title: Near-infrared spectroscopy (NIRS) neurofeedback as a treatment for children with attention deficit hyperactivity disorder (ADHD)-a pilot study.
abstract: In this pilot study near-infrared spectroscopy (NIRS) neurofeedback was investigated as a new method for the treatment of Attention Deficit-/Hyperactivity Disorder (ADHD). Oxygenated hemoglobin in the prefrontal cortex of children with ADHD was measured and fed back. 12 sessions of NIRS-neurofeedback were compared to the intermediate outcome after 12 sessions of EEG-neurofeedback (slow cortical potentials, SCP) and 12 sessions of EMG-feedback (muscular activity of left and right musculus supraspinatus). The task was either to increase or decrease hemodynamic activity in the prefrontal cortex (NIRS), to produce positive or negative shifts of SCP (EEG) or to increase or decrease muscular activity (EMG). In each group nine children with ADHD, aged 7-10 years, took part. Changes in parents' ratings of ADHD symptoms were assessed before and after the 12 sessions and compared within and between groups. For the NIRS-group additional teachers' ratings of ADHD symptoms, parents' and teachers' ratings of associated behavioral symptoms, childrens' self reports on quality of life and a computer based attention task were conducted before, 4 weeks and 6 months after training. As primary outcome, ADHD symptoms decreased significantly 4 weeks and 6 months after the NIRS training, according to parents' ratings. In teachers' ratings of ADHD symptoms there was a significant reduction 4 weeks after the training. The performance in the computer based attention test improved significantly. Within-group comparisons after 12 sessions of NIRS-, EEG- and EMG-training revealed a significant reduction in ADHD symptoms in the NIRS-group and a trend for EEG- and EMG-groups. No significant differences for symptom reduction were found between the groups. Despite the limitations of small groups and the comparison of a completed with two uncompleted interventions, the results of this pilot study are promising. NIRS-neurofeedback could be a time-effective treatment for ADHD and an interesting new option to consider in the treatment of ADHD.
authors.affiliation: Institute for Medical Psychology and Behavioral Neurobiology, University of Tuebingen Tuebingen, Germany.
authors.forename: Anna-Maria
authors.initials: AM
authors.lastname: Marx
authors.affiliation: Department of Psychiatry and Psychotherapy, Psychophysiology and Optical Imaging, University of Tuebingen Tuebingen, Germany.
authors.forename: Ann-Christine
authors.initials: AC
authors.lastname: Ehlis
authors.affiliation: Institute for Medical Psychology and Behavioral Neurobiology, University of Tuebingen Tuebingen, Germany.
authors.forename: Adrian
authors.initials: A
authors.lastname: Furdea
authors.affiliation: LWL-University Hospital for Child and Adolescent Psychiatry, Ruhr-University Bochum Hamm, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Holtmann
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim of the University of Heidelberg Mannheim, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Banaschewski
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim of the University of Heidelberg Mannheim, Germany ; Department of Child and Adolescent Psychiatry, University of Zuerich Zuerich, Switzerland.
authors.forename: Daniel
authors.initials: D
authors.lastname: Brandeis
authors.affiliation: Clinic for Child and Adolescent Psychiatry, University Medical Center of Goettingen Goettingen, Germany.
authors.forename: Aribert
authors.initials: A
authors.lastname: Rothenberger
authors.affiliation: Clinic for Child and Adolescent Psychiatry, University Medical Center of Goettingen Goettingen, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Gevensleben
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Goethe-University Frankfurt am Main Frankfurt am Main, Germany.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Freitag
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Goethe-University Frankfurt am Main Frankfurt am Main, Germany.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Fuchsenberger
authors.affiliation: Department of Psychiatry and Psychotherapy, Psychophysiology and Optical Imaging, University of Tuebingen Tuebingen, Germany.
authors.forename: Andreas J
authors.initials: AJ
authors.lastname: Fallgatter
authors.affiliation: Institute for Medical Psychology and Behavioral Neurobiology, University of Tuebingen Tuebingen, Germany.
authors.forename: Ute
authors.initials: U
authors.lastname: Strehl
keywords: attention deficit hyperactivity disorder (ADHD); children; fNIRS; near-infrared spectroscopy (NIRS); neurofeedback; prefrontal cortex (PFC)