Effects of EEG- Microstate Neurofeedback on Attention and Impulsivity in Adult Attention-deficit/Hyperactivity Disorder (ADHD) and Neurotypical Controls

NCT05582928 | Unknown DMC

• 1 other identifier: 2022-00848
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

EEG neurofeedback (NFB) may represent a new therapeutic opportunity for ADHD, a neuropsychiatric disorder characterized by attentional deficits and high impulsivity. Recent research of the Geneva group has demonstrated the ability of ADHD patients to control specific features of their EEG (notably alpha desynchronization) and that this control was associated with reduced impulsivity. In addition, alterations in EEG brain microstates (i.e., recurrent stable periods of short duration) have been described in adult ADHD patients, potentially representing a biomarker of the disorder. The present study aims to use neurofeedback to manipulate EEG microstates in ADHD patients and healthy controls, in order to observe the effects on neurophysiological, clinical and behavioural parameters.

Conditions

ADHD; Healthy

Outcome Measures

Primary Outcomes (2)

• Change in microstate coverage during training

  Difference in EEG microstate time coverage (%) between training and rest periods for each session (session 2, session 3) independently.

  Change within session at week 1 (session 2) and week 2 (session 2)

• Change in microstate coverage during rest

  Difference in EEG microstate time coverage (%) between rest periods for each session (session 2, session 3) independently.

  Change within session week 1 (session 2) and week 2 (session 2)

Secondary Outcomes (2)

• Correlations between EEG microstate time coverage (%) and task performance: error rates (%) and reaction time.

  Within session at week 1 (session 2) and week 2 (session 2)

• Change in EEG Event Related potentiels before and after neurofeedback training.

  Within session at week 1 (session 2) and week 2 (session 2)

Study Arms (2)

healthy population group

EXPERIMENTAL

The experimental design includes three sessions: * session 1 will be used to evaluate diagnostic using different targeted questionnaires. * sessions 2 and 3 will be decomposed into 3 consecutives parts: 1. Pre evaluation 2. Neurofeedback 3. Post evaluation

Device: Neurofeedback

ADHD population group

EXPERIMENTAL

The experimental design includes three sessions: * session 1 will be used to evaluate diagnostic using different targeted questionnaires. * sessions 2 and 3 will be decomposed into 3 consecutives parts: 1. Pre evaluation 2. Neurofeedback 3. Post evaluation

Device: Neurofeedback

Interventions

Neurofeedback DEVICE

Neurofeedback training during which participant will be asked to change the size of a bar using different strategies to vary the parameters of its current brain's states (neurofeedback training) computed on the realtime EEG signals.

ADHD population group; healthy population group

Eligibility Criteria

• Age: 18 Years - 50 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

ADHD POPULATION GROUP A subject will be eligible if all the following criteria apply: * Age: between 18-50 years * Gender: male and female * Health: general good health and normal or corrected-to-normal visual acuity * Patients clinically able to stop the following psychotropic medications for 48h: psychostimulants, benzodiazepines * Having provided written informed written consent A subject will not be eligible if any of the following criteria apply: * Past or current history of a clinically significant central nervous system disorder, including structural brain abnormalities; cerebrovascular disease; history of other neurological disease, epilepsy, stroke or head trauma (defined as loss of consciousness \> 5 min or requiring hospitalization) * Impaired vision (normal or corrected acuity below 20/40) * Medical illness (e.g., cardiovascular disease, renal failure, hepatic dysfunction) * Comorbidities with current psychiatric disorders (bipolar disorder, borderline personality disorder, major depressive disorder, anxiety disorder) including substance use disorder as defined by the DIGS. HEALTHY POPULATION GROUP A subject will be eligible if all of the following criteria apply: * Age: between 18-50 years * Gender: male and female * Health: general good health and normal or corrected-to-normal visual acuity * Having provided written informed written consent A subject will not be eligible if any of the following criteria apply: * Past or current history of ADHD * Past or current history of main psychiatric disorders (bipolar disorder, borderline personality disorder, major depressive disorder, anxiety disorder), including substance use disorder as defined by the DIGS. * Past or current history of a clinically significant central nervous system disorder, including structural brain abnormalities; cerebrovascular disease; history of other neurological disease, including epilepsy, stroke or head trauma (defined as loss of consciousness \> 5 min or requiring hospitalization) * Impaired vision (normal or corrected acuity below 20/40) * Medical illness (e.g., cardiovascular disease, renal failure, hepatic dysfunction)

Contact the study team to discuss eligibility requirements. They can help determine if this study is right for you.

