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Tosti B, Corrado S, Mancone S, Di Libero T, Rodio A, Andrade A, Diotaiuti P. Integrated use of biofeedback and neurofeedback techniques in treating pathological conditions and improving performance: a narrative review. Front Neurosci 2024; 18:1358481. [PMID: 38567285 PMCID: PMC10985214 DOI: 10.3389/fnins.2024.1358481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/01/2024] [Indexed: 04/04/2024] Open
Abstract
In recent years, the scientific community has begun tо explore the efficacy оf an integrated neurofeedback + biofeedback approach іn various conditions, both pathological and non-pathological. Although several studies have contributed valuable insights into its potential benefits, this review aims tо further investigate its effectiveness by synthesizing current findings and identifying areas for future research. Our goal іs tо provide a comprehensive overview that may highlight gaps іn the existing literature and propose directions for subsequent studies. The search for articles was conducted on the digital databases PubMed, Scopus, and Web of Science. Studies to have used the integrated neurofeedback + biofeedback approach published between 2014 and 2023 and reviews to have analyzed the efficacy of neurofeedback and biofeedback, separately, related to the same time interval and topics were selected. The search identified five studies compatible with the objectives of the review, related to several conditions: nicotine addiction, sports performance, Autism Spectrum Disorder (ASD), and Attention Deficit Hyperactivity Disorder (ADHD). The integrated neurofeedback + biofeedback approach has been shown to be effective in improving several aspects of these conditions, such as a reduction in the presence of psychiatric symptoms, anxiety, depression, and withdrawal symptoms and an increase in self-esteem in smokers; improvements in communication, imitation, social/cognitive awareness, and social behavior in ASD subjects; improvements in attention, alertness, and reaction time in sports champions; and improvements in attention and inhibitory control in ADHD subjects. Further research, characterized by greater methodological rigor, is therefore needed to determine the effectiveness of this method and the superiority, if any, of this type of training over the single administration of either. This review іs intended tо serve as a catalyst for future research, signaling promising directions for the advancement оf biofeedback and neurofeedback methodologies.
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Affiliation(s)
- Beatrice Tosti
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Lazio, Italy
| | - Stefano Corrado
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Lazio, Italy
| | - Stefania Mancone
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Lazio, Italy
| | - Tommaso Di Libero
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Lazio, Italy
| | - Angelo Rodio
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Lazio, Italy
| | - Alexandro Andrade
- Department of Physical Education, CEFID, Santa Catarina State University, Florianopolis, Santa Catarina, Brazil
| | - Pierluigi Diotaiuti
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Lazio, Italy
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Moradi N, Rajabi S, Mansouri Nejad A. The effect of neurofeedback training combined with computer cognitive games on the time perception, attention, and working memory in children with ADHD. Appl Neuropsychol Child 2024; 13:24-36. [PMID: 36002025 DOI: 10.1080/21622965.2022.2112679] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The purpose of this study was to examine the effect of neurofeedback (NF) based on quantitative electroencephalography (QEEG) and SmartMind game on the time perception, attention, and working memory of children with Attention Deficit/Hyperactivity Disorder (ADHD) through an experimental design. METHOD Using a purposive sampling method, 32 male students diagnosed with ADHD were selected and then randomly assigned to an experimental group and a control group. The experimental group received the treatment (NF + SmartMind) for 30 weekly sessions. Children's performances on a time perception test, a Continuous Performance Test (CPT), and a Wechsler working memory test (WISC) were examined before and after the intervention. RESULTS A significant difference was observed between the mean scores of the pretest and post-test for the experimental group, implying that NF training improved short-time perception and long-time perception attention in CPT test: omission error component, Correct Response component, and working memory: Visual forward component. However, the treatment did not have a significant effect on the commission error component (CPT), working memory in terms of the visual reverse, auditory reverse, and auditory forward components. CONCLUSION NF combined with computer cognitive games (CCGs) can improve time perception, attention, and working memory in children with ADHD.
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Affiliation(s)
| | | | - Ali Mansouri Nejad
- Department of English Language Teaching, Farhangian University, Tehran, Iran
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Lee CSC, Chen TT, Gao Q, Hua C, Song R, Huang XP. The Effects of Theta/Beta-based Neurofeedback Training on Attention in Children with Attention Deficit Hyperactivity Disorder: A Systematic Review and Meta-analysis. Child Psychiatry Hum Dev 2023; 54:1577-1606. [PMID: 35471754 DOI: 10.1007/s10578-022-01361-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/01/2022] [Indexed: 11/25/2022]
Abstract
Neurofeedback training is a common treatment option for attention deficit hyperactivity disorder (ADHD). Given theta/beta-based neurofeedback (T/B NF) training targets at the electrophysiological characteristics of children with ADHD, benefits for attention may be expected. PsycINFO, PubMed, ScienceDirect, Scopus, and Web of Science were searched through December 31, 2020. Studies were evaluated with Risk of Bias tools. Within-group effects based on Pre- and Post-treatment comparisons of the Intervention Group, and Between-group effects based on the between-group differences from Pre-treatment to Post-treatment were calculated. Nineteen studies met selection criteria for systematic review, 12 of them were included in meta-analysis. Within-group effects were medium at Post-treatment and large at Follow-up. Between-group analyses revealed that T/B NF was superior to waitlist control and physical activities, but not stimulant medication. Results showed that T/B NF has benefits for attention in children with ADHD, however, cautions should be taken when interpreting the findings.
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Affiliation(s)
- Clara S C Lee
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
| | - Ting-Ting Chen
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Qingwen Gao
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Chunzhuo Hua
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Rui Song
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Xiu-Ping Huang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
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Guedj C, Tyrand R, Badier E, Planchamp L, Stringer M, Zimmermann MO, Férat V, Ha-Vinh Leuchter R, Grouiller F. Self-Regulation of Attention in Children in a Virtual Classroom Environment: A Feasibility Study. Bioengineering (Basel) 2023; 10:1352. [PMID: 38135943 PMCID: PMC10741222 DOI: 10.3390/bioengineering10121352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 11/17/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023] Open
Abstract
Attention is a crucial cognitive function that enables us to selectively focus on relevant information from the surrounding world to achieve our goals. Impairments in sustained attention pose challenges, particularly in children with attention deficit hyperactivity disorder, a neurodevelopmental disorder characterized by impulsive and inattentive behavior. While psychostimulant medications are the most effective ADHD treatment, they often yield unwanted side effects, making it crucial to explore non-pharmacological treatments. We propose a groundbreaking protocol that combines electroencephalography-based neurofeedback with virtual reality (VR) as an innovative approach to address attention deficits. By integrating a virtual classroom environment, we aim to enhance the transferability of attentional control skills while simultaneously increasing motivation and interest among children. The present study demonstrates the feasibility of this approach through an initial assessment involving a small group of healthy children, showcasing its potential for future evaluation in ADHD children. Preliminary results indicate high engagement and positive feedback. Pre- and post-protocol assessments via EEG and fMRI recordings suggest changes in attentional function. Further validation is required, but this protocol is a significant advancement in neurofeedback therapy for ADHD. The integration of EEG-NFB and VR presents a novel avenue for enhancing attentional control and addressing behavioral challenges in children with ADHD.
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Affiliation(s)
- Carole Guedj
- Swiss Center for Affective Sciences, University of Geneva, 1202 Geneva, Switzerland; (R.T.); (E.B.); (F.G.)
