interviews were conducted with biofeedback practitioners, i.e., staff nurses, examining acceptance and feasibility. Data analysis was conducted using either descriptive statistics or Mayring's qualitative content analysis. Results In total, 40 patients and 10 biofeedback practitioners were included. Quantitative questionnaires revealed high satisfaction and acceptance in patients regarding biofeedback treatment. Qualitative interviews showed high acceptance in biofeedback practitioners but revealed several challenges that were encountered during the implementation process, e.g., increased workload due to additional tasks, organizational and structural difficulties. However, biofeedback practitioners were enabled to expand their own competencies and take over a therapeutic part of the inpatient treatment. Discussion Even though patient satisfaction and staff motivation are high, the implementation of biofeedback in an inpatient unit requires special actions to be taken. Not only should personnel resources be planned and available in advance of implementation but also be the workflow for biofeedback practitioners as easy and quality of biofeedback treatment as high as possible. Consequently, the implementation of a manualized biofeedback treatment should be considered. Nevertheless, more research needs to be done about suitable biofeedback protocols for this patient clientele.
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Affiliation(s)
- Kira Schmidt
- Department for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro-and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Drazena Barac-Dammeyer
- Department for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro-and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Axel Kowalski
- NeuroFit GmbH, Krefeld, Germany
- Department of Psychology, IB University of Applied Health and Social Sciences, Berlin, Germany
| | - Per Teigelack
- Department for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro-and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Corinna Pfeiffer
- Department for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro-and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Anita Robitzsch
- Department for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro-and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Nora Dörrie
- Department for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro-and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Eva-Maria Skoda
- Department for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro-and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Alexander Bäuerle
- Department for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro-and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Madeleine Fink
- Department for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro-and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Martin Teufel
- Department for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro-and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
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Onagawa R, Muraoka Y, Hagura N, Takemi M. An investigation of the effectiveness of neurofeedback training on motor performance in healthy adults: A systematic review and meta-analysis. Neuroimage 2023; 270:120000. [PMID: 36870431 DOI: 10.1016/j.neuroimage.2023.120000] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/26/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
Neurofeedback training (NFT) refers to a training where the participants voluntarily aim to manipulate their own brain activity using the sensory feedback abstracted from their brain activity. NFT has attracted attention in the field of motor learning due to its potential as an alternative or additional training method for general physical training. In this study, a systematic review of NFT studies for motor performance improvements in healthy adults and a meta-analysis on the effectiveness of NFT were conducted. A computerized search was performed using the databases Web of Science, Scopus, PubMed, JDreamIII, and Ichushi-Web to identify relevant studies published between January 1st, 1990, and August 3rd, 2021. Thirty-three studies were identified for the qualitative synthesis and 16 randomized controlled trials (374 subjects) for the meta-analysis. The meta-analysis, including all trials found in the search, revealed significant effects of NFT for motor performance improvement examined at the timing after the last NFT session (standardized mean difference = 0.85, 95% CI [0.18-1.51]), but with the existence of publication biases and substantial heterogeneity among the trials. Subsequent meta-regression analysis demonstrated the dose-response gradient between NFTs and motor performance improvements; more than 125 min of cumulative training time may benefit for the subsequent motor performance. For each motor performance measure (e.g., speed, accuracy, and hand dexterity), the effectiveness of NFT remains inconclusive, mainly due to its small sample sizes. More empirical NFT studies for motor performance improvement may be needed to show beneficial effects on motor performance and to safely incorporate NFT into real-world scenarios.
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Affiliation(s)
- Ryoji Onagawa
- Faculty of Science and Engineering, Waseda University, Tokyo, Japan.
| | - Yoshihito Muraoka
- Graduate School of Science and Technology, Keio University, Kanagawa, Japan
| | - Nobuhiro Hagura
- Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology, Osaka, Japan; Graduate School of Frontiers Biosciences, Osaka University, Osaka, Japan
| | - Mitsuaki Takemi
- Graduate School of Science and Technology, Keio University, Kanagawa, Japan.
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Lockhart AK, Sharpley CF, Bitsika V. Mu Desynchronisation in Autistic Individuals: What We Know and What We Need to Know. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2023. [DOI: 10.1007/s40489-023-00354-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
AbstractAutism spectrum disorder (ASD) is a neurodevelopmental condition that includes social-communication deficits and repetitive and stereotypical behaviours (APA 2022). Neurobiological methods of studying ASD are a promising methodology for identifying ASD biomarkers. Mu rhythms (Mu) have the potential to shed light on the socialisation deficits that characterise ASD; however, Mu/ASD studies thus far have yielded inconsistent results. This review examines the existing Mu/ASD studies to determine where this variability lies to elucidate potential factors that can be addressed in future studies.
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Selaskowski B, Asché LM, Wiebe A, Kannen K, Aslan B, Gerding TM, Sanchez D, Ettinger U, Kölle M, Lux S, Philipsen A, Braun N. Gaze-based attention refocusing training in virtual reality for adult attention-deficit/hyperactivity disorder. BMC Psychiatry 2023; 23:74. [PMID: 36703134 PMCID: PMC9879564 DOI: 10.1186/s12888-023-04551-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 01/16/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is characterized by substantial interindividual heterogeneity that challenges the systematic assessment and treatment. Considering mixed evidence from previous neurofeedback research, we present a novel feedback system that relies on gaze behavior to detect signs of inattention while performing a neuropsychological attention task in a virtual seminar room. More specifically, an audiovisual feedback was given whenever participants averted their gaze from the given task. METHODS Eighteen adults with ADHD and 18 healthy controls performed a continuous performance task (CPT) in virtual reality under three counterbalanced conditions in which either gaze-based feedback, sham feedback, or no feedback was provided. In all conditions, phases of high and low virtual distraction alternated. CPT errors and reaction times, proportions of gaze dwell times (e.g., task focus or distraction focus), saccade characteristics, EEG theta/beta ratios, head movements, and an experience sampling of ADHD symptoms were analyzed. RESULTS While patients can be discriminated well from healthy controls in that they showed more omission errors, higher reaction times, higher distraction-related dwell times, and more head movements, the feedback did not immediately improve task performance. It was also indicated that sham feedback was rather associated with an aggravation of symptoms in patients. CONCLUSIONS Our findings demonstrate sufficient suitability and specificity for this holistic ADHD symptom assessment. Regarding the feedback, a single-session training was insufficient to achieve learning effects based on the proposed metacognitive strategies. Future longitudinal, multi-session trials should conclusively examine the therapeutic efficacy of gaze-based virtual reality attention training in ADHD. TRIAL REGISTRATION drks.de (identifier: DRKS00022370).
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Affiliation(s)
- Benjamin Selaskowski
- grid.15090.3d0000 0000 8786 803XDepartment of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Laura Marie Asché
- grid.15090.3d0000 0000 8786 803XDepartment of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Annika Wiebe
- grid.15090.3d0000 0000 8786 803XDepartment of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Kyra Kannen
- grid.15090.3d0000 0000 8786 803XDepartment of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Behrem Aslan
- grid.15090.3d0000 0000 8786 803XDepartment of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Thiago Morano Gerding
- grid.15090.3d0000 0000 8786 803XDepartment of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Dario Sanchez
- grid.15090.3d0000 0000 8786 803XDepartment of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Ulrich Ettinger
- grid.10388.320000 0001 2240 3300Department of Psychology, University of Bonn, Bonn, Germany
| | - Markus Kölle
- grid.15090.3d0000 0000 8786 803XDepartment of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Silke Lux
- grid.15090.3d0000 0000 8786 803XDepartment of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Alexandra Philipsen
- grid.15090.3d0000 0000 8786 803XDepartment of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Niclas Braun
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany.
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Lim CG, Soh CP, Lim SSY, Fung DSS, Guan C, Lee TS. Home-based brain-computer interface attention training program for attention deficit hyperactivity disorder: a feasibility trial. Child Adolesc Psychiatry Ment Health 2023; 17:15. [PMID: 36698168 PMCID: PMC9878772 DOI: 10.1186/s13034-022-00539-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 11/29/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is a prevalent child neurodevelopmental disorder that is treated in clinics and in schools. Previous trials suggested that our brain-computer interface (BCI)-based attention training program could improve ADHD symptoms. We have since developed a tablet version of the training program which can be paired with wireless EEG headsets. In this trial, we investigated the feasibility of delivering this tablet-based BCI intervention at home. METHODS Twenty children diagnosed with ADHD, who did not receive any medication for the preceding month, were randomised to receive the 8-week tablet-based BCI intervention either in the clinic or at home. Those in the home intervention group received instructions before commencing the program and got reminders if they were lagging on the training sessions. The ADHD Rating Scale was completed by a blinded clinician at baseline and at week 8. Adverse events were monitored during any contact with the child throughout the trial and at week 8. RESULTS Children in both groups could complete the tablet-based intervention easily on their own with minimal support from the clinic therapist or their parents (at home). The intervention was safe with few reported adverse effects. Clinician-rated inattentive symptoms on the ADHD-Rating Scale reduced by 3.2 (SD 6.20) and 3.9 (SD 5.08) for the home-based and clinic-based groups respectively, suggesting that home-based intervention was comparable to clinic-based intervention. CONCLUSIONS This trial demonstrated that the tablet version of our BCI-based attention training program can be safely delivered to children in the comfort of their own home. Trial registration This trial is registered at clinicaltrials.gov as NCT01344044.
