Can neurophysiological markers of anticipation and attention predict ADHD severity and neurofeedback outcomes?

Pascal-M Aggensteiner; Björn Albrecht; Ute Strehl; Sonja Wörz; Christian Ruckes; Christine M Freitag; Aribert Rothenberger; Holger Gevensleben; Sabina Millenet; Sarah Hohmann; Tobias Banaschewski; Tanja Legenbauer; Martin Holtmann; Daniel Brandeis

doi:10.1016/j.biopsycho.2021.108169

Can neurophysiological markers of anticipation and attention predict ADHD severity and neurofeedback outcomes?

Biol Psychol. 2021 Oct:165:108169. doi: 10.1016/j.biopsycho.2021.108169. Epub 2021 Aug 18.

Affiliations

¹ Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany. Electronic address: Pascal.aggensteiner@zi-mannheim.de.
² Clinic for Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany; Philipps-University Marburg, Department of Psychology, Marburg, Germany.
³ Institute for Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany.
⁴ Interdisciplinary Center for Clinical Trials at the University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany.
⁵ Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.
⁶ Clinic for Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany.
⁷ Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
⁸ LWL-University Hospital for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Ruhr University Bochum, Hamm, Germany.
⁹ Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zürich, Zürich, Switzerland; Center for Integrative Human Physiology, University of Zürich, Zürich, Switzerland; Neuroscience Center Zürich, Swiss Federal Institute of Technology and University of Zürich, Zürich, Switzerland.

PMID: 34416347
DOI: 10.1016/j.biopsycho.2021.108169

Abstract

Neurophysiological measures of preparation and attention are often atypical in ADHD. Still, replicated findings that these measures predict which patients improve after Neurofeedback (NF), reveal neurophysiological specificity, and reflect ADHD-severity are limited.

Methods: We analyzed children's preparatory (CNV) and attentional (Cue-P3) brain activity and behavioral performance during a cued Continuous Performance Task (CPT) before and after slow cortical potential (SCP)-NF or semi-active control treatment (electromyogram biofeedback). Mixed-effects models were performed with 103 participants at baseline and 77 were assessed for pre-post comparisons focusing on clinical outcome prediction, specific neurophysiological effects of NF, and associations with ADHD-severity.

Results: Attentional and preparatory brain activity and performance were non-specifically reduced after treatment. Preparatory activity in the SCP-NF group increased with clinical improvement. Several performance and brain activity measures predicted non-specific treatment outcome.

Conclusion: Specific neurophysiological effects after SCP-NF were limited to increased neural preparation associated with improvement on ADHD-subscales, but several performance and neurophysiological measures of attention predicted treatment outcome and reflected symptom severity in ADHD. The results may help to optimize treatment.

Keywords: Attention-Deficit/Hyperactivity Disorder (ADHD); Contingent Negative Variation, CNV; Continuous Performance Test, CPT; Cue-P3; Event related potentials; Neurofeedback; Randomized Controlled Trial; Response control; Slow Cortical Potentials, SCP; Sustained attention.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Attention
Attention Deficit Disorder with Hyperactivity*
Child
Cues
Electroencephalography
Humans
Neurofeedback*