- Laboratory of Behavioral Neurology and Imaging of Cognition, Department of Basic Neurosciences, University of Geneva, 1202 Geneva, Switzerland; (L.P.); (M.S.); (M.O.Z.)
| | - Rémi Tyrand
- Swiss Center for Affective Sciences, University of Geneva, 1202 Geneva, Switzerland; (R.T.); (E.B.); (F.G.)
| | - Emmanuel Badier
- Swiss Center for Affective Sciences, University of Geneva, 1202 Geneva, Switzerland; (R.T.); (E.B.); (F.G.)
| | - Lou Planchamp
- Laboratory of Behavioral Neurology and Imaging of Cognition, Department of Basic Neurosciences, University of Geneva, 1202 Geneva, Switzerland; (L.P.); (M.S.); (M.O.Z.)
| | - Madison Stringer
- Laboratory of Behavioral Neurology and Imaging of Cognition, Department of Basic Neurosciences, University of Geneva, 1202 Geneva, Switzerland; (L.P.); (M.S.); (M.O.Z.)
| | - Myriam Ophelia Zimmermann
- Laboratory of Behavioral Neurology and Imaging of Cognition, Department of Basic Neurosciences, University of Geneva, 1202 Geneva, Switzerland; (L.P.); (M.S.); (M.O.Z.)
| | - Victor Férat
- Functional Brain Mapping Laboratory, Department of Basic Neurosciences, University of Geneva, 1202 Geneva, Switzerland;
| | - Russia Ha-Vinh Leuchter
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals, 1205 Geneva, Switzerland;
| | - Frédéric Grouiller
- Swiss Center for Affective Sciences, University of Geneva, 1202 Geneva, Switzerland; (R.T.); (E.B.); (F.G.)
- Laboratory of Behavioral Neurology and Imaging of Cognition, Department of Basic Neurosciences, University of Geneva, 1202 Geneva, Switzerland; (L.P.); (M.S.); (M.O.Z.)
- CIBM MRI Cognitive and Affective Neuroimaging Section, Center for Biomedical Imaging, University of Geneva, 1202 Geneva, Switzerland
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Herrera-Morales WV, Reyes-López JV, Tuz-Castellanos KNH, Ortegón-Abud D, Ramírez-Lugo L, Santiago-Rodríguez E, Núñez-Jaramillo L. Variations in Theta/Beta Ratio and Cognitive Performance in Subpopulations of Subjects with ADHD Symptoms: Towards Neuropsychological Profiling for Patient Subgrouping. J Pers Med 2023; 13:1361. [PMID: 37763129 PMCID: PMC10533160 DOI: 10.3390/jpm13091361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 09/01/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
ADHD is a neurodevelopmental disorder appearing in childhood but remaining in many cases in adults. There are both pharmacological and non-pharmacological approaches to treating ADHD, but they do not have the same efficacy in all subjects. Better knowledge of the neurophysiological basis of this disorder will allow for the design of more effective treatments. Studies performing qEEG analysis in children suggest the existence of subgroups of ADHD patients with different neurophysiological traits. There are fewer studies in adults, who might have undergone plastic changes allowing them to cope with ADHD symptoms along with brain maturation. Herein, we study cognitive performance and the theta/beta ratio in young adults with ADHD symptoms. We found that subjects with ADHD symptoms and low working memory performance (n = 30) present higher theta/beta ratios than controls (n = 40) at O2 and T6 in the eyes-closed condition, as well as a tendency toward a higher theta/beta ratio at O1 and Cz. Subjects with ADHD and high working memory performance (n = 50) do not differ from the controls in their theta/beta ratios at any derivation. Our results suggest that neuropsychological profiling could be useful for patient subgrouping. Further research will allow for the distinction of neuropsychological profiles and their neurophysiological correlates, leading to a better classification of ADHD subtypes, thus improving treatment selection.
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Affiliation(s)
- Wendy Verónica Herrera-Morales
- Laboratorio de Neurofisiología, Departamento de Ciencias Médicas, División de Ciencias de la Salud, Universidad Autónoma del Estado de Quintana Roo, Chetumal 77039, Mexico; (W.V.H.-M.); (K.N.-H.T.-C.)
| | - Julián Valeriano Reyes-López
- Unidad de Neurodiagnóstico y Rehabilitación “Dr. Moisés López Gonzáles” Secretaria de Vinculación y Servicios Universitarios, Facultad de Ciencias Naturales, Universidad Autónoma de Querétaro, Querétaro 76000, Mexico;
| | - Karen Nicte-Ha Tuz-Castellanos
- Laboratorio de Neurofisiología, Departamento de Ciencias Médicas, División de Ciencias de la Salud, Universidad Autónoma del Estado de Quintana Roo, Chetumal 77039, Mexico; (W.V.H.-M.); (K.N.-H.T.-C.)
| | - Desiree Ortegón-Abud
- Universidad Santander, Montañas Rocallosas 409, Lomas de Chapultepec, Ciudad de México 11000, Mexico;
| | - Leticia Ramírez-Lugo
- División de Neurociencias, Instituto de Fisiología Celular, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico;
| | - Efraín Santiago-Rodríguez
- Diagnóstico, Tratamiento e Investigación Neurológica, S.C. Querétaro, Santiago de Queretaro 76177, Mexico;
| | - Luis Núñez-Jaramillo
- Laboratorio de Neurofisiología, Departamento de Ciencias Médicas, División de Ciencias de la Salud, Universidad Autónoma del Estado de Quintana Roo, Chetumal 77039, Mexico; (W.V.H.-M.); (K.N.-H.T.-C.)
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Afrash S, Saemi E, Gong A, Doustan M. Neurofeedback training and motor learning: the enhanced sensorimotor rhythm protocol is better or the suppressed alpha or the suppressed mu? BMC Sports Sci Med Rehabil 2023; 15:93. [PMID: 37525277 PMCID: PMC10392010 DOI: 10.1186/s13102-023-00706-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 07/21/2023] [Indexed: 08/02/2023]
Abstract
A large number of previous studies have examined how different neurofeedback-based techniques may influence motor learning. However, only a few studies attempted to compare the effects of these different techniques on motor learning. Therefore, the present study attempts to examine the effects of neurofeedback training on motor learning in novice golfers, using three protocols, namely enhanced sensorimotor rhythm (SMR) at Cz, suppressed alpha waves at Fz, and suppressed mu waves at Cz. The participants were 64 adults (32 females; mean age = 22.31 ± 2.25 years). The study consisted of a pretest stage (day 1), intervention (6 sessions, over two weeks, 3 sessions per week), short-term retention (one day after intervention), and long-term retention (two weeks after intervention); in the pretest and short-term and long-term retention, motor performance for golf putting (12 trials) as well as amplitudes of SMR wave at Cz, alpha at Fz, and Mu at Cz were recorded. During each intervention session, the participants in three neurofeedback groups and a sham group first performed neurofeedback training (enhanced SMR at Cz, suppressed alpha at Fz, and suppressed Mu at Cz) for 20 min. Then, the participants in all groups performed three blocks of 12 trials consisting of golf putting training. The results indicated no difference between the sham and the experimental groups in the acquisition stage, as individuals in all groups experienced similar improvement in putting accuracy. However, in the short-term retention, all the three neurofeedback groups outperformed the sham group, although in the long-term retention, only the SMR group and the Alpha group showed a better performance than the sham group while the Mu group did not exhibit a notably better performance than the sham group. Our results also showed significant variations in the amplitudes of the SMR, alpha, and mu waves depending on the neurofeedback intervention provided, while no significant variation was observed in the sham group. Based on these results, it is recommended that coaches should make further use of enhanced SMR at Cz or suppressed alpha at Fz as their neurofeedback interventions to facilitate longer-term motor learning in golfers.
