Auditory Continuous Performance Test Research Articles

A diffusion decision model analysis of the cognitive effects of neurofeedback for ADHD.

To examine cognitive effects of neurofeedback (NF) for attention-deficit hyperactivity disorder (ADHD) as a secondary outcome of a randomized clinical trial. In a double-blind randomized clinical trial (NCT02251743), 133 7-10-year olds with ADHD received either 38 sessions of NF (n = 78) or control treatment (n = 55) and performed an integrated visual and auditory continuous performance test at baseline, mid- and end-treatment. We used the diffusion decision model to decompose integrated visual and auditory continuous performance test performance at each assessment into cognitive components: efficiency of integrating stimulus information (v), context sensitivity (cv), response cautiousness (a), response bias (z/a), and nondecision time for perceptual encoding and response execution (Ter). Based on prior findings, we tested whether the components known to be deficient improved with NF and explored whether other cognitive components improved using linear mixed modeling. Before NF, children with ADHD showed main deficits in integrating stimulus information (v), which led to less accurate and slower responses than healthy controls (p = .008). The NF group showed significantly more improvement in integrating auditory stimulus information (v) than control treatment (significant group-by-time-by-modality effect: p = .044). NF seems to improve v, deficient in ADHD. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Visual and auditory attention defects in children with intermittent exotropia

BackgroundPrevious studies have shown that children with intermittent exotropia (IXT) have a higher rate of psychiatric abnormalities as they grow up, such as attention deficit. This study explored visual and hearing attention among children with IXT, and evaluated its association with clinical characteristics and cognitive development.MethodsForty-nine children with a diagnosis of IXT and 29 children with traditional development were recruited. The Integrated Visual and Auditory Continuous Performance Test (IVA-CPT) was used to measure the subjects’ full-scale response control quotient (FSRCQ), full-scale attention quotient (FSAQ), auditory response control quotient (ARCQ), auditory attention quotient (AAQ), visual response control quotient (VRCQ), and visual attention quotient (VAQ). The Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) was used to assess their cognitive function. The differences between the scores of children with IXT and normal controls were analyzed.ResultsThe results showed that the FSRCQ, FSAQ, ARCQ, AAQ, VRCQ, and VAQ of children with IXT were all lower than those of normal controls with the same age (P < 0.05). The level of attention was significantly correlated with the age of strabismus onset (P < 0.05), but not with the degree of strabismus, stereopsis, or fusion control score. In addition, audiovisual attention was correlated significantly with their cognitive development level. The random forest classifier prediction model showed that age of strabismus onset was an important predictor of attention.ConclusionChildren with IXT have lower visual and auditory attention and control than their peers, and the age of onset of strabismus may be a major factor.

Cathodal HD-tDCS and attention: A study on patients with intractable left lateral frontal lobe epilepsy

ObjectiveDefects in the attentional network in patients with epilepsy are influenced by factors such as the location of epileptic foci. Examining the impact of cathodal high-definition transcranial direct current stimulation (HD-tDCS) on attention components could provide insights into potential attention-related side effects of tDCS. This study aimed to investigate the effect of cathodal HD-tDCS on interictal epileptiform discharges (IEDs), auditory/visual (A/V) attention components, and reaction time (RT) in patients with intractable focal left lateral frontal lobe epilepsy (LFLE). MethodsTo control for variations in individual epilepsy syndrome, 12 adult participants diagnosed with drug-resistant left LFLE with focal cortical IEDs on C3 underwent repeated measurements at pretest, posttest, and follow-up steps. 4 × 1 ring electrodes (cathode on C3 and four anodes on F3, P3, T3, and Cz) delivered 2 mA DC for 20 min per session for 10 consecutive days. The integrated visual and auditory continuous performance test (IVA+) assessed the A/V attention components and RT. One-way repeated-measure ANOVA was used. ResultsThe findings suggest a significant effect in reducing IEDs. The IVA+ results showed a significant improvement in auditory divided attention and visual selective and focused attention (p < 0.05). In the follow-up, these changes demonstrated lasting efficacy. A/V speed scales increased (p < 0.05), showing a significant decrease in reaction time. ConclusionsCathodal HD-tDCS significantly reduced IEDs and improved the components of auditory divided attention, visual focused attention, and visual selective attention, with a reduction in patient reaction time. A significant lasting, side-effect-free positive effect was observed for up to one month after the intervention.

