Immediate and Sustained Effects of Neurofeedback and Working Memory Training on Cognitive Functions in Children and Adolescents with ADHD: A Multi-Arm Pragmatic Randomized Controlled Trial

Neurofeedback Recuperates Cognitive Functions in Children with Autism Spectrum Disorders (ASD)

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impaired social interaction, verbal and nonverbal communication, and behaviors or interests. Besides behavioral, psychopharmacological and biomedical interventions there is increasing evidence of non-invasive treatments like neurofeedback (NFB) that can improve brain activity. In this study, we have investigated whether NFB can improve cognitive functions in children with ASD. Thirty-five children with ASD (7-17 years) were selected by purposive sampling. The subjects underwent 30 sessions of NFB training for 20 min over 10 weeks' period. Psychometric tests i.e. Childhood Autism Rating Scale (CARS), IQ scoring and Reward sensitivity tests were administered at baseline. Pre and post NFB intervention assessment of executive functions, working memory and processing speed were done by NIH Toolbox Cognition Batteries. Friedman test revealed that children showed a statistically significant improvement in the NIH Tool Box cognitive assessments, including the Flankers Inhibitory Control and Attention Test (Pre-test = 3.63, Post-test = 5.22; p = 0.00), the Dimensional Change Card Sorting Test (Pre-test = 2.88, Post-test = 3.26; p = 0.00), the Pattern Comparison Processing Speed Test (Pre-test = 6.00, Post-test = 11:00; p = 0.00) and the List Sorting Working Memory Test (Pre-test = 4.00, Post-test = 6:00; p = 0.00), and displayed a trend of improvement at 2-month follow-up (Flankers Inhibitory Control and Attention Test (Post-test = 5.11 ± 2.79, Follow-Up = 5.31 ± 2.67; p = 0.21), the Dimensional Change Card Sorting Test (Post-test = 3.32 ± 2.37, Follow-Up = 3.67 ± 2.35; p = 0.054), the Pattern Comparison Processing Speed Test (Post-test = 13.69 ± 9.53, Follow-Up = 14.42 ± 10.23 p = 0.079) and the List Sorting Working Memory Test (Post-test = 6.17 ± 4.41, Follow-Up = 5.94 ± 4.03; p = 0.334). Our findings suggest NFB intervention for 10 weeks produce improvement in executive functions (Inhibitory Control and Attention and Cognitive Flexibility), Processing Speed and Working Memory in ASD Children.

Extrahippocampal Contributions to Social Memory: The Role of Septal Nuclei

Social memory, the ability to recognize and remember individuals within a social group, is crucial for social interactions and relationships. Deficits in social memory have been linked to several neuropsychiatric and neurodegenerative disorders. The hippocampus, especially the circuit that links dorsal CA2 and ventral CA1 neurons, is considered a neural substrate for social memory formation. Recent studies have provided compelling evidence of extrahippocampal contributions to social memory. The septal nuclei, including the medial and lateral septum, make up a basal forebrain region that shares bidirectional neuronal connections with the hippocampus and has recently been identified as critical for social memory. The focus of our review is the neural circuit mechanisms that underlie social memory, with a special emphasis on the septum. We also discuss the social memory dysfunction associated with neuropsychiatric and neurodegenerative disorders.

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

INTRODUCTION

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

METHODS

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

RESULTS

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

CONCLUSION

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

Clinical efficacy of neurofeedback protocols in treatment of Attention Deficit/Hyperactivity Disorder (ADHD): A systematic review

Attention Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder of childhood and its effects mostly continue to adulthood. Neurofeedback training has shown promising results in the treatment of ADHD. However, there is no yet consensus as to the efficacy of neurofeedback in comparison to stimulant medication. Despite a large number of meta-analyses and comparative reviews on the effects of neurofeedback in the treatment of ADHD, there is a lack of comparative reviews on the efficacy of neurofeedback protocols. This review aims at examining the effect of different training protocols on the efficacy of neurofeedback in the treatment of ADHD across specific research studies published between 2017 and 2022. Altogether, a total of 916 records were identified and 18 articles met the inclusion criteria. Findings show that the efficacy of different neurofeedback protocols has been comparable to the efficacy of stimulant medications. Nevertheless, there is still room for more clinical trials on neurofeedback protocols for ADHD since some studies suggest not using neurofeedback as a stand-alone treatment for ADHD. To my knowledge, this systematic review is the first to review neurofeedback protocols for ADHD. This study provides significant implications and directions for researchers to conduct research, on alternatives to stimulant medications for ADHD, in the future.