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Wilens TE, Stone M, Lanni S, Berger A, Wilson RLH, Lydston M, Surman CB. Treating Executive Function in Youth With Attention Deficit Hyperactivity Disorder: A Review of Pharmacological and Non-Pharmacological Interventions. J Atten Disord 2024; 28:751-790. [PMID: 38178649 DOI: 10.1177/10870547231218925] [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] [Indexed: 01/06/2024]
Abstract
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.
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Affiliation(s)
- Timothy E Wilens
- Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Mira Stone
- Massachusetts General Hospital, Boston, MA, USA
| | | | - Amy Berger
- Massachusetts General Hospital, Boston, MA, USA
| | | | | | - Craig B Surman
- Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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Kaiser A, Aggensteiner PM, Blasco Fontecilla H, Ros T, Acquaviva E, Attal Y, Banaschewski T, Baumeister S, Bousquet E, Bussalb A, Delhaye M, Delorme R, Drechsler R, Goujon A, Häge A, Mayaud L, Mechler K, Menache C, Revol O, Tagwerker F, Walitza S, Werling AM, Bioulac S, Purper-Ouakil D, Brandeis D. Limited usefulness of neurocognitive functioning indices as predictive markers for treatment response to methylphenidate or neurofeedback@home in children and adolescents with ADHD. Front Psychiatry 2024; 14:1331004. [PMID: 38312916 PMCID: PMC10836215 DOI: 10.3389/fpsyt.2023.1331004] [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: 10/31/2023] [Accepted: 12/29/2023] [Indexed: 02/06/2024] Open
Abstract
Introduction Earlier studies exploring the value of executive functioning (EF) indices for assessing treatment effectiveness and predicting treatment response in attention-deficit/hyperactivity disorder (ADHD) mainly focused on pharmacological treatment options and revealed rather heterogeneous results. Envisioning the long-term goal of personalized treatment selection and intervention planning, this study comparing methylphenidate treatment (MPH) and a home-based neurofeedback intervention (NF@Home) aimed to expand previous findings by assessing objective as well as subjectively reported EF indices and by analyzing their value as treatment and predictive markers. Methods Children and adolescents (n = 146 in the per protocol sample) aged 7-13 years with a formal diagnosis of an inattentive or combined presentation of ADHD were examined. We explored the EF performance profile using the Conners Continuous Performance Task (CPT) and the BRIEF self-report questionnaire within our prospective, multicenter, randomized, reference drug-controlled NEWROFEED study with sites in five European countries (France, Spain, Switzerland, Germany, and Belgium). As primary outcome for treatment response, the clinician-rated ADHD Rating Scale-IV was used. Patients participating in this non-inferiority trial were randomized to either NF@home (34-40 sessions of TBR or SMR NF depending on the pre-assessed individual alpha peak frequency) or MPH treatment (ratio: 3:2). Within a mixed-effects model framework, analyses of change were calculated to explore the predictive value of neurocognitive indices for ADHD symptom-related treatment response. Results For a variety of neurocognitive indices, we found a significant pre-post change during treatment, mainly in the MPH group. However, the results of the current study reveal a rather limited prognostic value of neurocognitive indices for treatment response to either NF@Home or MPH treatment. Some significant effects emerged for parent-ratings only. Discussion Current findings indicate a potential value of self-report (BRIEF global score) and some objectively measured neurocognitive indices (CPT commission errors and hit reaction time variability) as treatment markers (of change) for MPH. However, we found a rather limited prognostic value with regard to predicting treatment response not (yet) allowing recommendation for clinical use. Baseline symptom severity was revealed as the most relevant predictor, replicating robust findings from previous studies.