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Affiliation(s)
- Choon Guan Lim
- Department of Developmental Psychiatry, Institute of Mental Health, 10, Buangkok View, Singapore, 539747, Singapore.
| | - Chui Pin Soh
- grid.414752.10000 0004 0469 9592Department of Developmental Psychiatry, Institute of Mental Health, 10, Buangkok View, Singapore, 539747 Singapore
| | - Shernice Shi Yun Lim
- grid.414752.10000 0004 0469 9592Department of Developmental Psychiatry, Institute of Mental Health, 10, Buangkok View, Singapore, 539747 Singapore
| | - Daniel Shuen Sheng Fung
- grid.414752.10000 0004 0469 9592Department of Developmental Psychiatry, Institute of Mental Health, 10, Buangkok View, Singapore, 539747 Singapore
| | - Cuntai Guan
- grid.59025.3b0000 0001 2224 0361School of Computer Science and Engineering, Nanyang Technological University, Singapore, Singapore
| | - Tih-Shih Lee
- grid.428397.30000 0004 0385 0924Neuroscience and Behavioral Disorders Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
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23
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Evaluation of Neurofeedback Learning in Patients with ADHD: A Systematic Review. Appl Psychophysiol Biofeedback 2023; 48:11-25. [PMID: 36178643 PMCID: PMC9908642 DOI: 10.1007/s10484-022-09562-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2022] [Indexed: 11/02/2022]
Abstract
NFB has a clear potential as a recognised treatment option for ADHD, but suffers from a lack of clarity about its efficacy, still unresolved after multiple controlled trials. Comparing learners and non-learners based on the evolution of patient-level indicators during the trial serves as a 'natural' control, and can help elucidate the mechanisms of NFB. We present a systematic review motivated by the need to establish the state of the art of patient learning during NFB treatment in current clinical literature. One particularly striking question we would like to answer here is whether existing NFB papers study learning variability, since only individual performance differences can give us information about mechanisms of learning. The results show that very few clinical trial reports have dealt with the heterogeneity of NFB learning, nor analysed whether NFB efficacy is dependent on NFB learning, even though NFB is believed to be a treatment based on learning to perform. In this systematic review we examine not only what has been reported, but also provide a critical analysis of possible flaws or gaps in existing studies, and discuss why no generalized conclusions about NFB efficacy have yet been made. Future research should focus on finding reliable ways of identifying the performers and studying participants' individual learning trajectories as it might enhance prognosis and the allocation of clinical resources.
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24
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Westwood SJ, Criaud M, Lam SL, Lukito S, Wallace-Hanlon S, Kowalczyk OS, Kostara A, Mathew J, Agbedjro D, Wexler BE, Cohen Kadosh R, Asherson P, Rubia K. Transcranial direct current stimulation (tDCS) combined with cognitive training in adolescent boys with ADHD: a double-blind, randomised, sham-controlled trial. Psychol Med 2023; 53:497-512. [PMID: 34225830 PMCID: PMC9899574 DOI: 10.1017/s0033291721001859] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/19/2021] [Accepted: 04/22/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) could be a side-effect-free alternative to psychostimulants in attention-deficit/hyperactivity disorder (ADHD). Although there is limited evidence for clinical and cognitive effects, most studies were small, single-session and stimulated left dorsolateral prefrontal cortex (dlPFC). No sham-controlled study has stimulated the right inferior frontal cortex (rIFC), which is the most consistently under-functioning region in ADHD, with multiple anodal-tDCS sessions combined with cognitive training (CT) to enhance effects. Thus, we investigated the clinical and cognitive effects of multi-session anodal-tDCS over rIFC combined with CT in double-blind, randomised, sham-controlled trial (RCT, ISRCTN48265228). METHODS Fifty boys with ADHD (10-18 years) received 15 weekday sessions of anodal- or sham-tDCS over rIFC combined with CT (20 min, 1 mA). ANCOVA, adjusting for baseline measures, age and medication status, tested group differences in clinical and ADHD-relevant executive functions at posttreatment and after 6 months. RESULTS ADHD-Rating Scale, Conners ADHD Index and adverse effects were significantly lower at post-treatment after sham relative to anodal tDCS. No other effects were significant. CONCLUSIONS This rigorous and largest RCT of tDCS in adolescent boys with ADHD found no evidence of improved ADHD symptoms or cognitive performance following multi-session anodal tDCS over rIFC combined with CT. These findings extend limited meta-analytic evidence of cognitive and clinical effects in ADHD after 1-5 tDCS sessions over mainly left dlPFC. Given that tDCS is commercially and clinically available, the findings are important as they suggest that rIFC stimulation may not be indicated as a neurotherapy for cognitive or clinical remediation for ADHD.
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Affiliation(s)
- Samuel J. Westwood
- Department of Child & Adolescent Psychiatry, King's College London, London, UK
| | - Marion Criaud
- Department of Child & Adolescent Psychiatry, King's College London, London, UK
| | - Sheut-Ling Lam
- Department of Child & Adolescent Psychiatry, King's College London, London, UK
| | - Steve Lukito
- Department of Child & Adolescent Psychiatry, King's College London, London, UK
| | | | - Olivia S. Kowalczyk
- Department of Child & Adolescent Psychiatry, King's College London, London, UK
- Department of Neuroimaging, King's College London, London, UK
| | - Afroditi Kostara
- Department of Child & Adolescent Psychiatry, King's College London, London, UK
| | - Joseph Mathew
- Department of Child & Adolescent Psychiatry, King's College London, London, UK
| | | | - Bruce E. Wexler
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Roi Cohen Kadosh
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Philip Asherson
- Social Genetic & Developmental Psychiatry, King's College London, London, UK
| | - Katya Rubia
- Department of Child & Adolescent Psychiatry, King's College London, London, UK
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25
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Pindi P, Houenou J, Piguet C, Favre P. Real-time fMRI neurofeedback as a new treatment for psychiatric disorders: A meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry 2022; 119:110605. [PMID: 35843369 DOI: 10.1016/j.pnpbp.2022.110605] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/12/2022] [Accepted: 07/11/2022] [Indexed: 10/17/2022]
Abstract
Neurofeedback using real-time functional MRI (RT-fMRI-NF) is an innovative technique that allows to voluntarily modulate a targeted brain response and its associated behavior. Despite promising results in the current literature, its effectiveness on symptoms management in psychiatric disorders is not yet clearly demonstrated. Here, we provide 1) a state-of-art qualitative review of RT-fMRI-NF studies aiming at alleviating clinical symptoms in a psychiatric population; 2) a quantitative evaluation (meta-analysis) of RT-fMRI-NF effectiveness on various psychiatric disorders and 3) methodological suggestions for future studies. Thirty-one clinical trials focusing on psychiatric disorders were included and categorized according to standard diagnostic categories. Among the 31 identified studies, 22 consisted of controlled trials, of which only eight showed significant clinical improvement in the experimental vs. control group after the training. Nine studies found an effect at follow-up on ADHD symptoms, emotion dysregulation, facial emotion processing, depressive symptoms, hallucinations, psychotic symptoms, and specific phobia. Within-group meta-analysis revealed large effects of the NF training on depressive symptoms right after the training (g = 0.81, p < 0.01) and at follow-up (g = 1.19, p < 0.01), as well as medium effects on anxiety (g = 0.44, p = 0.01) and emotion regulation (g = 0.48, p < 0.01). Between-group meta-analysis showed a medium effect on depressive symptoms (g = 0.49, p < 0.01) and a large effect on anxiety (g = 0.77, p = 0.01). However, the between-studies heterogeneity is very high. The use of RT-fMRI-NF as a treatment for psychiatric symptoms is promising, however, further double-blind, multicentric, randomized-controlled trials are warranted.