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Affiliation(s)
- Sana Afrash
- Department of Motor Behavior and Sport Psychology, Faculty of Sport Sciences, Shahid Chamran University of Ahvaz, Ahvaz, 6135783151, Iran
| | - Esmaeel Saemi
- Department of Motor Behavior and Sport Psychology, Faculty of Sport Sciences, Shahid Chamran University of Ahvaz, Ahvaz, 6135783151, Iran.
| | - Anmin Gong
- School of Information Engineering, Engineering University of People's Armed Police, Xi'an, 710086, China
| | - Mohammadreza Doustan
- Department of Motor Behavior and Sport Psychology, Faculty of Sport Sciences, Shahid Chamran University of Ahvaz, Ahvaz, 6135783151, Iran
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Oda K, Colman R, Koshiba M. Simplified Attachable EEG Revealed Child Development Dependent Neurofeedback Brain Acute Activities in Comparison with Visual Numerical Discrimination Task and Resting. Sensors (Basel) 2022; 22:7207. [PMID: 36236305 PMCID: PMC9572555 DOI: 10.3390/s22197207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
The development of an easy-to-attach electroencephalograph (EEG) would enable its frequent use for the assessment of neurodevelopment and clinical monitoring. In this study, we designed a two-channel EEG headband measurement device that could be used safely and was easily attachable and removable without the need for restraint or electrode paste or gel. Next, we explored the use of this device for neurofeedback applications relevant to education or neurocognitive development. We developed a prototype visual neurofeedback game in which the size of a familiar local mascot changes in the PC display depending on the user's brain wave activity. We tested this application at a local children's play event. Children at the event were invited to experience the game and, upon agreement, were provided with an explanation of the game and support in attaching the EEG device. The game began with a consecutive number visual discrimination task which was followed by an open-eye resting condition and then a neurofeedback task. Preliminary linear regression analyses by the least-squares method of the acquired EEG and age data in 30 participants from 5 to 20 years old suggested an age-dependent left brain lateralization of beta waves at the neurofeedback stage (p = 0.052) and of alpha waves at the open-eye resting stage (p = 0.044) with potential involvement of other wave bands. These results require further validation.
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Affiliation(s)
- Kazuyuki Oda
- Engineering Department, Graduate School of Sciences and Technology for Innovation Yamaguchi University, Yamaguchi 755-8611, Japan
| | - Ricki Colman
- Department of Cell and Regenerative Biology, University of Wisconsin, Madison, Madison, WI 53706, USA
| | - Mamiko Koshiba
- Engineering Department, Graduate School of Sciences and Technology for Innovation Yamaguchi University, Yamaguchi 755-8611, Japan
- Department of Pediatrics, Saitama Medical University, Saitama 350-0495, Japan
- Graduate School of Information Sciences, Tohoku University, Sendai 980-8579, Japan
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Patil AU, Madathil D, Fan YT, Tzeng OJL, Huang CM, Huang HW. Neurofeedback for the Education of Children with ADHD and Specific Learning Disorders: A Review. Brain Sci 2022; 12:brainsci12091238. [PMID: 36138974 PMCID: PMC9497239 DOI: 10.3390/brainsci12091238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/03/2022] [Accepted: 09/07/2022] [Indexed: 12/02/2022] Open
Abstract
Neurofeedback (NF) is a type of biofeedback in which an individual’s brain activity is measured and presented to them to support self-regulation of ongoing brain oscillations and achieve specific behavioral and neurophysiological outcomes. NF training induces changes in neurophysiological circuits that are associated with behavioral changes. Recent evidence suggests that the NF technique can be used to train electrical brain activity and facilitate learning among children with learning disorders. Toward this aim, this review first presents a generalized model for NF systems, and then studies involving NF training for children with disorders such as dyslexia, attention-deficit/hyperactivity disorder (ADHD), and other specific learning disorders such as dyscalculia and dysgraphia are reviewed. The discussion elaborates on the potential for translational applications of NF in educational and learning settings with details. This review also addresses some issues concerning the role of NF in education, and it concludes with some solutions and future directions. In order to provide the best learning environment for children with ADHD and other learning disorders, it is critical to better understand the role of NF in educational settings. The review provides the potential challenges of the current systems to aid in highlighting the issues undermining the efficacy of current systems and identifying solutions to address them. The review focuses on the use of NF technology in education for the development of adaptive teaching methods and the best learning environment for children with learning disabilities.
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Affiliation(s)
- Abhishek Uday Patil
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu 300093, Taiwan
| | - Deepa Madathil
- Jindal Institute of Behavioural Sciences, O.P. Jindal Global University, Haryana 131001, India
| | - Yang-Tang Fan
- Graduate Institute of Medicine, Yuan Ze University, Taoyuan 320315, Taiwan
| | - Ovid J. L. Tzeng
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu 300093, Taiwan
- Centre for Intelligent Drug Systems and Smart Bio-Devices (IDSB), National Yang Ming Chiao Tung University, Hsinchu 300093, Taiwan
- College of Humanities and Social Sciences, Taipei Medical University, Taipei 106339, Taiwan
- Department of Educational Psychology and Counseling, National Taiwan Normal University, Taipei 106308, Taiwan
- Hong Kong Institute for Advanced Studies, City University of Hong Kong, Hong Kong
| | - Chih-Mao Huang
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu 300093, Taiwan
- Centre for Intelligent Drug Systems and Smart Bio-Devices (IDSB), National Yang Ming Chiao Tung University, Hsinchu 300093, Taiwan
| | - Hsu-Wen Huang
- Department of Linguistics and Translation, City University of Hong Kong, Hong Kong
- Correspondence: ; Tel.: +852-3442-2579
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Nermend M, Flaga-Gieruszyńska K, Kroplewski Z, Nermend K. Neurological Mechanisms of Diagnosis and Therapy in School Children with ADHD in Poland. IJERPH 2022; 19:ijerph19137615. [PMID: 35805275 PMCID: PMC9265331 DOI: 10.3390/ijerph19137615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/15/2022] [Accepted: 06/21/2022] [Indexed: 11/24/2022]
Abstract
The paper aims to present a holistic view of attention deficit hyperactivity disorder (ADHD) in pedagogical, psychological, legal, and social dimensions in Polish schools. The authors present the benefits of neurofeedback therapy for elementary school pupils. In order to verify the validity, the paper compares the concordance of a medical diagnosis confirming ADHD syndrome with the occurrence of abnormal electrical brain function recording and abnormalities therein as well as the effectiveness of the neurofeedback therapy. The study confirms that the reported problems faced by pupils and affecting their emotional functioning are reflected in their EEG records. Conclusions from the study lead to the proposal that the neurofeedback assessment should be performed at schools, which should result in the implementation of effective therapy. Moreover, the neurofeedback method should be promoted in Polish schools as an alternative to pharmacological therapy, which, as the research proves, is not always effective. Neurofeedback therapy, similarly to behavioral therapy, is very much needed and useful because it provides optimal conditions for the child’s development and shapes their relations with the environment effectively and harmlessly.
