Neurofeedback of slow cortical potentials as a treatment for adults with Attention Deficit-/Hyperactivity Disorder

Mayer, Konstantin; Blume, Friederike; Wyckoff, Sarah; Brokmeier, Luisa Leonie; Strehl, Ute

doi:10.1016/j.clinph.2015.11.013

Cited by 57 publications

(57 citation statements)

References 59 publications

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“…Mixed results were reported for working-memory tasks, which may be attributable to ceiling effects (Hudak et al, 2017). This is in line with the EEG-neurofeedback literature where similar effects were observed for inhibitory control tasks (Bluschke et al, 2016;Mayer et al, 2016). However, nonspecific factors (psychosocial/placebo effects) may explain a large proportion of the effect sizes found in neurofeedback studies (Ros et al, 2020;Schönenberg et al, 2017;.…”

Section: Conclusion -Behavioral Effects Of Fnirs-neurofeedback In Heasupporting

confidence: 77%

The potential of functional near-infrared spectroscopy-based neurofeedback – a systematic review and recommendations for best practice

Mehler¹,

Lührs²,

Thibault³

et al. 2019

Preprint

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Background: The effects of electroencephalography (EEG) and functional magnetic resonance imaging (fMRI)-neurofeedback on brain activation and behaviors have been studied extensively in the past. More recently, researchers have begun to investigate the effects of functional near-infrared spectroscopy-based neurofeedback (fNIRS-neurofeedback). FNIRS is a functional neuroimaging technique based on brain hemodynamics, which is easy to use, portable, inexpensive, and has reduced sensitivity to movement artifacts.Method: We provide the first systematic review and database of fNIRS-neurofeedback studies, synthesizing findings from 22 peer-reviewed studies (including a total of N=441 participants; 337 healthy, 104 patients). We (1) give a comprehensive overview of how fNIRS-neurofeedback training protocols were implemented, (2) review the online signal-processing methods used, (3) evaluate the quality of studies using pre-set methodological and reporting quality criteria and also present statistical sensitivity/power analyses, (4) investigate the effectiveness of fNIRS-neurofeedback in modulating brain activation, and (5) review its effectiveness in changing behavior in healthy and pathological populations. Results and discussion: (1-2) Published studies are heterogeneous (e.g., neurofeedback targets, investigated populations, applied training protocols, and methods). (3) Large randomized controlled trials are still lacking. In view of the novelty of the field, the quality of the published studies is moderate. We identified room for improvement in reporting important information and statistical power to detect realistic effects. (4) Several studies show that people can regulate hemodynamic signals from cortical brain regions with fNIRS-neurofeedback and (5) these studies indicate the feasibility of modulating motor control and prefrontal brain functioning in healthy participants and ameliorating symptoms in clinical populations (stroke, ADHD, autism, and social anxiety). However, valid conclusions about specificity or potential clinical utility are premature. Conclusion: Due to the advantages of practicability and relatively low cost, fNIRS-neurofeedback might provide a suitable and powerful alternative to EEG and fMRI neurofeedback and has great potential for clinical translation of neurofeedback. Together with more rigorous research and reporting practices, further methodological improvements may lead to a more solid understanding of fNIRS-neurofeedback. Future research will benefit from exploiting the advantages of fNIRS, which offers unique opportunities for neurofeedback research.

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Section: Conclusion -Behavioral Effects Of Fnirs-neurofeedback In Heasupporting

confidence: 77%

The potential of functional near-infrared spectroscopy-based neurofeedback – a systematic review and recommendations for best practice

Mehler¹,

Lührs²,

Thibault³

et al. 2019

Preprint

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“… a No effect sizes given . b The articles by Mayer et al ( 44 , 45 ) refer to the same study. Description is based on Mayer et al ( 45 ) .…”

Section: Resultsmentioning

confidence: 99%

“… Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram of selection of studies. Two articles included in the search results ( 44 , 45 ) refer to the same study, so the flow chart does not count them twice. …”

Section: Methodsmentioning

confidence: 99%

Neurofeedback Training for Psychiatric Disorders Associated with Criminal Offending: A Review