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Affiliation(s)
- Anna Kaiser
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Pascal M Aggensteiner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | | | - Tomas Ros
- Department of Neuroscience, Campus Biotech CISA-Université de Genève, Genève, Switzerland
| | - Eric Acquaviva
- Child and Adolescent Psychiatry Department and Child Brain Institute, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris and Universite Paris Cite, Paris, France
| | | | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Sarah Baumeister
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Elisa Bousquet
- Unit of Child and Adolescent Psychiatry (MPEA1), CHU Montpellier-Saint Eloi Hospital, University of Montpellier, Montpellier, France
| | | | - Marie Delhaye
- Child and Adolescent Psychiatry, Erasme Academic Hospital, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Richard Delorme
- Child and Adolescent Psychiatry Department and Child Brain Institute, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris and Universite Paris Cite, Paris, France
| | - Renate Drechsler
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Allison Goujon
- Unit of Child and Adolescent Psychiatry (MPEA1), CHU Montpellier-Saint Eloi Hospital, University of Montpellier, Montpellier, France
| | - Alexander Häge
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | | | - Konstantin Mechler
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | | | - Olivier Revol
- Unit of Child and Adolescent Psychiatry, Hospices civils de Lyon, Hôpital Femme Mère Enfant, Bron Cedex, France
| | - Friederike Tagwerker
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Anna Maria Werling
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Stéphanie Bioulac
- SANPSY, USR 3413, CNRS, Bordeaux, France
- Clinique du Sommeil, CHU Pellegrin, Bordeaux Cedex, France
| | - Diane Purper-Ouakil
- Unit of Child and Adolescent Psychiatry (MPEA1), CHU Montpellier-Saint Eloi Hospital, University of Montpellier, Montpellier, France
- Development and Trajectories, INSERM CESP U 1018 Psychiatry, Montpellier, France
- CESP, INSERM U 1018, Paul Brousse Hospital, Villejuif, France
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
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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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Flanagan K, Saikia MJ. Consumer-Grade Electroencephalogram and Functional Near-Infrared Spectroscopy Neurofeedback Technologies for Mental Health and Wellbeing. SENSORS (BASEL, SWITZERLAND) 2023; 23:8482. [PMID: 37896575 PMCID: PMC10610697 DOI: 10.3390/s23208482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 09/04/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023]
Abstract
Neurofeedback, utilizing an electroencephalogram (EEG) and/or a functional near-infrared spectroscopy (fNIRS) device, is a real-time measurement of brain activity directed toward controlling and optimizing brain function. This treatment has often been attributed to improvements in disorders such as ADHD, anxiety, depression, and epilepsy, among others. While there is evidence suggesting the efficacy of neurofeedback devices, the research is still inconclusive. The applicability of the measurements and parameters of consumer neurofeedback wearable devices has improved, but the literature on measurement techniques lacks rigorously controlled trials. This paper presents a survey and literary review of consumer neurofeedback devices and the direction toward clinical applications and diagnoses. Relevant devices are highlighted and compared for treatment parameters, structural composition, available software, and clinical appeal. Finally, a conclusion on future applications of these systems is discussed through the comparison of their advantages and drawbacks.
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Affiliation(s)
- Kira Flanagan
- Electrical Engineering, University of North Florida, Jacksonville, FL 32224, USA
- Biomedical Sensors and Systems Laboratory, University of North Florida, Jacksonville, FL 32224, USA
| | - Manob Jyoti Saikia
- Electrical Engineering, University of North Florida, Jacksonville, FL 32224, USA
- Biomedical Sensors and Systems Laboratory, University of North Florida, Jacksonville, FL 32224, USA
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Qiu H, Liang X, Wang P, Zhang H, Shum DHK. Efficacy of non-pharmacological interventions on executive functions in children and adolescents with ADHD: A systematic review and meta-analysis. Asian J Psychiatr 2023; 87:103692. [PMID: 37450981 DOI: 10.1016/j.ajp.2023.103692] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE Although front-line doctors recommend medications, this kind of treatment has limited efficacy in improving executive functions (EFs) in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). This study explored the effects of non-pharmacological intervention on EFs in children and adolescents with ADHD. METHODS In accordance with the Preferred Reporting Items for Systematic Review and Meta-analyses guidelines, we searched seven electronic databases: APA PsycINFO, CINAHL Complete, EMBASE, ERIC, Medline, Pubmed, and Web of Science, from inception to March 2022. Two authors independently screened studies for eligibility, extracted data, and assessed bias risk using the Physiotherapy Evidence Database scale. Our analyses included randomized controlled trials and non-randomized comparison studies of non-pharmacological interventions and assessed EFs through neurocognitive tasks in children and adolescents between 5 and 18 years. RESULTS Sixty-seven studies with 3147 participants met the inclusion criteria. The final meta-analysis included 74 independent interventions categorized into six categories: cognitive training, EF-specific curriculum, game-based training, mindfulness practice, neurofeedback training, and physical exercise. Overall, non-pharmacological interventions (combined) produced significant moderate to large effects on overall EFs in children and adolescents with ADHD (g=0.673). Physical exercise had a large positive effect on domain-specific EFs, including inhibitory control (g=0.900) and cognitive flexibility (g=1.377). Cognitive training had a large training effect on working memory (g=0.907), and an EF-specific curriculum had a small to moderate beneficial effect on planning performance (g=0.532). CONCLUSION Non-pharmacological interventions, particularly physical exercise, cognitive training, and an EF-specific curriculum, appear to have beneficial effects on EFs in children and adolescents with ADHD.