Sponsors & Collaborators

• Nader Perroud: lead
• University of Geneva, Switzerland: collaborator
• University Hospital, Geneva: collaborator

Study Sites (1)

TRE Unit (Trouble de la Régulation Emotionnelle) Department of psychiatry, HUG

Geneva, 1201, Switzerland

RECRUITING

Related Publications (28)

• Arns M, Conners CK, Kraemer HC. A decade of EEG Theta/Beta Ratio Research in ADHD: a meta-analysis. J Atten Disord. 2013 Jul;17(5):374-83. doi: 10.1177/1087054712460087. Epub 2012 Oct 19.

  PMID: 23086616 BACKGROUND

• Arns M, Kenemans JL. Neurofeedback in ADHD and insomnia: vigilance stabilization through sleep spindles and circadian networks. Neurosci Biobehav Rev. 2014 Jul;44:183-94. doi: 10.1016/j.neubiorev.2012.10.006. Epub 2012 Oct 23.

  PMID: 23099283 BACKGROUND

• Arns M, de Ridder S, Strehl U, Breteler M, Coenen A. Efficacy of neurofeedback treatment in ADHD: the effects on inattention, impulsivity and hyperactivity: a meta-analysis. Clin EEG Neurosci. 2009 Jul;40(3):180-9. doi: 10.1177/155005940904000311.

  PMID: 19715181 BACKGROUND

• Brechet L, Brunet D, Birot G, Gruetter R, Michel CM, Jorge J. Capturing the spatiotemporal dynamics of self-generated, task-initiated thoughts with EEG and fMRI. Neuroimage. 2019 Jul 1;194:82-92. doi: 10.1016/j.neuroimage.2019.03.029. Epub 2019 Mar 19.

  PMID: 30902640 BACKGROUND

• Arns M, Vollebregt MA, Palmer D, Spooner C, Gordon E, Kohn M, Clarke S, Elliott GR, Buitelaar JK. Electroencephalographic biomarkers as predictors of methylphenidate response in attention-deficit/hyperactivity disorder. Eur Neuropsychopharmacol. 2018 Aug;28(8):881-891. doi: 10.1016/j.euroneuro.2018.06.002. Epub 2018 Jun 22.

  PMID: 29937325 BACKGROUND

• Breteler MH, Arns M, Peters S, Giepmans I, Verhoeven L. Improvements in spelling after QEEG-based neurofeedback in dyslexia: a randomized controlled treatment study. Appl Psychophysiol Biofeedback. 2010 Mar;35(1):5-11. doi: 10.1007/s10484-009-9105-2. Epub 2009 Aug 27.

  PMID: 19711183 BACKGROUND

• Britz J, Van De Ville D, Michel CM. BOLD correlates of EEG topography reveal rapid resting-state network dynamics. Neuroimage. 2010 Oct 1;52(4):1162-70. doi: 10.1016/j.neuroimage.2010.02.052. Epub 2010 Feb 24.

  PMID: 20188188 BACKGROUND

• Cannon R, Congedo M, Lubar J, Hutchens T. Differentiating a network of executive attention: LORETA neurofeedback in anterior cingulate and dorsolateral prefrontal cortices. Int J Neurosci. 2009;119(3):404-41. doi: 10.1080/00207450802480325.

  PMID: 19116846 BACKGROUND

• Comsa IM, Bekinschtein TA, Chennu S. Transient Topographical Dynamics of the Electroencephalogram Predict Brain Connectivity and Behavioural Responsiveness During Drowsiness. Brain Topogr. 2019 Mar;32(2):315-331. doi: 10.1007/s10548-018-0689-9. Epub 2018 Nov 29.

