Abstract
ObjectiveEvent-related potentials (ERPs) are reported to be altered in relation to cognitive processing deficits in attention deficit hyperactivity disorder (ADHD). However, this evidence is mostly limited to cross-sectional data. The current study utilized neurofeedback (NFB) as a neuromodulatory tool to examine the ERP correlates of attentional and inhibitory processes in adult ADHD using a single-session, within-subject design. MethodsWe recorded high-density EEG in 25 adult ADHD patients and 22 neurotypical controls during a Go/NoGo task, before and after a 30-minute NFB session designed to down-regulate the alpha (8–12 Hz) rhythm. ResultsAt baseline, ADHD patients demonstrated impaired Go/NoGo performance compared to controls, while Go-P3 amplitude inversely correlated with ADHD-associated symptomatology in childhood. Post NFB, task performance improved in both groups, significantly enhancing stimulus detectability (d-prime) and reducing reaction time variability, while increasing N1 and P3 ERP component amplitudes. Specifically for ADHD patients, the pre-to-post enhancement in Go-P3 amplitude correlated with measures of improved executive function, i.e., enhanced d-prime, reduced omission errors and reduced reaction time variability. ConclusionsA single-session of alpha down-regulation NFB was able to reverse the abnormal neurocognitive signatures of adult ADHD during a Go/NoGo task. SignificanceThe study demonstrates for the first time the beneficial neurobehavioral effect of a single NFB session in adult ADHD, and reinforces the notion that ERPs could serve as useful diagnostic/prognostic markers of executive dysfunction.
Highlights
We investigated the behavioral and electrophysiological correlates of attentional and inhibitory processes during a visual continuous performance task (CPT) in adult patients with attention-deficit hyperactivity disorder (ADHD) compared to age-matched neurotypical controls, in a pre-to-post neurofeedback (NFB) intervention design
Following the 30-minute NFB training session, there was a significant increase in stimulus detectability as well as a decrease in Reaction time (RT) variability, in both attention deficit hyperactivity disorder (ADHD) and control groups
Pre-to-post NFB comparisons of event-related potentials (ERPs) revealed an enhancement effect of NFB on the main P3 component amplitude, which correlated with measures of improved Continuous Performance Task (CPT) performance in ADHD patients
Summary
Event-related potentials (ERPs) are reported to be altered in relation to cognitive processing deficits in attention deficit hyperactivity disorder (ADHD). This evidence is mostly limited to cross-sectional data. The current study utilized neurofeedback (NFB) as a neuromodulatory tool to examine the ERP correlates of attentional and inhibitory processes in adult ADHD using a single-session, within-subject design. Methods: We recorded high-density EEG in 25 adult ADHD patients and 22 neurotypical controls during a Go/NoGo task, before and after a 30-minute NFB session designed to down-regulate the alpha (8–12 Hz) rhythm. For ADHD patients, the pre-to-post enhancement in Go-P3 amplitude correlated with measures of improved executive function, i.e., enhanced d-prime, reduced omission errors and reduced reaction time variability.
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