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Affiliation(s)
- Małgorzata Nermend
- Department of Early Education, University of Szczecin, 71-004 Szczecin, Poland;
| | - Kinga Flaga-Gieruszyńska
- Research Team on Civil Procedural Law and Informatization of the Justice, Faculty of Law and Administration, University of Szczecin, 71-101 Szczecin, Poland;
| | - Zdzisław Kroplewski
- Institute of Psychology, University of Szczecin, Krakowska 69, 71-017 Szczecin, Poland;
| | - Kesra Nermend
- Department of Decision Support Methods and Cognitive Neuroscience, Institute of Management, University of Szczecin, 71-004 Szczecin, Poland
- Correspondence:
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Nan W, Wan M, Jiang Y, Shi X, Wan F, Cai D. Alpha/Theta Ratio Neurofeedback Training for Attention Enhancement in Normal Developing Children: A Brief Report. Appl Psychophysiol Biofeedback 2022; 47:223-229. [PMID: 35691974 DOI: 10.1007/s10484-022-09550-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2022] [Indexed: 01/12/2023]
Abstract
Attention plays an important role in children's development and learning, and neurofeedback training (NFT) has been proposed as a promising method to improve attention, mainly in population with attention problems such as attention deficit hyperactivity disorder. However, whether this approach has a positive effect on attention in normal developing children has been rarely investigated. This pilot study conducted ten sessions of alpha/theta ratio (ATR) NFT on eight primary students in school environment, with two to three sessions per week. The results showed inter-individual difference in NFT learning efficacy that was assessed by the slope of ATR over training sessions. In addition, the attention performance was significantly improved after NFT. Importantly, the improvement of attention performance was positively correlated with the NFT learning efficacy. It thus highlighted the need for optimizing ATR NFT protocol for the benefits on attention at the individual level. Future work can employ a double-blind placebo-controlled design with larger sample size to validate the benefits of ATR NFT for attention in normal developing children.
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Affiliation(s)
- Wenya Nan
- Department of Psychology, Shanghai Normal University, Shanghai, China
| | - Mengqi Wan
- Department of Psychology, Shanghai Normal University, Shanghai, China
| | - Yali Jiang
- Department of Psychology, Shanghai Normal University, Shanghai, China
| | - Xiaoping Shi
- Department of Psychology, Shanghai Normal University, Shanghai, China
| | - Feng Wan
- Department of Electrical and Computer Engineering, Faculty of Science and Engineering, University of Macau, Macau, China
- Centre for Cognitive and Brain Sciences, Institute of Collaborative Innovation, University of Macau, Macau, China
| | - Dan Cai
- Department of Psychology, Shanghai Normal University, Shanghai, China.
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Maya-Piedrahita MC, Herrera-Gomez PM, Berrío-Mesa L, Cárdenas-Peña DA, Orozco-Gutierrez AA. Supported Diagnosis of Attention Deficit and Hyperactivity Disorder from EEG Based on Interpretable Kernels for Hidden Markov Models. Int J Neural Syst 2022; 32:2250008. [PMID: 34996341 DOI: 10.1142/s0129065722500083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
As a neurodevelopmental pathology, Attention Deficit Hyperactivity Disorder (ADHD) mainly arises during childhood. Persistent patterns of generalized inattention, impulsivity, or hyperactivity characterize ADHD that may persist into adulthood. The conventional diagnosis relies on clinical observational processes yielding high rates of overdiagnosis due to varying interpretations among specialists or missing information. Although several studies have designed objective behavioral features to overcome such an issue, they lack significance. Despite electroencephalography (EEG) analyses extracting alternative biomarkers using signal processing techniques, the nonlinearity and nonstationarity of EEG signals restrain performance and generalization of hand-crafted features. This work proposes a methodology to support ADHD diagnosis by characterizing EEG signals from hidden Markov models (HMM), classifying subjects based on similarity measures for probability functions, and spatially interpreting the results using graphic embeddings of stochastic dynamic models. The methodology learns a single HMM for EEG signal from each patient, so favoring the inter-subject variability. Then, the Probability Product Kernel, specifically developed for assessing the similarity between HMMs, fed a support vector machine that classifies subjects according to their stochastic dynamics. Lastly, the kernel variant of Principal Component Analysis provided a means to visualize the EEG transitions in a two-dimensional space, evidencing dynamic differences between ADHD and Healthy Control children. From the electrophysiological perspective, we recorded EEG under the Stop Signal Task modified with reward levels, which considers cognitive features of interest as insufficient motivational circuits recruitment. The methodology compares the supported diagnosis in two EEG channel setups (whole channel set and channels of interest in frontocentral area) and four frequency bands (Theta, Alpha, Beta rhythms, and a wideband). Results evidence an accuracy rate of 97.0% in the Beta band and in the channels where previous works found error-related negativity events. Such accuracy rate strongly supports the dual pathway hypothesis and motivational deficit concerning the pathophysiology of ADHD. It also demonstrates the utility of joining inhibitory and motivational paradigms with dynamic EEG analysis into a noninvasive and affordable diagnostic tool for ADHD patients.
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Affiliation(s)
- M C Maya-Piedrahita
- Automatics Research Group, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia
| | - P M Herrera-Gomez
- Research Group Psiquiatría Neurociencias y Comunidad, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia
| | - L Berrío-Mesa
- Automatics Research Group, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia
| | - D A Cárdenas-Peña
- Automatics Research Group, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia
| | - A A Orozco-Gutierrez
- Automatics Research Group, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia
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12
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Abstract
Recent research has shown that electroencephalography (EEG) theta/beta ratio (TBR) in cases with attention deficit hyperactivity disorder (ADHD) has thus far been reported lower than that in healthy individuals. Accordingly, utilizing EEG-TBR as a biomarker to diagnose ADHD has been called into question. Besides, employing known protocol to reduce EEG-TBR in the vertex (Cz) channel to treat ADHD via neurofeedback (NFB) has been doubted. The present study was to propose a new NFB treatment protocol to manage ADHD using EEG signals from 30 healthy controls and 30 children with ADHD through an attention-based task and to calculate relative power in their different frequency bands. Then, the most significant distinguishing features of EEG signals from both groups were determined via a genetic algorithm (GA). The results revealed that EEG-TBR values in children with ADHD were lower compared with those in healthy peers; however, such a difference was not statistically significant. Likewise, inhibiting alpha band activity and enhancing delta one in F7 or T5 channels was proposed as a new NFB treatment protocol for ADHD. No significant increase in EEG-TBR in the Cz channel among children with ADHD casts doubt on the effectiveness of using EEG-TBR inhibitory protocols in the Cz channel. Consequently, it was proposed to apply the new protocol along with reinforced beta-band activity to treat or reduce ADHD symptoms.