Comparing the Effectiveness of Computer-Based and Task-Oriented Cognitive Rehabilitation Programs on Epileptic Children’s Attention in Tehran

Background: There are important cognitive issues in patients with epilepsy, which can be referred to as impairment in executive functions such as attention. Objectives: This research aims to compare the effectiveness of computer-based cognitive rehabilitation programs and task-oriented cognitive rehabilitation programs on attention in children with epilepsy in Tehran. Methods: The present research was a semi-experimental study with a pre-test and post-test design with a control group. The statistical population of the study included all children with epilepsy who were referred to the neurology clinic of Mofid Children's Hospital in 2021. Using the purposeful sampling method, 45 eligible children were included in the study and were randomly divided into 2 experimental groups and 1 control group (15 people in each group). The Integrated Visual and Auditory Continuous Performance Test (IVA2) of Sohlberg and Mateer (2001) was used for data collection. The experimental groups underwent the intervention of the computerized cognitive rehabilitation program of the Cambridge Neuropsychological Test (1980) (12 sessions of 45 minutes) and the task-oriented cognitive rehabilitation program (12 sessions of 45 minutes). The control group did not receive any intervention. SPSS 20 software was used for data analysis. Univariate covariance analysis (ANCOVA) was performed using a significance level of 0.05. Results: The results demonstrated that both computer-based cognitive rehabilitation programs and task-based cognitive rehabilitation were effective in increasing the attention of epileptic children in Tehran (P &lt; 0.001). There was no significant difference between the effectiveness of computer-based cognitive rehabilitation programs and task-based cognitive rehabilitation in increasing the attention of epileptic children (P = 0.67). Conclusions: It can be concluded that computer-based and task-oriented cognitive rehabilitation programs can be used to increase attention and executive functions in children with epilepsy.

Effects of a Computer-Based Intervention on Sustained Attention, Divided Attention, and Impulsivity in Children with Attention Deficit Hyperactivity Disorder

Background: Attention deficit hyperactivity disorder (ADHD) is a condition that causes poor academic performance. If left untreated, it can lead to different comorbidities such as depression, anxiety, and substance abuse. Objectives: This study compared the effects of a computer-based intervention (Captain's Log MindPower Builder) combined with Ritalin to those of Ritalin alone on sustained attention, divided attention, and impulsivity in children with ADHD. Methods: The statistical population included all boys and girls with ADHD aged 7 - 12 years who visited Baqiyatallah Hospital of Tehran in 2021 (N = 103). Purposive sampling was employed to select 30 eligible children as the research sample. They were then randomly assigned to an intervention group (Captain's Log MindPower Builder + Ritalin) and a waitlist control group (Ritalin alone). The computer-based intervention was performed in twelve 60-minute sessions. The data were collected by conducting the Integrated Visual and Auditory Continuous Performance Test. The analysis of covariance (ANCOVA) was then utilized to analyze the research data. SPSS software v26 was used for data analysis. Results: The mean ± SD of sustained attention, divided attention and impulsivity were 78.26 ± 6.90, 80.20 ± 6.01, and 73.70 ± 8.91on the pretest in the intervention group; moreover, it was 88.87 ± 7.19, 90.94 ± 5.45, and 82.41 ± 8.46 on the pretest in the control group. According to the results, the computer-based intervention had significant effects on both sustained attention and divided attention; however, it failed to significantly improve impulsivity (P &lt; 0.001). Additionally, the intervention effects during the 45-day follow-up period only showed stability for sustained attention (P &lt; 0.001). In fact, its effects on divided attention and impulsivity control were not significant. Conclusions: The computer-based intervention enhanced Ritalin's effects in some ways and improved sustained attention. Therefore, education centers for children with ADHD are recommended to adopt this method in order to improve attention in such children. Nevertheless, further studies are needed in this field to gain a better insight into the effectiveness of Captain's Log MindPower Builder.

The Influence of Noise Exposure at Different Loudness Levels on EEG Index and Types of Attention.

