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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 →Neurofeedback for Elementary Students with Identified Learning Problems
Introduction. The goal of this research was to ascertain whether basic reading, reading comprehension, the reading composite, and IQ scores could be improved using neurofeedback. Pre-test and post-test reading and cognitive assessments were administered to sixth, seventh and eighth graders identified as having learning problems. Control and experimental groups were chosen at random. With the exception of three students, every student in the control and experimental group had previously been diagnosed with Specific Learning Disabilities or as Other Health Impaired according to State and Federal guidelines for special education services. The three students were medically diagnosed as having ADHD and were on a 504 Accommodation Plan. Method. The research began in late August 2001 with securing administrative and parental permissions. Student participation began during the last week in September and lasted through the last week in April. A day was set aside to administer QEEGs (also called "brain maps") to the students in the experimental group. Protocols were developed by following the brain maps and by using clinical judgment after staffing the students with their teachers on a regular basis; their psychoeducational evaluations were also used to plan the protocols. Following the statistics on the biofeedback machines also influenced protocol decisions. Neurofeedback training was provided to the participants of the experimental group only. Both the experimental group and the control group had their Individualized Educational Plans (IEP) or 504 Plans plus their general curriculum plans. Neurofeedback training lasted approximately 30 to 45 minutes within each one-hour time block. The sessions were conducted weekly for the seven-month period. Some students received more sessions than others because of absences, field trips, testing and other natural rhythms of home and school life. The average number of sessions per student was 28. Results. Neurofeedback was more effective in improving scores on reading tests than no neurofeedback training. There were significant interactions between neurofeedback and time on basic reading. Wilks' lambda (Λ) = .69, F(1, 23) = 10.32, p < .01, on reading comprehension, Λ = .75, F(1, 23) = 7.62, p = .01, and on reading composite scores, Λ = .65, F(1, 23) = 12.59, p < .01. Neurofeedback training was more effective in improving both the Verbal and Full Scale IQ scores than no neurofeedback training. There was a significant interaction between neurofeedback and time on Verbal IQ, Λ = .62, F(1, 21) = 12.71, p < .01, and on Full Scale IQ, Λ = .56, F(1, 21) = 16.50, p [removed]
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