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Dakwar-Kawar O, Mentch-Lifshits T, Hochman S, Mairon N, Cohen R, Balasubramani P, Mishra J, Jordan J, Cohen Kadosh R, Berger I, Nahum M. Aperiodic and periodic components of oscillatory brain activity in relation to cognition and symptoms in pediatric ADHD. Cereb Cortex 2024; 34:bhae236. [PMID: 38858839 DOI: 10.1093/cercor/bhae236] [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] [Received: 12/30/2023] [Revised: 05/12/2024] [Indexed: 06/12/2024] Open
Abstract
Children with attention-deficit/hyperactivity disorder show deficits in processing speed, as well as aberrant neural oscillations, including both periodic (oscillatory) and aperiodic (1/f-like) activity, reflecting the pattern of power across frequencies. Both components were suggested as underlying neural mechanisms of cognitive dysfunctions in attention-deficit/hyperactivity disorder. Here, we examined differences in processing speed and resting-state-Electroencephalogram neural oscillations and their associations between 6- and 12-year-old children with (n = 33) and without (n = 33) attention-deficit/hyperactivity disorder. Spectral analyses of the resting-state EEG signal using fast Fourier transform revealed increased power in fronto-central theta and beta oscillations for the attention-deficit/hyperactivity disorder group, but no differences in the theta/beta ratio. Using the parameterization method, we found a higher aperiodic exponent, which has been suggested to reflect lower neuronal excitation-inhibition, in the attention-deficit/hyperactivity disorder group. While fast Fourier transform-based theta power correlated with clinical symptoms for the attention-deficit/hyperactivity disorder group only, the aperiodic exponent was negatively correlated with processing speed across the entire sample. Finally, the aperiodic exponent was correlated with fast Fourier transform-based beta power. These results highlight the different and complementary contribution of periodic and aperiodic components of the neural spectrum as metrics for evaluation of processing speed in attention-deficit/hyperactivity disorder. Future studies should further clarify the roles of periodic and aperiodic components in additional cognitive functions and in relation to clinical status.
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Affiliation(s)
- Ornella Dakwar-Kawar
- School of Occupational Therapy, Hebrew University, Mount Scopus, Jerusalem, 9124001, Israel
| | - Tal Mentch-Lifshits
- School of Occupational Therapy, Hebrew University, Mount Scopus, Jerusalem, 9124001, Israel
| | - Shachar Hochman
- School of Psychology, Faculty of Health and Medical Sciences, Kate Granger Building, 30 Priestley Road, Surrey Research Park, Guildford, Surrey, GU2 7YH
| | - Noam Mairon
- School of Occupational Therapy, Hebrew University, Mount Scopus, Jerusalem, 9124001, Israel
| | - Reut Cohen
- School of Occupational Therapy, Hebrew University, Mount Scopus, Jerusalem, 9124001, Israel
| | - Pragathi Balasubramani
- Department of Psychiatry, University of California, UC San Diego 9500 Gilman Dr. La Jolla, CA 92093, United States
- Department of Cognitive Science, Indian Institute of Technology Kanpur, Kanpur 208016, India
| | - Jyoti Mishra
- Department of Psychiatry, University of California, UC San Diego 9500 Gilman Dr. La Jolla, CA 92093, United States
| | - Josh Jordan
- Department of Psychology, Dominican University of California, 50 Acacia Avenue, San Rafael, CA 94901, United States
| | - Roi Cohen Kadosh
- School of Psychology, Faculty of Health and Medical Sciences, Kate Granger Building, 30 Priestley Road, Surrey Research Park, Guildford, Surrey, GU2 7YH
| | - Itai Berger
- Pediatric Neurology, Assuta-Ashdod University Hospital, Faculty of Health Sciences, Ben-Gurion University, Beer-Shevablvd 1, 84105 Beer Sheva, Israel
- School of Social Work and Social Welfare, Hebrew University, Mount Scopus, Jerusalem, 9124001, Israel
| | - Mor Nahum
- School of Occupational Therapy, Hebrew University, Mount Scopus, Jerusalem, 9124001, Israel
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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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Tabiee M, Azhdarloo A, Azhdarloo M. Comparing executive functions in children with attention deficit hyperactivity disorder with or without reading disability: A resting-state EEG study. Brain Behav 2023; 13:e2951. [PMID: 36882973 PMCID: PMC10097152 DOI: 10.1002/brb3.2951] [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: 11/11/2022] [Revised: 01/22/2023] [Accepted: 02/19/2023] [Indexed: 03/09/2023] Open
