Albrecht Johanna S, Bubenzer-Busch Sarah, Gallien Anne, Knospe Eva Lotte, Gaber Tilman J, Zepf Florian D
Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen; JARA Translational Brain Medicine, Aachen & Jülich; Center for Pediatrics and Adolescent Medicine Elisabeth Hospital Rheydt, Mönchengladbach.
Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen; JARA Translational Brain Medicine, Aachen & Jülich.
Neuropsychiatr Dis Treat. 2017 Mar 2;13:667-683. doi: 10.2147/NDT.S119694. eCollection 2017.
The aim of this approach was to conduct a structured electroencephalography-based neurofeedback training program for children and adolescents with attention-deficit hyperactivity disorder (ADHD) using slow cortical potentials with an intensive first (almost daily sessions) and second phase of training (two sessions per week) and to assess aspects of attentional performance.
A total of 24 young patients with ADHD participated in the 20-session training program. During phase I of training (2 weeks, 10 sessions), participants were trained on weekdays. During phase II, neurofeedback training occurred twice per week (5 weeks). The patients' inattention problems were measured at three assessment time points before (pre, T0) and after (post, T1) the training and at a 6-month follow-up (T2); the assessments included neuropsychological tests (Alertness and Divided Attention subtests of the Test for Attentional Performance; Sustained Attention Dots and Shifting Attentional Set subtests of the Amsterdam Neuropsychological Test) and questionnaire data (inattention subscales of the so-called Fremdbeurteilungsbogen für Hyperkinetische Störungen and Child Behavior Checklist/4-18 [CBCL/4-18]). All data were analyzed retrospectively.
The mean auditive reaction time in a Divided Attention task decreased significantly from T0 to T1 (medium effect), which was persistent over time and also found for a T0-T2 comparison (larger effects). In the Sustained Attention Dots task, the mean reaction time was reduced from T0-T1 and T1-T2 (small effects), whereas in the Shifting Attentional Set task, patients were able to increase the number of trials from T1-T2 and significantly diminished the number of errors (T1-T2 & T0-T2, large effects).
First positive but very small effects and preliminary results regarding different parameters of attentional performance were detected in young individuals with ADHD. The limitations of the obtained preliminary data are the rather small sample size, the lack of a control group/a placebo condition and the open-label approach because of the clinical setting and retrospective analysis. The value of the current approach lies in providing pilot data for future studies involving larger samples.
该方法的目的是为患有注意力缺陷多动障碍（ADHD）的儿童和青少年开展一项基于结构化脑电图的神经反馈训练计划，使用慢皮层电位进行强化的第一阶段（几乎每天训练）和第二阶段训练（每周两次），并评估注意力表现的各个方面。
共有24名患有ADHD的年轻患者参加了为期20节的训练计划。在训练的第一阶段（2周，10节），参与者在工作日接受训练。在第二阶段，神经反馈训练每周进行两次（共5周）。在训练前（T0）、训练后（T1）以及6个月随访（T2）这三个评估时间点测量患者的注意力不集中问题；评估包括神经心理学测试（注意力表现测试中的警觉性和分散注意力子测试；阿姆斯特丹神经心理学测试中的持续注意力点和注意力转移集子测试）以及问卷数据（所谓的多动障碍他人评价量表和儿童行为检查表/4 - 18 [CBCL/4 - 18]的注意力不集中子量表）。所有数据均进行回顾性分析。
在分散注意力任务中，平均听觉反应时间从T0到T1显著缩短（中等效应），这种效应随时间持续存在，在T0 - T2比较中也有发现（更大效应）。在持续注意力点任务中，平均反应时间从T0 - T1以及T1 - T2有所缩短（小效应），而在注意力转移集任务中，患者能够从T1 - T2增加试验次数，并显著减少错误数量（T1 - T2和T0 - T2，大效应）。
在患有ADHD的年轻人中检测到了关于注意力表现不同参数的初步积极但非常小的效果和结果。所获得的初步数据的局限性在于样本量较小、缺乏对照组/安慰剂条件以及由于临床设置和回顾性分析采用的开放标签方法。当前方法的价值在于为未来涉及更大样本的研究提供试点数据。