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Affiliation(s)
- Pamela Pindi
- Paris Est Créteil University (UPEC), INSERM U955, IMRB, Translational Neuro-psychiatry Team, AP-HP, DMU IMPACT, Mondor University Hospitals, FondaMental Foundation, F-94010 Créteil, France; Paris-Saclay University, Neurospin, CEA, UNIACT Lab, PsyBrain Team, F-91191 Gif-sur-Yvette, France
| | - Josselin Houenou
- Paris Est Créteil University (UPEC), INSERM U955, IMRB, Translational Neuro-psychiatry Team, AP-HP, DMU IMPACT, Mondor University Hospitals, FondaMental Foundation, F-94010 Créteil, France; Paris-Saclay University, Neurospin, CEA, UNIACT Lab, PsyBrain Team, F-91191 Gif-sur-Yvette, France.
| | - Camille Piguet
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Campus Biotech, Geneva, Switzerland
| | - Pauline Favre
- Paris Est Créteil University (UPEC), INSERM U955, IMRB, Translational Neuro-psychiatry Team, AP-HP, DMU IMPACT, Mondor University Hospitals, FondaMental Foundation, F-94010 Créteil, France; Paris-Saclay University, Neurospin, CEA, UNIACT Lab, PsyBrain Team, F-91191 Gif-sur-Yvette, France
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26
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Hao Z, He C, Ziqian Y, Haotian L, Xiaoli L. Neurofeedback training for children with ADHD using individual beta rhythm. Cogn Neurodyn 2022; 16:1323-1333. [PMID: 36408061 PMCID: PMC9666577 DOI: 10.1007/s11571-022-09798-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 03/03/2022] [Accepted: 03/08/2022] [Indexed: 11/29/2022] Open
Abstract
Neurofeedback training (NFT) is a noninvasive neuromodulation method for children with attention-deficit/hyperactivity disorder (ADHD). Brain rhythms, the unique pattern in electroencephalogram (EEG), are widely used as the training target. Most of current studies used a fixed frequency division of brain rhythms, which ignores the individual developmental difference of each child. In this study, we validated the feasibility of NFT using individual beta rhythm. A total of 55 children with ADHD were divided into two groups using the relative power of individual or fixed beta rhythms as the training index. ADHD rating scale (ADHD-RS) was completed before and after NFT, and the EEG and behavioral features were extracted during the training process. After intervention, the attention ability of both groups was significantly improved, showing a significant increase in beta power, a decrease in scores of ADHD-RS and an improvement in behavioral and other EEG features. The training effect was significantly better with individualized beta training, showing more improvement in ADHD-RS scores. Furthermore, the distribution of brain rhythms moved towards high frequency after intervention. This study demonstrates the effectiveness of NFT based on individual beta rhythm for the intervention of children with ADHD. When designing a NFT protocol and the corresponding data analysis process, an individualized brain rhythm division should be applied to reflect the actual brain state and to accurately evaluate the effect of NFT.
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Affiliation(s)
- Zhang Hao
- The State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875 China
| | - Chen He
- The State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875 China
- School of Systems Science, Beijing Normal University, Beijing, 100875 China
| | - Yuan Ziqian
- The State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875 China
| | - Liao Haotian
- The State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875 China
| | - Li Xiaoli
- The State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875 China
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27
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McGough JJ. Neurofeedback for ADHD: Time to Call It Quits? Am J Psychiatry 2022; 179:888-889. [PMID: 36453036 DOI: 10.1176/appi.ajp.20220861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Affiliation(s)
- James J McGough
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles
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28
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Additive effects of EEG neurofeedback on medications for ADHD: a systematic review and meta-analysis. Sci Rep 2022; 12:20401. [PMID: 36437272 PMCID: PMC9701807 DOI: 10.1038/s41598-022-23015-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 10/21/2022] [Indexed: 11/29/2022] Open
Abstract
To elucidate possible additive effects of electroencephalogram-based neurofeedback (EEG-NF) on medications against the core symptoms of attention-deficit/hyperactivity disorder (ADHD), randomized controlled trials (RCTs) were retrieved from electronic databases including PubMed, EMBASE, ClinicalKey, Cochrane CENTRAL, ScienceDirect, and ClinicalTrials.gov from inception to March 2022. The primary outcomes were changes in ADHD symptoms (i.e., global, inattention, hyperactivity/impulsivity) assessed with validated rating scales, while secondary outcome was all-cause discontinuation rate. Meta-analysis of five RCTs involving 305 participants [Median age = 9.285 years (range 8.6-11.05)] with a median follow-up of 12 weeks showed additive effects of EEG-NF on medications from parents' observations against ADHD global symptoms (Hedges' g = 0.2898, 95%CI [0.0238; 0.5557]) and inattention symptoms (Hedges' g = 0.3274, 95%CI [0.0493; 0.6055]). However, additive effects failed to sustain six months after EEG-NF intervention. Besides, there was no difference in improvement of hyperactivity/impulsivity from parents' observation, attentional performance, and all-cause discontinuation rate between the two groups. Our results supported additional benefits of combining EEG-NF with medications compared to medication alone in treating global symptoms and symptoms of inattention in ADHD patients. Nevertheless, given a lack of evidence showing a correlation between underlying physiological changes and small effect sizes in our preliminary results, further studies are warranted to support our findings.
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29
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The Effects of Different Theta and Beta Neurofeedback Training Protocols on Cognitive Control in ADHD. JOURNAL OF COGNITIVE ENHANCEMENT 2022; 6:463-477. [PMID: 36373033 PMCID: PMC9638270 DOI: 10.1007/s41465-022-00255-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 10/20/2022] [Indexed: 11/06/2022]
Abstract
Neurofeedback (NF) is an important treatment for attention deficit/hyperactivity disorder (ADHD). In ADHD, cognitive control deficits pose considerable problems to patients. However, NF protocols are not yet optimized to enhance cognitive control alongside with clinical symptoms, partly because they are not driven by basic cognitive neuroscience. In this study, we evaluated different EEG theta and/or beta frequency band NF protocols designed to enhance cognitive control. Participants were n = 157 children and adolescents, n = 129 of them were patients with ADHD (n = 28 typically developing (TD) controls). Patients with ADHD were divided into five groups in the order of referral, with four of them taking part in different NF protocols systematically varying theta and beta power. The fifth ADHD group and the TD group did not undergo NF. All NF protocols resulted in reductions of ADHD symptoms. Importantly, only when beta frequencies were enhanced during NF (without any theta regulation or in combination with theta upregulation), consistent enhancing effects in both response inhibition and conflict control were achieved. The theta/beta NF protocol most widely used in clinical settings revealed comparatively limited effects. Enhancements in beta band activity are key when aiming to improve cognitive control functions in ADHD. This calls for a change in the use of theta/beta NF protocols and shows that protocols differing from the current clinical standard are effective in enhancing important facets of cognitive control in ADHD. Further studies need to examine regulation data within the neurofeedback sessions to provide more information about the mechanisms underlying the observed effects.
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30
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Abouzari M, Tawk K, Lee D, Djalilian HR. Migrainous Vertigo, Tinnitus, and Ear Symptoms and Alternatives. Otolaryngol Clin North Am 2022; 55:1017-1033. [PMID: 36150941 PMCID: PMC9580398 DOI: 10.1016/j.otc.2022.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Migraine headaches frequently coexist with vestibular symptoms such as vertigo, motion sickness, and gait instability. Migraine-related vasospasm can also damage the inner ear, which results in symptoms such as sudden sensorineural hearing loss and resultant tinnitus. The pathophysiology of these symptoms is not yet fully understood, and despite their prevalence, there is no universally approved management. This review summarizes the data on complementary and integrative medicine in treating patients with migrainous ear disorders.
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Affiliation(s)
- Mehdi Abouzari
- Division of Neurotology and Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, 19182 Jamboree Road, Otolaryngology-5386, Irvine, CA 92697, USA
| | - Karen Tawk
- Division of Neurotology and Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, 19182 Jamboree Road, Otolaryngology-5386, Irvine, CA 92697, USA
| | - Darlene Lee
- Susan Samueli Integrative Health Institute, University of California, 5141 California Avenue, Suite 200B, Irvine, CA 92617, USA
| | - Hamid R Djalilian
- Division of Neurotology and Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, 19182 Jamboree Road, Otolaryngology-5386, Irvine, CA 92697, USA; Department of Biomedical Engineering, University of California, Irvine, USA.