Abstract
INTRODUCTION As numerous studies have shown, executive dysfunction is the main impairment in attention-deficit/hyperactivity disorder. According to recent neuroimaging studies, the frontoparietal coherence plays a key role in overall cognitive functions. Therefore, the aim of this study was to compare executive functions during resting-state EEG by monitoring brain connectivity (coherence) patterns in children with attention deficit hyperactivity disorder (ADHD) with or without reading disability (RD). METHODS The statistical sample of the study consisted of 32 children with ADHD aged between 8 and 12 years old with or without specific RD. Each group consisted of 11 boys and 5 girls that were matched on chronological age and gender. EEG was recorded during eyes-opened condition and brain connectivity within and between frontal and parietal regions was analyzed within theta, alpha, and beta bands. RESULTS The results revealed that across the frontal regions, the comorbid group showed a significant reduction in the left intrahemispheric coherence in the alpha and beta bands. The ADHD-alone group exhibited increased theta and decreased alpha and beta coherence in frontal regions. In the frontoparietal regions, children in the comorbid group showed lower coherence between frontal and parietal networks compared to children without comorbid RD. CONCLUSION The findings indicate that brain connectivity (coherence) patterns of children with ADHD with comorbid RD were more abnormal and lend support to more disrupted cortical connectivity in the comorbid group. Thus, these findings can be a useful marker for better recognizing ADHD and comorbid disabilities.
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Affiliation(s)
- Maryam Tabiee
- Department of Foreign Languages and Linguistics, School of Literature and Humanities, Shiraz University, Shiraz, Iran
| | - Ahmad Azhdarloo
- Department of Psychology, Islamic Azad University of Arsanjan Branch, Arsanjan, Fars, Iran
| | - Mohammad Azhdarloo
- Department of Psychology, Islamic Azad University of Marvdasht Branch, Marvdasht, Fars, Iran
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Huang H, Jin Z, He C, Guo S, Zhang Y, Quan M. Chronic Exercise for Core Symptoms and Executive Functions in ADHD: A Meta-analysis. Pediatrics 2023; 151:190271. [PMID: 36510746 DOI: 10.1542/peds.2022-057745] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/03/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The effects of chronic exercise interventions (CEIs) on core symptoms and executive functions (EFs) of attention-deficit/hyperactivity disorder (ADHD) and how different characteristics of CEIs could modify the effect remain unclear. We synthesized the current evidence on the effects of CEIs on core symptoms and EFs in children and adolescents with ADHD. METHODS Data sources include PubMed, Embase, Web of Science, Cochrane Library, and China National Knowledge Infrastructure from database inception to July 31, 2022. Study selection includes randomized controlled trials that reported on the effects of CEIs on core symptoms and/or EFs in ADHD aged 6 to 18 years. RESULTS Twenty-two randomized controlled trials were included. CEIs had a small beneficial effect on overall core symptoms (standardized mean difference [SMD] = -0.39, 95% confidence interval [CI]: -0.64 to -0.14), as well as inattention (SMD = -0.32, 95% CI: -0.63 to -0.004) among children and adolescents with ADHD. Closed-skill exercise showed a large improvement in core symptoms (SMD = -0.83, 95% CI: -1.30 to -0.35), whereas open-skill exercise did not. Additionally, CEIs had a moderately beneficial effect on overall EFs (SMD = -0.68, 95% CI: -0.91 to -0.45) and a moderate-to-large effect on the specific domains of EFs. The pooled effects on overall core symptoms and EFs were not significantly modified by study population (children or adolescents), exercise session duration (≤50 or >50 minutes per session, median), or total exercise sessions (<24 or ≥24 sessions, median). CONCLUSIONS CEIs have small-to-moderate beneficial effects on overall core symptoms and EFs in children and adolescents with ADHD.