  PMID: 30498872 BACKGROUND

• Custo A, Van De Ville D, Wells WM, Tomescu MI, Brunet D, Michel CM. Electroencephalographic Resting-State Networks: Source Localization of Microstates. Brain Connect. 2017 Dec;7(10):671-682. doi: 10.1089/brain.2016.0476. Epub 2017 Nov 17.

  PMID: 28938855 BACKGROUND

• Damoiseaux JS, Rombouts SA, Barkhof F, Scheltens P, Stam CJ, Smith SM, Beckmann CF. Consistent resting-state networks across healthy subjects. Proc Natl Acad Sci U S A. 2006 Sep 12;103(37):13848-53. doi: 10.1073/pnas.0601417103. Epub 2006 Aug 31.

  PMID: 16945915 BACKGROUND

• Deiber MP, Ammann C, Hasler R, Colin J, Perroud N, Ros T. 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.

  PMID: 34153722 BACKGROUND

• Deiber MP, Hasler R, Colin J, Dayer A, Aubry JM, Baggio S, Perroud N, Ros T. Linking alpha oscillations, attention and inhibitory control in adult ADHD with EEG neurofeedback. Neuroimage Clin. 2020;25:102145. doi: 10.1016/j.nicl.2019.102145. Epub 2019 Dec 24.

  PMID: 31911342 BACKGROUND

• Diaz Hernandez L, Rieger K, Baenninger A, Brandeis D, Koenig T. Towards Using Microstate-Neurofeedback for the Treatment of Psychotic Symptoms in Schizophrenia. A Feasibility Study in Healthy Participants. Brain Topogr. 2016 Mar;29(2):308-21. doi: 10.1007/s10548-015-0460-4. Epub 2015 Nov 19.

  PMID: 26582260 BACKGROUND

• Drechsler R, Brem S, Brandeis D, Grunblatt E, Berger G, Walitza S. ADHD: Current Concepts and Treatments in Children and Adolescents. Neuropediatrics. 2020 Oct;51(5):315-335. doi: 10.1055/s-0040-1701658. Epub 2020 Jun 19.

  PMID: 32559806 BACKGROUND

• Ferat V, Arns M, Deiber MP, Hasler R, Perroud N, Michel CM, Ros T. Electroencephalographic Microstates as Novel Functional Biomarkers for Adult Attention-Deficit/Hyperactivity Disorder. Biol Psychiatry Cogn Neurosci Neuroimaging. 2022 Aug;7(8):814-823. doi: 10.1016/j.bpsc.2021.11.006. Epub 2021 Nov 22.

  PMID: 34823049 BACKGROUND

• Hammer BU, Colbert AP, Brown KA, Ilioi EC. Neurofeedback for insomnia: a pilot study of Z-score SMR and individualized protocols. Appl Psychophysiol Biofeedback. 2011 Dec;36(4):251-64. doi: 10.1007/s10484-011-9165-y.

  PMID: 21789650 BACKGROUND

• Heinrich H, Gevensleben H, Strehl U. Annotation: neurofeedback - train your brain to train behaviour. J Child Psychol Psychiatry. 2007 Jan;48(1):3-16. doi: 10.1111/j.1469-7610.2006.01665.x.

  PMID: 17244266 BACKGROUND

• Horrell T, El-Baz A, Baruth J, Tasman A, Sokhadze G, Stewart C, Sokhadze E. Neurofeedback Effects on Evoked and Induced EEG Gamma Band Reactivity to Drug-related Cues in Cocaine Addiction. J Neurother. 2010 Jul;14(3):195-216. doi: 10.1080/10874208.2010.501498.

  PMID: 20976131 BACKGROUND

• Katayama H, Gianotti LR, Isotani T, Faber PL, Sasada K, Kinoshita T, Lehmann D. Classes of multichannel EEG microstates in light and deep hypnotic conditions. Brain Topogr. 2007 Fall;20(1):7-14. doi: 10.1007/s10548-007-0024-3. Epub 2007 Jun 21.