Fielenbach

Donkers

Spreen³

et al. 2018

Front. Psychiatry

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BackgroundEffective treatment interventions for criminal offenders are necessary to reduce risk of criminal recidivism. Evidence about deviant electroencephalographic (EEG)-frequencies underlying disorders found in criminal offenders is accumulating. Yet, treatment modalities, such as neurofeedback, are rarely applied in the forensic psychiatric domain. Since offenders usually have multiple disorders, difficulties adhering to long-term treatment modalities, and are highly vulnerable for psychiatric decompensation, more information about neurofeedback training protocols, number of sessions, and expected symptom reduction is necessary before it can be successfully used in offender populations.MethodStudies were analyzed that used neurofeedback in adult criminal offenders, and in disorders these patients present with. Specifically aggression, violence, recidivism, offending, psychopathy, schizophrenia, attention-deficit hyperactivity disorder (ADHD), substance-use disorder (SUD), and cluster B personality disorders were included. Only studies that reported changes in EEG-frequencies posttreatment (increase/decrease/no change in EEG amplitude/power) were included.ResultsDatabases Psychinfo and Pubmed were searched in the period 1990–2017 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, resulting in a total of 10 studies. Studies in which neurofeedback was applied in ADHD (N = 3), SUD (N = 3), schizophrenia (N = 3), and psychopathy (N = 1) could be identified. No studies could be identified for neurofeedback applied in cluster B personality disorders, aggression, violence, or recidivism in criminal offenders. For all treatment populations and neurofeedback protocols, number of sessions varied greatly. Changes in behavioral levels ranged from no improvements to significant symptom reduction after neurofeedback training. The results are also mixed concerning posttreatment changes in targeted EEG-frequency bands. Only three studies established criteria for EEG-learning.ConclusionImplications of the results for the applicability of neurofeedback training in criminal offender populations are discussed. More research focusing on neurofeedback and learning of cortical activity regulation is needed in populations with externalizing behaviors associated with violence and criminal behavior, as well as multiple comorbidities. At this point, it is unclear whether standard neurofeedback training protocols can be applied in offender populations, or whether QEEG-guided neurofeedback is a better choice. Given the special context in which the studies are executed, clinical trials, as well as single-case experimental designs, might be more feasible than large double-blind randomized controls.

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“…Meta‐analyses of randomized controlled trials (RCT) of EEG‐NF show medium effect sizes for symptom improvements [Arns et al, 2009], reduced to trends when only “probably” blinded raters are included [Holtmann et al, 2014; Sonuga‐Barke et al, 2013]. Crucially, unlike psychostimulant treatment, NF effects seem stable and longer‐lasting (up to 2 years), with no side effects [Arns and Kenemans, 2014; Gani et al, 2008; Gevensleben et al, 2010; Leins et al, 2007; Mayer et al, 2016; Steiner et al, 2014; Strehl et al, 2006]. …”

Section: Introductionmentioning

confidence: 99%

Real‐time fMRI neurofeedback in adolescents with attention deficit hyperactivity disorder

Alegría

Wulff

Brinson

et al. 2017

Human Brain Mapping

117

103

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Attention Deficit Hyperactivity Disorder (ADHD) is associated with poor self‐control, underpinned by inferior fronto‐striatal deficits. Real‐time functional magnetic resonance neurofeedback (rtfMRI‐NF) allows participants to gain self‐control over dysregulated brain regions. Despite evidence for beneficial effects of electrophysiological‐NF on ADHD symptoms, no study has applied the spatially superior rtfMRI‐NF neurotherapy to ADHD. A randomized controlled trial tested the efficacy of rtfMRI‐NF of right inferior prefrontal cortex (rIFG), a key region that is compromised in ADHD and upregulated with psychostimulants, on improvement of ADHD symptoms, cognition, and inhibitory fMRI activation. To control for region‐specificity, an active control group received rtfMRI‐NF of the left parahippocampal gyrus (lPHG). Thirty‐one ADHD boys were randomly allocated and had to learn to upregulate their target brain region in an average of 11 rtfMRI‐NF runs over 2 weeks. Feedback was provided through a video‐clip of a rocket that had to be moved up into space. A transfer session without feedback tested learning retention as a proximal measure of transfer to everyday life. Both NF groups showed significant linear activation increases with increasing number of runs in their respective target regions and significant reduction in ADHD symptoms after neurotherapy and at 11‐month follow‐up. Only the group targeting rIFG, however, showed a transfer effect, which correlated with ADHD symptom reductions, improved at trend level in sustained attention, and showed increased IFG activation during an inhibitory fMRI task. This proof‐of‐concept study demonstrates for the first time feasibility, safety, and shorter‐ and longer‐term efficacy of rtfMRI‐NF of rIFG in adolescents with ADHD. Hum Brain Mapp 38:3190–3209, 2017. © 2017 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc.

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Neurofeedback of slow cortical potentials as a treatment for adults with Attention Deficit-/Hyperactivity Disorder

Cited by 57 publications

References 59 publications

The potential of functional near-infrared spectroscopy-based neurofeedback – a systematic review and recommendations for best practice

The potential of functional near-infrared spectroscopy-based neurofeedback – a systematic review and recommendations for best practice

Neurofeedback Training for Psychiatric Disorders Associated with Criminal Offending: A Review

Real‐time fMRI neurofeedback in adolescents with attention deficit hyperactivity disorder

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