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Affiliation(s)
| | - Zhijuan Jin
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | | | | | - Yiwen Zhang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Minghui Quan
- School of Exercise and Health.,Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, China
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Martins RMG, Mazzoli E, Duncan MJ, Clark CCT, Eyre ELJ. The Acute Effects of Cognitively Demanding Physical Activity on Inhibitory and Affective Responses in Children: An Online-Based Mixed Methods Approach. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121896. [PMID: 36553340 PMCID: PMC9776716 DOI: 10.3390/children9121896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 12/09/2022]
Abstract
This online study investigated the acute effects of a cognitively demanding physical activity (CDPA) vs a simple physical activity (SPA) bout on children’s inhibitory and affective responses. Using a counterbalanced within-subjects’ crossover design, thirty-nine participants aged 9−12 years old (29 boys; Mage = 11 ± 1 years) performed a CDPA and a SPA bout online (via ZOOM) for 15 min. Inhibition (Stroop test) was measured at the baseline, 1 and 30 min following the physical activity (PA) bouts, and self-report measures of affect, mental and physical exertion were taken prior, during and post-PA. Additionally, 31 children took part in semi-structured focus groups to explore the factors affecting their enjoyment. The quantitative results suggest no significant differences on inhibitory responses, affect and physical exertion (all p > 0.05). However, the CDPA induced more mental exertion than the SPA did (p < 0.05). In the focus groups, four themes were identified: physical exertion (e.g., tiredness), social (e.g., teams/groups), environment (e.g., outdoors and competition) and emotional (e.g., fun/enjoyment). Some children (n = 18) reported that the CDPA condition confused them, and to make these activities more interesting and enjoyable, they suggested performing the activities outdoors (n = 15) and including other children as part of a group/team (n = 19). The findings suggest no additional benefit of a cognitively enriched physical activity compared to an SPA bout on the inhibitory responses, affect and enjoyment. Using the instructions provided and given the low cost, the easy administration and the minimal amount of equipment and time involved, either of the approaches may be used in a diversity of contexts (i.e., online, schools or outdoors), and it is worth exploring the effects of these conditions on other aspects of executive function.
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Affiliation(s)
- Ricardo M. G. Martins
- Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry CV1 5FB, UK
- Correspondence:
| | - Emiliano Mazzoli
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Geelong, VIC 3216, Australia
| | - Michael J. Duncan
- Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry CV1 5FB, UK
| | - Cain C. T. Clark
- Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry CV1 5FB, UK
| | - Emma L. J. Eyre
- Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry CV1 5FB, UK
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Chen IC, Lee PW, Wang LJ, Chang CH, Lin CH, Ko LW. Incremental Validity of Multi-Method and Multi-Informant Evaluations in the Clinical Diagnosis of Preschool ADHD. J Atten Disord 2022; 26:1293-1303. [PMID: 34949123 DOI: 10.1177/10870547211045739] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This study investigated the discriminative validity of various single or combined measurements of electroencephalogram (EEG) data, Conners' Kiddie Continuous Performance Test (K-CPT), and Disruptive Behavior Disorder Rating Scale (DBDRS) to differentiate preschool children with ADHD from those with typical development (TD). METHOD We recruited 70 preschoolers, of whom 38 were diagnosed with ADHD and 32 exhibited TD; all participants underwent the K-CPT and wireless EEG recording in different conditions (rest, slow-rate, and fast-rate task). RESULTS Slow-rate task-related central parietal delta (1-4 Hz) and central alpha (8-13 Hz) and beta (13-30 Hz) powers between groups with ADHD and TD were significantly distinct (p < .05). A combination of DBDRS, K-CPT, and specific EEG data provided the best probability scores (area under curve = 0.926, p < .001) and discriminative validity to identify preschool children with ADHD (overall correct classification rate = 85.71%). CONCLUSIONS Multi-method and multi-informant evaluations should be emphasized in clinical diagnosis of preschool ADHD.