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Affiliation(s)
- Hui Qiu
- Department of Educational Administration and Policy, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Xiao Liang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China.
| | - Peng Wang
- Center for Lifestyle Medicine, Fuwai Hospital, Chinese Academy of Medical, Sciences & Peking Union Medical College, Beijing, China
| | - Hui Zhang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China; Research Institute for Intelligent Wearable Systems, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - David H K Shum
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
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Wu JH, Yang CY, Chang YC, Shan YC. Effects of Near-Infrared Pulsed Light on the Attention of Human Beings Using Electroencephalography. Life (Basel) 2023; 13:1490. [PMID: 37511867 PMCID: PMC10381890 DOI: 10.3390/life13071490] [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: 05/19/2023] [Revised: 06/21/2023] [Accepted: 06/30/2023] [Indexed: 07/30/2023] Open
Abstract
In our previous studies, photobiomodulation (PBM) stimulation can induce significant brain activation in normal subjects. In an open-eye study, the PBM stimulation was able to increase the power of alpha rhythms and theta waves, as well as decrease the beta activities after PBM stimulation. However, in the closed eyes study, the alpha rhythms in the laser group were reduced. This means the PBM stimulation can induce specific brainwaves under different conditions. Thus, to investigate the effects of PBM stimulation on human's attention, forty students were recruited in this single-blind randomized trial. A PBM stimulator, with seven pcs laser diodes (LDs), frequency 10 Hz, 30 mW/each LD, and wavelength 830 nm, was used to radiate the palm of the subject. PBM stimulation was found to induce significant variation in beta activity in most of the regions of the brain in the laser group. Compared to the placebo group, the PBM stimulation has a significant change in beta activity on electroencephalography (EEG). Three types of tests, the random number test, the Stroop color-word test, and the Multiple-Dimension Attention Test (MDAT), were used to evaluate the effects of the PBM stimulation. The scores of MDAT in the laser group increased more significantly than those in the placebo group after PBM stimulation (p < 0.01). An improvement in attention was observed in this study.
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Affiliation(s)
- Jih-Huah Wu
- Department of Biomedical Engineering, Ming Chuan University, No. 5, Deming Rd., Gweishan Township, Taoyuan 333, Taiwan
| | - Chia-Yen Yang
- Department of Biomedical Engineering, Ming Chuan University, No. 5, Deming Rd., Gweishan Township, Taoyuan 333, Taiwan
| | - Yang-Chyuan Chang
- Department of Neurology, Min-Sheng General Hospital, No. 168, Jin-Kuo Rd., Taoyuan 330, Taiwan
| | - Yi-Chia Shan
- Department of Information and Telecommunications Engineering, Ming Chuan University, No. 5, Deming Rd., Gweishan Township, Taoyuan 333, Taiwan
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Jamil N, Belkacem AN, Lakas A. On enhancing students' cognitive abilities in online learning using brain activity and eye movements. EDUCATION AND INFORMATION TECHNOLOGIES 2023; 28:4363-4397. [PMID: 36277512 PMCID: PMC9574174 DOI: 10.1007/s10639-022-11372-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 09/19/2022] [Indexed: 05/11/2023]
Abstract
The COVID-19 pandemic has interrupted education institutions in over 150 nations, affecting billions of students. Many governments have forced a transition in higher education from in-person to remote learning. After this abrupt, worldwide transition away from the classroom, some question whether online education will continue to grow in acceptance in post-pandemic times. However, new technology, such as the brain-computer interface and eye-tracking, have the potential to improve the remote learning environment, which currently faces several obstacles and deficiencies. Cognitive brain computer interfaces can help us develop a better understanding of brain functions, allowing for the development of more effective learning methodologies and the enhancement of brain-based skills. We carried out a systematic literature review of research on the use of brain computer interfaces and eye-tracking to measure students' cognitive skills during online learning. We found that, because many experimental tasks depend on recorded rather than real-time video, students don't have direct and real-time interaction with their teacher. Further, we found no evidence in any of the reviewed papers for brain-to-brain synchronization during remote learning. This points to a potentially fruitful future application of brain computer interfaces in education, investigating whether the brains of student-teacher pairs who interact with the same course content have increasingly similar brain patterns.
