The Effects of Equine-assisted Activities and Therapy on Resting-state Brain Function in Attention-deficit/Hyperactivity Disorder: A Pilot Study

Abstract

ObjectiveEquine-assisted activities and therapy (EAA/T) have been used as adjunct treatment options for physical and psychosocial rehabilitation. However, the therapeutic effects on resting-state brain function have not yet been studied. The aim of this study is to investigate the effects of EAA/T on participants with attention-deficit/hyperactivity disorder (ADHD) by comparing resting-state functional magnetic resonance imaging (rs-fMRI) signals and their clinical correlates.MethodsTen participants with ADHD participated in a 12-week EAA/T program without any medication. Two rs-fMRIs were acquired for all participants before and after EAA/T. For estimating therapeutic effect, the regional homogeneity (ReHo) method was applied to capture the changes in the regional synchronization of functional signals.ResultsAfter the EAA/T program, clear symptom improvement was found even without medication. Surface-based pairwise comparisons revealed that ReHo in the right precuneus and right pars orbitalis clusters had significantly diminished after the program. Reduced ReHo in the right precuneus cluster was positively correlated with changes in the scores on DuPaul’s ADHD Rating Scale-Korean version.ConclusionOur results indicate that EAA/T is associated with short-range functional connectivity in the regions related to the default mode network and the behavioral inhibition system, which are associated with symptom improvement.

Rehabilitation‐induced brain changes detected through magnetic resonance imaging in children with neurodevelopmental disorders: A systematic review

“…Twenty‐six studies found functional/behavioural improvement after the implemented rehabilitation interventions; however, one study examining the effects of cognitive training on children with ADHD did not find any functional or behavioural improvements (Hoekzema et al, 2011). Eleven studies reported a positive relationship between improvements in rehabilitation‐induced brain plasticity and behavioural measures (Manning et al, 2016; Murdaugh et al, 2016, 2015; Soh et al, 2015; Chaturvedi et al, 2013; You et al, 2005; Kim et al, 2015; Hoekzema et al, 2011; Englander et al, 2015; Sterling et al, 2013; Yoo et al, 2016). In what follows, we review and tabulate the results by studied MRI outcomes: structural connectivity, functional connectivity, cortical activation, and structural volume .…”

“…In children with CP, a 3‐week CIMT intervention induced a more balanced resting state network, which correlated with functional capacity of the hemiplegic hand (Manning et al, 2016). Equine‐assisted therapy reduced ADHD symptoms after 12 weeks, which correlated with improved functional connectivity in the right precuneus and pars orbitalis (Yoo et al, 2016). The only strong‐quality study investigated functional connectivity in children with ASD and showed that 10 weeks of visualizing and verbalizing for language comprehension and thinking intervention increased reading comprehension abilities, which correlated with greater connectivity in Broca's and Wernicke's area (Murdaugh et al, 2015).…”

“…In addition, the resting state networks showed improvement in functions that were related to the intervention goal for each study. For example, right precuneus and pars orbitalis showed improved functional connectivity in children with ADHD who underwent equine‐assisted therapy to ameliorate their attention and impulsivity inhibition (Yoo et al, 2016); the right precuneus is involved in episodic memory retrieval and visuospatial processing (Cavanna and Trimble, 2006) and the pars orbitalis as part of inferior frontal gyrus plays a critical role in executive motor control (Tanji and Hoshi, 2008) and behavioural inhibition (Aron et al, 2004). Another example refers to higher connectivity between sensory (Wernicke's area) and motor (Broca's area) speech regions of the brain in children with ASD who received a treatment called visualizing and verbalizing for language comprehension; the former helps understanding speech and the latter guides the required movement to produce speech.…”

“…Yoo et al, 2016) Reduced similarity/synchronization in resting state activity within the right precuneus and pars orbitalis. The mean change in resting state activity the right precuneus positively correlated with changes in the scores of DuPaul's ADHD Rating Scale-Korean Version.Improvement in ADHD symptoms including attention and hyperactivityStructural Volume(Hoekzema et al, 2011) Increased grey matter volume in right inferior-posterior cerebellum and bilateral middle frontal cortex.…”

A Study Exploring the Implementation of an Equine Assisted Intervention for Young People with Mental Health and Behavioural Issues

“…In addition one pilot study has been undertaken looking at the effects of EAIs and therapy on resting brain state function in attention-deficit/hyperactivity disorder [32]. This study found that the intervention was associated with short range functional connectivity in the regions of the brain related to the behavioural inhibition system, which are associated with symptom improvement in this group.…”