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Affiliation(s)
- I-Chun Chen
- National Yang Ming Chiao Tung University, Hsinchu.,Ton Yen General Hospital, Hsinchu
| | | | - Liang-Jen Wang
- Chang Gung Memorial Hospital, Kaohsiung.,Chang Gung University, Taoyuan
| | | | | | - Li-Wei Ko
- National Yang Ming Chiao Tung University, Hsinchu
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7
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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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Medina R, Bouhaben J, de Ramón I, Cuesta P, Antón-Toro L, Pacios J, Quintero J, Quiroga AR, Maestú F. Alfa band power increases in posterior brain regions in attention deficit hyperactivity disorder after digital cognitive stimulation treatment. Brain Commun 2022; 4:fcac038. [PMID: 35402910 PMCID: PMC8984701 DOI: 10.1093/braincomms/fcac038] [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: 04/23/2021] [Revised: 10/11/2021] [Accepted: 02/15/2022] [Indexed: 11/15/2022] Open
Abstract
Abstract
The changes triggered by pharmacological treatments in resting-state alpha-band (8–14 Hz) oscillations have been widely studied in attention deficit hyperactivity disorder. However, to date, there has been no evidence regarding the possible changes in cognitive stimulation treatments on these oscillations. This paper sets out to verify whether cognitive stimulation treatments based on progressive increases in cognitive load can be effective in triggering changes in alpha-band power in attention deficit hyperactivity disorder. With this objective, we compared a cognitive stimulation treatment (n = 13) to placebo treatment (n = 13) for 12 weeks (36 sessions of 15 min) in child patients (8–11 years old) with attention deficit hyperactivity disorder. Two magnetoencephalographic recordings were acquired for all the participants. In order to extract the areas with changes in alpha power between both magnetoencephalographic recordings, the differences in the power ratio (pre/post-condition) were calculated using an Analysis of Covariance test adjusted for the age variable. The results show an increase in the post-treatment power ratio in the experimental group versus the placebo group (P < 0.01) in posterior regions and the default mode network. In addition, these alpha changes were related to measures of attention, working memory and cognitive flexibility. The results seem to indicate that cognitive stimulation treatment based on progressive increases in cognitive load triggers alpha-band power changes in child attention deficit hyperactivity disorder patients in the direction of their peers without this disorder.
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Affiliation(s)
| | | | - Ignacio de Ramón
- Sincrolab, Ltd., Madrid 28033, Spain
- Laboratory of Cognitive and Computational Neuroscience, Centre for Biomedical Technology (CTB), Technical University of Madrid, Madrid 28660, Spain
| | - Pablo Cuesta
- Laboratory of Cognitive and Computational Neuroscience, Centre for Biomedical Technology (CTB), Technical University of Madrid, Madrid 28660, Spain
| | - Luis Antón-Toro
- Laboratory of Cognitive and Computational Neuroscience, Centre for Biomedical Technology (CTB), Technical University of Madrid, Madrid 28660, Spain
- Department of Experimental Psychology, Complutense University of Madrid, Madrid 28223, Spain
| | - Javier Pacios
- Laboratory of Cognitive and Computational Neuroscience, Centre for Biomedical Technology (CTB), Technical University of Madrid, Madrid 28660, Spain
- Department of Experimental Psychology, Complutense University of Madrid, Madrid 28223, Spain
| | - Javier Quintero
- Department of Psychiatry, University Hospital Infanta Leonor, Madrid 28031, Spain
| | | | - Fernando Maestú
- Laboratory of Cognitive and Computational Neuroscience, Centre for Biomedical Technology (CTB), Technical University of Madrid, Madrid 28660, Spain
- Department of Experimental Psychology, Complutense University of Madrid, Madrid 28223, Spain
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9
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Comparing the Transfer Effects of Three Neurocognitive Training Protocols in Children With Attention-Deficit/Hyperactivity Disorder: A Single-Case Experimental Design. BEHAVIOUR CHANGE 2021. [DOI: 10.1017/bec.2021.26] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Abstract
The current study used behavioural and electroencephalograph measures to compare the transferability of three home-based interventions — cognitive training (CT), neurofeedback training (NFT), and CT combined with NFT — for reducing symptoms in children with attention-deficit/hyperactivity disorder (AD/HD). Following a multiple-baseline single-case experimental design, twelve children were randomised to a training condition. Each child completed a baseline phase, followed by an intervention phase. The intervention phase consisted of 20 sessions of at-home training. Tau-U analysis and standardised visual analysis were adopted to detect effects. Results showed that CT improved inhibitory function and NFT improved alpha EEG activity and working memory. The combined condition, which was a reduced ‘dose’ of CT and NFT, did not show any improvements. The three conditions did not alleviate AD/HD symptoms. While CT and NFT may have transfer effects on executive functions, considering the lack of improvement in symptoms, this study does not support CT and NFT on their own as a treatment for children with AD/HD.
