The theta/beta ratio (TBR) is a major area of interest within electroencephalogram (EEG) research in AD/HD. While researchers suggest a prognostic role for TBR in AD/HD, its relationship to behavior remains uncertain. Recent evidence suggests that elevated TBR in AD/HD may be related to atypical inhibition, particularly at an attentional level. This study aimed to examine the performance on three inhibitory tasks of children with AD/HD. Fifty-eight children with AD/HD participated, divided into an elevated TBR (ET) group and a control group (CT). A behavioral disassociation was found - compared to CT, ET showed more difficulty in inhibiting surrounding stimuli but had less day-to-day inhibitory issues measured by BRIEF. There was no significant group difference on response inhibition. The results support the prognostic value of TBR in AD/HD. Elevated TBR may be an inhibitory biomarker; further studies are needed to explore the behavioral implications in patients without elevated TBR.

The results do not support the diagnostic value of TBR. Instead, given the heterogeneous features, the results support the prognostic value of EEG in AD/HD.

Changes in EEG when moving from an eyes-closed to an eyes-open resting condition result from bottom-up sensory processing and have been referred to as activation. In children, activation is characterized by a global reduction in alpha, frontally present reductions for delta and theta, and a frontal increase for beta. The present study aimed to replicate frontal EEG activation effects using single-channel, dry-sensor EEG, and to extend current understanding by examining developmental change in children. Frontal EEG was recorded using a single-channel, dry-sensor EEG device while 182 children aged 7 to 12 years completed eyes-closed resting (EC), eyes-open resting (EO), and focus (FO) tasks. Results indicated that frontal delta, theta, and alpha power were reduced, and frontal beta power was increased, in the EO compared with the EC condition. Exploratory analysis of a form of top-down activation showed that frontal beta power was increased in the FO compared with to the EO condition, with no differences for other bands. The activation effects were robust at the individual level. The bottom-up activation effects reduced with age for frontal delta and theta, increased for frontal alpha, with no developmental change for top-down or bottom-up frontal beta activation. These findings contribute further to validation of the single-channel, dry-sensor, frontal EEG and provide support for use in a range of medical, therapeutic, and clinical domains.

No abstract

There is an increasing interest in non-pharmacological treatments for children with attention-deficit/hyperactivity disorder (AD/HD), especially digital techniques that can be remotely delivered, such as neurofeedback (NFT) and computerized cognitive training (CCT). In this study, a randomized controlled design was used to compare training outcomes between remotely delivered NFT, CCT, and combined NFT/CCT training approaches. A total of 121 children with AD/HD were randomly assigned to the NFT, CCT, or NFT/CCT training groups, with 80 children completing the training program. Pre- and post-training symptoms (primary outcome), executive and daily functions were measured using questionnaires as well as resting EEG during eyes-closed (EC) and eyes-open (EO) conditions. After 3 months of training, the inattentive and hyperactive/impulsive symptoms, inhibition, working memory, learning and life skills of the three groups of children were significantly improved. The objective EEG activity showed a consistent increase in the relative alpha power in the EO condition among the three training groups. Training differences were not observed between groups. There was a positive correlation between pre-training EO relative alpha power and symptom improvement scores of inattention and hyperactivity/impulsivity, as well as a negative correlation between pre-training inattention scores and change in EO relative alpha. This study verified the training effects of NFT, CCT, and combined NFT/CCT training in children with AD/HD and revealed an objective therapeutic role for individual relative alpha activity. The verified feasibility and effectiveness of home-based digital training support promotion and application of digital remote training. Supplementary Information The online version contains supplementary material available at 10.1007/s00787-022-01956-1.

The current study used behavioural and electroencephalograph measures to compare the transferability of three home-based interventions — cognitive training (CT), neurofeedback training (NFT), and CT combined with NFT — for reducing symptoms in children with attention-deficit/hyperactivity disorder (AD/HD). Following a multiple-baseline single-case experimental design, twelve children were randomised to a training condition. Each child completed a baseline phase, followed by an intervention phase. The intervention phase consisted of 20 sessions of at-home training. Tau-U analysis and standardised visual analysis were adopted to detect effects. Results showed that CT improved inhibitory function and NFT improved alpha EEG activity and working memory. The combined condition, which was a reduced ‘dose’ of CT and NFT, did not show any improvements. The three conditions did not alleviate AD/HD symptoms. While CT and NFT may have transfer effects on executive functions, considering the lack of improvement in symptoms, this study does not support CT and NFT on their own as a treatment for children with AD/HD.

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Objective: Objective: This preliminary study investigated effectiveness of neurocognitive training on academic engagement (AET) for children with ADHD. The training approach targeted working memory, inhibitory control, and attention/relaxation (via brain electrical activity).Method: Method: A reversal design with a 2-week follow-up was used to assess the effectiveness of the treatment on two children with diagnosed ADHD in two learning settings. Direct observation was used to collect academic-related behavior.Results: Results: Improvements in on-task expected behavior (ONT-EX) and general AET, as well as reductions in off-task motor activity (OFF-MA) and off-task passive behavior (OFF-PB) were observed for both students over baselines and across the settings. Moreover, differences in behavioral change were found between participants and settings.Conclusion: Conclusion: These findings support using the treatment for improving academic performance of children with ADHD. Future studies may investigate influences of contextual differences, nontreatment variables, or adult's feedback during the training session on treatment effectiveness. AbstractThis preliminary study investigated effectiveness of neurocognitive training on academic engagement for children with AD/HD. The training approach targeted working memory, inhibitory control, and attention/relaxation (via brain electrical activity). A reversal design with a two-week follow-up was used to assess the effectiveness of the treatment on two children with diagnosed AD/HD in two learning settings. The results of direct observation indicated improvements in on-task expected behavior (ONT-EX) and general academic engagement (AET), as well as, reductions in off-task motor activity (OFF-MA) and off-task passive behavior (OFF-PB) for both students over baselines and across the settings. Moreover, differences in behavioral change were found between participants and settings.These findings support using the treatment for improving academic performance of children with AD/HD. Future studies may investigate influences of contextual differences, nontreatment variables or adult's feedback during the training session on treatment effectiveness.