attention improvement
Research Papers
Self-regulation of Slow Cortical Potentials: A New Treatment for Children With Attention-Deficit/Hyperactivity Disorder
OBJECTIVE. We investigated the effects of self-regulation of slow cortical potentials for children with attention-deficit/hyperactivity disorder. Slow cortical potentials are slow event-related direct-current shifts of the electroencephalogram. Slow cortical potential shifts in the electrical negative direction reflect the depolarization of large cortical cell assemblies, reducing their excitation threshold. This training aims at regulation of cortical excitation thresholds considered to be impaired in children with attention-deficit/hyperactivity disorder. Electroencephalographic data from the training and the 6-month follow-up are reported, as are changes in behavior and cognition. METHOD. Twenty-three children with attention-deficit/hyperactivity disorder aged between 8 and 13 years received 30 sessions of self-regulation training of slow cortical potentials in 3 phases of 10 sessions each. Increasing and decreasing slow cortical potentials at central brain regions was fed back visually and auditorily. Transfer trials without feedback were intermixed with feedback trials to allow generalization to everyday-life situations. In addition to the neurofeedback sessions, children exercised during the third training phase to apply the self-regulation strategy while doing their homework. RESULTS. For the first time, electroencephalographic data during the course of slow cortical potential neurofeedback are reported. Measurement before and after the trials showed that children with attention-deficit/hyperactivity disorder learn to regulate negative slow cortical potentials. After training, significant improvement in behavior, attention, and IQ score was observed. The behavior ratings included Diagnostic and Statistical Manual of Mental Disorders criteria, number of problems, and social behavior at school and were conducted by parents and teachers. The cognitive variables were assessed with the Wechsler Intelligence Scale for Children and with a computerized test battery that measures several components of attention. All changes proved to be stable at 6 months' follow-up after the end of training. Clinical outcome was predicted by the ability to produce negative potential shifts in transfer sessions without feedback. CONCLUSIONS. According to the guidelines of the efficacy of treatments, the evidence of the efficacy of slow cortical potential feedback found in this study reaches level 2: “possibly efficacious.” In the absence of a control group, no causal relationship between observed improvements and the ability to regulate brain activity can be made. However, it could be shown for the first time that good performance in self-regulation predicts clinical outcome. “Good performance” was defined as the ability to produce negative potential shifts in trials without feedback, because it is known that the ability to self-regulate without feedback is impaired in children and adults with attention problems. Additional research should focus on the control of unspecific effects, medication, and subtypes to confirm the assumption that slow cortical potential feedback is a viable treatment option for attention-deficit/hyperactivity disorder. Regulation of slow cortical potentials may involve similar neurobiological pathways as medical treatment. It is suggested that regulation of frontocentral negative slow cortical potentials affects the cholinergic-dopaminergic balance and allows children to adapt to task requirements more flexibly.
View Full Paper →Validating the efficacy of neurofeedback for optimising performance
The field of neurofeedback training has largely proceeded without validation. Here we review our studies directed at validating SMR, beta and alpha–theta protocols for improving attention, memory, mood and music and dance performance in healthy participants. Important benefits were demonstrable with cognitive and neurophysiological measures which were predicted on the basis of regression models of learning. These are initial steps in providing a much needed scientific basis to neurofeedback, but much remains to be done.
View Full Paper →Effects of Hemoencephalographic (HEG) Training at Three Prefrontal Locations Upon EEG Ratios at Cz
Background. Light in the wavelength region of 650 to 1000 nanometers is able to penetrate living human tissue, including bone. Medical research has exploited this optical window into the body to develop non-invasive monitoring of brain functioning. In 1994 Herschel Toomim discovered that he could both measure and teach persons to control the amount of oxygenated blood flowing in the prefrontal regions with such an optical device. He has labeled the biofeedback of brain blood flow hemoencephalography (HEG). Methods. A fifteen-year-old male with a history of mild articulation problems and poor spelling was administered twenty sessions of combined HEG/EEG biofeedback, with a referential recording at Cz. Feedback in each session was conducted in three trials with the HEG optodes placed over the left eye, at midline, and over the right eye for ten minutes each. The order of placement was counterbalanced across trials. Changes in HEG levels within each trial were computed and plotted across sessions, as was the theta/beta ratio for each trial. Results. The subject clearly learned improved voluntary control over brain blood flow. The slope of increases of HEG within each trial improved across sessions at all three forehead locations. There were three indications from this case that HEG training to improve attention might be most efficacious at the midline location: (a) the theta/beta ratio at Cz decreased slightly over sessions only in response to HEG training at midline, (b) bursts of beta lasting ten seconds or more occurred more often, and (c) occasionally a marked increase in HEG within a trial was associated with a corresponding increase in power in beta. This occurred only with HEG at midline. Conclusion. HEG biofeedback is a promising treatment modality, especially for improving the functioning of executive control systems mediated by the prefrontal regions of the cerebral cortex.
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