Neuromonitoring-guided working memory intervention in children with ADHD.

Area of Science:

• Neuroscience
• Pediatric Psychology
• Cognitive Science

Background:

• Attention-deficit/hyperactivity disorder (ADHD) is associated with deficits in executive functions, particularly working memory (WM).
• Frontoparietal brain activity is crucial for WM performance and is often impaired in children with ADHD.

Purpose of the Study:

• To investigate the efficacy of a personalized intervention integrating computerized WM training with real-time functional neuromonitoring and neurofeedback (NFB).
• To enhance frontoparietal activity and improve cognitive and clinical outcomes in children with ADHD.

Main Methods:

• Seventy-seven children (aged 7-11 years) with ADHD were assigned to 12 sessions of NFB or treatment-as-usual.
• Functional near-infrared spectroscopy (fNIRS) and fMRI measured frontoparietal activity during an n-back task.
• Cognitive (WM performance) and clinical (BRIEF-2, Conners 3) outcomes were assessed at baseline and post-intervention.

Main Results:

• The NFB group showed significant improvements in frontoparietal brain activity and WM performance compared to the control group.
• Participants in the NFB group also demonstrated significant improvements in BRIEF-2 WM t-scores and Conners 3 ADHD index scores.
• Thirty-six participants completed the study, with 21 in the NFB group and 15 in the treatment-as-usual group.

Conclusions:

• Neuromonitoring-guided NFB is an effective intervention for enhancing cognitive and clinical outcomes in children with ADHD.
• This approach successfully targets brain mechanisms underlying WM deficits in ADHD.
• The findings support NFB as a promising therapeutic strategy for pediatric ADHD.