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Medina R, Bouhaben J, de Ramón I, Cuesta P, Antón-Toro L, Pacios J, Quintero J, Ramos-Quiroga JA, Maestú F. Electrophysiological Brain Changes Associated With Cognitive Improvement in a Pediatric Attention Deficit Hyperactivity Disorder Digital Artificial Intelligence-Driven Intervention: Randomized Controlled Trial. J Med Internet Res 2021; 23:e25466. [PMID: 34842533 PMCID: PMC8665400 DOI: 10.2196/25466] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/11/2020] [Accepted: 05/13/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cognitive stimulation therapy appears to show promising results in the rehabilitation of impaired cognitive processes in attention deficit hyperactivity disorder. OBJECTIVE Encouraged by this evidence and the ever-increasing use of technology and artificial intelligence for therapeutic purposes, we examined whether cognitive stimulation therapy implemented on a mobile device and controlled by an artificial intelligence engine can be effective in the neurocognitive rehabilitation of these patients. METHODS In this randomized study, 29 child participants (25 males) underwent training with a smart, digital, cognitive stimulation program (KAD_SCL_01) or with 3 commercial video games for 12 weeks, 3 days a week, 15 minutes a day. Participants completed a neuropsychological assessment and a preintervention and postintervention magnetoencephalography study in a resting state with their eyes closed. In addition, information on clinical symptoms was collected from the child´s legal guardians. RESULTS In line with our main hypothesis, we found evidence that smart, digital, cognitive treatment results in improvements in inhibitory control performance. Improvements were also found in visuospatial working memory performance and in the cognitive flexibility, working memory, and behavior and general executive functioning behavioral clinical indexes in this group of participants. Finally, the improvements found in inhibitory control were related to increases in alpha-band power in all participants in the posterior regions, including 2 default mode network regions of the interest: the bilateral precuneus and the bilateral posterior cingulate cortex. However, only the participants who underwent cognitive stimulation intervention (KAD_SCL_01) showed a significant increase in this relationship. CONCLUSIONS The results seem to indicate that smart, digital treatment can be effective in the inhibitory control and visuospatial working memory rehabilitation in patients with attention deficit hyperactivity disorder. Furthermore, the relation of the inhibitory control with alpha-band power changes could mean that these changes are a product of plasticity mechanisms or changes in the neuromodulatory dynamics. TRIAL REGISTRATION ISRCTN Registry ISRCTN71041318; https://www.isrctn.com/ISRCTN71041318.