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Affiliation(s)
- Nuraini Jamil
- Department of Computer Science and Software Engineering, College of Information Technology, UAE University, P.O. Box 15551 Abu Dhabi Al-Ain, UAE
| | - Abdelkader Nasreddine Belkacem
- Department of Computer and Network Engineering, College of Information Technology, UAE University, P.O. Box 15551 Abu Dhabi Al-Ain, UAE
| | - Abderrahmane Lakas
- Department of Computer and Network Engineering, College of Information Technology, UAE University, P.O. Box 15551 Abu Dhabi Al-Ain, UAE
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Chiu HJ, Sun CK, Fan HY, Tzang RF, Wang MY, Cheng YC, Cheng YS, Yeh PY, Chung W. Surface electroencephalographic neurofeedback improves sustained attention in ADHD: a meta-analysis of randomized controlled trials. Child Adolesc Psychiatry Ment Health 2022; 16:104. [PMID: 36536438 PMCID: PMC9764556 DOI: 10.1186/s13034-022-00543-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The efficacy of surface electroencephalographic neurofeedback (EEG-NF) for improving attentional performance assessed by laboratory measures in patients with attention-deficit/hyperactivity disorder (ADHD) remains unclear. METHODS Following the PRISMA guidelines, the PubMed, Embase, ClinicalKey, Cochrane CENTRAL, ScienceDirect, Web of Science, and ClinicalTrials.gov databases were systematically searched for randomized controlled trials on the efficacy of surface EEG-NF against ADHD focusing on attentional performance evaluated by laboratory measures from inception to January 2022. RESULTS Fourteen eligible studies were analyzed. Of the 718 participants involved, 429 diagnosed with ADHD received EEG-NF treatment. Significant improvement in attentional performance in ADHD subjects receiving EEG-NF was noted compared to their comparators (p < 0.01). Besides, there was a significant EEG-NF-associated beneficial effect on sustained attention (Hedges' g = 0.32, p < 0.01), whereas the impact on selective attention (p = 0.57) and working memory (p = 0.59) was limited. Moreover, protocol including beta wave enhancement was superior to that only focusing on reducing theta/beta ratio or modulation of slow cortical potential. Subgroup analyses showed that three sessions per week of EEG-NF produced the best effect, while the efficacy of surface EEG-NF was much poorer (Hedges' g = 0.05) when only studies that blinded their participants from knowledge of treatment allocation were included. No significant difference was noted in the improvement of attentional performance 6-12 months after EEG-NF intervention (n = 3, p = 0.42). CONCLUSIONS Our results demonstrated the satisfactory effectiveness of surface EEG-NF for improving sustained attention, especially when beta wave enhancement was included, despite its failure to sustain a long-term effect. Further large-scale trials are warranted to support our findings.
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Affiliation(s)
- Hsien-Jane Chiu
- Taoyuan Psychiatric Center, Ministry of Health and Welfare, Taoyuan, Taiwan.,Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Cheuk-Kwan Sun
- Department of Emergency Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.,School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Hsin-Yi Fan
- Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai's Home, No. 509, Fengping 1St Rd., Daliao Dist, Kaohsiung, Taiwan
| | - Ruu-Fen Tzang
- Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan
| | - Ming-Yu Wang
- Department of Psychiatry, China Medical University Hsinchu Hospital, China Medical University, Hsinchu, Taiwan.,Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - Ying-Chih Cheng
- Department of Psychiatry, China Medical University Hsinchu Hospital, China Medical University, Hsinchu, Taiwan.,Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.,Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yu-Shian Cheng
- Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai's Home, No. 509, Fengping 1St Rd., Daliao Dist, Kaohsiung, Taiwan.
| | - Pin-Yang Yeh
- Department of Psychology, College of Medical and Health Science, Asia University, 500, Lioufeng Rd., Wufeng, Taichung, 41354, Taiwan.
| | - Weilun Chung
- Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai's Home, No. 509, Fengping 1St Rd., Daliao Dist, Kaohsiung, Taiwan.
