[Neurofeedback training in children with ADHD: behavioral and neurophysiological effects].
Z Kinder Jugendpsychiatr Psychother. 2010 Nov;38(6):409-19; quiz 419-20. PMID: 21128217
Holger Gevensleben, Gunther H Moll, Hartmut Heinrich
Kinder- und Jugendpsychiatrie, Universitätsmedizin Göttingen.
In a multicentre randomised controlled trial, we evaluated the clinical efficacy of neurofeedback (NF) training in children with ADHD and investigated the mechanisms underlying a successful training. We used an attention skills training, coupled with the training setting and demands made upon participants, as the control condition. At the behavioural level, NF was superior to the control group concerning core ADHD symptomatology as well as associated domains. For the primary outcome measure (improvement in the FBB-HKS total score), the effect size was .60. The same pattern of results was obtained at the 6-month follow-up. Thus, NF may be seen as a clinically effective module in the treatment of children with ADHD. At the neurophysiological level (EEG, ERPs), specific effects for the two NF protocols, theta/beta training, and training of slow cortical potentials were demonstrated. For example, for theta/beta training, a decrease of theta activity in the EEG was associated with a reduction of ADHD symptomatology. SCP training was accompanied inter alia by an increase in the contingent negative variation in the attention network test; thus, children were able to allocate more resources for preparation. EEG- and ERP-based predictors were also found. The present article reviewed the findings of the original papers related to the trial and outlines future research topics.
Article Published Date : Nov 01, 2010
Is neurofeedback an efficacious treatment for ADHD? A randomised controlled clinical trial.
J Child Psychol Psychiatry. 2009 Jul;50(7):780-9. Epub 2009 Jan 12. PMID: 19207632
Holger Gevensleben, Birgit Holl, Björn Albrecht, Claudia Vogel, Dieter Schlamp, Oliver Kratz, Petra Studer, Aribert Rothenberger, Gunther H Moll, Hartmut Heinrich
BACKGROUND: For children with attention deficit/hyperactivity disorder (ADHD), a reduction of inattention, impulsivity and hyperactivity by neurofeedback (NF) has been reported in several studies. But so far, unspecific training effects have not been adequately controlled for and/or studies do not provide sufficient statistical power. To overcome these methodological shortcomings we evaluated the clinical efficacy of neurofeedback in children with ADHD in a multisite randomised controlled study using a computerised attention skills training as a control condition. METHODS: 102 children with ADHD, aged 8 to 12 years, participated in the study. Children performed either 36 sessions of NF training or a computerised attention skills training within two blocks of about four weeks each (randomised group assignment). The combined NF treatment consisted of one block of theta/beta training and one block of slow cortical potential (SCP) training. Pre-training, intermediate and post-training assessment encompassed several behaviour rating scales (e.g., the German ADHD rating scale, FBB-HKS) completed by parents and teachers. Evaluation ('placebo') scales were applied to control for parental expectations and satisfaction with the treatment. RESULTS: For parent and teacher ratings, improvements in the NF group were superior to those of the control group. For the parent-rated FBB-HKS total score (primary outcome measure), the effect size was .60. Comparable effects were obtained for the two NF protocols (theta/beta training, SCP training). Parental attitude towards the treatment did not differ between NF and control group. CONCLUSIONS: Superiority of the combined NF training indicates clinical efficacy of NF in children with ADHD. Future studies should further address the specificity of effects and how to optimise the benefit of NF as treatment module for ADHD.
Article Published Date : Jul 01, 2009
Somatosensory alpha oscillations gate perceptual learning efficiency.
Nat Commun. 2019 Jan 16;10(1):263
Authors: Brickwedde M, Krüger MC, Dinse HR
Cognition and perception are closely coupled to alpha power, but whether there is a link between alpha power and perceptual learning efficacy is unknown. Here we show that somatosensory alpha power can be successfully up- and down-regulated with short-term neurofeedback training, which in turn controls subsequent tactile perceptual learning. We find that neurofeedback-induced increases in alpha power lead to enhanced learning, whereas reductions in alpha power impede learning. As a consequence, interindividual learning variability is substantially reduced. No comparable impact is observed for oscillatory power in theta, beta, and lower gamma frequency bands. Our results demonstrate that high pre-learning alpha levels are a requirement for reaching high learning efficiency. These data provide further evidence that alpha oscillations shape the functional architecture of the brain network by gating neural resources and thereby modulating levels of preparedness for upcoming processing.
PMID: 30651567 [PubMed - in process]
What Do Meta-Analyses Have to Say About the Efficacy of Neurofeedback Applied to Children With ADHD? Review of Previous Meta-Analyses and a New Meta-Analysis.
J Atten Disord. 2019 Jan 15;:1087054718821731
Authors: Riesco-Matías P, Yela-Bernabé JR, Crego A, Sánchez-Zaballos E
OBJECTIVE: We reviewed previously published meta-analyses of neurofeedback applied to children with ADHD and conducted a new meta-analysis of randomized controlled trials (RCTs) that updates previous results and incorporates methodological modifications.
METHOD: Searches were carried out through PubMed, Sage, PsycINFO, SpringerLink, and Psicodoc. We used Hedges' (adjusted) g and a random-effects model. To assess heterogeneity, Q and I2 were calculated. We performed different analyses depending on the control groups, ADHD symptoms, pre- and/or posttreament data used and symptom evaluator.
RESULTS: We reviewed seven meta-analyses, and 17 studies were incorporated into the meta-analysis. RCTs support the efficacy of neurofeedback applied to ADHD when most proximal evaluators assess symptoms. Neurofeedback significantly improves inattention symptoms when possibly blinded evaluators assess symptoms. The preliminary results suggest that stimulant medication is more effective than neurofeedback.
CONCLUSION: New RCTs that establish links between ADHD symptom measurements, subjects' learning after neurofeedback, and neurophysiological measures could improve the quality of the conclusions.
PMID: 30646779 [PubMed - as supplied by publisher]
Network neuroscience for optimizing brain-computer interfaces.
Phys Life Rev. 2019 Jan 08;:
Authors: De Vico Fallani F, Bassett DS
Human-machine interactions are being increasingly explored to create alternative ways of communication and to improve our daily life. Based on a classification of the user's intention from the user's underlying neural activity, brain-computer interfaces (BCIs) allow direct interactions with the external environment while bypassing the traditional effector of the musculoskeletal system. Despite the enormous potential of BCIs, there are still a number of challenges that limit their societal impact, ranging from the correct decoding of a human's thoughts, to the application of effective learning strategies. Despite several important engineering advances, the basic neuroscience behind these challenges remains poorly explored. Indeed, BCIs involve complex dynamic changes related to neural plasticity at a diverse range of spatiotemporal scales. One promising antidote to this complexity lies in network science, which provides a natural language in which to model the organizational principles of brain architecture and function as manifest in its interconnectivity. Here, we briefly review the main limitations currently affecting BCIs, and we offer our perspective on how they can be addressed by means of network theoretic approaches. We posit that the emerging field of network neuroscience will prove to be an effective tool to unlock human-machine interactions.
PMID: 30642781 [PubMed - as supplied by publisher]