Neurofeedback in ADHD
Hartmut Heinrich (editor)
Neurofeedback in ADHD
Free
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Neurofeedback is an operant learning procedure where participants learn to gain self-control over specific aspects of neural activity. Thus, depending on the neurofeedback protocol applied behavioural, cognitive and / or emotional effects can be induced. Different assumptions about mechanisms, moderators and mediators of neurofeedback exist, associated with different ways of application. 



EEG-based neurofeedback is used as a therapeutic approach in attention-deficit / hyperactivity disorder (ADHD), a clinically and pathophysiologically heterogeneous child psychiatric disorder. There is increasing evidence for specific effects of neurofeedback when applying 'standard' protocols (slow cortical potentials, theta/beta, SMR). Knowledge about underlying mechanisms and moderating variables is increasing. Nevertheless, further well-controlled and conducted trials are needed to answer open questions concerning optimisation and individualisation of neurofeedback training. Further improvements may be expected from new methodical and technical developments (e.g., tomographic neurofeedback) and new concepts (integrated ADHD treatment). 



The Frontiers Reserach Topic intends to provide answers to the following questions concerning neurofeedback in ADHD: 

• How efficacious is neurofeedback / does a certain neurofeedback protocol work? 

• What is the rationale of applying a certain neurofeedback protocol in ADHD? 

• What are central mechanisms and which moderating variables may affect training outcome? 

• How to optimise treatment? What are new developments and which benefits may be expected?