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Cervantes JA, López S, Molina J, López F, Perales-Tejeda M, Carmona-Frausto J. CogniDron-EEG: A system based on a brain-computer interface and a drone for cognitive training. COGN SYST RES 2022. [DOI: 10.1016/j.cogsys.2022.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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10
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Oda K, Colman R, Koshiba M. Simplified Attachable EEG Revealed Child Development Dependent Neurofeedback Brain Acute Activities in Comparison with Visual Numerical Discrimination Task and Resting. SENSORS (BASEL, SWITZERLAND) 2022; 22:7207. [PMID: 36236305 PMCID: PMC9572555 DOI: 10.3390/s22197207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
The development of an easy-to-attach electroencephalograph (EEG) would enable its frequent use for the assessment of neurodevelopment and clinical monitoring. In this study, we designed a two-channel EEG headband measurement device that could be used safely and was easily attachable and removable without the need for restraint or electrode paste or gel. Next, we explored the use of this device for neurofeedback applications relevant to education or neurocognitive development. We developed a prototype visual neurofeedback game in which the size of a familiar local mascot changes in the PC display depending on the user's brain wave activity. We tested this application at a local children's play event. Children at the event were invited to experience the game and, upon agreement, were provided with an explanation of the game and support in attaching the EEG device. The game began with a consecutive number visual discrimination task which was followed by an open-eye resting condition and then a neurofeedback task. Preliminary linear regression analyses by the least-squares method of the acquired EEG and age data in 30 participants from 5 to 20 years old suggested an age-dependent left brain lateralization of beta waves at the neurofeedback stage (p = 0.052) and of alpha waves at the open-eye resting stage (p = 0.044) with potential involvement of other wave bands. These results require further validation.
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Affiliation(s)
- Kazuyuki Oda
- Engineering Department, Graduate School of Sciences and Technology for Innovation Yamaguchi University, Yamaguchi 755-8611, Japan
| | - Ricki Colman
- Department of Cell and Regenerative Biology, University of Wisconsin, Madison, Madison, WI 53706, USA
| | - Mamiko Koshiba
- Engineering Department, Graduate School of Sciences and Technology for Innovation Yamaguchi University, Yamaguchi 755-8611, Japan
- Department of Pediatrics, Saitama Medical University, Saitama 350-0495, Japan
- Graduate School of Information Sciences, Tohoku University, Sendai 980-8579, Japan
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11
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Nan W, Wan M, Jiang Y, Shi X, Wan F, Cai D. Alpha/Theta Ratio Neurofeedback Training for Attention Enhancement in Normal Developing Children: A Brief Report. Appl Psychophysiol Biofeedback 2022; 47:223-229. [PMID: 35691974 DOI: 10.1007/s10484-022-09550-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2022] [Indexed: 01/12/2023]
Abstract
Attention plays an important role in children's development and learning, and neurofeedback training (NFT) has been proposed as a promising method to improve attention, mainly in population with attention problems such as attention deficit hyperactivity disorder. However, whether this approach has a positive effect on attention in normal developing children has been rarely investigated. This pilot study conducted ten sessions of alpha/theta ratio (ATR) NFT on eight primary students in school environment, with two to three sessions per week. The results showed inter-individual difference in NFT learning efficacy that was assessed by the slope of ATR over training sessions. In addition, the attention performance was significantly improved after NFT. Importantly, the improvement of attention performance was positively correlated with the NFT learning efficacy. It thus highlighted the need for optimizing ATR NFT protocol for the benefits on attention at the individual level. Future work can employ a double-blind placebo-controlled design with larger sample size to validate the benefits of ATR NFT for attention in normal developing children.
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Affiliation(s)
- Wenya Nan
- Department of Psychology, Shanghai Normal University, Shanghai, China
| | - Mengqi Wan
- Department of Psychology, Shanghai Normal University, Shanghai, China
| | - Yali Jiang
- Department of Psychology, Shanghai Normal University, Shanghai, China
| | - Xiaoping Shi
- Department of Psychology, Shanghai Normal University, Shanghai, China
| | - Feng Wan
- Department of Electrical and Computer Engineering, Faculty of Science and Engineering, University of Macau, Macau, China
- Centre for Cognitive and Brain Sciences, Institute of Collaborative Innovation, University of Macau, Macau, China
| | - Dan Cai
- Department of Psychology, Shanghai Normal University, Shanghai, China.