Noise is one of the most important harmful factors in the environment. There are limited studies on the effect of noise loudness on brain signals and attention. The main objective of this study was to investigate the relationship between exposure to different loudness levels with brain index, types of attention, and subjective evaluation. Four noises with different loudness levels were generated. Sixty-four male students participated in this study. Each subject performed the integrated visual and auditory continuous performance test (IVA-2) test before and during exposure to noise loudness signals while their electroencephalography was recorded. Finally, the alpha-to-gamma ratio (AGR), five types of attention, and the subjective evaluation results were examined. During exposure to loudness levels, the AGR and types of attention decreased while the NASA-Tax Load Index (NASA-TLX) scores increased. The noise exposure at lower loudness levels (65 and 75 phon) leads to greater attention dysfunction than at higher loudness. The AGR was significantly changed during exposure to 65 and 75 phon and audio stimuli. This significant change was observed in exposure at all loudness levels except 85 phon and visual stimuli. The divided and sustained attention changed significantly during exposure to all loudness levels and visual stimuli. The AGR had a significant inverse correlation with the total score of NASA-TLX during noise exposure. These results can lead to the design of methods to control the psychological effects of noise at specific frequencies (250 and 4000 Hz) and can prevent non-auditory damage to human cognitive performance in industrial and urban environments.

Cognitive deficits in multiple sclerosis: Auditory and visual attention and inhibitory control

Background A growing body of evidence has been paid to the cognitive impairment in patients with multiple sclerosis (MS). However, studies concerning cognitive functions in MS have also yielded conflicting results. This study investigates the attention and inhibitory control functions in patients with MS and their relationship with other clinical features, such as depression and fatigue in these patients. Methods Participants included 80 patients with MS and 60 healthy controls. The attention and inhibitory control, fatigue, and psychiatric screening in all subjects were studied, respectively with the Integrated Visual and Auditory Continuous Performance Test (IVA-CPT), Fatigue Severity Scale (FSS), and the Hospital Anxiety and Depression Scale (HADS). Results Patients with MS performed the IVA-CPT task more poorly than the healthy control group (p < 0.001). However, multiple regression analysis did not show any significant relationship between disease duration, FSS, and HADS on attention and inhibitory control. Conclusion Inhibitory control and attention are significantly impaired in patients with MS. Finding the basics of cognitive deficits in MS have potentially important clinical implications for developing better cognitive rehabilitation strategies.

A randomized, sham-controlled trial of high-definition transcranial direct current stimulation on the right orbital frontal cortex in children and adolescents with attention-deficit hyperactivity disorder.

This study aimed to find out the clinical and cognitive effects of high-definition transcranial direct current stimulation (HD-tDCS) on the right orbital frontal cortex (OFC) in the treatment of attention deficit hyperactivity disorder (ADHD). A total of 56 patients with ADHD were recruited as subjects and completely and randomly divided into the HD-tDCS group and the Sham group. A 1.0 mA anode current was applied to the right OFC. The HD-tDCS group received real stimulation, while the Sham group received sham stimulation in 10 sessions of treatment. ADHD symptom assessment (the SNAP-IV Rating Scale and the Perceived Stress Questionnaire) was carried out before treatment, after the 5th and 10th stimuli, and at the 6th week after the end of all stimulations, while the cognitive effect was assessed by the Integrated Visual and Auditory Continuous Performance Test (IVA-CPT), the Stroop Color and Word Test (Stroop), and the Tower of Hanoi (TOH). Repeated-measure ANOVA was used to find out the results of both groups before and after treatment. A total of 47 patients completed all sessions and evaluations. Their SNAP-IV score, their PSQ score, the mean visual and auditory reaction times by IVA-CPT, the interference RT of Stroop Color and Word, and the number of completed steps of TOH did not change with intervention time before and after treatment (P > 0.0031). However, the integrated visual and audiovisual commission errors and the TOH completion time results of the HD-tDCS group were significantly decreased after the 5th intervention, the 10th intervention, and the 6th week of intervention follow-up compared to the Sham group (P < 0.0031). This study draws cautious conclusions that HD-tDCS does not significantly alleviate the overall symptoms of patients with ADHD but leads to significant improvements in the cognitive measures of attention maintenance. The study also attempted to fill in the gaps in research studies on HD-tDCS stimulation of the right OFC. ChiCTR2200062616.