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31
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Mosayebi R, Dehghani A, Hossein-Zadeh GA. Dynamic functional connectivity estimation for neurofeedback emotion regulation paradigm with simultaneous EEG-fMRI analysis. Front Hum Neurosci 2022; 16:933538. [PMID: 36188168 PMCID: PMC9524189 DOI: 10.3389/fnhum.2022.933538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 08/22/2022] [Indexed: 11/15/2022] Open
Abstract
Joint Analysis of EEG and fMRI datasets can bring new insight into brain mechanisms. In this paper, we employed the recently introduced Correlated Coupled Tensor Matrix Factorization (CCMTF) method for analysis of the emotion regulation paradigm based on EEG frontal asymmetry neurofeedback in the alpha frequency band with simultaneous fMRI. CCMTF method assumes that the co-variations of the common dimension (temporal dimension) between EEG and fMRI are correlated and not necessarily identical. The results of the CCMTF method suggested that EEG and fMRI had similar covariations during the transition of brain activities from resting states to task (view and upregulation) states and these covariations followed an increasing trend. The fMRI shared spatial component showed activations in the limbic system, DLPFC, OFC, and VLPC regions, which were consistent with the previous studies and were linked to EEG frequency patterns in the range of 1–15 Hz with a correlation value close to 0.75. The estimated regions from the CCMTF method were then used as the candidate nodes for dynamic functional connectivity (dFC) analysis, in which the changes in connectivity from view to upregulation states were examined. The results of the dFC analysis were compared with a Normalized Mutual information (NMI) based approach in two different frequency ranges (1–15 and 15–40 Hz) as the NMI method was applied to the vectors of dFC nodes of EEG and fMRI data. The results of the two methods illustrated that the relation between EEG and fMRI datasets was mostly in the frequency range of 1–15 Hz. These relations were both in the brain activations and the dFCs between the two modalities. This paper suggests that the CCMTF method is a capable approach for extracting the shared information between EEG and fMRI data and can reveal new information about brain functions and their connectivity without solving the EEG inverse problem or analyzing different frequency bands.
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Affiliation(s)
- Raziyeh Mosayebi
- School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran
- *Correspondence: Raziyeh Mosayebi,
| | - Amin Dehghani
- School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran
| | - Gholam-Ali Hossein-Zadeh
- School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran
- School of Cognitive Sciences, Institute for Research in Fundamental Sciences (IPM), Tehran, Iran
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32
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Hasslinger J, Meregalli M, Bölte S. How standardized are “standard protocols”? Variations in protocol and performance evaluation for slow cortical potential neurofeedback: A systematic review. Front Hum Neurosci 2022; 16:887504. [PMID: 36118975 PMCID: PMC9478392 DOI: 10.3389/fnhum.2022.887504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 07/26/2022] [Indexed: 11/16/2022] Open
Abstract
Neurofeedback (NF) aims to alter neural activity by enhancing self-regulation skills. Over the past decade NF has received considerable attention as a potential intervention option for many somatic and mental conditions and ADHD in particular. However, placebo-controlled trials have demonstrated insufficient superiority of NF compared to treatment as usual and sham conditions. It has been argued that the reason for limited NF effects may be attributable to participants' challenges to self-regulate the targeted neural activity. Still, there is support of NF efficacy when only considering so-called “standard protocols,” such as Slow Cortical Potential NF training (SCP-NF). This PROSPERO registered systematic review following PRISMA criteria searched literature databases for studies applying SCP-NF protocols. Our review focus concerned the operationalization of self-regulatory success, and protocol-details that could influence the evaluation of self-regulation. Such details included; electrode placement, number of trials, length per trial, proportions of training modalities, handling of artifacts and skill-transfer into daily-life. We identified a total of 63 eligible reports published in the year 2000 or later. SCP-NF protocol-details varied considerably on most variables, except for electrode placement. However, due to the increased availability of commercial systems, there was a trend to more uniform protocol-details. Although, token-systems are popular in SCP-NF for ADHD, only half reported a performance-based component. Also, transfer exercises have become a staple part of SCP-NF. Furthermore, multiple operationalizations of regulatory success were identified, limiting comparability between studies, and perhaps usefulness of so-called transfer-exercises, which purpose is to facilitate the transfer of the self-regulatory skills into every-day life. While studies utilizing SCP as Brain-Computer-Interface mainly focused on the acquisition of successful self-regulation, clinically oriented studies often neglected this. Congruently, rates of successful regulators in clinical studies were mostly low (<50%). The relation between SCP self-regulation and behavior, and how symptoms in different disorders are affected, is complex and not fully understood. Future studies need to report self-regulation based on standardized measures, in order to facilitate both comparability and understanding of the effects on symptoms. When applied as treatment, future SCP-NF studies also need to put greater emphasis on the acquisition of self-regulation (before evaluating symptom outcomes).
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Affiliation(s)
- John Hasslinger
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet & Stockholm Healthcare Services, Region Stockholm, Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Healthcare Services, Region Stockholm, Stockholm, Sweden
- *Correspondence: John Hasslinger
| | - Micaela Meregalli
- Child and Adolescent Psychiatry, Stockholm Healthcare Services, Region Stockholm, Stockholm, Sweden
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet & Stockholm Healthcare Services, Region Stockholm, Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Healthcare Services, Region Stockholm, Stockholm, Sweden
- Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, Perth, WA, Australia
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33
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Liao YC, Guo NW, Su BY, Chen SJ, Tsai HF. Effects of Twenty Hours of Neurofeedback-Based Neuropsychotherapy on the Executive Functions and Achievements among ADHD Children. Clin EEG Neurosci 2022; 53:387-398. [PMID: 35611492 DOI: 10.1177/15500594221101693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective. Neurofeedback can reduce ADHD symptoms; however, current programs are relatively long, with fewer concerns about executive function (EF). The present study aimed to investigate a 20-hour combined computerized training neurofeedback program. Methods. Fifty ADHD children were randomly assigned to either the experimental group (EXP) or the wait-list control group (CON), who took training after the post-tests. The EF measures were the Tower of London (ToL), Wisconsin Card Sorting Test (WCST), and Comprehensive Nonverbal Attention Test (CNAT). SNAP-IV and questionnaires reported by parents constituted the behavioral measures. Two-way repeated-measures ANOVA and bootstrapping dependent t-tests were also used. Results. The F-tests revealed the interaction effects on ADHD symptoms and math scores. The EXP had increased the ToL scores, decreased the error and perseverative error rates on WCST, as well as the dysexecutive index on CNAT in the t-test. Conclusions. The training effects were related to behavioral symptoms and functions, EFs, and generalized achievement performances. We suggest that future studies could apply to different patients and examine the maintenance of the program.
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Affiliation(s)
- Yu-Chi Liao
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan.,Clinical Psychology Center, Asia University Hospital, Taichung, Taiwan
| | - Nai-Wen Guo
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Taichung, Taiwan.,Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Taichung, Taiwan
| | - Bei-Yi Su
- Department of Psychology, Chung-Shan Medical University, Taichung, Taiwan.,Room of Clinical Psychology, Chung Shan Medical University Hospital, Taichung, Taiwan
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34
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Nermend M, Flaga-Gieruszyńska K, Kroplewski Z, Nermend K. Neurological Mechanisms of Diagnosis and Therapy in School Children with ADHD in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137615. [PMID: 35805275 PMCID: PMC9265331 DOI: 10.3390/ijerph19137615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/15/2022] [Accepted: 06/21/2022] [Indexed: 11/24/2022]
Abstract
The paper aims to present a holistic view of attention deficit hyperactivity disorder (ADHD) in pedagogical, psychological, legal, and social dimensions in Polish schools. The authors present the benefits of neurofeedback therapy for elementary school pupils. In order to verify the validity, the paper compares the concordance of a medical diagnosis confirming ADHD syndrome with the occurrence of abnormal electrical brain function recording and abnormalities therein as well as the effectiveness of the neurofeedback therapy. The study confirms that the reported problems faced by pupils and affecting their emotional functioning are reflected in their EEG records. Conclusions from the study lead to the proposal that the neurofeedback assessment should be performed at schools, which should result in the implementation of effective therapy. Moreover, the neurofeedback method should be promoted in Polish schools as an alternative to pharmacological therapy, which, as the research proves, is not always effective. Neurofeedback therapy, similarly to behavioral therapy, is very much needed and useful because it provides optimal conditions for the child’s development and shapes their relations with the environment effectively and harmlessly.
