Electrophysiological correlates of improved executive function following EEG neurofeedback in adult attention deficit hyperactivity disorder

Clin Neurophysiol. 2021 Aug;132(8):1937-1946. doi: 10.1016/j.clinph.2021.05.017. Epub 2021 Jun 11.

Abstract

Objective: Event-related potentials (ERPs) are reported to be altered in relation to cognitive processing deficits in attention deficit hyperactivity disorder (ADHD). However, this evidence is mostly limited to cross-sectional data. The current study utilized neurofeedback (NFB) as a neuromodulatory tool to examine the ERP correlates of attentional and inhibitory processes in adult ADHD using a single-session, within-subject design.

Methods: We recorded high-density EEG in 25 adult ADHD patients and 22 neurotypical controls during a Go/NoGo task, before and after a 30-minute NFB session designed to down-regulate the alpha (8-12 Hz) rhythm.

Results: At baseline, ADHD patients demonstrated impaired Go/NoGo performance compared to controls, while Go-P3 amplitude inversely correlated with ADHD-associated symptomatology in childhood. Post NFB, task performance improved in both groups, significantly enhancing stimulus detectability (d-prime) and reducing reaction time variability, while increasing N1 and P3 ERP component amplitudes. Specifically for ADHD patients, the pre-to-post enhancement in Go-P3 amplitude correlated with measures of improved executive function, i.e., enhanced d-prime, reduced omission errors and reduced reaction time variability.

Conclusions: A single-session of alpha down-regulation NFB was able to reverse the abnormal neurocognitive signatures of adult ADHD during a Go/NoGo task.

Significance: The study demonstrates for the first time the beneficial neurobehavioral effect of a single NFB session in adult ADHD, and reinforces the notion that ERPs could serve as useful diagnostic/prognostic markers of executive dysfunction.

Keywords: Adult ADHD; Event-related Potentials; Executive Control; Neurofeedback; P300 component.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Attention Deficit Disorder with Hyperactivity / diagnosis
  • Attention Deficit Disorder with Hyperactivity / physiopathology*
  • Cohort Studies
  • Electroencephalography / methods*
  • Evoked Potentials / physiology
  • Executive Function / physiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neurofeedback / methods*
  • Neurofeedback / physiology*
  • Psychomotor Performance / physiology*
  • Young Adult