Effects of surgical procedures and general anesthesia exposure within 2 hours in early childhood on neurodevelopmental outcomes in school-age

Objective: To observe the effect of surgical procedures and general anesthesia exposure (<2 h) in early childhood on neurodevelopmental outcomes in school-age. Methods: A total of 147 children aged 6-12 years old, who received surgery under general anesthesia (<2 h) at the age of 0-2 years in Children's Hospital of Nanjing Medical Universityfrom June 2009 to December 2012 were retrospectively enrolled in this study (from June 2018 to December 2021) as exposure group, including 76 males and 71 females, with a mean age of (8.8±1.6) years. All the cases were divided into single-exposure group (n=65) and multiple-exposure group (≥2 times, n=82) according to different times of anesthesia exposure. According to the cohort of exposure group, 160 healthy children of the same age with no history of surgery under general anesthesia were recruited from the community from June 2018 to December 2021 as the control group, including 87 males and 73 females, and aged (8.6±1.9) years. A variety of standardized neurological tests including Wechsler intelligence scale for children fourth edition (WSC-Ⅳ), integrated visual and auditory continuous performance test (IVA-CPT), Swanson Nolan and Pelham, version Ⅳ (SNAP-Ⅳ), children sensory integration capacity development rating scale (CSIC), and social living ability scale were performed in all subjects by a child health specialist who failed to know the details. The primary outcome was the full-scale IQ (FSIQ) in WISC-Ⅳ, and the secondary outcomes were IVA-CPT, SNAP-Ⅳ, CSIC, and social living ability scale. Results: The FSIQ of single-exposure, multiple-exposure and control groups was 105.4±14.1, 100.9±10.2 and 103.6±13.5, respectively, with no statistically significant difference (F=2.37, P=0.095). The FSIQ of different first age exposure groups (aged 0-6 months, 7-12 months and 1-2 years) was 99.8±10.2, 104.5±10.5 and 104.4±14.5, respectively, with no statistically significant difference (F=2.39, P=0.095). The FSIQ of different exposure duration groups (0-59 min, 60-119 min and control group) was 102.8±11.3, 103.0±13.7 and 103.6±13.5, respectively, with no statistically significant difference (F=0.13, P=0.882). As for the secondary outcomes, the scores of visual persistence quotient in single-exposure, multiple-exposure and control groups were 94.8±10.5, 94.0±10.9 and 100.6±17.7, with a statistically significant difference (F=6.96, P=0.001). In terms of locomotion in social living ability scale, the score of the three groups was 10.0±0.2, 10.2±0.6 and 10.4±0.7, respectively, with a statistically significant difference (F=10.61, P<0.001), but all were within the standard range. Conclusions: The surgical procedures and general anesthesia exposure within 2 hours in early childhood has no effect on the overall FSIQ in school age, but has a slight impacts on the visual persistence quotient of IVA-CPT and the locomotion score of social living ability scale.

Cognitive markers for efficacy of neurofeedback for attention-deficit hyperactivity disorder – personalized medicine using computational psychiatry in a randomized clinical trial

ABSTRACT Background Exploring whether cognitive components (identified by baseline cognitive testing and computational modeling) moderate clinical outcome of neurofeedback (NF) for attention-deficit hyperactivity disorder (ADHD). Method 142 children (aged 7–10) with ADHD were randomly assigned to either NF (n = 84) or control treatment (n = 58) in a double-blind clinical trial (NCT02251743). The NF group received live, self-controlled downtraining of electroencephalographic theta/beta ratio power. The control group received identical-appearing reinforcement from prerecorded electroencephalograms from other children. 133 (78 NF, 55 control) children had cognitive processing measured at baseline with the Integrated Visual and Auditory Continuous Performance Test (IVA2-CPT) and were included in this analysis. A diffusion decision model applied to the IVA2-CPT data quantified two latent cognitive components deficient in ADHD: drift rate and drift bias, indexing efficiency and context sensitivity of cognitive processes involving information integration. We explored whether these cognitive components moderated the improvement in parent- and teacher-rated inattention symptoms from baseline to treatment end (primary clinical outcome). Results Baseline cognitive components reflecting information integration (drift rate, drift bias) moderated the improvement in inattention due to NF vs. control treatment (p = 0.006). Specifically, those with either the most or least severe deficits in these components showed more improvement in parent- and teacher-rated inattention when assigned to NF (Cohen’s d = 0.59) than when assigned to control (Cohen’s d = −0.21). Conclusions Pre-treatment cognitive testing with computational modeling identified children who benefitted more from neurofeedback than control treatment for ADHD.