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13
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Loriette C, Ziane C, Ben Hamed S. Neurofeedback for cognitive enhancement and intervention and brain plasticity. Rev Neurol (Paris) 2021; 177:1133-44. [PMID: 34674879 DOI: 10.1016/j.neurol.2021.08.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 08/27/2021] [Indexed: 12/18/2022]
Abstract
In recent years, neurofeedback has been used as a cognitive training tool to improve brain functions for clinical or recreational purposes. It is based on providing participants with feedback about their brain activity and training them to control it, initiating directional changes. The overarching hypothesis behind this method is that this control results in an enhancement of the cognitive abilities associated with this brain activity, and triggers specific structural and functional changes in the brain, promoted by learning and neuronal plasticity effects. Here, we review the general methodological principles behind neurofeedback and we describe its behavioural benefits in clinical and experimental contexts. We review the non-specific effects of neurofeedback on the reinforcement learning striato-frontal networks as well as the more specific changes in the cortical networks on which the neurofeedback control is exerted. Last, we analyse the current challenges faces by neurofeedback studies, including the quantification of the temporal dynamics of neurofeedback effects, the generalisation of its behavioural outcomes to everyday life situations, the design of appropriate controls to disambiguate placebo from true neurofeedback effects and the development of more advanced cortical signal processing to achieve a finer-grained real-time modelling of cognitive functions.
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14
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Shtoots L, Dagan T, Levine J, Rothstein A, Shati L, Levy DA. The Effects of Theta EEG Neurofeedback on the Consolidation of Spatial Memory. Clin EEG Neurosci 2021; 52:338-344. [PMID: 33207955 DOI: 10.1177/1550059420973107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
How can the stability of a recently acquired memory be improved? Recent findings regarding the importance of theta frequency EEG activity in the hippocampus suggest that entraining neural activity in that frequency band might increase post-encoding waking replay, reinforcing learning-related plasticity. Our previous studies revealed that upregulating postlearning theta power using EEG neurofeedback (NFB) significantly benefitted procedural and episodic memory performance (both immediate and delayed), and may provide optimal conditions for stabilization of new memories. We have now explored whether memory benefits of theta NFB generalize to delayed spatial memory, an additional hippocampus-dependent process. Participants learned to associate object images with locations on a computer screen. NFB was used to enable participants to selectively increase scalp EEG theta power for 30 minutes. Visuo-spatial memory was tested one week later, with the theta NFB participants compared with 2 control groups (beta-augmentation NFB as an active control group, and an additional passive control group that did not engage in NFB). Theta upregulation was found to improve visuo-spatial memory, as reflected in reduced error distances in location marking and faster reaction time for correct answers by the theta group. This supports the contention that theta upregulation immediately after learning strengthens early consolidation of visuo-spatial memory. This intervention could potentially benefit various memory-challenged populations, as well as healthy individuals.
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Affiliation(s)
- Limor Shtoots
- Baruch Ivcher School of Psychology, Interdisciplinary Center Herzliya, Herzliya, Israel
| | - Tom Dagan
- Baruch Ivcher School of Psychology, Interdisciplinary Center Herzliya, Herzliya, Israel
| | - Josh Levine
- Baruch Ivcher School of Psychology, Interdisciplinary Center Herzliya, Herzliya, Israel
| | - Aryeh Rothstein
- Baruch Ivcher School of Psychology, Interdisciplinary Center Herzliya, Herzliya, Israel
| | - Liran Shati
- Baruch Ivcher School of Psychology, Interdisciplinary Center Herzliya, Herzliya, Israel
| | - Daniel A Levy
- Baruch Ivcher School of Psychology, Interdisciplinary Center Herzliya, Herzliya, Israel
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15
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Veilahti AVP, Kovarskis L, Cowley BU. Neurofeedback Learning Is Skill Acquisition but Does Not Guarantee Treatment Benefit: Continuous-Time Analysis of Learning-Curves From a Clinical Trial for ADHD. Front Hum Neurosci 2021; 15:668780. [PMID: 34276325 PMCID: PMC8277562 DOI: 10.3389/fnhum.2021.668780] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 06/02/2021] [Indexed: 11/24/2022] Open
Abstract
Neurofeedback for attention deficit/hyperactivity disorder (ADHD) has long been studied as an alternative to medication, promising non-invasive treatment with minimal side-effects and sustained outcome. However, debate continues over the efficacy of neurofeedback, partly because existing evidence for efficacy is mixed and often non-specific, with unclear relationships between prognostic variables, patient performance when learning to self-regulate, and treatment outcomes. We report an extensive analysis on the understudied area of neurofeedback learning. Our data comes from a randomised controlled clinical trial in adults with ADHD (registered trial ISRCTN13915109; N = 23; 13:10 female:male; age 25–57). Patients were treated with either theta-beta ratio or sensorimotor-rhythm regimes for 40 one-hour sessions. We classify 11 learners vs 12 non-learners by the significance of random slopes in a linear mixed growth-curve model. We then analyse the predictors, outcomes, and processes of learners vs non-learners, using these groups as mutual controls. Significant predictive relationships were found in anxiety disorder (GAD), dissociative experience (DES), and behavioural inhibition (BIS) scores obtained during screening. Low DES, but high GAD and BIS, predicted positive learning. Patterns of behavioural outcomes from Test Of Variables of Attention, and symptoms from adult ADHD Self-Report Scale, suggested that learning itself is not required for positive outcomes. Finally, the learning process was analysed using structural-equations modelling with continuous-time data, estimating the short-term and sustained impact of each session on learning. A key finding is that our results support the conceptualisation of neurofeedback learning as skill acquisition, and not merely operant conditioning as originally proposed in the literature.
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Affiliation(s)
- Antti Veikko Petteri Veilahti
- Department of Communication, Faculty of Humanities, University of Copenhagen Research Unit, Social Insurance Institution of Finland (Kela), Helsinki, Finland
| | | | - Benjamin Ultan Cowley
- Faculty of Educational Sciences, University of Helsinki, Helsinki, Finland.,Cognitive Science, Department of Digital Humanities, Faculty of Arts, University of Helsinki, Helsinki, Finland.,Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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16
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Abstract
A growing number of studies suggest that EEG theta/beta ratio (TBR) is inversely related to executive cognitive control. Neurofeedback training aimed at reducing TBR (TBR NFT) might provide a tool to study causality in this relation and might enhance human performance. To investigate whether TBR NFT reduces TBR in healthy participants. Twelve healthy female participants were assigned (single blind) to one of three groups. Groups differed on baseline durations and one group received only sham NFT. TBR NFT consisted of eight or fourteen 25-min sessions. No evidence was found that TBR NFT had any effect on TBR. The current TBR NFT protocol is possibly ineffective. This is in line with a previous study with a different protocol.
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Affiliation(s)
- Dana van Son
- Institute of Psychology, Leiden University, Leiden, The Netherlands. .,Leiden Institute for Brain and Cognition, Leiden, The Netherlands.
| | - Willem van der Does
- Institute of Psychology, Leiden University, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Guido P H Band
- Institute of Psychology, Leiden University, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Peter Putman
- Institute of Psychology, Leiden University, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden, The Netherlands
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17
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Núñez-Jaramillo L, Herrera-Solís A, Herrera-Morales WV. ADHD: Reviewing the Causes and Evaluating Solutions. J Pers Med 2021; 11:166. [PMID: 33804365 DOI: 10.3390/jpm11030166] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/05/2021] [Accepted: 02/23/2021] [Indexed: 12/11/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder in which patients present inattention, hyperactivity, and impulsivity. The etiology of this condition is diverse, including environmental factors and the presence of variants of some genes. However, a great diversity exists among patients regarding the presence of these ADHD-associated factors. Moreover, there are variations in the reported neurophysiological correlates of ADHD. ADHD is often treated pharmacologically, producing an improvement in symptomatology, albeit there are patients who are refractory to the main pharmacological treatments or present side effects to these drugs, highlighting the importance of developing other therapeutic options. Different non-pharmacological treatments are in this review addressed, finding diverse results regarding efficacy. Altogether, ADHD is associated with different etiologies, all of them producing changes in brain development, leading to the characteristic symptomatology of this condition. Given the heterogeneous etiology of ADHD, discussion is presented about the convenience of personalizing ADHD treatment, whether pharmacological or non-pharmacological, to reach an optimum effect in the majority of patients. Approaches to personalizing both pharmacological therapy and neurofeedback are presented.
