Microstate-based Neurofeedback in Attention Deficit Hyperactivity Disorder Population: A Randomized Controlled...

Area of Science:

• Neuroscience
• Clinical Psychology
• Biomedical Engineering

Background:

• Traditional spectral neuromarker neurofeedback for Attention-Deficit/Hyperactivity Disorder (ADHD) faces efficacy and replication challenges.
• Microstate D, a fronto-central EEG activity pattern linked to attention, is increasingly implicated in ADHD.
• This study investigates microstate D as a novel neurofeedback target for ADHD.

Purpose of the Study:

• To assess the efficacy of neurofeedback in modulating microstate D in adult ADHD patients.
• To examine short-term neurobehavioral correlates of microstate D neurofeedback.
• To evaluate the specificity and safety of microstate D-based neurofeedback.

Main Methods:

• A within-subject, crossover design was used with 19 adult ADHD patients.
• Participants underwent two counterbalanced neurofeedback sessions: one for upregulating microstate D, the other for downregulating it.
• EEG data was analyzed to assess microstate D modulation and neurobehavioral effects.

Main Results:

• Adult ADHD patients could voluntarily increase microstate D during upregulation feedback.
• No significant changes in microstate D were observed during the downregulation session.
• Neurofeedback control of microstate D was specific to closed-loop feedback, not task engagement; no short-term neurobehavioral effects were detected.
• The intervention was safe, with no moderate or major adverse effects reported.

Conclusions:

• Microstate D neurofeedback shows specificity and safety in adult ADHD patients, despite limitations in statistical power.
• While short-term clinical improvements were not observed, the study demonstrates the feasibility of microstate-based neurofeedback protocols.
• Findings provide valuable technical and methodological insights for future research in ADHD neurofeedback.