An auditory processing advantage enables communication in less complex social settings: Signs of an extreme female brain in children and adolescents being assessed for Autism Spectrum Disorders.

The underlying factors of the male predominance in Autism Spectrum Disorders (ASD) are largely unknown, although a female advantage in social communication has been pointed out as a potential factor. Recently, attention has been given to ASD as a sensory processing disorder, focusing on the audio-visual temporal processing paramount for the development of communication. In ASD, a deviant audio-visual processing has been noted, resulting in difficulties interpreting multisensory information. Typically Developed (TD) females have shown an enhanced language processing in unisensory situations compared to multisensory situations. We aim to find out whether such an advantage also can be seen in girls within the ASD population, and if so, is it related to social communication skills? Forty children (IQ > 85), 20 females (mean age = 13.90 years, SD = 2.34) and 20 males (mean age = 12.15 years, SD = 2.83) triaged for an ASD assessment were recruited from a child and youth psychiatric clinic in Sweden. Using The Social Responsiveness Scale (SRS) we looked at associations with child performance on the Integrated Visual and Auditory Continuous Performance Test (IVA-2). An auditory advantage in the female group was associated with less rated problems in social communications in unisensory processing whereas in multisensory processing an auditory dominance was associated with more rated problems in Social Awareness. In the male group, a visual dominance was associated with more rated problems in Social Rigidity. A female unisensory processing advantage in ASD could very well be explaining the male domination in ASD. However, the social difficulties related to multisensory processing indicate that ASD females might be struggling as hard as males in more complex settings. Implications on the assessment procedure are discussed.

The study of functional connectivity of attention cognitive impairment in children with nocturnal enuresis.

We aimed to explore the brain functional connectivity mechanism of attention cognitive impairment in children with nocturnal enuresis (NE). Children with NE often show attention cognitive deficit, but its brain mechanism remains unclear. Most previous studies have only focused on a single brain region, without involving the association among brain regions. In this study, 26 NE and 26 normal children were selected. Functional magnetic resonance imaging (fMRI) and integrated visual and auditory continuous performance test (IVA-CPT) were performed. The 12 key brain regions of the dorsal attention network (DAN), default mode network (DMN) and ventral attention network (VAN) were selected as areas of interest, and 66 groups of functional connectivity (FC) were analysed among these 12 brain regions. The correlation between FC and IVA-CPT in the two groups was analysed. The FC values showed that the groups with significant differences between NE and normal children were lFEF-aMPFC, rFEF-lIFG, rFEF-rIPS and lAG-VFC (P < 0.05), and the FC value of lAG-VFC was positively correlated with the Full-Scale Attention Quotient (FAQ). Our results showed that attention deficit in children with NE was associated with all three networks and was relative to the FC among the three attention networks. DAN was the brain network most related to attention cognition in children with NE, and most of the brain regions with abnormal connectivity in NE were related to the prefrontal lobe. The lAG was also an important brain region in attention impairment in NE.

Early Effects of Repetitive Transcranial Magnetic Stimulation Combined With Sertraline in Adolescents With First-Episode Major Depressive Disorder.