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18
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Wang S, Zhang D, Fang B, Liu X, Yan G, Sui G, Huang Q, Sun L, Wang S. A Study on Resting EEG Effective Connectivity Difference before and after Neurofeedback for Children with ADHD. Neuroscience 2021; 457:103-113. [PMID: 33476697 DOI: 10.1016/j.neuroscience.2020.12.038] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 11/30/2020] [Accepted: 12/31/2020] [Indexed: 11/29/2022]
Abstract
Altered functional networks in attention deficit/hyperactivity disorder (ADHD) have been frequently reported, but effective connectivity has hardly been studied. Especially the differences of effective connectivity in children with ADHD after receiving neurofeedback (NF) training have been merely reported. Therefore, this study aimed to explore the effective networks of ADHD and the positive influence of NF on the effective networks. Electroencephalogram (EEG) data were recorded from 22 children with ADHD (including data from children pretraining and posttraining) and 15 age-matched healthy controls during an eyes-closed resting state. Phase transfer entropy (PTE) was used to construct the effective connectivity. The topological properties of networks and flow gain were measured separately in four bands (delta, theta, alpha, and beta). Results revealed the following: pretraining children with ADHD manifested a higher clustering coefficient and lower characteristic path length in the delta band than healthy controls; weakened anterior-to-posterior flow gain in the delta band, strengthened posterior-to-anterior flow gain in the alpha band and strengthened anterior-to-posterior flow gain in the beta band were observed in pretraining children with ADHD; The topological properties and flow gain in posttraining children with ADHD were close to those of healthy controls. Moreover, parent's SWAN presented significant improvements of ADHD symptoms after NF. Our findings revealed that the effective connectivity of ADHD was altered and that NF could improve the brain function of ADHD. The present study provided the first evidence that children with ADHD differed from healthy children in phase-based effective connectivity and that NF could reduce the differences.
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Affiliation(s)
- Shanshan Wang
- School of Biomedical Engineering and Technology, Tianjin Medical University, Tianjin 300070, China
| | - Dujuan Zhang
- School of Biomedical Engineering and Technology, Tianjin Medical University, Tianjin 300070, China
| | - Bei Fang
- School of Biomedical Engineering and Technology, Tianjin Medical University, Tianjin 300070, China
| | - Xingping Liu
- Department of Interventional Radiology, Chongqing University Three Gorges Hospital, Chongqing 404000, China
| | - Guoli Yan
- Department of Child and Adolescent Psychology, Tianjin Anding Hospital, Tianjin 300222, China
| | - Guanghong Sui
- Department of Child and Adolescent Psychology, Tianjin Anding Hospital, Tianjin 300222, China
| | - Qingwei Huang
- Department of Child and Adolescent Psychology, Tianjin Anding Hospital, Tianjin 300222, China
| | - Ling Sun
- Department of Child and Adolescent Psychology, Tianjin Anding Hospital, Tianjin 300222, China.
| | - Suogang Wang
- School of Biomedical Engineering and Technology, Tianjin Medical University, Tianjin 300070, China.
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19
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Gevensleben H, Schmiedeke D, Heinrich H, Rothenberger A. Yes, I can - maybe … Effects of placebo-related instructions on neuroregulation in children with ADHD. J Neural Transm (Vienna) 2020; 127:1093-1096. [PMID: 32390102 PMCID: PMC7293682 DOI: 10.1007/s00702-020-02193-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 04/15/2020] [Indexed: 10/26/2022]
Abstract
Neurofeedback training (NFT) provides strategies for children with ADHD to achieve changes on the neurophysiological and behavioral level to attenuate ADHD symptoms. We assume self-efficacy (an "active attitude"), a core variable in successful NFT. In a randomized, double-blind controlled study, we investigated the impact of a "placebo instruction" on the EEG-regulation performance during two sessions of Theta-Beta-NFT in children with ADHD (age 8-12 years). Children receiving the information "this might be a placebo-training" showed inferior neuroregulation (n = 10) compared to children receiving a standard instruction (n = 12). Results of our pilot study are discussed in view of factors necessary for a valid training (ensuring maximal self-efficacy in the participants) and the fidelity of placebo-controlled trials in NFT-research.
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Affiliation(s)
- Holger Gevensleben
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, von-Siebold-Str. 5, D37075, Goettingen, Germany.
| | - David Schmiedeke
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, von-Siebold-Str. 5, D37075, Goettingen, Germany
| | - Hartmut Heinrich
- NeuroCare Group, Munich, Germany.,Research Institute Brainclinics, Nijmegen, The Netherlands.,kbo-Heckscher-Klinikum, Munich, Germany.,Department of Child and Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Aribert Rothenberger
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, von-Siebold-Str. 5, D37075, Goettingen, Germany
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20
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López S, Cervantes JA, Cervantes S, Molina J, Cervantes F. The plausibility of using unmanned aerial vehicles as a serious game for dealing with attention deficit-hyperactivity disorder. COGN SYST RES 2020. [DOI: 10.1016/j.cogsys.2019.09.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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21
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Heinrich H, Gevensleben H, Becker A, Rothenberger A. Effects of neurofeedback on the dysregulation profile in children with ADHD: SCP NF meets SDQ-DP - a retrospective analysis. Psychol Med 2020; 50:258-263. [PMID: 30674360 DOI: 10.1017/s0033291718004130] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND As children with attention-deficit/hyperactivity disorder (ADHD) usually show psychopathological signs beyond their core symptoms (e.g. elevated scores of the dysregulation profile (DP) in 30-40%), treatments with a broader approach to self-regulation skills may be supportive. Neurofeedback (NF) may reflect such an option. Aim of the present analysis was to compare the effects of slow cortical potential (SCP) NF and θ/β NF on the DP using data from a previous trial. METHODS Thirty children with ADHD (aged 8-12 years) and a DP score in the Strengths and Difficulties Questionnaire (SDQ-DP) ⩾ 3 were included. NF treatment consisted of one block of SCP NF and one block of θ/β NF (18 units per block) allowing an intraindividual comparison. Effects of the NF protocols were also contrasted to a control group (n = 18) that completed an attention skills training (between-group analysis). RESULTS Regarding the SDQ-DP, SCP NF was superior to θ/β NF and the control condition. Effects of SCP NF and θ/β NF on ADHD symptom severity were not significantly different. The SDQ-DP score did not correlate with EEG-related measures previously found to be predictors for SCP NF on ADHD symptoms. CONCLUSIONS SCP NF may reflect a more general approach to improve cognitive, emotional and behavioral self-regulation skills. If confirmed in a larger sample, the SDQ-DP score could be used as an indication criterion and contribute to the individualization of NF in ADHD. Overall, the differential effect provides further evidence for the specificity of NF effects.
