Abstract
[Purpose]The purpose of this study was to investigate the effect of hippotherapy and electroencephalography (EEG) neurofeedback on brain function and blood brain-derived neurotrophic factor (BDNF) level in children with attention-deficit or/and hyperactivity disorder (ADHD).[Methods]Sixteen children with ADHD participated in this study and were randomly divided into 2 groups, a 1-time hippotherapy group (W1G, n = 8) and a 2-time hippotherapy group (W2G, n = 8). All the participants attended 8 weeks of hippotherapy program in the primary training, and then 7 children with ADHD attended 8 weeks of hippotherapy program combined with neurofeedback training in the secondary training. Blood BDNF levels were measured, and functional magnetic resonance imaging (fMRI) was performed. The EEG neurofeedback training program was used to train and measure psychological factors.[Results]The combined effect of hippotherapy and neurofeedback on BDNF level showed a decreased tendency in W1G (pretraining, 1766.03 ± 362.54 pg/ml; posttraining, 1630.65 ± 276.70 pg/ml). However, the BDNF level of W2G showed an increased tendency (pretraining, 1968.28 ± 429.08 pg/ml; posttraining, 1976.28 ± 425.35 pg/ml). Moreover, combined training showed a significant group x repetition interaction in W1G (pretraining, 1436.57 ± 368.76 pg/ml; posttraining, 1525.23 ± 346.22 pg/ml; F = 3.870, p = 0.039). fMRI results showed that the left thalamus activity in both groups had a decreased tendency and a significantly lower change in W2G than in W1G (p < 0.05).[Conclusion]This study confirmed a significant increase in blood BDNF level after combined training, which may induce brain function improvement in children with ADHD.
Highlights
Attention-deficit or/and hyperactivity disorder (ADHD) has been known to usually evoke hyperactivity, impulsiveness, and aggression, and the incidence of ADHD higher in boys than in girls[1]
Our study results showed a significant increase in blood brain-derived neurotrophic factor (BDNF) level after combined training, which may induce brain function improvement in children with ADHD
Enhanced brain function was observed in the children with ADHD as their participation frequency in hippotherapy increased
Summary
Attention-deficit or/and hyperactivity disorder (ADHD) has been known to usually evoke hyperactivity, impulsiveness, and aggression, and the incidence of ADHD higher in boys than in girls[1]. ADHD occurs in school-aged boys and girls, and is characterized by difficulty in social relationships and lower study achievement[2, 3]. The physiological mechanism of ADHD shows that lower activity levels of dopamine D4 receptor gene and norepinephrine mainly induce functional reduction in the right and dorsal frontal lobe of the brain[7, 8]. Dopamine is involved in the regulation of the posterior attention system (PAS) related to action, memory, judgment, plan, and response. Malfunction of PAS and AAS may cause severe problems in execution functions such as personal relationships and coordination[10, 11]. Children with ADHD need to have medical treatment and management as early as possible because only 20% of these children recover as they age and most continue to have ADHD through their adulthood[8]
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