  PMID: 17587166 BACKGROUND

• Kropotov JD, Grin-Yatsenko VA, Ponomarev VA, Chutko LS, Yakovenko EA, Nikishena IS. ERPs correlates of EEG relative beta training in ADHD children. Int J Psychophysiol. 2005 Jan;55(1):23-34. doi: 10.1016/j.ijpsycho.2004.05.011.

  PMID: 15598513 BACKGROUND

• Krylova M, Alizadeh S, Izyurov I, Teckentrup V, Chang C, van der Meer J, Erb M, Kroemer N, Koenig T, Walter M, Jamalabadi H. Evidence for modulation of EEG microstate sequence by vigilance level. Neuroimage. 2021 Jan 1;224:117393. doi: 10.1016/j.neuroimage.2020.117393. Epub 2020 Sep 21.

  PMID: 32971266 BACKGROUND

• Mantini D, Perrucci MG, Del Gratta C, Romani GL, Corbetta M. Electrophysiological signatures of resting state networks in the human brain. Proc Natl Acad Sci U S A. 2007 Aug 7;104(32):13170-5. doi: 10.1073/pnas.0700668104. Epub 2007 Aug 1.

  PMID: 17670949 BACKGROUND

• Michel CM, Koenig T. EEG microstates as a tool for studying the temporal dynamics of whole-brain neuronal networks: A review. Neuroimage. 2018 Oct 15;180(Pt B):577-593. doi: 10.1016/j.neuroimage.2017.11.062. Epub 2017 Dec 2.

  PMID: 29196270 BACKGROUND

• Mottaz A, Solca M, Magnin C, Corbet T, Schnider A, Guggisberg AG. Neurofeedback training of alpha-band coherence enhances motor performance. Clin Neurophysiol. 2015 Sep;126(9):1754-60. doi: 10.1016/j.clinph.2014.11.023. Epub 2014 Dec 6.

  PMID: 25540133 BACKGROUND

• Walker JE, Kozlowski GP. Neurofeedback treatment of epilepsy. Child Adolesc Psychiatr Clin N Am. 2005 Jan;14(1):163-76, viii. doi: 10.1016/j.chc.2004.07.009.

  PMID: 15564057 BACKGROUND

• Walker JE. Using QEEG-guided neurofeedback for epilepsy versus standardized protocols: enhanced effectiveness? Appl Psychophysiol Biofeedback. 2010 Mar;35(1):29-30. doi: 10.1007/s10484-009-9123-0.

  PMID: 20012556 BACKGROUND

• Zioga I, Hassan R, Luft CDB. Success, but not failure feedback guides learning during neurofeedback: An ERP study. Neuroimage. 2019 Oct 15;200:26-37. doi: 10.1016/j.neuroimage.2019.06.002. Epub 2019 Jun 12.

  PMID: 31200067 BACKGROUND

MeSH Terms

Conditions

Attention Deficit Disorder with Hyperactivity

Interventions

Neurofeedback

Condition Hierarchy (Ancestors)

Attention Deficit and Disruptive Behavior Disorders; Neurodevelopmental Disorders; Mental Disorders

Intervention Hierarchy (Ancestors)

Biofeedback, Psychology; Mind-Body Therapies; Complementary Therapies; Therapeutics; Behavior Therapy; Psychotherapy; Behavioral Disciplines and Activities; Feedback, Psychological

Study Officials

• Nader Perroud, Professor

  University Hospital, Geneva

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Nader Perroud, Professor

CONTACT

+41 22 305 45 11; nader.perroud@hcuge.ch

Marie-Pierre Deiber, PhD

CONTACT

+41 22 379 11 25; marie-pierre.deiber@hcuge.ch

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: BASIC SCIENCE
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: October 10, 2022
• First Posted: October 17, 2022
• Study Start: September 19, 2022
• Primary Completion: June 1, 2025
• Study Completion: June 1, 2025
• Last Updated: November 29, 2023

Record last verified: 2023-11

Locations

CH (1)