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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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Kaushik P, Jena SPK. Effect of cognitive behavioral intervention on electroencephalographic band powers of children with learning difficulty under eyes-closed and eyes-open conditions. ARQUIVOS DE NEURO-PSIQUIATRIA 2022; 80:224-232. [DOI: 10.1590/0004-282x-anp-2020-0503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 06/14/2021] [Indexed: 11/22/2022]
Abstract
ABSTRACT Background: Electroencephalography (EEG) plays an important role in assessing children with learning difficulties or related behavioral issues. Understanding EEG alterations in students with learning difficulties is crucial for evaluating cognitive functioning. Objective: The first aim was to examine the effects of the Program for Enhancing Academic and Behavioral Learning Skills (PEABLS), a cognitive-behavioral intervention on absolute and relative EEG band powers under eyes-closed and eyes-open conditions. Another aim was to examine the relationship between relative band powers of EEG waveforms through specific cognitive measurements like IQ, working memory and BGT for perceptual motor skills and organization. Methods: This study had a quasi-experimental pre-test post-test research design and involved a group of 50 students with learning problems. PEABLS, an accessible school-based intervention, was offered to academically low-performing students. EEG recordings were conducted before and after the intervention on prefrontal (FP1 FP2), temporal (T3 T4) and occipital (O1 O2) scalp locations. The data acquired were processed using MATLAB to find the absolute and relative band powers of waveforms. Results: Paired t tests on the recorded EEG data suggested that significant improvements in absolute and relative power values of waveforms were achieved, post-intervention. There were significant increases in relative alpha power values in the prefrontal and temporal regions under both eyes-closed and eyes-open conditions and significant increases in relative theta and delta power in the prefrontal and temporal regions. Pearson's correlation suggested that there was a significant relationship between relative alpha and beta power values in the prefrontal and occipital regions, through the cognitive measurements. Conclusion: PEABLS was significative in bringing changes to EEG band powers.
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Rahmani E, Mahvelati A, Alizadeh A, Mokhayeri Y, Rahmani M, Zarabi H, Hassanvandi S. Is neurofeedback effective in children with ADHD? A systematic review and meta-analysis. Neurocase 2022; 28:84-95. [PMID: 35068368 DOI: 10.1080/13554794.2022.2027456] [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: 01/01/2023]
Abstract
To evaluate the evidences related to the effectiveness of neurofeedback treatment for children and adolescent with attention-deficit/hyperactivity disorder (ADHD) based on the most-proximal raters. A systematic review of randomized control trials (RCTs) was carried out across multiple databases. the primary outcome measure was the most proximal ratings of ADHD symptoms in subjects. Conner's Parent Rating Scale (CPRS), Conner's Teacher Rating Scale (CTRS), and ADHD Rating Scale (ADHD-RS- are considered as primary outcomes. Seventeen trials met inclusion criteria (including 1211 patients). Analysis showed that there was no significant benefit of neurofeedback treatment compared with other treatments or control conditions [weighted mean difference/CI = HI-P: -0.02 (-0.26, 0.21), HI-T: 0.01 (-0.46, 0.48), weighted mean difference/CI = I-P: 0.00 (-0.23, 0.23), I-P: 0.12 (-0.14, 0.38)]. The results provide preliminary evidence that neurofeedback treatment is no efficacious clinical method for ADHD and suggest that more RTCs are needed to compare common treatment .
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Affiliation(s)
- Ebrahim Rahmani
- Counseling Psychology, Razi University of Kermanshah, Kermanshah, Iran
| | - Azadeh Mahvelati
- Department of counseling, Imam Reza International University, Mashhad, Iran
| | - Aida Alizadeh
- Department of Clinical Psychology, Faculty of Education and Psychology, University of Science and Research Branch, Tehran, Iran
| | - Yaser Mokhayeri
- Cardiovascular Research Center, Shahid Rahimi Hospital, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Masoud Rahmani
- Clinical Psychology, Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Hamid Zarabi
- Department of Clinical Psychology, School of Behavior Science and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Science, Tehran, Iran
| | - Saba Hassanvandi
- Department of Psychology, Faculty of Humanistic Sciences, Khorramabad Branch, Islamic Azad University, Khorramabad, Iran
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15
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EEG-Based Closed-Loop Neurofeedback for Attention Monitoring and Training in Young Adults. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:5535810. [PMID: 34234929 PMCID: PMC8219410 DOI: 10.1155/2021/5535810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/02/2021] [Accepted: 06/07/2021] [Indexed: 12/05/2022]
Abstract
Attention is an important mechanism for young adults, whose lives largely involve interacting with media and performing technology multitasking. Nevertheless, the existing studies related to attention are characterized by low accuracy and poor attention levels in terms of attention monitoring and inefficiency during attention training. In this paper, we propose an improved random forest- (IRF-) algorithm-based attention monitoring and training method with closed-loop neurofeedback. For attention monitoring, an IRF classifier that uses grid search optimization and multiple cross-validation to improve monitoring accuracy and performance is utilized, and five attention levels are proposed. For attention training, we develop three training modes with neurofeedback corresponding to sustained attention, selective attention, and focus attention and apply a self-control method with four indicators to validate the resulting training effect. An offline experiment based on the Personal EEG Concentration Tasks dataset and an online experiment involving 10 young adults are conducted. The results show that our proposed IRF-algorithm-based attention monitoring approach achieves an average accuracy of 79.34%, thereby outperforming the current state-of-the-art algorithms. Furthermore, when excluding familiarity with the game environment, statistically significant performance improvements (p < 0.05) are achieved by the 10 young adults after attention training, which demonstrates the effectiveness of the proposed serious games. Our work involving the proposed method of attention monitoring and training proves to be reliable and efficient.
