Effects of a novel non-pharmacological intervention based on respiratory biofeedback, neurofeedback and median nerve stimulation to treat children with ADHD.

IF 2.4 3区 医学 Q3 NEUROSCIENCES
Frontiers in Human Neuroscience Pub Date : 2025-02-07 eCollection Date: 2025-01-01 DOI:10.3389/fnhum.2025.1478501
Eduardo Santamaría-Vázquez, Anayali Estudillo-Guerra, Lna Ali, Diana Martinez, Roberto Hornero, Leon Morales-Quezada
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引用次数: 0

Abstract

Introduction: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition that affects cognitive, academic, behavioral, emotional, and social functioning, primarily in children. Despite its high prevalence, current pharmacological treatments are not effective in 30% of cases and show poor long-term adherence. Non-pharmacological interventions can complement medication-based treatments to improve results. Among these therapies, neurofeedback (NFB) and respiratory biofeedback (R-BFB) have shown promise in treating ADHD symptoms. Moreover, median nerve stimulation (MNS) can help to enhance the efficacy of these treatments, but it has never been explored in this context. This study aimed to: (1) investigate the effectiveness of a combined R-BFB and NFB intervention to treat ADHD, and (2) explore the potential benefits of MNS in enhancing the proposed intervention.

Methods: Sixty children with ADHD participated in the study, divided into two experimental groups. The active group received verum MNS, and the sham group received sham MNS. Both groups performed the NFB/R-BFB treatment. Clinical assessments (i.e., Conner's parent rating scale) and electroencephalography (EEG) measurements were taken before the intervention, immediately after treatment, and one month later.

Results: The results showed that the combined therapy significantly improved behavioral problems, anxiety, hyperactivity, and impulsivity-hyperactivity. Moreover, MNS enhanced the positive effects of the intervention, as the active group achieved higher improvement compared to the sham group. EEG analysis revealed significant changes in spontaneous brain activity, with an increase in frontal theta power (p = 0.0125) associated with reduced anxiety, which might explain the clinical outcomes. These changes were maintained 1 month after the intervention (p = 0.0325). Correlations between EEG changes and clinical outcomes were observed, suggesting a potential relationship between neurophysiological markers and ADHD symptoms measured by standardized scales.

Discussion: The study findings suggest that the proposed R-BFB/NFB intervention may be an effective non-pharmacological therapy for ADHD, with the additional application of MNS potentially enhancing its effects.

简介注意缺陷多动障碍(ADHD)是一种神经发育疾病,主要影响儿童的认知、学习、行为、情感和社交功能。尽管发病率很高,但目前的药物治疗对 30% 的病例无效,而且长期坚持治疗的效果不佳。非药物干预可以辅助药物治疗,从而提高疗效。在这些疗法中,神经反馈疗法(NFB)和呼吸生物反馈疗法(R-BFB)已显示出治疗多动症症状的前景。此外,正中神经刺激(MNS)也有助于提高这些疗法的疗效,但在这方面还从未进行过探索。本研究旨在(1)研究 R-BFB 和 NFB 联合干预治疗多动症的有效性,以及(2)探索 MNS 在增强拟议干预中的潜在益处:方法:60 名患有多动症的儿童参加了研究,他们被分为两个实验组。方法:60 名患有多动症的儿童参加了这项研究,他们被分为两个实验组,积极组接受verum MNS,而无效组则接受假MNS。两组均接受 NFB/R-BFB 治疗。分别在干预前、治疗后和一个月后进行临床评估(即康纳尔家长评分量表)和脑电图测量:结果显示,综合疗法明显改善了康纳的行为问题、焦虑、多动和冲动多动。此外,MNS 还增强了干预的积极效果,因为与假治疗组相比,积极治疗组的改善程度更高。脑电图分析显示,大脑自发活动发生了显著变化,额叶θ功率增加(p = 0.0125)与焦虑减少有关,这可能是临床结果的原因。这些变化在干预一个月后得以保持(p = 0.0325)。观察到脑电图变化与临床结果之间存在相关性,这表明神经生理标记物与标准化量表测量的多动症症状之间存在潜在关系:讨论:研究结果表明,拟议的 R-BFB/NFB 干预可能是治疗多动症的有效非药物疗法,额外应用 MNS 有可能增强其效果。
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来源期刊
Frontiers in Human Neuroscience
Frontiers in Human Neuroscience 医学-神经科学
CiteScore
4.70
自引率
6.90%
发文量
830
审稿时长
2-4 weeks
期刊介绍: Frontiers in Human Neuroscience is a first-tier electronic journal devoted to understanding the brain mechanisms supporting cognitive and social behavior in humans, and how these mechanisms might be altered in disease states. The last 25 years have seen an explosive growth in both the methods and the theoretical constructs available to study the human brain. Advances in electrophysiological, neuroimaging, neuropsychological, psychophysical, neuropharmacological and computational approaches have provided key insights into the mechanisms of a broad range of human behaviors in both health and disease. Work in human neuroscience ranges from the cognitive domain, including areas such as memory, attention, language and perception to the social domain, with this last subject addressing topics, such as interpersonal interactions, social discourse and emotional regulation. How these processes unfold during development, mature in adulthood and often decline in aging, and how they are altered in a host of developmental, neurological and psychiatric disorders, has become increasingly amenable to human neuroscience research approaches. Work in human neuroscience has influenced many areas of inquiry ranging from social and cognitive psychology to economics, law and public policy. Accordingly, our journal will provide a forum for human research spanning all areas of human cognitive, social, developmental and translational neuroscience using any research approach.
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