BackgroundAdolescence is a period of high incidence for depression. However, there is a limited treatment option for the adolescent depression. For treatment-resistant major depressive disorder, HF-rTMS of the left dorsolateral prefrontal cortex (DLPFC) appears therapeutically effective. The aim of the study is to explore the early effects of repetitive transcranial magnetic stimulation in combination with sertraline in adolescents with first-episode major depressive disorder.MethodsA total of 100 teenage patients with first-episode depression were randomly divided into the study groups. Both groups were treated with sertraline. In addition, the study group was treated with ten sessions of add-on rTMS. The control group was given sertraline only. The depressive symptom and cognitive function were assessed by the Hamilton depression rating scale 17 version (HAMD-17), Children’s Depression Rating Scale-Revised (CDRS-R), Integrated visual and auditory continuous performance test (IVA-CPT), and THINC-it.ResultsThe number of early improvers after 2 weeks of treatment in the study group was statistically significant higher compared to the control group (95.83% vs 73.47%, χ2 = 9.277, P = 0.002). There was significant difference observed in responder rates (62.50% vs. 28.57%, χ2 = 11.262, P = 0.001) or in remission rates (31.25% vs. 6.12%, χ2 = 10.130, P = 0.001) between the two groups at 4 weeks. The score of HAMD-17 and CDRS-R in the study group were significantly lower than the control group (Fgroup = 12.91 vs 10.21, P < 0.05). Attention Quotient (listening, visual and full-scale) attention quotient of IVA-CPT in the study group were higher than those in the control group after treatment, and the differences were statistically significant(P < 0.05). The study group showed higher score in Spotter than the control group after treatment (P < 0.05).DiscussionThis is the most extensive blinded, randomized clinical study to date examining the efficacy of 10-Hz add-on rTMS for first-onset adolescent depression. Our results support that add-on rTMS accelerates the efficacy of the antidepressants, improving the depressive symptoms and cold cognitive function in first-episode adolescent depression.Clinical Trial Registration[www.ClinicalTrials.gov], identifier [ChiCTR2100048534].

The Effect of Serious Games on Response Inhibition, Selective Attention and Visual-Spatial Processing in Attention Deficit/Hyperactivity Disorder (ADHD): BrainـTrain and Cogniplus Games CogniPlus

Background and Aims This study aims to compare the effectiveness of two computerized cognitive training applications, “Brain Train” and" CogniPlus”, in improving the response inhibition, selective attention, and visual-spatial processing speed of children with attention deficit/hyperactivity disorder (ADHD). Methods This is a quasi-experimental. Participants were 45 elementary school students diagnosed with ADHD who were selected by a convenience sampling method. The students were divided randomly into three groups: intervention group 1 (n=15, receiving training by Brain Train), intervention group 2 (n=15, receiving training by CogniPlus) and control (n=15). Each intervention group separately received training for two months, three session per week, each for 50-60-minutes. Performance of three groups were evaluated in response inhibition, selective attention, and visual-spatial processing in pre-test and post-test phases using Stroop test, the integrated visual and auditory continuous performance test (IVA+Plus), and visual-spatial processing subscale of the Stanford-Binet Intelligence Scales. Collected data were analyzed using the analysis of covariance. Results Results showed a significant difference between the two intervention groups in the study variables (P&lt;0.05), but there was no significant difference between two intervention groups in improving selective attention and response inhibition (P&gt;0.05). However, in visual-spatial processing, the group received training by Brain Train application showed a significant improvement more than the group received training by CogniPlus (P&lt; 0.05). Conclusion Computerized cognitive training applications can improve the cognitive skills of children with ADHD, where the Brain Train application is more effective than Cogniplus regarding the visual-spatial processing ability.

Comparative efficacy of targeted structural patterns of electroencephalography neurofeedback in children with inattentive or combined attention deficit hyperactivity disorder.

ObjectiveTo evaluate and compare the effects of three courses of different structural patterns of electroencephalography neurofeedback on predominantly inattentive attention deficit hyperactivity disorder (ADHD‐PI) and combined ADHD (ADHD‐CT).MethodsThirty‐eight ADHD‐PI and ADHD‐CT children were selected and completed three courses of different structural patterns of electroencephalography neurofeedback according to their ADHD type. Before and after each course, relative power value of electroencephalography, including θ, β, α, SMR and their ratios (θ/β, θ/α), and eighteen integrated visual and auditory continuous performance test (IVA/CPT) quotients were obtained and compared. Data were analyzed by SPSS software, and p < .05 was considered statistically significant.ResultsAfter one course, θ, three IVA/CPT quotients in both types and two comprehensive quotients in ADHD‐CT changed significantly (all p < .05). After two courses, θ/α, θ/β and five IVA/CPT quotients in both types, θ and α in ADHD‐PI, four comprehensive quotients, and four respond control quotients in ADHD‐CT varied significantly compared to before treatment and after one course (all p < .05). After three courses, α, β, θ, θ/α, θ/β and ten IVA/CPT quotients in both types changed significantly compared to before treatment and after one course (all p < .05). In addition, six IVA/CPT quotients in both types after three courses were significantly higher than those after two courses (all p < .05).ConclusionDifferent structural patterns of electroencephalography neurofeedback targeted for ADHD‐CT and ADHD‐PI were both effective and feasible. Three courses of EEG neurofeedback were most effective.