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Affiliation(s)
- Hartmut Heinrich
- Department of Child & Adolescent Mental Health, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen, Germany
- kbo-Heckscher-Klinikum, Munich, Germany
- Research Institute Brainclinics, Nijmegen, The Netherlands (Research Fellow)
| | - Holger Gevensleben
- Department of Child & Adolescent Psychiatry, University Medical Center Göttingen, Göttingen, Germany
| | - Andreas Becker
- Department of Child & Adolescent Psychiatry, University Medical Center Göttingen, Göttingen, Germany
| | - Aribert Rothenberger
- Department of Child & Adolescent Psychiatry, University Medical Center Göttingen, Göttingen, Germany
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22
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Bussalb A, Congedo M, Barthélemy Q, Ojeda D, Acquaviva E, Delorme R, Mayaud L. Clinical and Experimental Factors Influencing the Efficacy of Neurofeedback in ADHD: A Meta-Analysis. Front Psychiatry 2019; 10:35. [PMID: 30833909 PMCID: PMC6388544 DOI: 10.3389/fpsyt.2019.00035] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 01/21/2019] [Indexed: 11/13/2022] Open
Abstract
Meta-analyses have been extensively used to evaluate the efficacy of neurofeedback (NFB) treatment for Attention Deficit/Hyperactivity Disorder (ADHD) in children and adolescents. However, each meta-analysis published in the past decade has contradicted the methods and results from the previous one, thus making it difficult to determine a consensus of opinion on the effectiveness of NFB. This works brings continuity to the field by extending and discussing the last and much controversial meta-analysis by Cortese et al. (1). The extension comprises an update of that work including the latest control trials, which have since been published and, most importantly, offers a novel methodology. Specifically, NFB literature is characterized by a high technical and methodological heterogeneity, which partly explains the current lack of consensus on the efficacy of NFB. This work takes advantage of this by performing a Systematic Analysis of Biases (SAOB) in studies included in the previous meta-analysis. Our extended meta-analysis (k = 16 studies) confirmed the previously obtained results of effect sizes in favor of NFB efficacy as being significant when clinical scales of ADHD are rated by parents (non-blind, p-value = 0.0014), but not when they are rated by teachers (probably blind, p-value = 0.27). The effect size is significant according to both raters for the subset of studies meeting the definition of "standard NFB protocols" (parents' p-value = 0.0054; teachers' p-value = 0.043, k = 4). Following this, the SAOB performed on k = 33 trials identified three main factors that have an impact on NFB efficacy: first, a more intensive treatment, but not treatment duration, is associated with higher efficacy; second, teachers report a lower improvement compared to parents; third, using high-quality EEG equipment improves the effectiveness of the NFB treatment. The identification of biases relating to an appropriate technical implementation of NFB certainly supports the efficacy of NFB as an intervention. The data presented also suggest that the probably blind assessment of teachers may not be considered a good proxy for blind assessments, therefore stressing the need for studies with placebo-controlled intervention as well as carefully reported neuromarker changes in relation to clinical response.
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Affiliation(s)
- Aurore Bussalb
- Mensia Technologies SA, Paris, France.,Child and Adolescent Psychiatry Department, Robert Debré Hospital, Paris, France
| | - Marco Congedo
- GIPSA-Lab, Université Grenoble Alpes, CNRS, Grenoble-INP, Grenoble, France
| | | | | | - Eric Acquaviva
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, Paris, France
| | - Richard Delorme
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, Paris, France
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23
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Jiang X, Liu L, Ji H, Zhu Y. Association of Affected Neurocircuitry With Deficit of Response Inhibition and Delayed Gratification in Attention Deficit Hyperactivity Disorder: A Narrative Review. Front Hum Neurosci 2018; 12:506. [PMID: 30618685 PMCID: PMC6305413 DOI: 10.3389/fnhum.2018.00506] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 12/05/2018] [Indexed: 12/11/2022] Open
Abstract
The neural networks that constitute corticostriatothalamocortical circuits between prefrontal cortex and subcortical structure provide a heuristic framework for bridging gaps between neurocircuitry and executive dysfunction in attention deficit hyperactivity disorder (ADHD). “Cool” and “Hot” executive functional theory and the models of dual pathway are supposed to be applied within the neuropsychology of ADHD. The theoretical model elaborated response inhibition and delayed gratification in ADHD. We aimed to review and summarize the literature about the circuits on ADHD and ADHD-related comorbidities, as well as the effects of neurocircuitry on the executive dysfunction in ADHD.
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Affiliation(s)
- Xixi Jiang
- Shanghai Changning Mental Health Center, Affiliated Greenland Hospital of Bio-X Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Li Liu
- Shanghai Changning Mental Health Center, Affiliated Greenland Hospital of Bio-X Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Haifeng Ji
- Shanghai Changning Mental Health Center, Affiliated Greenland Hospital of Bio-X Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Yuncheng Zhu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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24
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Abstract
Reading disorder (RD), a specific learning disorder (SLD) of reading that includes impairment in word reading, reading fluency, and/or reading comprehension, is common in the general population but often is not comprehensively understood or assessed in mental health settings. In education settings, comorbid mental and associated disorders may be inadequately integrated into intervention plans. Assessment and intervention for RD may be delayed or absent in children with frequently co-occurring mental disorders not fully responding to treatment in both school and mental health settings. To address this oversight, this review summarizes current knowledge regarding RDs and common comorbid or co-occurring disorders that are important for mental health and school settings. We chose to highlight RD because it is the most common SLD, and connections to other often comorbid disorders have been more thoroughly described in the literature. Much of the literature we describe is on decoding-based RD (or developmental dyslexia) as it is the most common form of RD. In addition to risk for academic struggle and social, emotional, and behavioral problems, those with RD often show early evidence of combined or intertwined Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition childhood disorders. These include attention deficit hyperactivity disorder, anxiety and depression, disruptive, impulse-control, and conduct disorders, autism spectrum disorders, and other SLDs. The present review highlights issues and areas of controversy within these comorbidities, as well as directions for future research. An interdisciplinary, integrated approach between mental health professionals and educators can lead to comprehensive and targeted treatments encompassing both academic and mental health interventions. Such targeted treatments may contribute to improved educational and health-related outcomes in vulnerable youth. While there is a growing research literature on this association, more studies are needed of when to intervene and of the early and long-term benefits of comprehensive intervention.