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Affiliation(s)
- Małgorzata Nermend
- Department of Early Education, University of Szczecin, 71-004 Szczecin, Poland;
| | - Kinga Flaga-Gieruszyńska
- Research Team on Civil Procedural Law and Informatization of the Justice, Faculty of Law and Administration, University of Szczecin, 71-101 Szczecin, Poland;
| | - Zdzisław Kroplewski
- Institute of Psychology, University of Szczecin, Krakowska 69, 71-017 Szczecin, Poland;
| | - Kesra Nermend
- Department of Decision Support Methods and Cognitive Neuroscience, Institute of Management, University of Szczecin, 71-004 Szczecin, Poland
- Correspondence:
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Fan HY, Sun CK, Cheng YS, Chung W, Tzang RF, Chiu HJ, Ho CN, Hung KC. A pilot meta-analysis on self-reported efficacy of neurofeedback for adolescents and adults with ADHD. Sci Rep 2022; 12:9958. [PMID: 35705685 PMCID: PMC9200800 DOI: 10.1038/s41598-022-14220-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 06/02/2022] [Indexed: 12/31/2022] Open
Abstract
Self-reported effectiveness of electroencephalogram-based neurofeedback (EEG-NF) against the core symptoms of attention-deficit hyperactivity disorder (ADHD) in adolescents/adults remains unclear. We searched PubMed, Embase, ClinicalKey, Cochrane CENTRAL, ScienceDirect, Web of Science, and ClinicalTrials.gov from inception to August 2021 for randomized clinical trials (RCTs) of EEG-NF with self-reported ADHD symptom ratings. Comparators included participants on waitlist/treatment as usual (TAU) or receiving other interventions. Of the 279 participants (mean age = 23.48; range: 6-60) in five eligible RCTs, 183 received EEG-NF treatment. Forest plot demonstrated no difference in inattention (SMD = -0.11, 95% CI -0.39-0.18, p = 0.46), total score (SMD = -0.08, 95% CI -0.36-0.2, p = 0.56), and hyperactivity/impulsivity (SMD = 0.01, 95% CI -0.23-0.25, p = 0.91) between EEG-NF and comparison groups. Nevertheless, compared with waitlist/TAU, EEG-NF showed better improvement in inattention (SMD = -0.48, 95% CI -0.9--0.06, p = 0.03) but not hyperactivity/impulsivity (SMD = -0.03, 95% CI -0.45-0.38, p = 0.87). Follow-up 6-12 months demonstrated no difference in inattention (SMD = -0.01, 95% CI -0.41-0.38, p = 0.94), total score (SMD = 0.22, 95% CI -0.08-0.52, p = 0.15), and hyperactivity/impulsivity (SMD = -0.01, 95% CI -0.27-0.26, p = 0.96) between the two groups. Dropout rate also showed no difference (RR = 1.05, 95% CI 0.82-1.33, p = 0.72). Our results support EEG-NF for improving inattention in adolescents/young adults, although its effectiveness against hyperactivity/impulsivity remains inconclusive.
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Affiliation(s)
- Hsin-Yi Fan
- Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ais Home, Taiwan
| | - Cheuk-Kwan Sun
- Department of Emergency Medicine, E-Da Hospital, Kaohsiung City, Taiwan.,School of Medicine for International Students, I-Shou University, Kaohsiung City, Taiwan
| | - Yu-Shian Cheng
- Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ais Home, Taiwan.,Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung City, Taiwan
| | - Weilun Chung
- Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ais Home, Taiwan
| | - Ruu-Fen Tzang
- Department of Psychiatry, Mackay Memorial Hospital, Taipei City, Taiwan
| | - Hsien-Jane Chiu
- Taoyuan Psychiatric Center, Ministry of Health and Welfare, Taoyuan City, Taiwan.,Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei City, Taiwan
| | - Chun-Ning Ho
- Department of Anesthesiology, Chi Mei Medical Center, No. 901, ChungHwa Road, YungKung Dist, Tainan, 71004, Taiwan
| | - Kuo-Chuan Hung
- Department of Anesthesiology, Chi Mei Medical Center, No. 901, ChungHwa Road, YungKung Dist, Tainan, 71004, Taiwan.
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Wang FH, Sun LY, Cui XM, Zhao HD, Yang LF, Wang Z, Shi TK. Comparative efficacy of targeted structural patterns of electroencephalography neurofeedback in children with inattentive or combined attention deficit hyperactivity disorder. Brain Behav 2022; 12:e2572. [PMID: 35462456 PMCID: PMC9226819 DOI: 10.1002/brb3.2572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/08/2022] [Accepted: 03/20/2022] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate and compare the effects of three courses of different structural patterns of electroencephalography neurofeedback on predominantly inattentive attention deficit hyperactivity disorder (ADHD-PI) and combined ADHD (ADHD-CT). METHODS Thirty-eight ADHD-PI and ADHD-CT children were selected and completed three courses of different structural patterns of electroencephalography neurofeedback according to their ADHD type. Before and after each course, relative power value of electroencephalography, including θ, β, α, SMR and their ratios (θ/β, θ/α), and eighteen integrated visual and auditory continuous performance test (IVA/CPT) quotients were obtained and compared. Data were analyzed by SPSS software, and p < .05 was considered statistically significant. RESULTS After one course, θ, three IVA/CPT quotients in both types and two comprehensive quotients in ADHD-CT changed significantly (all p < .05). After two courses, θ/α, θ/β and five IVA/CPT quotients in both types, θ and α in ADHD-PI, four comprehensive quotients, and four respond control quotients in ADHD-CT varied significantly compared to before treatment and after one course (all p < .05). After three courses, α, β, θ, θ/α, θ/β and ten IVA/CPT quotients in both types changed significantly compared to before treatment and after one course (all p < .05). In addition, six IVA/CPT quotients in both types after three courses were significantly higher than those after two courses (all p < .05). CONCLUSION Different structural patterns of electroencephalography neurofeedback targeted for ADHD-CT and ADHD-PI were both effective and feasible. Three courses of EEG neurofeedback were most effective.
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Affiliation(s)
- Feng-Hua Wang
- School of Medicine, Jiaxing University, Jiaxing, China
| | - Li-Yan Sun
- School of Medicine, Jiaxing University, Jiaxing, China
| | - Xiao-Mei Cui
- Women's and Children's Hospital Affiliated to Jiaxing University, Jiaxing, China
| | | | - Ling-Fei Yang
- School of Medicine, Jiaxing University, Jiaxing, China
| | - Zheng Wang
- School of Medicine, Jiaxing University, Jiaxing, China
| | - Tong-Kun Shi
- School of Medicine, Jiaxing University, Jiaxing, China
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Westwood SJ, Bozhilova N, Criaud M, Lam SL, Lukito S, Wallace-Hanlon S, Kowalczyk OS, Kostara A, Mathew J, Wexler BE, Kadosh RC, Asherson P, Rubia K. The effect of transcranial direct current stimulation (tDCS) combined with cognitive training on EEG spectral power in adolescent boys with ADHD: A double-blind, randomized, sham-controlled trial. IBRO Neurosci Rep 2022; 12:55-64. [PMID: 35746969 PMCID: PMC9210460 DOI: 10.1016/j.ibneur.2021.12.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 12/19/2021] [Indexed: 12/19/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) is a possible alternative to psychostimulants in Attention-Deficit/Hyperactivity Disorder (ADHD), but its mechanisms of action in children and adolescents with ADHD are poorly understood. We conducted the first 15-session, sham-controlled study of anodal tDCS over right inferior frontal cortex (rIFC) combined with cognitive training (CT) in 50 children/adolescents with ADHD. We investigated the mechanisms of action on resting and Go/No-Go Task-based QEEG measures in a subgroup of 23 participants with ADHD (n, sham = 10; anodal tDCS = 13). We failed to find a significant sham versus anodal tDCS group differences in QEEG spectral power during rest and Go/No-Go Task performance, a correlation between QEEG and Go/No-Go Task performance, and changes in clinical and cognitive measures. These findings extend the non-significant clinical and cognitive effects in our sample of 50 children/adolescents with ADHD. Given that the subgroup of 23 participants would have been underpowered, the interpretation of our findings is limited and should be used as a foundation for future investigations. Larger, adequately powered randomized controlled trials should explore different protocols titrated to the individual and using comprehensive measures to assess cognitive, clinical, and neural effects of tDCS and its underlying mechanisms of action in ADHD.
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Affiliation(s)
- Samuel J. Westwood
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
- School of Psychology, University of Wolverhampton, Wolverhampton WV1 1LY UK
- Department of Psychology, School of Social Science, University of Westminster, London W1W 6UW, UK
- Correspondence to: Department of Child and Adolescent Psychiatry - PO85 Institute of Psychiatry, Psychology and Neuroscience King’s College London, 16 De Crespigny Park, London SE5 8AF, UK.
| | - Natali Bozhilova
- Social Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
- School of Psychology, University of Surrey, Guildford GU2 7XH, UK
- Correspondence to: School of Psychology Elizabeth Fry Building, University of Surrey, Guildford GU2 7XH, UK.
| | - Marion Criaud
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
| | - Sheut-Ling Lam
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
| | - Steve Lukito
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
| | - Sophie Wallace-Hanlon
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
- School of Psychology, University of Surrey, Guildford GU2 7XH, UK
| | - Olivia S. Kowalczyk
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
| | - Afroditi Kostara
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
| | - Joseph Mathew
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
| | - Bruce E. Wexler
- Department of Psychiatry, Yale University School of Medicine, 06520–8096, USA
| | - Roi Cohen Kadosh
- School of Psychology, University of Surrey, Guildford GU2 7XH, UK
| | - Philip Asherson
- Social Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
| | - Katya Rubia
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
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A. Markovics J. Training the Conductor of the Brainwave Symphony: In Search of a Common Mechanism of Action for All Methods of Neurofeedback. ARTIF INTELL 2022. [DOI: 10.5772/intechopen.98343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
There are several different methods of neurofeedback, most of which presume an operant conditioning model whereby the subject learns to control their brain activity in particular regions of the brain and/or at particular brainwave frequencies based on reinforcement. One method, however, called infra-low frequency [ILF] neurofeedback cannot be explained through this paradigm, yet it has profound effects on brain function. Like a conductor of a symphony, recent evidence demonstrates that the primary ILF (typically between 0.01–0.1 Hz), which correlates with the fluctuation of oxygenated and deoxygenated blood in the brain, regulates all of the classic brainwave bands (i.e. alpha, theta, delta, beta, gamma). The success of ILF neurofeedback suggests that all forms of neurofeedback may work through a similar mechanism that does not fit the operant conditioning paradigm. This chapter focuses on the possible mechanisms of action for ILF neurofeedback, which may be generalized, based on current evidence.
