Slow cortical potential neurofeedback in attention deficit hyperactivity disorder: Is there neurophysiological evidence for specific effects?

ArticleinJournal of Neural Transmission 115(10):1445-56 · October 2008with13 Reads
DOI: 10.1007/s00702-008-0104-x · Source: PubMed
Abstract
This study compared changes in quantitative EEG (QEEG) and CNV (contingent negative variation) of children suffering from ADHD treated by SCP (slow cortical potential) neurofeedback (NF) with the effects of group therapy (GT) to separate specific from non-specific neurophysiological effects of NF. Twenty-six children (age: 11.1 +/- 1.15 years) diagnosed as having ADHD were assigned to NF (N = 14) or GT (N = 12) training groups. QEEG measures at rest, CNV and behavioral ratings were acquired before and after the trainings and statistically analyzed. For children with ADHD-combined type in the NF group, treatment effects indicated a tendency toward improvement of selected QEEG markers. We could not find the expected improvement of CNV, but CNV reduction was less pronounced in good NF performers. QEEG changes were associated with some behavioral scales. Analyses of subgroups suggested specific influences of SCP training on brain functions. To conclude, SCP neurofeedback improves only selected attentional brain functions as measurable with QEEG at rest or CNV mapping. Effects of neurofeedback including the advantage of NF over GT seem mediated by both specific and non-specific factors.
    • "We used the RTV from the baseline condition, as this condition is more sensitive to ADHD (Kuntsi et al., 2013). The cued flanker Continuous Performance Task (CPT-OX) (Doehnert et al., 2008; Valko et al., 2009). This CPT includes rare cued Go and NoGo conditions embedded in a vigilance task with frequent distractors to assess attention and inhibition. "
    [Show abstract] [Hide abstract] ABSTRACT: Objective: A controversial issue is whether self-report of symptoms and impairment is sufficient for diagnosis of attention-deficit/hyperactivity disorder (ADHD) in adolescents and adults in the absence of other informants, such as parents. The present study investigated how well self-report is reflected by cognitive-neurophysiological and actigraph measures, which we have previously shown to discriminate between ADHD persisters, remitters and controls using parent-report (Cheung et al., 2015; Brit J Psychiat http://dx.doi.org/10.1192/bjp.bp.114.145185). Method: Parent- and self-reported ADHD symptoms and impairment, together with cognitive, electroencephalogram (EEG) frequency, event-related potential (ERP) and actigraph measures were obtained from 108 adolescents and young adults with childhood ADHD and 167 controls. Results: Participants reported lower levels of ADHD symptoms and impairments than parents (p < 0.05) and the ADHD persistence rate based on self-report was low at 44%, compared to the persistence rate of 79% previously reported based on parent-report. Regression analyses showed that the objective measures distinguished poorly between ADHD persistent and remittent groups based on self-report, in contrast to findings based on parent-report (Cheung et al., 2015), although the measures differentiated well between ADHD persisters and controls. Correlation analyses revealed that self-reported impairment significantly correlated with fewer of the objective measures, despite parent- and self-reported symptoms showing similar correlations with the measures. Conclusions: The findings show that self-reported ADHD outcome is not as well reflected by cognitive-neurophysiological and movement correlates as we previously found for parent-reported ADHD.
    Full-text · Article · Jul 2016
    • "However, other studies with children with ADHD were not able to replicate these results (Doehnert et al., 2008). An additional factor might be a lack of motivation at the end of the long and repetitive testing time, as suggested by Doehnert et al. (2008) . Further , age does not seem to be the only factor affecting the ability to change the CNV through SCP-NF. "
    [Show abstract] [Hide abstract] ABSTRACT: Objective: Attention Deficit-/Hyperactivity Disorder (ADHD) has been treated successfully in children with neurofeedback (NF). In this study, for the first time NF is investigated in adults with ADHD. To answer the question of specificity the relationship between treatment outcome and self-regulation ability is assessed. Methods: Twenty-four participants underwent 30 sessions of slow cortical potential NF. Measurements of ADHD and comorbid symptoms, as well as neurophysiological data (reaction time (RT) and RT variability (RTV) and contingent negative variation (CNV)) were performed before and after treatment, and again six months after sessions were completed. Participants were categorized into self-regulation learners and non-learners. Results: Significant improvements on all symptom scales were observed with medium to large effect sizes after treatment and six months post treatment. RT and RTV decreased significantly and there was a trend for an increased CNV. Half of the participants successfully learned to regulate their brain activity. In the long-term, symptoms in the group of learners improved more than in non-learners with large effect sizes. Conclusion: NF is effective in treating adult ADHD long-term. The impact of self-regulation ability and possible unspecific effects still require further investigation. Significance: This study is the first to investigate the effects of NF in adults with ADHD, relating clinical outcome to self-regulation performance.
    Article · Nov 2015
    • "2.4.1. Cued continuous performance test with flankers (CPT-OX; Doehnert et al., 2008; McLoughlin, et al., 2010): The task consisted of 400 black letters, Including cue letter 'O', target letter 'X' and distractors 'H', 'B', 'C', 'D', 'E', 'F', 'G', 'J' and 'L'. "
    [Show abstract] [Hide abstract] ABSTRACT: Attention-deficit/hyperactivity disorder (ADHD) is associated with cognitive performance and functional brain changes that are sensitive to task conditions, indicating a role for dynamic impairments rather than stable cognitive deficits. Prominent hypotheses consistent with this observation are a failure to optimise brain arousal or activation states. Here we investigate cortical activation during different conditions. Using a sample of 41 non-comorbid adults with ADHD and 48 controls, we examine quantitative EEG activity during a resting state, a cued continuous performance test with flankers (CPT-OX) and the Sustained Attention to Response Task (SART). We further investigate the effects of methylphenidate in a subsample of 21 ADHD cases. Control participants showed a task-related increase in theta activity when engaged in cognitive tasks, primarily in frontal and parietal regions, which was absent in participants with ADHD. Treatment with methylphenidate resulted in normalisation of the resting state to task activation pattern. These findings suggest that ADHD in adults is associated with insufficient allocation of neuronal resources required for normal cortical activation commensurate with task demands. Further work is required to clarify the causal role of the deficit in cortical activation and provide a clearer understanding of the mechanisms involved.
    Article · Nov 2014
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