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Affiliation(s)
- Robert L Hendren
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States.,Dyslexia Center, University of California San Francisco, San Francisco, CA, United States
| | - Stephanie L Haft
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States
| | - Jessica M Black
- School of Social Work, Boston College, Chestnut Hill, MA, United States
| | - Nancy Cushen White
- Dyslexia Center, University of California San Francisco, San Francisco, CA, United States.,Department of Pediatrics, University of California San Francisco, San Francisco, CA, United States
| | - Fumiko Hoeft
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States.,Dyslexia Center, University of California San Francisco, San Francisco, CA, United States.,University of California Multi-Campus Precision Learning Center (PrecL), San Francisco, CA, United States.,Haskins Laboratories, New Haven, CT, United States.,Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
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Rozengurt R, Shtoots L, Sheriff A, Sadka O, Levy DA. Enhancing early consolidation of human episodic memory by theta EEG neurofeedback. Neurobiol Learn Mem 2017; 145:165-71. [DOI: 10.1016/j.nlm.2017.10.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Revised: 10/04/2017] [Accepted: 10/07/2017] [Indexed: 01/09/2023]
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Mohagheghi A, Amiri S, Moghaddasi Bonab N, Chalabianloo G, Noorazar SG, Tabatabaei SM, Farhang S. A Randomized Trial of Comparing the Efficacy of Two Neurofeedback Protocols for Treatment of Clinical and Cognitive Symptoms of ADHD: Theta Suppression/Beta Enhancement and Theta Suppression/Alpha Enhancement. Biomed Res Int 2017; 2017:3513281. [PMID: 28321406 DOI: 10.1155/2017/3513281] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 11/18/2016] [Accepted: 01/19/2017] [Indexed: 11/17/2022]
Abstract
Introduction. Neurofeedback (NF) is an adjuvant or alternative therapy for children with Attention Deficit Hyperactivity Disorder (ADHD). This study intended to compare the efficacy of two different NF protocols on clinical and cognitive symptoms of ADHD. Materials and Methods. In this clinical trial, sixty children with ADHD aged 7 to 10 years old were randomly grouped to receive two different NF treatments (theta suppression/beta enhancement protocol and theta suppression/alpha enhancement protocol). Clinical and cognitive assessments were conducted prior to and following the treatment and also after an eight-week follow-up. Results. Both protocols alleviated the symptoms of ADHD in general (p < 0.001), hyperactivity (p < 0.001), inattention (p < 0.001), and omission errors (p < 0.001); however, they did not affect the oppositional and impulsive scales nor commission errors. These effects were maintained after an eight-week intervention-free period. The only significant difference between the two NF protocols was that high-frequency alpha enhancement protocol performed better in suppressing omission errors (p < 0.001). Conclusion. The two NF protocols with theta suppression/beta enhancement and theta suppression/alpha enhancement have considerable and comparable effect on clinical symptoms of ADHD. Alpha enhancement protocol was more effective in suppressing omission errors.
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Fielenbach S, Donkers FCL, Spreen M, Visser HA, Bogaerts S. Neurofeedback Training for Psychiatric Disorders Associated with Criminal Offending: A Review. Front Psychiatry 2017; 8:313. [PMID: 29422873 PMCID: PMC5788905 DOI: 10.3389/fpsyt.2017.00313] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 12/29/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Effective treatment interventions for criminal offenders are necessary to reduce risk of criminal recidivism. Evidence about deviant electroencephalographic (EEG)-frequencies underlying disorders found in criminal offenders is accumulating. Yet, treatment modalities, such as neurofeedback, are rarely applied in the forensic psychiatric domain. Since offenders usually have multiple disorders, difficulties adhering to long-term treatment modalities, and are highly vulnerable for psychiatric decompensation, more information about neurofeedback training protocols, number of sessions, and expected symptom reduction is necessary before it can be successfully used in offender populations. METHOD Studies were analyzed that used neurofeedback in adult criminal offenders, and in disorders these patients present with. Specifically aggression, violence, recidivism, offending, psychopathy, schizophrenia, attention-deficit hyperactivity disorder (ADHD), substance-use disorder (SUD), and cluster B personality disorders were included. Only studies that reported changes in EEG-frequencies posttreatment (increase/decrease/no change in EEG amplitude/power) were included. RESULTS Databases Psychinfo and Pubmed were searched in the period 1990-2017 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, resulting in a total of 10 studies. Studies in which neurofeedback was applied in ADHD (N = 3), SUD (N = 3), schizophrenia (N = 3), and psychopathy (N = 1) could be identified. No studies could be identified for neurofeedback applied in cluster B personality disorders, aggression, violence, or recidivism in criminal offenders. For all treatment populations and neurofeedback protocols, number of sessions varied greatly. Changes in behavioral levels ranged from no improvements to significant symptom reduction after neurofeedback training. The results are also mixed concerning posttreatment changes in targeted EEG-frequency bands. Only three studies established criteria for EEG-learning. CONCLUSION Implications of the results for the applicability of neurofeedback training in criminal offender populations are discussed. More research focusing on neurofeedback and learning of cortical activity regulation is needed in populations with externalizing behaviors associated with violence and criminal behavior, as well as multiple comorbidities. At this point, it is unclear whether standard neurofeedback training protocols can be applied in offender populations, or whether QEEG-guided neurofeedback is a better choice. Given the special context in which the studies are executed, clinical trials, as well as single-case experimental designs, might be more feasible than large double-blind randomized controls.
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Affiliation(s)
- Sandra Fielenbach
- FPC Dr. S. van Mesdag, Groningen, Netherlands.,Tilburg University, Tilburg, Netherlands
| | | | | | | | - Stefan Bogaerts
- Tilburg University, Tilburg, Netherlands.,FPC De Kijvelanden, Poortugaal, Netherlands
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Hong J, Park BY, Cho HH, Park H. Age-related connectivity differences between attention deficit and hyperactivity disorder patients and typically developing subjects: a resting-state functional MRI study. Neural Regen Res 2017; 12:1640-1647. [PMID: 29171429 PMCID: PMC5696845 DOI: 10.4103/1673-5374.217339] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Attention deficit and hyperactivity disorder (ADHD) is a disorder characterized by behavioral symptoms including hyperactivity/impulsivity among children, adolescents, and adults. These ADHD related symptoms are influenced by the complex interaction of brain networks which were under explored. We explored age-related brain network differences between ADHD patients and typically developing (TD) subjects using resting state fMRI (rs-fMRI) for three age groups of children, adolescents, and adults. We collected rs-fMRI data from 184 individuals (27 ADHD children and 31 TD children; 32 ADHD adolescents and 32 TD adolescents; and 31 ADHD adults and 31 TD adults). The Brainnetome Atlas was used to define nodes in the network analysis. We compared three age groups of ADHD and TD subjects to identify the distinct regions that could explain age-related brain network differences based on degree centrality, a well-known measure of nodal centrality. The left middle temporal gyrus showed significant interaction effects between disease status (i.e., ADHD or TD) and age (i.e., child, adolescent, or adult) (P < 0.001). Additional regions were identified at a relaxed threshold (P < 0.05). Many of the identified regions (the left inferior frontal gyrus, the left middle temporal gyrus, and the left insular gyrus) were related to cognitive function. The results of our study suggest that aberrant development in cognitive brain regions might be associated with age-related brain network changes in ADHD patients. These findings contribute to better understand how brain function influences the symptoms of ADHD.
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Affiliation(s)
- Jisu Hong
- Department of Electronic, Electrical and Computer Engineering, Sungkyunkwan University, Suwon; Center for Neuroscience Imaging Research (CNIR), Institute for Basic Science, Suwon, Korea
| | - Bo-Yong Park
- Department of Electronic, Electrical and Computer Engineering, Sungkyunkwan University, Suwon; Center for Neuroscience Imaging Research (CNIR), Institute for Basic Science, Suwon, Korea
| | - Hwan-Ho Cho
- Department of Electronic, Electrical and Computer Engineering, Sungkyunkwan University, Suwon; Center for Neuroscience Imaging Research (CNIR), Institute for Basic Science, Suwon, Korea
| | - Hyunjin Park
- Center for Neuroscience Imaging Research (CNIR), Institute for Basic Science, Suwon; School of Electronic and Electrical Engineering, Sungkyunkwan University, Suwon, Korea
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