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Louthrenoo O, Boonchooduang N, Likhitweerawong N, Charoenkwan K, Srisurapanont M. The Effects of Neurofeedback on Executive Functioning in Children With ADHD: A Meta-Analysis. J Atten Disord 2022; 26:976-984. [PMID: 34697957 DOI: 10.1177/10870547211045738] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Possible beneficial effects of neurofeedback in improving ADHD functional outcomes have been increasingly reported. This meta-analysis aimed to evaluate the relationship between neurofeedback and executive functioning in children with ADHD. METHODS PubMed, EMBASE, EBSCO, Web of Science, and Cochrane databases were searched to identify studies reporting the effects of neurofeedback on executive functioning, including response inhibition, sustained attention, and working memory, assessed by neuropsychological tests. Only randomized controlled studies of children aged 5 to 18 years were included using a random-effects model. RESULTS Ten studies were included. The effects of neurofeedback were not found on three domains of executive functions. A meta-regression analysis revealed a trend of numbers of neurofeedback sessions positively associated with response inhibition (p = .06). CONCLUSION Results did not show the benefits of neurofeedback on executive functions assessed by neuropsychological tests. Future studies should focus on standard neurofeedback protocols, the intensity of intervention, and neuropsychological outcomes.
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A parallel-group study of near-infrared spectroscopy-neurofeedback in children with attention deficit hyperactivity disorder. Psychiatry Res 2022; 309:114364. [PMID: 35026672 DOI: 10.1016/j.psychres.2021.114364] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/21/2021] [Accepted: 12/23/2021] [Indexed: 11/20/2022]
Abstract
The present study aimed to assess the efficacy of Near-infrared spectroscopy (NIRS) real-time neurofeedback (NF) vs. atomoxetine (AT) in children with attention deficit hyperactivity disorder (ADHD). A parallel-group study was conducted to enroll children with ADHD between 8 and 12 years of age. Participants were assigned into the NIRS group and AT group as their wish. Subjects in the NIRS group received 12 sessions of NF training within 6 weeks, and subjects in the AT group were given oral medication. Changes in Swanson, Nolan, and Pelham-V rating scales (SNAP-IV), and performance of Go/No-Go and N-back working memory tasks at week 3, 6 and 8 were evaluated. Forty-nine patients completed the study, including 18 ADHD in the NIRS group and 31 in the AT group. Total scores of SNAP-IV significantly decreased from baseline to week 3, week 6, and week 8 in both groups. Patients in the NIRS group showed significant lower scores on the inattention subscale of SNAP-IV at week 3 and week 6, compared to the AT group. NIRS group had a shorter reaction time during the Go/No-Go task at week 6 and fewer errors during 2-back than the AT group at week 3. The findings revealed that NIRS real-time NF is more efficacious relative to AT in improving behavioral performance, highlighting its potential role and advantages in treating patients with ADHD.
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Lakes KD, Cibrian FL, Schuck S, Nelson M, Hayes GR. Digital health interventions for youth with ADHD: A systematic review. COMPUTERS IN HUMAN BEHAVIOR REPORTS 2022. [DOI: 10.1016/j.chbr.2022.100174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Ghadamgahi Sani N, Akbarfahimi M, Akbari S, Alizadeh Zarei M, Taghizadeh G. Neurofeedback Training Versus Perceptual-motor Exercises Interventions in Visual Attention for Children With Attention-Deficit/Hyperactivity Disorder: A Randomized Controlled Trial. Basic Clin Neurosci 2022; 13:215-224. [PMID: 36425951 PMCID: PMC9682311 DOI: 10.32598/bcn.2021.563.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 01/15/2021] [Accepted: 02/21/2021] [Indexed: 06/16/2023] Open
Abstract
INTRODUCTION Attention-deficit/hyperactivity disorder (ADHD) is one of the most common childhood psychiatric disorders characterized by poor attention and subsequently lower learning abilities than normal children. This study aimed to compare the effectiveness of neurofeedback and perceptual-motor exercises as two common nonpharmacological treatments for visual attention. METHODS A total of 40 combined medicated ADHD children (aged 5-12 years) were randomly allocated into two groups: neurofeedback training and perceptual-motor exercises. Visual attention and motor proficiency were assessed before and after the treatment by continuous performance test (CPT) and Bruininks-Oseretsky Test (BOT), respectively. RESULTS According to repeated measures analysis of variance (ANOVA), both groups showed significant improvement in three attention-related areas of CPT, including reaction time, omission, and commission errors (P<0.001), while the difference between the two groups was not significant (P>0.05). However, in the perceptual-motor exercises group, motor proficiency improved significantly (P<0.01). CONCLUSION Neurofeedback training intervention, as well as perceptual-motor exercises, are effective in improving ADHD symptoms, and given the similar effect of both interventions and their lack of side effects, perceptual-motor exercises appear to be the more appropriate option for reducing symptoms of ADHD, because of its additional effect on motor proficiency, rich content of purposeful activities, and social interactions. HIGHLIGHTS Neurofeedback training intervention promote attention in ADHD;Perceptual-motor exercises improve ADHD symptoms;Perceptual-motor exercises has an additional effect on motor proficiency. PLAIN LANGUAGE SUMMARY The effectiveness and cost of interventions is an important issue. The result of this study revealed although neuro-feedback training intervention as well as perceptual-motor exercises are effective in improving ADHD symptoms, perceptual-motor exercises seem more appropriate option for reducing symptoms of ADHD, due to its additional effect on motor proficiency.
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Affiliation(s)
- Neda Ghadamgahi Sani
- Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Malahat Akbarfahimi
- Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Shadi Akbari
- Department of Cognitive Neuroscience, Faculty of Education and Psychology, University of Tabriz, Tabriz, Iran
| | - Mehdi Alizadeh Zarei
- Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Ghorban Taghizadeh
- Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
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Suarez I, De Los Reyes Aragón C, Grandjean A, Barceló E, Mebarak M, Lewis S, Pineda-Alhucema W, Casini L. Two sides of the same coin: ADHD affects reactive but not proactive inhibition in children. Cogn Neuropsychol 2022; 38:349-363. [PMID: 35209797 DOI: 10.1080/02643294.2022.2031944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Children with attention-deficit/hyperactivity disorder (ADHD) present a deficit in inhibitory control. Still, it remains unclear whether it comes from a deficit in reactive inhibition (ability to stop the action in progress), proactive inhibition (ability to exert preparatory control), or both.We compared the performance of 39 children with ADHD and 42 typically developing children performing a Simon choice reaction time task. The Simon task is a conflict task that is well-adapted to dissociate proactive and reactive inhibition. Beyond classical global measures (mean reaction time, accuracy rate, and interference effect), we used more sophisticated dynamic analyses of the interference effect and accuracy rate to investigate reactive inhibition. We studied proactive inhibition through the congruency sequence effect (CSE).Our results showed that children with ADHD had impaired reactive but not proactive inhibition. Moreover, the deficit found in reactive inhibition seems to be due to both a stronger impulse capture and more difficulties in inhibiting impulsive responses. These findings contribute to a better understanding of how ADHD affects inhibitory control in children.
