behavioral outcomes
Research Papers
TMS-based neuromodulation of evoked and induced gamma oscillations and event-related potentials in children with autism
Gamma oscillations are important for the integration of information and are involved in a variety of perceptual, cognitive, and motor process that are affected in autism spectrum disorder (ASD). We used gamma oscillations along with event-related potentials (ERP) as functional markers of response to repetitive transcranial magnetic stimulation (rTMS). The subjects were age- and gender-matched ASD and typically developing children (TDC). Behavioral evaluations along with evoked and induced gamma and ERPs during oddball task were collected at pre- and post-TMS in ASD group (N = 23) and at baseline in TDC (N = 21). ASD subjects were assigned to 18 sessions of rTMS over the dorsolateral prefrontal cortex. Baseline test showed significant differences between ASD and TDC groups in terms of responses to non-targets where ASD showed excessive gamma oscillations and larger ERPs as compared to the TDC group. Behavioral response differences were manifested in a lower accuracy of motor responses. The rTMS resulted in improved accuracy of response, attenuated evoked gamma responses to non-targets, and increased induced gamma to targets. Behavioral outcomes showed decreased irritability and hyperactivity scores and decreased repetitive and stereotype behaviors. There is discussed utility of gamma oscillations as biomarkers for functional diagnostics and predictions of TMS outcomes in ASD.
View Full Paper →Behavioral effects of neurofeedback in adolescents with ADHD: a randomized controlled trial
Neurofeedback has been proposed as a potentially effective intervention for reducing Attention Deficit Hyperactivity Disorder (ADHD) symptoms. However, it remains unclear whether neurofeedback is of additional value to treatment as usual (TAU) for adolescents with clinical ADHD symptoms. Using a multicenter parallel-randomized controlled trial design, adolescents with ADHD symptoms were randomized to receive either a combination of TAU and neurofeedback (NFB + TAU, n = 45) or TAU-only (n = 26). Randomization was computer generated and stratified for age group (ages 12 through 16, 16 through 20, 20 through 24). Neurofeedback treatment consisted of approximately 37 sessions of theta/sensorimotor rhythm (SMR)-training on the vertex (Cz). Primary behavioral outcome measures included the ADHD-rating scale, Youth Self Report, and Child Behavior Checklist all assessed pre- and post-intervention. Behavioral problems decreased equally for both groups with medium to large effect sizes, range of partial η2 = 0.08–0.31, p < 0.05. Hence, the combination of NFB + TAU was not more effective than TAU-only on the behavioral outcome measures. In addition, reported adverse effects were similar for both groups. On behavioral outcome measures, the combination of neurofeedback and TAU was as effective as TAU-only for adolescents with ADHD symptoms. Considering the absence of additional behavioral effects in the current study, in combination with the limited knowledge of specific treatment effects, it is questionable whether theta/SMR neurofeedback for adolescents with ADHD and comorbid disorders in clinical practice should be used. Further research is warranted to investigate possible working mechanisms and (long-term) specific treatment effects of neurofeedback.
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