Neurofeedback trains a superordinate system relevant for seemingly opposing behavioral control deficits depending on ADHD subtype

Bluschke, Annet; Schreiter, Marie Luise; Friedrich, Julia; Adelhöfer, Nico; Roessner, Veit; Beste, Christian

doi:10.1111/desc.12956

Cited by 12 publications

(10 citation statements)

References 72 publications

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“…Furthermore, it is still elusive whether a specific subtype is critical to consider when examining treatment effects. For example, a recent study suggests that the effectiveness of neurofeedback treatment on the executive functioning of children with ADHD is subtype-specific [ 12 ]. ADHD-I showed improved performance on the execution of an action in an experimental Go/NoGo task while the ADHD-C showed improved ability to withhold a prepotent response tendency in NoGo trials.…”

Section: Introductionmentioning

confidence: 99%

ADHD subtype-specific cognitive correlates and association with self-esteem: a quantitative difference

Molavi¹,

Nadermohammadi²,

Ghojehbeiglou³

et al. 2020

BMC Psychiatry

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Background Attention-deficit hyperactivity disorder (ADHD) is a major neurodevelopmental disorder with heterogeneous symptoms, subtypes, and cognitive deficits. Cognitive deficits are central to ADHD pathophysiology and one potential source of heterogeneity in ADHD. Subtype-specific cognitive correlates are not, however, well-studied. We explored cognitive correlates of ADHD subtypes based on the Wechsler Intelligence Scale for Children (WISC-IV) scores. We also assessed subtype-specific self-esteem rating in ADHD subtypes and explored its association with cognitive correlates. Methods One hundred thirty-nine children with ADHD (80.6% boy, 19.4% girl) were categorized into the predominantly “hyperactive (ADHD-H)”, “inattentive (ADHD-I)” and “combined (ADHD-C)” subtype based on their symptoms and scores on the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS-PL) and Conners Parent-Rating Scale (CPRS-RS). They were then individually administrated the WISC-IV and completed a self-esteem inventory. Group differences in the WISC-IV indices and their predictability in discriminating ADHD subtypes were analyzed. Results We found a quantitative differentiation of cognitive abilities among ADHD subtypes with “working memory” as the most compromised cognitive domain. ADHD-I had the poorest cognitive profile while ADHD-H scored highest in all cognitive domains. Importantly, cognitive abilities were negatively correlated with inattention and positively correlated with hyperactive symptoms. Moreover, self-esteem ratings were positively correlated with the cognitive domains and were rated differently based on the subtypes. ADHD-H, with the highest cognitive strength, reported the highest level of self-esteem among all subtypes. Conclusions ADHD subtype-specific symptoms, cognitive deficits, and self-esteem problems should be considered for precise diagnosis and effective and personalized treatment in ADHD in light of further supporting evidence and assessments. Cognitive interventions might be more compatible with and effective in inattentive and combined subtypes of ADHD. Working memory improving-based interventions can benefit all ADHD subtypes. A supportive educational system in school and providing adjunct supportive interventions should be considered for children with ADHD as well.

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Section: Introductionmentioning

confidence: 99%

ADHD subtype-specific cognitive correlates and association with self-esteem: a quantitative difference

Molavi¹,

Nadermohammadi²,

Ghojehbeiglou³

et al. 2020

BMC Psychiatry

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“…We found no association between attention or ADHD diagnosis, assessed by a parent questionnaire, and sensory or sensorimotor gating. Perhaps attentional difficulties do not originate from a general gating deficit but rather from a specific issue with controlled attention ( 76 , 77 ). For instance, a sample of 10–12-year-olds with ADHD did not show any differences in PPI during a passive listening task but when participants had to actively ignore the stimuli, an attenuated PPI response was observed ( 78 ).…”

