Department of Child and Adolescent Psychiatry, Institute of Mental Health, Singapore, Singapore.
School of Computer Science and Engineering, Nanyang Technological University, Singapore, Singapore.
PLoS One. 2019 May 21;14(5):e0216225. doi: 10.1371/journal.pone.0216225. eCollection 2019.
The use of brain-computer interface in neurofeedback therapy for attention deficit hyperactivity disorder (ADHD) is a relatively new approach. We conducted a randomized controlled trial (RCT) to determine whether an 8-week brain computer interface (BCI)-based attention training program improved inattentive symptoms in children with ADHD compared to a waitlist-control group, and the effects of a subsequent 12-week lower-intensity training.
We randomized 172 children aged 6-12 attending an outpatient child psychiatry clinic diagnosed with inattentive or combined subtypes of ADHD and not receiving concurrent pharmacotherapy or behavioral intervention to either the intervention or waitlist-control group. Intervention involved 3 sessions of BCI-based training for 8 weeks, followed by 3 training sessions per month over the subsequent 12 weeks. The waitlist-control group received similar 20-week intervention after a wait-time of 8 weeks.
The participants' mean age was 8.6 years (SD = 1.51), with 147 males (85.5%) and 25 females (14.5%). Modified intention to treat analyzes conducted on 163 participants with at least one follow-up rating showed that at 8 weeks, clinician-rated inattentive symptoms on the ADHD-Rating Scale (ADHD-RS) was reduced by 3.5 (SD 3.97) in the intervention group compared to 1.9 (SD 4.42) in the waitlist-control group (between-group difference of 1.6; 95% CI 0.3 to 2.9 p = 0.0177). At the end of the full 20-week treatment, the mean reduction (pre-post BCI) of the pooled group was 3.2 (95% CI 2.4 to 4.1).
The results suggest that the BCI-based attention training program can improve ADHD symptoms after a minimum of 24 sessions and maintenance training may sustain this improvement. This intervention may be an option for treating milder cases or as an adjunctive treatment.
脑-机接口在注意缺陷多动障碍（ADHD）神经反馈治疗中的应用是一种相对较新的方法。我们进行了一项随机对照试验（RCT），以确定 8 周的基于脑-机接口（BCI）的注意力训练计划是否比候补对照组更能改善 ADHD 儿童的注意力不集中症状，以及后续 12 周低强度训练的效果。
我们将 172 名年龄在 6-12 岁的儿童随机分为干预组和候补对照组，这些儿童在门诊儿童精神病诊所被诊断为注意力不集中或注意力缺陷多动障碍混合亚型，且未同时接受药物治疗或行为干预。干预组包括 3 次为期 8 周的基于 BCI 的训练，随后在接下来的 12 周内每月进行 3 次训练。候补对照组在等待 8 周后接受类似的 20 周干预。
参与者的平均年龄为 8.6 岁（标准差=1.51），其中 147 名男性（85.5%）和 25 名女性（14.5%）。对至少有一次随访评分的 163 名参与者进行的意向治疗修正分析表明，在 8 周时，干预组的 ADHD-Rating Scale（ADHD-RS）上的注意力不集中症状评分降低了 3.5（标准差 3.97），而候补对照组降低了 1.9（标准差 4.42）（组间差异为 1.6；95%置信区间 0.3 至 2.9；p=0.0177）。在 20 周治疗结束时，混合组的平均（BCI 前后）降低幅度为 3.2（95%置信区间 2.4 至 4.1）。
结果表明，基于 BCI 的注意力训练计划在至少 24 次治疗后可以改善 ADHD 症状，维持治疗可能会维持这种改善。这种干预可能是治疗轻度病例的一种选择，也可能是一种辅助治疗方法。
