Benefits of a 12-Week Non-Drug "Brain Fitness Program" for Patients with Attention-Deficit/Hyperactive Disorder, Post-Concussion Syndrome, or Memory Loss

Majid Fotuhi; Noah D Khorrami; Cyrus A Raji

doi:10.3233/ADR-220091

Benefits of a 12-Week Non-Drug "Brain Fitness Program" for Patients with Attention-Deficit/Hyperactive Disorder, Post-Concussion Syndrome, or Memory Loss

J Alzheimers Dis Rep. 2023 Jun 29;7(1):675-697. doi: 10.3233/ADR-220091. eCollection 2023.

Authors

Majid Fotuhi^{1

2}, Noah D Khorrami², Cyrus A Raji^{3

4}

Affiliations

¹ Department of Psychological & Brain Sciences, George Washington University, Washington, DC, USA.
² NeuroGrow Brain Fitness Center, McLean, VA, USA.
³ Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO, USA.
⁴ Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.

Abstract

Background: Non-pharmacologic interventions can potentially improve cognitive function, sleep, and/or mood in patients with attention-deficit/hyperactive disorder (ADHD), post-concussion syndrome (PCS), or memory loss.

Objective: We evaluated the benefits of a brain rehabilitation program in an outpatient neurology practice that consists of targeted cognitive training, lifestyle coaching, and electroencephalography (EEG)-based neurofeedback, twice weekly (90 minutes each), for 12 weeks.

Methods: 223 child and adult patients were included: 71 patients with ADHD, 88 with PCS, and 64 with memory loss (mild cognitive impairment or subjective cognitive decline). Patients underwent a complete neurocognitive evaluation, including tests for Verbal Memory, Complex Attention, Processing Speed, Executive Functioning, and Neurocognition Index. They completed questionnaires about sleep, mood, diet, exercise, anxiety levels, and depression-as well as underwent quantitative EEG-at the beginning and the end of the program.

Results: Pre-post test score comparison demonstrated that all patient subgroups experienced statistically significant improvements on most measures, especially the PCS subgroup, which experienced significant score improvement on all measures tested (p≤0.0011; d_z≥0.36). After completing the program, 60% to 90% of patients scored higher on cognitive tests and reported having fewer cognitive and emotional symptoms. The largest effect size for pre-post score change was improved executive functioning in all subgroups (ADHD d_z= 0.86; PCS d_z= 0.83; memory d_z= 1.09).

Conclusion: This study demonstrates that a multimodal brain rehabilitation program can have benefits for patients with ADHD, PCS, or memory loss and supports further clinical trials in this field.

Keywords: Alzheimer’s disease; attention-deficit/hyperactivity disorder; electroencephalography; memory; neurofeedback; post-concussion syndrome; rehabilitation; subjective cognitive decline; subjective cognitive impairment; traumatic brain injury.