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Affiliation(s)
- Isabel Suarez
- Department of Psychology, Universidad del Norte, Barranquilla, Colombia.,CNRS, LNC, Laboratoire de Neurosciences Cognitives, Aix Marseille Univ, Marseille, France
| | | | - Aurelie Grandjean
- CNRS, LNC, Laboratoire de Neurosciences Cognitives, Aix Marseille Univ, Marseille, France
| | - Ernesto Barceló
- Instituto Colombiano de Neuropedagogía, Universidad de la Costa, Barranquilla, Colombia
| | - Moises Mebarak
- Department of Psychology, Universidad del Norte, Barranquilla, Colombia
| | - Soraya Lewis
- Department of Psychology, Universidad del Norte, Barranquilla, Colombia
| | - Wilmar Pineda-Alhucema
- Programa de Psicología, facultad de Ciencias Jurídicas y Sociales, Universidad Simón Bolívar, Barranquilla, Colombia
| | - Laurence Casini
- CNRS, LNC, Laboratoire de Neurosciences Cognitives, Aix Marseille Univ, Marseille, France
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Luo X, Guo X, Zhao Q, Zhu Y, Chen Y, Zhang D, Jiang H, Wang Y, Johnstone S, Sun L. A randomized controlled study of remote computerized cognitive, neurofeedback, and combined training in the treatment of children with attention-deficit/hyperactivity disorder. Eur Child Adolesc Psychiatry 2022:10.1007/s00787-022-01956-1. [PMID: 35182242 PMCID: PMC8857637 DOI: 10.1007/s00787-022-01956-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 02/02/2022] [Indexed: 12/04/2022]
Abstract
There is an increasing interest in non-pharmacological treatments for children with attention-deficit/hyperactivity disorder (AD/HD), especially digital techniques that can be remotely delivered, such as neurofeedback (NFT) and computerized cognitive training (CCT). In this study, a randomized controlled design was used to compare training outcomes between remotely delivered NFT, CCT, and combined NFT/CCT training approaches. A total of 121 children with AD/HD were randomly assigned to the NFT, CCT, or NFT/CCT training groups, with 80 children completing the training program. Pre- and post-training symptoms (primary outcome), executive and daily functions were measured using questionnaires as well as resting EEG during eyes-closed (EC) and eyes-open (EO) conditions. After 3 months of training, the inattentive and hyperactive/impulsive symptoms, inhibition, working memory, learning and life skills of the three groups of children were significantly improved. The objective EEG activity showed a consistent increase in the relative alpha power in the EO condition among the three training groups. Training differences were not observed between groups. There was a positive correlation between pre-training EO relative alpha power and symptom improvement scores of inattention and hyperactivity/impulsivity, as well as a negative correlation between pre-training inattention scores and change in EO relative alpha. This study verified the training effects of NFT, CCT, and combined NFT/CCT training in children with AD/HD and revealed an objective therapeutic role for individual relative alpha activity. The verified feasibility and effectiveness of home-based digital training support promotion and application of digital remote training.
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Affiliation(s)
- Xiangsheng Luo
- Peking University Sixth Hospital and, Peking University Institute of Mental Health, Beijing, People’s Republic of China ,NHC Key Laboratory of Mental Health (Peking University) and National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, 100191 People’s Republic of China
| | - Xiaojie Guo
- Peking University Sixth Hospital and, Peking University Institute of Mental Health, Beijing, People’s Republic of China ,NHC Key Laboratory of Mental Health (Peking University) and National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, 100191 People’s Republic of China
| | - Qihua Zhao
- Peking University Sixth Hospital and, Peking University Institute of Mental Health, Beijing, People’s Republic of China ,NHC Key Laboratory of Mental Health (Peking University) and National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, 100191 People’s Republic of China
| | - Yu Zhu
- Peking University Sixth Hospital and, Peking University Institute of Mental Health, Beijing, People’s Republic of China ,NHC Key Laboratory of Mental Health (Peking University) and National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, 100191 People’s Republic of China
| | - Yanbo Chen
- Peking University Sixth Hospital and, Peking University Institute of Mental Health, Beijing, People’s Republic of China ,NHC Key Laboratory of Mental Health (Peking University) and National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, 100191 People’s Republic of China
| | - Dawei Zhang
- Department of Psychology, School of Educational Science, Yangzhou University, Jiangsu, People’s Republic of China
| | - Han Jiang
- School of Special Education, Zhejiang Normal University, Hangzhou, People’s Republic of China
| | - Yufeng Wang
- Peking University Sixth Hospital and, Peking University Institute of Mental Health, Beijing, People’s Republic of China ,NHC Key Laboratory of Mental Health (Peking University) and National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, 100191 People’s Republic of China
| | - Stuart Johnstone
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia. .,Brain and Behavior Research Institute, University of Wollongong, Wollongong, NSW, 2500, Australia.
| | - Li Sun
- Peking University Sixth Hospital and, Peking University Institute of Mental Health, Beijing, People's Republic of China. .,NHC Key Laboratory of Mental Health (Peking University) and National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, 100191, People's Republic of China.
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Process Design for Optimized Respiration Identification Based on Heart Rate Variability for Efficient Respiratory Sinus Arrhythmia Biofeedback. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042087. [PMID: 35206277 PMCID: PMC8871855 DOI: 10.3390/ijerph19042087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/04/2022] [Accepted: 02/08/2022] [Indexed: 01/27/2023]
Abstract
Respiratory sinus arrhythmia (RSA) is a phenomenon in which the heart rate (HR) changes with respiration, increasing during inspiration and decreasing during expiration. RSA biofeedback training has an effect in relieving negative mental conditions, such as anxiety and stress. Respiration is an important indicator affecting the parasympathetic activation within the body during RSA biofeedback training. Although there are existing studies that consider individual differences when selecting optimized respiration using heart rate variability, the studies that use the high frequency components of HRV, which is an indicator of parasympathetic activation, are insufficient. For this reason, this paper proposes a process to identify optimized respiration for efficient RSA feedback, consisting of three steps: (1) application, (2) optimization, and (3) validation. In the application phase, we measured PPG data against various respiratory cycles based on the HF components of HRV and calculated the proposed heart stabilization indicator (HSI) from the data. Then, we determined the optimized respiration cycle based on the HSI in the optimization step. Finally, we analyzed seven stress-related indices against the optimized respiration cycle. The experimental results show that HSI is associated with the parasympathetic nervous system activation, and the proposed method could help to determine the optimal respiratory cycle for each individual. Lastly, we expect that the proposed design could be used as an alternative to improving the efficiency of RSA biofeedback training.
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Chang Y, Stevenson C, Chen IC, Lin DS, Ko LW. Neurological state changes indicative of ADHD in children learned via EEG-based LSTM networks. J Neural Eng 2022; 19. [PMID: 35081524 DOI: 10.1088/1741-2552/ac4f07] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 01/26/2022] [Indexed: 11/12/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that pervasively interferes with the lives of individuals starting in childhood. OBJECTIVE To address the subjectivity of current diagnostic approaches, many studies have been dedicated to efforts to identify the differences between ADHD and neurotypical (NT) individuals using EEG and continuous performance tests (CPT). APPROACH In this study, we proposed EEG-based long short-term memory (LSTM) networks that utilize deep learning techniques with learning the cognitive state transition to discriminate between ADHD and NT children via EEG signal processing. A total of thirty neurotypical children and thirty ADHD children participated in CPT tests while being monitored with EEG. Several architectures of deep and machine learning were applied to three EEG data segments including resting state, cognitive execution, and a period containing a fusion of those. MAIN RESULTS The experimental results indicated that EEG-based LSTM networks produced the best performance with an average accuracy of 90.50 ± 0.81 % in comparison with the deep neural networks, the convolutional neural networks, and the support vector machines with learning the cognitive state transition of EEG data. Novel observations of individual neural markers showed that the beta power activity of the O1 and O2 sites contributed the most to the classifications, subjects exhibited decreased beta power in the ADHD group, and had larger decreases during cognitive execution. SIGNIFICANCE These findings showed that the proposed EEG-based LSTM networks are capable of extracting the varied temporal characteristics of high-resolution electrophysiological signals to differentiate between ADHD and NT children, and brought a new insight to facilitate the diagnosis of ADHD. The registration numbers of the institutional review boards are 16MMHIS021 and EC1070401-F.