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Affiliation(s)
| | | | - Ignacio de Ramón
- Sincrolab Ltd, Madrid, Spain
- Laboratory of Computational and Cognitive Neuroscience, Centre for Biomedical Technology, Polytechnic University of Madrid, Pozuelo de Alarcón, Spain
- Faculty of Health, Camilo Jose Cela University, Villafranca del Castillo, Spain
| | - Pablo Cuesta
- Laboratory of Computational and Cognitive Neuroscience, Centre for Biomedical Technology, Polytechnic University of Madrid, Pozuelo de Alarcón, Spain
- Radiology Rehabilitation and Physiotherapy, Complutense University of Madrid, Madrid, Spain
| | - Luis Antón-Toro
- Laboratory of Computational and Cognitive Neuroscience, Centre for Biomedical Technology, Polytechnic University of Madrid, Pozuelo de Alarcón, Spain
- Department of Experimental Psychology, Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
| | - Javier Pacios
- Laboratory of Computational and Cognitive Neuroscience, Centre for Biomedical Technology, Polytechnic University of Madrid, Pozuelo de Alarcón, Spain
- Department of Experimental Psychology, Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
| | - Javier Quintero
- Department of Psychiatry, University Hospital Infanta Leonor, Madrid, Spain
| | - Josep Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health, Barcelona, Spain
| | - Fernando Maestú
- Laboratory of Computational and Cognitive Neuroscience, Centre for Biomedical Technology, Polytechnic University of Madrid, Pozuelo de Alarcón, Spain
- Department of Experimental Psychology, Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
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11
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Zhang DW, Zaphf A, Klingberg T. Resting State EEG Related to Mathematical Improvement After Spatial Training in Children. Front Hum Neurosci 2021; 15:698367. [PMID: 34305556 PMCID: PMC8297825 DOI: 10.3389/fnhum.2021.698367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 06/14/2021] [Indexed: 12/02/2022] Open
Abstract
Spatial cognitive abilities, including mental rotation (MR) and visuo-spatial working memory (vsWM) are correlated with mathematical performance, and several studies have shown that training of these abilities can enhance mathematical performance. Here, we investigated the behavioral and neural correlates of MR and vsWM training combined with number line (NL) training. Fifty-seven children, aged 6–7, performed 25 days of NL training combined with either vsWM or MR and participated in an Electroencephalography (EEG)-session in school to measure resting state activity and steady-state visual evoked potentials during a vsWM task before and after training. Fifty children, aged 6–7, received usual teaching and acted as a control group. Compared to the control group, both training groups improved on a combined measure of mathematics. Cognitive improvement was specific to the training. Significant pre-post changes in resting state-EEG (rs-EEG), common to both training groups, were found for power as well as for coherence, with no significant differences in rs-EEG-changes between the vsWM and MR groups. Two of the common rs-EEG changes were correlated with mathematical improvement: (1) an increase in coherence between the central frontal lobe and the right parietal lobe in frequencies ranging from 16 to 25 Hz, and (2) an increase in coherence between the left frontal lobe and the right parietal lobe ranging from 23 to 25 Hz. These results indicate that changes in fronto-parietal coherence are related to an increase in mathematical performance, which thus might be a useful measure in further investigations of mathematical interventions in children.
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Affiliation(s)
- Da-Wei Zhang
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Anna Zaphf
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Torkel Klingberg
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Tsai YJ, Hsieh SS, Huang CJ, Hung TM. Dose-Response Effects of Acute Aerobic Exercise Intensity on Inhibitory Control in Children With Attention Deficit/Hyperactivity Disorder. Front Hum Neurosci 2021; 15:617596. [PMID: 34220467 PMCID: PMC8249764 DOI: 10.3389/fnhum.2021.617596] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 05/17/2021] [Indexed: 11/22/2022] Open
Abstract
The present study aimed to examine whether the effect of acute aerobic exercise on inhibitory control of children with attention-deficit/hyperactivity disorder (ADHD) is moderated by exercise intensity. Using a within-subjects design, 25 children with ADHD completed a flanker task with concurrent collection of electroencephalography (EEG) data after three different intensities of treadmill running. The results showed that low- and moderate-intensity exercises resulted in shorter reaction times (RTs) relative to vigorous-intensity exercise during the incompatible condition of the flanker task regardless of task congruency. A P3 congruency effect was observed following low- and vigorous-intensity exercises but not after moderate-intensity exercise. The mean alpha power, a measure of cortical arousal, increased following low- and moderate-intensity exercises but decreased following vigorous-intensity exercise. In addition, the change in arousal level after moderate-intensity exercise was negatively correlated with RT during incompatible flanker tasks. The current findings suggest that children with ADHD have better inhibitory control following both low- and moderate-intensity exercises relative to vigorous aerobic exercise, which could be characterized by an optimal state of cortical arousal.