Effect of hyperbaric oxygen therapy on cognitive dysfunction induced by nitrous oxide abuse: protocol of a randomised, double-blinded, placebo-controlled trial

IntroductionThe cognitive dysfunction associated with nitrous oxide abuse is gradually becoming a major global public health concern. Despite the increasing prevalence of nitrous oxide abuse, there are currently no authorised/approved...

The Effectiveness of Computer-Assisted Cognitive Rehabilitation and the Degree of Recovery in Patients with Traumatic Brain Injury and Stroke.

Objectives: To determine the effectiveness of computer-assisted cognitive rehabilitation and compare the patterns of cognitive function recovery occurring in both traumatic brain injury (TBI) and stroke. Methods: A total of 62 patients were finally enrolled, consisting of 30 with TBI and 32 with stroke. The patients received 30 sessions of computer-assisted cognitive rehabilitation (Comcog) five times per week. Each session lasted for 30 min. Before and immediately after cognitive rehabilitation, all patients were evaluated by computerized neuropsychological test (CNT), Mini-Mental State Examination (MMSE), and modified Barthel index (MBI). Results: We analyzed the differences between pre- and post-cognitive rehabilitation in each TBI and stroke group. Significant differences were observed in MMSE, MBI, and some CNT contents, including digit span forward, verbal learning, verbal learning delayed recall, visual span forward, visual span backward, visual learning, trail making test A and B, and intelligence quotient (IQ) in the TBI group (p < 0.05). In the stroke group, in addition to significant differences that appeared in the TBI group, additional significant differences in the digit span backward, visual learning delayed recall, auditory continuous performance test (CPT), visual CPT, and card sorting test. We compared the difference values at pre- and post-cognitive rehabilitation for cognitive recovery between the TBI and stroke groups. All contents, except the digital span forward, visual learning, word-color test, and MMSE, had greater mean values in the stroke group; and thus, statistically significant higher values were observed in the visual span forward and card sorting test (p < 0.05). Conclusion: Most evaluation results showed improvement and the evaluation between the TBI and stroke groups also showed significant differences in cognitive functions in addition to more CNT contents, which significantly change in the stroke group. The stroke group showed a high difference value in most CNT contents. Therefore, those with stroke in the focal brain region tend to have better cognitive function recovery after a computer-assisted cognitive rehabilitation than those with TBI, which could cause diffuse brain damage and post-injury inflammation.

Long-term effectiveness of behavioural intervention in preschool children with attention deficit hyperactivity disorder in Southeast China \u2013 a randomized controlled trial

BackgroundAttention-deficit hyperactivity disorder (ADHD) is the most common behavioral disorder. Behavioural intervention in preschool children with ADHD is considered effective. This study discussed the long-term effectiveness of behavioural intervention in the context of nondrug therapy.MethodsThe study was a prospective, randomised controlled trial in which 201 preschoolers diagnosed with ADHD who were not receiving any treatment were assigned to two groups from January 2018 to May 2019, 101 were assigned to the conventional group and 100 to the behavioural intervention group. The behavioural intervention group included parental training, behavioural therapy, attention training, relief therapy and game therapy, in addition to the conventional group offerings. Children were evaluated at a baseline, at the end of the 12-month intervention and six months after the intervention. The primary and secondary outcome variables included attention time, the impulse-hyperactivity and hyperactivity index from Conners parent symptom questionnaire (PSQ), full-scale attention quotient (FAQ) and full-scale response control quotient (FRCQ) from integrated visual and auditory comprehensive continuous performance tests. The attention time was observed and recorded by parents, and others were performe(PSQ)d by physicians in the clinic. All statistical analyses were conducted using SPSS V26.0 (IBM), including the descriptive statistics and mixed-effects models and so on.ResultsThe participants’ mean age was (66.17±9.00) months in the behavioural group and (67.54±6.22) months in the conventional group .A total of 190 participants completed a follow-up six months after the intervention. The attention time, Conners parent symptom questionnaire (PSQ), full-scale attention quotient (FAQ) and full-scale response control quotient (FRCQ) increased significantly over time, and the behavioural group improvements were higher than those of conventional group. There was a significant main effect of time (pretest/posttest/follow-up) and group on all outcome measures (t =-12.549-4.069, p<0.05), and a significant interaction of time and group on attention time, impulsivity/hyperactivity, FAQ and FRCQ (t =-3.600-3.313, p<0.05).ConclusionBehavioural intervention can effectively improve behaviour management and relieve symptoms in children with ADHD. These effects lasted at least six months. This study provides a promising approach for improving clinical efficacy with preschool children with ADHD.

