“Brain training” may help manage attention deficit disorder

Researchers from the University of Geneva (UNIGE) and the University Hospitals of Geneva (HUG) in Switzerland explored how neurofeedback enables patients with attention deficit hyperactivity disorder (ADHD) to train their attention based on instant feedback from the level of their brain activity, according to findings were published in the journal Clinical Neurophysiology.

The team found that not only did the training have a positive effect on patients' concentration abilities, but also that the attention improvement was closely linked to an enhanced response from the brain, the P3 wave, which is known to reflect integration of information in the brain, with higher P3 amplitudes indicating greater attention towards detected targets.

ADHD develops in childhood and leads to numerous difficulties with attention, concentration, and impulsiveness. It has genetic associated with environmental causes, and is characterized by a deficit in dopamine, a neurotransmitter involved in executive functions. 

Today, ADHD is treated with medications that increase the concentration of dopamine, which improves the patient's attention. As the disorder is often accompanied by depression, anxiety or even bipolar disorders, treatment is generally combined with psychotherapy.

Neurofeedback is a type of neurocognitive intervention based on the training of "real-time" brain signals. Using an electroencephalogram (EEG) with 64 sensors, the scientists capture the electrical activity of cortical neurons and focus their analysis on the spontaneous Alpha rhythm, with frequency around 10 Hertz, coupling its amplitude fluctuation to a video game that the patients can control with the power of their attention. 

The aim of neurofeedback is to make the patients aware of the moments when they are no longer attentive, the researchers said. With practice, brain networks then "learn" to reduce attentional lapses through neuroplasticity. To do this, the patient's EEG is connected to a computer that displays the image of a space shuttle. When the patient is in an attentive brain state or low Alpha rhythm, this makes the space shuttle move forward. But as soon as the patient is distracted or loses attention or high Alpha rhythm, this stops the space-shuttle movement instantly. Faced with the stopping of the space shuttle, the patient realizes that they were no longer paying attention and refocuses to restart the shuttle.

To measure the effects of neurofeedback training, the Geneva team administered an attention test to 25 adults with ADHD, and 22 neurotypical adults. The results showed that, at baseline, ADHD patients made more mistakes and had a more variable reaction time than the control participants, in line with a signature of impaired attention. After 30 minutes of neurofeedback training, the participants took the attention test again.

This study shows that a single 30-minute session of neurofeedback can induce short-term plasticity in the brain and encourages attentional improvements in ADHD patients. Secondly, it supports the existence of an electro-physiological marker of attentional processing in ADHD. Finally, as the effects are evident in the short term, the scientists plan to carry out a neurofeedback treatment based on multiple training sessions, to observe whether the brain's plasticity is strengthened over time.