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Affiliation(s)
- Yu-Jung Tsai
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei, Taiwan
| | - Shu-Shih Hsieh
- Department of Psychology, Northeastern University, Boston, MA, United States
| | - Chung-Ju Huang
- Graduate Institute of Sport Pedagogy, University of Taipei, Taipei, Taiwan
| | - Tsung-Min Hung
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei, Taiwan.,Institute for Research Excellence in Learning Science, National Taiwan Normal University, Taipei, Taiwan
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Aiding diagnosis of childhood attention-deficit/hyperactivity disorder of the inattentive presentation: Discriminant function analysis of multi-domain measures including EEG. Biol Psychol 2021; 161:108080. [PMID: 33744372 DOI: 10.1016/j.biopsycho.2021.108080] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 03/09/2021] [Accepted: 03/12/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION We developed a neurocognitive assessment tool (NCAT) in consultation with mental health professionals working with children with AD/HD as a diagnostic aid and screening tool. This study examines the predictive utility of NCAT in the classification of children with AD/HD Inattentive presentation. METHOD Fifty three children with AD/HD Inattentive presentation and 161 typically-developing children completed an NCAT assessment. Discriminant function analyses examined group membership prediction for separate components of NCAT and for the components combined. RESULTS The combined model correctly classified 93.4 % of participants, with 91.4 % sensitivity and 93.9 % specificity. Contributions to classification were from SNAP-IV, psychological needs satisfaction, self-regulation, executive function performance, and EEG. The combined model resulted in a 9.3 % increase in specificity and 5.9 % increase in sensitivity compared to SNAP-IV alone. CONCLUSIONS NCAT provides good discrimination between children with and without AD/HD of the Inattentive presentation, and further investigation including other subtypes and comorbidities is warranted.
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Yuan L, Fan Y, Gan Q, Feng H. Clinical Diagnosis of Psychiatry Based on Electroencephalography. JOURNAL OF MEDICAL IMAGING AND HEALTH INFORMATICS 2021. [DOI: 10.1166/jmihi.2021.3338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
At present, neurophysiological signals used for neuro feedback are EEG (Electroencephalogram), functional magnetic resonance imaging. Among them, the acquisition of EEG signals has the advantages of non-invasive way with low cost. It has been widely used in brain-machine interface technology
in recent years. Important progress has been made in rehabilitation and environmental control. However, neural feedback and brainmachine interface technology are completely similar in signal acquisition, signal feature extraction, and pattern classification. Therefore, the related research
results of brain-machine interface can be used to closely cooperate with clinical needs to research and develop neural feedback technology based on EEG. Based on neurophysiology and brain-machine interface technology, this paper develops a neural feedback training system based on the acquisition
and analysis of human EEG signals. Aiming at the autonomous rhythm components in the EEG signal, such as sensorimotor rhythm and alpha rhythm, the characteristic parameters are extracted through real-time EEG signal processing to generate feedback information, and the subject is self-regulated
and trained from a physiological-psychological perspective by providing adjuvant treatment, a practical and stable treatment platform for the clinic.
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Affiliation(s)
- Lixue Yuan
- Department of Intensive Care Unit, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University, Edong Healthcare Group, Hubei, 435000, People’s Republic of China
| | - Yinyan Fan
- Department of Psychiatry, Huangshi Second Hospital, Huangshi, Hubei, 435000, People’s Republic of China
| | - Quanxi Gan
- Department of Psychiatry, Huangshi Second Hospital, Huangshi, Hubei, 435000, People’s Republic of China
| | - Huibin Feng
- Department of Intensive Care Unit, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University, Edong Healthcare Group, Hubei, 435000, People’s Republic of China
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Clarke AR, Barry RJ, Johnstone S. Resting state EEG power research in Attention-Deficit/Hyperactivity Disorder: A review update. Clin Neurophysiol 2020; 131:1463-1479. [DOI: 10.1016/j.clinph.2020.03.029] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 02/20/2020] [Accepted: 03/16/2020] [Indexed: 01/19/2023]
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Maguire MJ, Schneider JM. Socioeconomic status related differences in resting state EEG activity correspond to differences in vocabulary and working memory in grade school. Brain Cogn 2019; 137:103619. [DOI: 10.1016/j.bandc.2019.103619] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 08/13/2019] [Accepted: 10/07/2019] [Indexed: 01/21/2023]
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