Division of Psychiatric Specialties, Department of Psychiatry, University Hospitals of Geneva, Geneva, Switzerland; Department of Psychiatry, University of Geneva, Geneva, Switzerland; Functional Brain Mapping Laboratory, Department of Basic Neurosciences, University of Geneva, Geneva, Switzerland.
Geneva Medical Center, University of Geneva, Geneva, Switzerland.
Clin Neurophysiol. 2021 Aug;132(8):1937-1946. doi: 10.1016/j.clinph.2021.05.017. Epub 2021 Jun 11.
OBJECTIVE: Event-related potentials (ERPs) are reported to be altered in relation to cognitive processing deficits in attention deficit hyperactivity disorder (ADHD). However, this evidence is mostly limited to cross-sectional data. The current study utilized neurofeedback (NFB) as a neuromodulatory tool to examine the ERP correlates of attentional and inhibitory processes in adult ADHD using a single-session, within-subject design. METHODS: We recorded high-density EEG in 25 adult ADHD patients and 22 neurotypical controls during a Go/NoGo task, before and after a 30-minute NFB session designed to down-regulate the alpha (8-12 Hz) rhythm. RESULTS: At baseline, ADHD patients demonstrated impaired Go/NoGo performance compared to controls, while Go-P3 amplitude inversely correlated with ADHD-associated symptomatology in childhood. Post NFB, task performance improved in both groups, significantly enhancing stimulus detectability (d-prime) and reducing reaction time variability, while increasing N1 and P3 ERP component amplitudes. Specifically for ADHD patients, the pre-to-post enhancement in Go-P3 amplitude correlated with measures of improved executive function, i.e., enhanced d-prime, reduced omission errors and reduced reaction time variability. CONCLUSIONS: A single-session of alpha down-regulation NFB was able to reverse the abnormal neurocognitive signatures of adult ADHD during a Go/NoGo task. SIGNIFICANCE: The study demonstrates for the first time the beneficial neurobehavioral effect of a single NFB session in adult ADHD, and reinforces the notion that ERPs could serve as useful diagnostic/prognostic markers of executive dysfunction.
目的:事件相关电位(ERPs)据报道与注意力缺陷多动障碍(ADHD)的认知加工缺陷有关。然而,这方面的证据主要局限于横断面数据。本研究利用神经反馈(NFB)作为神经调节工具,采用单次、被试内设计,研究成人 ADHD 的注意力和抑制过程的 ERP 相关性。
方法:我们在一项 Go/NoGo 任务中记录了 25 名成人 ADHD 患者和 22 名神经典型对照者的高密度 EEG,在 30 分钟的 NFB 疗程前后,该疗程旨在下调 alpha(8-12Hz)节律。
结果:在基线时,与对照组相比,ADHD 患者的 Go/NoGo 表现受损,而 Go-P3 振幅与儿童时期与 ADHD 相关的症状呈负相关。NFB 后,两组的任务表现均有所改善,显著提高了刺激可检测性(d-prime),降低了反应时变异性,同时增加了 N1 和 P3 ERP 成分的振幅。特别是对于 ADHD 患者,Go-P3 振幅的预-后增强与改善执行功能的指标相关,即增强的 d-prime、减少的遗漏错误和减少的反应时变异性。
结论:单次 alpha 下调 NFB 能够逆转 Go/NoGo 任务中成人 ADHD 的异常神经认知特征。
意义:该研究首次证明了单次 NFB 疗程对成人 ADHD 的有益神经行为效应,并强化了 ERPs 可以作为执行功能障碍的有用诊断/预后标志物的观点。
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