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Affiliation(s)
- Yang Chang
- Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Rm. 742, Bio-ICT Building, No. 75, Bo'ai St., East Dist., Hsinchu City 300 , Taiwan (R.O.C.), Hsinchu, 300, TAIWAN
| | - Cory Stevenson
- Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Rm. 742, Bio-ICT Building, No. 75, Bo'ai St., East Dist., Hsinchu City 300 , Taiwan (R.O.C.), Hsinchu, 300, TAIWAN
| | - I-Chun Chen
- Department of Physical Medicine and Rehabilitation, Ton-Yen General Hospital, No. 69, Xianzheng 2nd Rd., Zhubei City, Hsinchu County 302, Taiwan (R.O.C.), Hsinchu, 302, TAIWAN
| | - Dar-Shong Lin
- Department of Pediatrics, Mackay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd., Zhongshan Dist., Taipei City 104, Taiwan (R.O.C.), Taipei, 104, TAIWAN
| | - Li-Wei Ko
- Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Rm. 742, Bio-ICT Building, No. 75, Bo'ai St., East Dist., Hsinchu City 300 , Taiwan (R.O.C.), Hsinchu, 300, TAIWAN
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Blume M, Schmidt R, Schmidt J, Martin A, Hilbert A. EEG Neurofeedback in the Treatment of Adults with Binge-Eating Disorder: a Randomized Controlled Pilot Study. Neurotherapeutics 2022; 19:352-365. [PMID: 34931276 PMCID: PMC9130382 DOI: 10.1007/s13311-021-01149-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2021] [Indexed: 12/21/2022] Open
Abstract
Specific alterations in electroencephalography (EEG)-based brain activity have recently been linked to binge-eating disorder (BED), generating interest in treatment options targeting these neuronal processes. This randomized-controlled pilot study examined the effectiveness and feasibility of two EEG neurofeedback paradigms in the reduction of binge eating, eating disorder and general psychopathology, executive functioning, and EEG activity. Adults with BED and overweight (N = 39) were randomly assigned to either a food-specific EEG neurofeedback paradigm, aiming at reducing fronto-central beta activity and enhancing theta activity after viewing highly palatable food pictures, or a general EEG neurofeedback paradigm training the regulation of slow cortical potentials. In both conditions, the study design included a waiting period of 6 weeks, followed by 6 weeks EEG neurofeedback (10 sessions à 30 min) and a 3-month follow-up period. Both EEG neurofeedback paradigms significantly reduced objective binge-eating episodes, global eating disorder psychopathology, and food craving. Approximately one third of participants achieved abstinence from objective binge-eating episodes after treatment without any differences between treatments. These results were stable at 3-month follow-up. Among six measured executive functions, only decision making improved at posttreatment in both paradigms, and cognitive flexibility was significantly improved after food-specific neurofeedback only. Both EEG neurofeedback paradigms were equally successful in reducing relative beta and enhancing relative theta power over fronto-central regions. The results highlight EEG neurofeedback as a promising treatment option for individuals with BED. Future studies in larger samples are needed to determine efficacy and treatment mechanisms.
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Affiliation(s)
- Marie Blume
- Integrated Research and Treatment Center Adiposity Diseases, Department of Psychosomatic Medicine and Psychotherapy, Behavioral Medicine Research Unit, University of Leipzig Medical Center, Leipzig, Germany.
| | - Ricarda Schmidt
- Integrated Research and Treatment Center Adiposity Diseases, Department of Psychosomatic Medicine and Psychotherapy, Behavioral Medicine Research Unit, University of Leipzig Medical Center, Leipzig, Germany
| | - Jennifer Schmidt
- Muenster School of Health, FH Muenster University of Applied Sciences, Muenster, Germany
| | - Alexandra Martin
- Clinical Psychology and Psychotherapy, School of Human and Social Sciences, University of Wuppertal, Wuppertal, Germany
| | - Anja Hilbert
- Integrated Research and Treatment Center Adiposity Diseases, Department of Psychosomatic Medicine and Psychotherapy, Behavioral Medicine Research Unit, University of Leipzig Medical Center, Leipzig, Germany
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SUBANDRIYO APRILIAP, JONGSMA MARIJTJEL, WIJAYA DANISWARAA, TRISNADEWI BENEDICTAA, PARAVOTI AMALIA, NOVIHARTANTI BERNADETHL, WIDYORINI ENDANG, SULASTRI AUGUSTINA, BRETELER MARINUSH. Offering Neurofeedback as an Intervention for Children with Attention Deficit/Hyperactivity Disorder in Indonesia: A Feasibility Study. THE KOBE JOURNAL OF MEDICAL SCIENCES 2021; 67:E125-E136. [PMID: 35367999 PMCID: PMC9677581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 08/24/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND EEG Neurofeedback training is an accepted non-pharmacological therapy for attention deficit/ hyperactivity disorder (ADHD). Although stimulant medication is known to decrease ADHD symptoms, possible adverse effects, concerns about prolonged drug use on neural development, and problems related to the compliance with the medications are often reported. In Indonesia, research on the feasibility of EEG Neurofeedback to treat ADHD is still lacking. The current study aimed to investigate whether setting up an EEG neurofeedback training program for children with ADHD would be feasible in Indonesia. METHODS Nine children (aged 6-12 years) participated in the study. ADHD was diagnosed using the Vanderbilt ADHD Diagnostic Rating Scale (VADRS). Children received twenty-five sessions of sensorimotor rhythm (SMR) neurofeedback training twice a week. Each session consisted of a 3-minute baseline, followed by 5*3 minutes of training. IQ scores and VADRS scores were collected at baseline, after completion of the intervention, and at 3 months follow-up, while school reports were provided by the schools. The EEG spectral content was determined for all 25 training sessions. In addition, a Go/No-Go Task, was administered at the first 5 training sessions, and at session 10, 15, 20 and 25. RESULTS AND CONCLUSION An overview of all the collected data is provided descriptively, given the small group size. One child dropped-out during the training because of parental request, but the remaining eight children completed the full intervention program. Descriptive data suggested improvement with respect to both the ADHD symptomatology and performance IQ. These findings are in line with previous studies. Although a control arm was not included, we propose that the abovementioned SMR neurofeedback protocol may still be offered as a suitable non-pharmacological intervention for children with ADHD in Indonesia and deserves further research.
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Affiliation(s)
| | | | - DANISWARA A. WIJAYA
- Faculty of Psychology, Soegijapranata Catholic University, Semarang, Indonesia
| | | | - AMALIA PARAVOTI
- Faculty of Psychology, Soegijapranata Catholic University, Semarang, Indonesia
| | | | - ENDANG WIDYORINI
- Faculty of Psychology, Soegijapranata Catholic University, Semarang, Indonesia
| | - AUGUSTINA SULASTRI
- Faculty of Psychology, Soegijapranata Catholic University, Semarang, Indonesia
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Cabaleiro P, Cueli M, Cañamero LM, González-Castro P. A Case Study in Attention-Deficit/Hyperactivity Disorder: An Innovative Neurofeedback-Based Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010191. [PMID: 35010449 PMCID: PMC8751092 DOI: 10.3390/ijerph19010191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 12/21/2021] [Accepted: 12/23/2021] [Indexed: 12/14/2022]
Abstract
In research about attention-deficit/hyperactivity disorder (ADHD) there is growing interest in evaluating cortical activation and using neurofeedback in interventions. This paper presents a case study using monopolar electroencephalogram recording (brain mapping known as MiniQ) for subsequent use in an intervention with neurofeedback for a 10-year-old girl presenting predominantly inattentive ADHD. A total of 75 training sessions were performed, and brain wave activity was assessed before and after the intervention. The results indicated post-treatment benefits in the beta wave (related to a higher level of concentration) and in the theta/beta ratio, but not in the theta wave (related to higher levels of drowsiness and distraction). These instruments may be beneficial in the evaluation and treatment of ADHD.
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Ning K, Wang T. Multimodal Interventions Are More Effective in Improving Core Symptoms in Children With ADHD. Front Psychiatry 2021; 12:759315. [PMID: 34975569 PMCID: PMC8716759 DOI: 10.3389/fpsyt.2021.759315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 11/17/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: To investigate the effect of sensory integration training combined with EEG biofeedback on core symptoms in children with ADHD. Methods: Fifty-two children with attention-deficit, hyperactive-impulsive and combined ADHD were selected. They were randomly divided into control group, sensory integration training group, EEG biofeedback group, and sensory integration training + EEG biofeedback group, and after 4 months of intervention, concentration time and impulsive- hyperactivity and hyperactivity index scores on the PSQ scale were assessed. Results: Compared with that before the intervention, the attention time was significantly increased (P < 0.01), and the impulsive-hyperactivity and hyperactivity index scores were significantly decreased (P < 0.05, P < 0.01). After the intervention, the attention time was significantly higher than that of the control group (P < 0.05, P < 0.01), the attention time of the multimodal intervention group was significantly higher than that of the single intervention group (P < 0.01), and the impulsive-hyperactivity and hyperactivity index scores were significantly lower than those of the single intervention group (P < 0.05). Conclusion: Multimodal intervention can significantly improve the concentration level of children with ADHD, and significantly improve the behavioral symptoms of impulsive-hyperactivity and hyperactivity. Multimodal interventions were more effective than single interventions in improving core symptoms in children with ADHD. The results of this study provide a reference for related research and practical application.
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Affiliation(s)
- Ke Ning
- Physical Education Institute of Shaanxi Normal University, Xi'an, China
| | - Tingzhao Wang
- School of Education Shaanxi Normal University, Xi'an, China
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