Gevensleben Holger, Moll Gunther H, Heinrich Hartmut
Kinder- und Jugendpsychiatrie, Universitätsmedizin Göttingen.
Z Kinder Jugendpsychiatr Psychother. 2010 Nov;38(6):409-19; quiz 419-20. doi: 10.1024/1422-4917/a000070.
In a multicentre randomised controlled trial, we evaluated the clinical efficacy of neurofeedback (NF) training in children with ADHD and investigated the mechanisms underlying a successful training. We used an attention skills training, coupled with the training setting and demands made upon participants, as the control condition. At the behavioural level, NF was superior to the control group concerning core ADHD symptomatology as well as associated domains. For the primary outcome measure (improvement in the FBB-HKS total score), the effect size was .60. The same pattern of results was obtained at the 6-month follow-up. Thus, NF may be seen as a clinically effective module in the treatment of children with ADHD. At the neurophysiological level (EEG, ERPs), specific effects for the two NF protocols, theta/beta training, and training of slow cortical potentials were demonstrated. For example, for theta/beta training, a decrease of theta activity in the EEG was associated with a reduction of ADHD symptomatology. SCP training was accompanied inter alia by an increase in the contingent negative variation in the attention network test; thus, children were able to allocate more resources for preparation. EEG- and ERP-based predictors were also found. The present article reviewed the findings of the original papers related to the trial and outlines future research topics.
在一项多中心随机对照试验中,我们评估了神经反馈(NF)训练对多动症儿童的临床疗效,并探究了成功训练背后的机制。我们将注意力技能训练与训练环境及对参与者的要求相结合,作为对照条件。在行为层面,就多动症的核心症状及相关领域而言,NF优于对照组。对于主要结局指标(FBB-HKS总分的改善情况),效应大小为0.60。在6个月的随访中也得到了相同的结果模式。因此,NF可被视为治疗多动症儿童的一种临床有效方法。在神经生理层面(脑电图、事件相关电位),两种NF方案,即θ/β训练和慢皮层电位训练,都显示出了特定效果。例如,对于θ/β训练,脑电图中θ活动的减少与多动症症状的减轻相关。慢皮层电位训练尤其伴随着注意力网络测试中关联性负变的增加;因此,儿童能够为准备工作分配更多资源。还发现了基于脑电图和事件相关电位的预测指标。本文回顾了与该试验相关的原始论文的研究结果,并概述了未来的研究课题。