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Mazur LM, Adams R, Mosaly PR, Nuamah J, Adapa K, Marks LB. Effect of Simulation-Based Training and Neurofeedback Interventions on Radiation Technologists' Workload, Situation Awareness, and Performance. Pract Radiat Oncol 2020; 11:e124-e133. [PMID: 32853755 DOI: 10.1016/j.prro.2020.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/17/2020] [Accepted: 08/19/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Our purpose was to assess the effect of a combined intervention - simulation-based training supported by neurofeedback sessions - on radiation technologists' (RTs') workload, situation awareness, and performance during routine quality assurance and treatment delivery tasks. METHODS AND MATERIALS As part of a prospective institutional review board approved study, 32 RTs previously randomized to receive versus not receive simulation-based training focused on patient safety were again randomized to receive versus not receive a 3-week neurofeedback intervention (8 sessions of alpha-theta protocol) focused on stress reduction as well as conscious precision, strong focus, and ability to solve arising problems. Perceived workload was quantified using the NASA Task Load Index. Situation awareness was quantified using the situation awareness rating technique. Performance score was calculated using procedural compliance with time-out components and error detection. RESULTS RTs randomized to simulation-based training followed by neurofeedback sessions demonstrated no significant changes in perceived workload or situation awareness scores, but did have better performance compared with other study groups (P < .01). CONCLUSIONS This finding is encouraging and provides basis for using neurofeedback as means to possibly augment performance improvements gained during simulation-based training.
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Affiliation(s)
- Lukasz M Mazur
- Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; School of Information and Library Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Carolina Health Informatics Program, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Robert Adams
- Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Prithima R Mosaly
- Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; School of Information and Library Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Carolina Health Informatics Program, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Joseph Nuamah
- Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Karthik Adapa
- Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Carolina Health Informatics Program, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Lawrence B Marks
- Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Lai YJ, Chang KM. Improvement of Attention in Elementary School Students through Fixation Focus Training Activity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134780. [PMID: 32635159 PMCID: PMC7370093 DOI: 10.3390/ijerph17134780] [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: 05/14/2020] [Revised: 06/26/2020] [Accepted: 06/30/2020] [Indexed: 11/16/2022]
Abstract
The attentional problems of school children are a crucial topic due to abundant information in this digital era. There are five attention dimensions for children: focused attention, sustained attention, selective attention, alternating attention, and divided attention. Focused training is a traditional method of improving attention ability. Subjects are required to focus on a fixed point for an extensive period without blinking and to perceive small objects as large. This study investigates which types of attention indicators are influenced by focus training. Eighty-two grade five and six elementary school students (45 experiment group, 37 control group) were involved. The experiment group underwent focus training for 12 weeks. The training was conducted once per week, and the Attention Scales for Elementary School Children were used before and after the training to examine the children's attention. The percentile rank scores of five attention dimensions and the total attention scale were evaluated. The results gave difference data, defined as post-test results minus the pretest results, where significant differences occurred for the total scale (p < 0.05), focused attention (p < 0.05), and selective attention (p < 0.01). Participants also noted that the training helped them improve concentration during school lessons (54.15%), fall asleep (29.1%), and relax the body (8.4%).
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Affiliation(s)
- Yi-Jung Lai
- Department of Early Childhood Educare, Wu Feng University, Chiayi 62153, Taiwan;
| | - Kang-Ming Chang
- Department of Photonics and Communication Engineering, Asia University, Taichung 41354, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 40402, Taiwan
- Correspondence:
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Salpekar JA. Seeking Alpha: Can Neurofeedback Actually Work? Epilepsy Curr 2020; 20:134-135. [PMID: 32550830 PMCID: PMC7281893 DOI: 10.1177/1535759720916178] [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] [Indexed: 11/27/2022] Open
Abstract
Neurofeedback Impacts Cognition and Quality of Life in Pediatric Focal Epilepsy:
An Exploratory Randomized Double-Blinded Sham-Controlled Trial Morales-Quezada L, Martinez D, El-Hagrassy MM, et al. Epilepsy
Behav. 2019;101(pt A):106570. doi:10.1016/j.yebeh.2019.106570. Objective: Children with epilepsy experience cognitive deficits and well-being issues that
have detrimental effects on their development. Pharmacotherapy is the standard of
care in epilepsy; however, few interventions exist to promote cognitive development
and to mitigate disease burden. We aimed to examine the impact of 2 different
modalities of neurofeedback (NFB) on cognitive functioning and quality of life (QOL)
measurements in children and adolescents with controlled focal epilepsy. The study
also explored the effects of NFB on clinical outcomes and electroencephalography
(EEG) quantitative analysis. Methods: Participants (n = 44) with controlled focal epilepsy were randomized to 1 of 3
arms: sensorimotor rhythm (SMR) NFB (n = 15), slow cortical potentials (SCP) NFB (n
= 16), or sham NFB (n = 13). All participants received 25 sessions of intervention.