Language
English
ISBN
978-2-88919-722-4
Cover
Frontiers Copyright Statement
Neurofeedback in ADHD
Table of Contents
Editorial: Neurofeedback in ADHD
References
Pathophysiology of ADHD and associated problems—starting points for NF interventions?
Introduction
Characteristics of Attention Deficit Hyperactivity Disorder
ADHD and its Neuronal Background
Cognitive Functions
Action Monitoring and Response Inhibition
Preparation
Reward Processing
Resting State Brain Activity
Heterogeniety in ADHD
Clinical Heterogeneity—Hyperactive/Impulsive and Inattentive Subtypes
Similarities and Differences Between Boys and Girls with ADHD
ADHD and Conduct Disorder
ADHD and Tic Disorder
Conclusion
Acknowledgments
References
Neurofeedback in attention-deficit/hyperactivity disorder – different models, different ways of application
Introduction
Mechanisms and applications – models of nf in children with adhd
Competing assumptions about nf
What is the indication for nf: repairing a neural dysfunction vs. strengthening resources/compensatory mechanisms on different levels
The effect of nf: is there a change of “eeg trait3” or a change in ``eeg state''?
Neuro-regulation – implicit vs. explicit learning?
Generalization – does it occur automatically or is special effort needed to achieve transfer into daily life?
Implications for the application of nf
Indication – “repairing'' a neural dysfunction vs. strengthening neural resources
Acquisition of (neuro-)regulation: mechanisms of learning, mechanisms of change
How to assure generalization?
“conditioning-and-repairing” vs. “skill-acquisition” model
Annotations about specificity of treatments
Implications for the evaluation of nf
How to evaluate efficacy of nf? which variables account for the efficacy of nf? which variables should be considered “specific” or “unspecific”? can the fidelity of the nf treatment be ensured under placebo-control conditions?
Empirical evidence
Indication for nf and effects/results of nf
What is the evidence for distinct neurophysiological deficits in adhd?
Does nf repair this neurophysiological deficit or strengthen compensatory mechanisms? is there a change of ``eeg trait'' or a change in ``eeg state''?
Acquisition of neuro-regulation capability – learning during nf sessions
Implicit or explicit learning of neuro-regulation?
Generalization
Automatic generalization
Effortful transfer
Conclusion and implications
References
What learning theories can teach us in designing neurofeedback treatments
Introduction
Basics from learning theories to be considered in designing a neurofeedback protocol
Feedback, reinforcement and knowledge of results
Shaping and the question of threshold regulation
Transfer
Automation: practice makes perfect
Strategies and instructions
Practice schedules, how much practice and skill decay?
Individual variables
Motivation
Cognition
Disease
Neuronal basis of neurofeedback learning
Conclusion: neurofeedback and psychotherapy
Acknowledgments
References
Are treatment effects of neurofeedback training in children with ADHD related to the successful regulation of brain activity? A review on the learning of regulation of brain activity and a contribution to the discussion on specificity
ADHD Neurofeedback Protocols and Learning of EEG Self-Regulation
Measuring Learning of EEG Self-Regulation
Units of Measurement
Cross-Session Learning
Within-Session Learning
Baseline Increments
Classification of Good and Poor Learning
Failing to Learn
Learning Patterns of Self-Regulated Brain Activity
The Association between Self-Regulated Brain Activity and Clinical Outcome Gains
Electrophysiological Pre-Post Changes, Protocol Specific Effects and Prediction
Is it Possible to Promote EEG Self-Regulation Performance?
Conclusion
References
Tuning pathological brain oscillations with neurofeedback: a systems neuroscience framework
(De)synchronized brain states
Normal and pathological oscillations
The brain as a dynamical system
Neurofeedback: unlocking direct control of brain oscillations
Control I: an engineering perspective on neurofeedback control
Control II: neurobehavioral conditioning
Control III: must neurofeedback signals be conscious? A global workspace hypothesis
Plasticity I: Hebbian mechanisms of plasticity
Plasticity II: homeostatic plasticity
Plasticity III: structural plasticity
Closing remarks: why neurofeedback?
Acknowledgments
References
What future research should bring to help resolving the debate about the efficacy of EEG-neurofeedback in children with ADHD
EEG-NF; the current state of affairs
Study-design
Placebo-controlled RCT's
Alternatives to placebo-controlled RCT's
The optimal design
Implementation and embedding of the training
EEG deviation
Reward feedback
Learning paradigms
Transfer
Different forms of neurofeedback
Conclusion
Acknowledgments
References
EEG-based local brain activity feedback training—tomographic neurofeedback
Introduction
Proposed solutions
The EEG-based LBA-feedback training: the principle
First applications
Discussion
Conclusion
Acknowledgments
References
EEG spectral analysis of attention in ADHD: implications for neurofeedback training?
Introduction
Resting EEG studies in ADHD
EEG studies in ADHD during task performance
Information about the dataset/objectives of the study
Materials and methods
Participants
Procedure and task
EEG recording and preprocessing
Data analysis
Statistical analysis
Results
Performance measures
Spectral EEG parameters
Associations between spectral EEG parameters and performance measures
Discussion
Spectral EEG measures during an attentive state in ADHD (subtypes)
Associations between spectral EEG parameters and reaction time measures
Potential implications for neurofeedback training in ADHD
Limitations of our study
Conclusions
Acknowledgments
References
Neurofeedback of slow cortical potentials: neural mechanisms and feasibility of a placebo-controlled design in healthy adults
Introduction
Materials and methods
Subjects
Procedure
Treatment (training)
SCP training
Sham training
Estimation of treatment assignment
Neuro-regulation assessment and analysis
Continuous performance task (CPT)
EEG recording and processing
fMRI imaging and data analysis
EEG data analysis
Results
Estimation of treatment assignment
SCP-regulation performance
Interrelation of regulation capability and estimation of treatment assignment
Neurophysiological test session: tCNV and performance
Functional MRI
Discussion
Neuronal plasticity: tCNV, fMRI, and performance
Blinding, estimation of treatment assignment, and regulation capability
Limitations and conclusions
Acknowledgments
References
Slow cortical potential and theta/beta neurofeedback training in adults: effects on attentional processes and motor system excitability
Introduction
Materials and methods
Participants
Design
Neurofeedback
Control training
Learning of self-regulation skills
Assessments and neurophysiological recordings
Attention task and event-related potentials
Tms
Statistical analysis
Results
Learning of self-regulation skills
Attentional processes
Performance measures
CNV
Target-p3
Motor system excitability
Discussion
Learning of self-regulation skills
Attentional processes
Motor system excitability
Methodical issues
Conclusion
Acknowledgments
References
EEG neurofeedback treatments in children with ADHD:an updated meta-analysis of randomized controlled trials
Introduction
Methods
Results
Results of the literature search
Results of the meta-analysis
Studies and populations characteristics
Effects of EEG-NF on parent assessment (probably no-blinded assessment)
Effect of EEG-NF on teacher assessment (probably blinded assessment)
Sensitivity analysis to test for medication effects
Discussion
Acknowledgments
References
Differential effects of theta/beta and SMR neurofeedback in ADHD on sleep onset latency
Introduction
Sleep and cognition in children
Sleep, sleep restriction and ADHD
Neurofeedback and sleep
Methods
Participants
Controls
Neurofeedback treatment
Analysis
Results
Healthy controls vs. adult ADHD
Neurofeedback treatment effects: SMR vs. TBR
Mediator analysis
Learning
Post-hoc tests
Discussion
Author contributions
Disclosures
Acknowledgments
References
Slow cortical potential neurofeedback and self-management training in outpatient care for children with ADHD: study protocol and first preliminary results of a randomized controlled trial
Background
Aims of the trial
Methods
Participants
Inclusion criteria
Exclusion criteria
Design and procedure
Recruitment and consent
Randomization and treatment allocation
Procedure
Treatment protocols
Neurofeedback
Self-management
Treatment of comorbid disorders
Parent Training
Therapists
Measurements
Selection and diagnostic measurements
Outcome measures
Primary and secondary outcome measures
Statistical analyses
Sample size
Ethical review and trial registration
Preliminary Results
Discussion
Limitations
Conclusion
Author's contributions
Author's information
References
Near-infrared spectroscopy (NIRS) neurofeedback as a treatment for children with attention deficit hyperactivity disorder (ADHD)—a pilot study
Introduction
Materials and methods
Participants
Procedure and measurement instruments
NIRS-neurofeedback
EEG-neurofeedback and EMG-feedback
Data analysis and statistics
Results
Within-group comparisons for the NIRS-group
FBB-ADHS
SDQ and KID-KINDL
TAP
Within and between group comparisons for EEG-, EMG- and NIRS-group
Discussion
NIRS -neurofeedback—effects and feasibility
Comparison with EEG-neurofeedback and EMG-feedback and future directions
Acknowledgments
References
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