Section: Discussionmentioning

confidence: 99%

Prepulse Inhibition and P50 Suppression in Relation to Creativity and Attention: Dispersed Attention Beneficial to Quantitative but Not Qualitative Measures of Divergent Thinking

et al. 2022

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The current study investigated whether lower sensory and sensorimotor gating were related to higher levels of creativity and/or attentional difficulties in a natural population of primary school children (9- to 13-year-old). Gating abilities were measured with P50 suppression and prepulse inhibition of the startle reflex (PPI). The final sample included 65 participants in the P50 analyses and 37 participants in the PPI analyses. Our results showed that children with a high P50 amplitude to testing stimuli scored significantly higher on the divergent outcome measures of fluency and flexibility but not originality compared to children with a lower amplitude. No significant differences were found on any of the creativity measures when the sample was split on average PPI parameters. No significant differences in attention, as measured with a parent questionnaire, were found between children with low or high levels of sensory or sensorimotor gating. The data suggest that quantitative, but not qualitative measures of divergent thinking benefit from lower psychophysiological gating and that attentional difficulties stem from specific instead of general gating deficits. Future studies should take the effect of controlled attention into consideration.

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“…Concerning beta band activity, its functional relevance and importance in theta/beta NF protocols and its effect on cognitive control processes in ADHD is largely elusive. Basic research suggests that beta band activity is important to allow a high functioning of cognitive (attentional) and sensorimotor systems (Engel & Fries, 2010 ; Studer et al, 2014 ; Womelsdorf & Everling, 2015 ) and enables response regulation processes (Bluschke et al, 2020 ; Dahan et al, 2018 ) allowing sensory information to efficiently guide subsequent motor actions (MacKay, 1997 ). This may be the reason why training to upregulate beta band activity is useful for the enhancement of cognitive control processes (Bluschke et al, 2020 , 2016a , 2016b ).…”

Section: Introductionmentioning

confidence: 99%

The Effects of Different Theta and Beta Neurofeedback Training Protocols on Cognitive Control in ADHD

et al. 2022

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Neurofeedback (NF) is an important treatment for attention deficit/hyperactivity disorder (ADHD). In ADHD, cognitive control deficits pose considerable problems to patients. However, NF protocols are not yet optimized to enhance cognitive control alongside with clinical symptoms, partly because they are not driven by basic cognitive neuroscience. In this study, we evaluated different EEG theta and/or beta frequency band NF protocols designed to enhance cognitive control. Participants were n = 157 children and adolescents, n = 129 of them were patients with ADHD (n = 28 typically developing (TD) controls). Patients with ADHD were divided into five groups in the order of referral, with four of them taking part in different NF protocols systematically varying theta and beta power. The fifth ADHD group and the TD group did not undergo NF. All NF protocols resulted in reductions of ADHD symptoms. Importantly, only when beta frequencies were enhanced during NF (without any theta regulation or in combination with theta upregulation), consistent enhancing effects in both response inhibition and conflict control were achieved. The theta/beta NF protocol most widely used in clinical settings revealed comparatively limited effects. Enhancements in beta band activity are key when aiming to improve cognitive control functions in ADHD. This calls for a change in the use of theta/beta NF protocols and shows that protocols differing from the current clinical standard are effective in enhancing important facets of cognitive control in ADHD. Further studies need to examine regulation data within the neurofeedback sessions to provide more information about the mechanisms underlying the observed effects.

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Neurofeedback trains a superordinate system relevant for seemingly opposing behavioral control deficits depending on ADHD subtype

Cited by 12 publications

References 72 publications

ADHD subtype-specific cognitive correlates and association with self-esteem: a quantitative difference

ADHD subtype-specific cognitive correlates and association with self-esteem: a quantitative difference

Prepulse Inhibition and P50 Suppression in Relation to Creativity and Attention: Dispersed Attention Beneficial to Quantitative but Not Qualitative Measures of Divergent Thinking

The Effects of Different Theta and Beta Neurofeedback Training Protocols on Cognitive Control in ADHD

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