The attention switching task (AST), Liverpool Seizure Severity Scale, seizure
frequency, EEG power spectrum, and coherence were measured at baseline,
postintervention, and at 3-month follow-up. Results: In children and adolescents with controlled focal epilepsy, SMR training
significantly reduced reaction time in the AST (P = .006), and this
was correlated with the difference of change for θ power on EEG (P
= .03); only the SMR group showed a significant decrease in β coherence
(P = .03). All groups exhibited improvement in QOL
(P ≤ .05). Conclusions: This study provides the first data on 2 NFB modalities (SMR and SCP) including
cognitive, neurophysiological, and clinical outcomes in pediatric epilepsy.
Sensorimotor rhythm NFB improved cognitive functioning, while all the interventions
showed improvements in QOL, demonstrating a powerful placebo effect in the sham
group.
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Benitez-Andonegui A, Burden R, Benning R, Möckel R, Lührs M, Sorger B. An Augmented-Reality fNIRS-Based Brain-Computer Interface: A Proof-of-Concept Study. Front Neurosci 2020; 14:346. [PMID: 32410938 PMCID: PMC7199634 DOI: 10.3389/fnins.2020.00346] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 03/23/2020] [Indexed: 02/04/2023] Open
Abstract
Augmented reality (AR) enhances the user's environment by projecting virtual objects into the real world in real-time. Brain-computer interfaces (BCIs) are systems that enable users to control external devices with their brain signals. BCIs can exploit AR technology to interact with the physical and virtual world and to explore new ways of displaying feedback. This is important for users to perceive and regulate their brain activity or shape their communication intentions while operating in the physical world. In this study, twelve healthy participants were introduced to and asked to choose between two motor-imagery tasks: mental drawing and interacting with a virtual cube. Participants first performed a functional localizer run, which was used to select a single fNIRS channel for decoding their intentions in eight subsequent choice-encoding runs. In each run participants were asked to select one choice of a six-item list. A rotating AR cube was displayed on a computer screen as the main stimulus, where each face of the cube was presented for 6 s and represented one choice of the six-item list. For five consecutive trials, participants were instructed to perform the motor-imagery task when the face of the cube that represented their choice was facing them (therewith temporally encoding the selected choice). In the end of each run, participants were provided with the decoded choice based on a joint analysis of all five trials. If the decoded choice was incorrect, an active error-correction procedure was applied by the participant. The choice list provided in each run was based on the decoded choice of the previous run. The experimental design allowed participants to navigate twice through a virtual menu that consisted of four levels if all choices were correctly decoded. Here we demonstrate for the first time that by using AR feedback and flexible choice encoding in form of search trees, we can increase the degrees of freedom of a BCI system. We also show that participants can successfully navigate through a nested menu and achieve a mean accuracy of 74% using a single motor-imagery task and a single fNIRS channel.
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Affiliation(s)
- Amaia Benitez-Andonegui
- Department Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht Brain Imaging Center, Maastricht University, Maastricht, Netherlands
- Laboratory for Cognitive Robotics and Complex Self-Organizing Systems, Department of Data Science and Knowledge Engineering, Faculty of Science and Engineering, Maastricht University, Maastricht, Netherlands
| | - Rodion Burden
- Department Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht Brain Imaging Center, Maastricht University, Maastricht, Netherlands
| | - Richard Benning
- Instrumentation Engineering, Dean and Directors Office, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Rico Möckel
- Laboratory for Cognitive Robotics and Complex Self-Organizing Systems, Department of Data Science and Knowledge Engineering, Faculty of Science and Engineering, Maastricht University, Maastricht, Netherlands
| | - Michael Lührs
- Department Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht Brain Imaging Center, Maastricht University, Maastricht, Netherlands
- Research Department, Brain Innovation B.V., Maastricht, Netherlands
| | - Bettina Sorger
- Department Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht Brain Imaging Center, Maastricht University, Maastricht, Netherlands
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