Rahimpour Jounghani Ali, Gozdas Elveda, Dacorro Lauren, Avelar-Pereira Bárbara, Reitmaier Samantha, Fingerhut Hannah, Hong David S, Elliott Glen, Hardan Antonio Y, Hinshaw Stephen P, Hosseini S M Hadi
C-BRAIN Lab, Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, USA.
Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
iScience. 2024 Sep 30;27(11):111087. doi: 10.1016/j.isci.2024.111087. eCollection 2024 Nov 15.
We proposed a personalized intervention that integrates computerized working memory (WM) training with real-time functional neuromonitoring and neurofeedback (NFB) to enhance frontoparietal activity and improve cognitive and clinical outcomes in children with attention-deficit/hyperactivity disorder (ADHD). The study involved 77 children with ADHD aged 7-11 years, who were assigned to either 12 sessions of NFB or treatment-as-usual (i.e., received standard clinical care) groups. Real-time neuromonitoring with functional near-infrared spectroscopy (fNIRS) and fMRI measured frontoparietal activity during n-back task at baseline and post-intervention. Thirty-six participants (21 NFB, 15 treatment-as-usual) completed the study. Significant improvements in NFB group were observed in frontoparietal brain activity and WM performance (primary outcomes). NFB group also showed improvements in Behavior Rating Inventory of Executive Function (BRIEF-2) WM t-scores and Conners 3 ADHD index scores (secondary outcomes) compared to treatment-as-usual group. These findings suggest that neuromonitoring-guided NFB effectively enhances cognitive and clinical outcomes in children with ADHD by targeting brain mechanisms underlying WM deficits.
我们提出了一种个性化干预措施，该措施将计算机化工作记忆（WM）训练与实时功能神经监测及神经反馈（NFB）相结合，以增强额顶叶活动，并改善注意力缺陷多动障碍（ADHD）儿童的认知和临床结果。该研究纳入了77名7至11岁的ADHD儿童，他们被分配到接受12次NFB治疗的组或常规治疗组（即接受标准临床护理）。在基线和干预后，使用功能近红外光谱（fNIRS）和功能磁共振成像（fMRI）进行实时神经监测，测量n-back任务期间的额顶叶活动。三十六名参与者（21名NFB组，15名常规治疗组）完成了研究。NFB组在额顶叶脑活动和WM表现（主要结果）方面有显著改善。与常规治疗组相比，NFB组在执行功能行为评定量表（BRIEF-2）的WM t分数和康纳斯3 ADHD指数分数（次要结果）方面也有所改善。这些发现表明，神经监测引导的NFB通过针对WM缺陷背后的脑机制，有效地改善了ADHD儿童的认知和临床结果。