Gray matter structural plasticity in patients with basal ganglia germ cell tumors: A voxel-based morphometry study

BackgroundBasal ganglia germ cell tumors (BGGCTs) are rare intracranial germ cell tumors (iGCTs) that often presents with cognitive impairment. ObjectiveTo assess structural brain plasticity in the presence of unilateral basal ganglia germ cell tumors (BGGCTs), and the correlation between gray matter volume (GMV) changes and cognitive tests. Materials and methodsWe applied voxel-based morphometry (VBM) to structural magnetic resonance imaging (MRI) scans to compare a sample of 41 patients with BGGCTs in the left (n = 22) or right (n = 19) and a sample of 16 patients as control group using a two-sample t-test, correcting for family-wise-errors. A battery of cognitive tests was administered to all BGGCTs patients prior to MRI. We used Pearson correlation analysis to assess the correlation between cognitive test scores and GMV changes. ResultsIn patients with left BGGCTs, whole-brain VBM analysis revealed a large cluster of voxels reflecting an increase in GMV in the left parahippocampal region (k = 529 voxels, T = 4.18, p < 0.01), right middle cingulate cortex (k = 172 voxels, T = 3.96, p < 0.01), and a decrease in volume in the left thalamus (k = 527 voxels, T = −4.88, p < 0.01), right inferior frontal gyrus (k = 495 voxels, T = −4.29, p < 0.01). Pearson correlation analysis showed that the GMV were significantly correlated with the Integrated Visual and Auditory continuous performance test (IVA-CPT) scale (r = 0.637, P = 0.002), abstract reasoning (r = 0.597, P = 0.011), Self-rating Depression Scale (SAS) scale (r = −0.623, P = 0.004) and memory recall (r = 0.648, P = 0.003). ConclusionThese results demonstrate that slow growing but destructive BGGCTs markedly and asymmetrically effect the GMV in left parahippocampal, left thalamus, right middle cingulate cortex, right inferior frontal gyrus and GMV changes were significantly associated with cognitive test.

Effect of Cognitive Rehabilitation Combined With Physical Exercise on Sustained, Selective, and Alternating attention in School-aged Girls Attention-Deficit/Hyperactivity Disorder

Objectives: Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common mental disorders in childhood. This study aims to assess the effect of cognitive rehabilitation combined with physical exercise on sustained, selective and alternating attention in ADHD children. Methods: This is a quasi-experimental study with a Pre-test/posttest design. The study population consists of all primary school girls with ADHD in Yazd, Iran. Of these, 40 aged 9-12 years were selected and randomly divided into four groups of cognitive rehabilitation, physical exercise, combined (exercise + rehabilitation), and control. The Conners’ Teacher Rating Scale (CTRS) was used for initial assessment of children, Goodenough- Harris Drawing Test (GHDT) to measure intelligence score, Integrated Visual and Auditory-Continuous Performance Test (IVA-CPT) to assess sustained attention, Wisconsin Card Sorting Test (WCST) to measure alternating attention, and Stroop test to measure selective attention. For cognitive rehabilitation, My Brain application was used. The intervention was presented at 16 sessions, each for 60 minutes. Posttest assessment was performed 24 and 72 hours after the end of intervention. ANCOVA was used for data analysis. All analyses were performed in SPSS v. 20, considering a significance level of P&lt;0.05. Results: The results of ANCOVA showed that the combined group had significantly lower errors in sustained, selective and alternating attention tests compared to other groups. In the omission response variable, the mean score of the children in the combined group was significantly lower than in the control group (P&lt;0.05). Conclusion: Cognitive rehabilitation combined with physical exercises can improve different types of attention in children with ADHD.