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Investigation of behavioral changes due to neurofeedback application in children with attention deficit hyperactivity disorder by using Wechsler Intelligence Scale for Children - Revised: a randomized single-blind preliminary study

Year 2023, Volume: 62 Issue: 2, 184 - 194, 12.06.2023

Rukiye Ölçüoğlu , İlknur Kozanoğlu , Eylem Gül

https://doi.org/10.19161/etd.1310383

Abstract

Aim: The aim of this study is examining the effects of neurofeedback system in terms of Wechsler intelligence scale for children aged 8-12 with attention deficit.
Materials and Methods: For this purpose, the experimental group (n = 20) and sham group (n = 20) were formed with random sampling from participants who applied to the special education center between May-December 2021. In the first phase of the study, Wechsler intelligence scale for children was applied as a pre-test to determine the mental performance of participants in both study groups. Then, the infra low frequency protocol was applied to the experimental group for 5 months, every other day for half an hour, totally 60 sessions. After 6 months, Wechsler intelligence scale for children was applied again as a post-test and the data were analyzed.
Results: In the comparison, no difference was found (p>0.05) between the pre-test and post-test scores of the experimental and control groups. Examining the differences within-group, verbal IQ scores did not differ in the experimental group (p=0.121), while the scores in the control group were different (p=0.011). Performance IQ scores varied in both the experimental group (p=0.011) and the control group (p=0.003). In terms of total IQ score, pre-test and post-test scores were different in both the experimental group (p<0.001) and the control group (p=0.007).
Conclusion: In terms of Wechsler intelligence scale for children, it was determined that the mental performance of neurofeedback group increased in terms of performance IQ and total IQ. However, this finding could not be statistically confirmed in the sham-group.

Keywords

Attention deficit hyperactivity disorder neurofeedback Wechsler intelligence scale for children

References

  • Owens JS, Hustus CL, Everly EL, Evans SW, Margherio SM. Attention deficit hyperactivity disorder: evidence-based assessment and treatment for children and adolescents. In: Reference module in neuroscience and biobehavioral psychology. 2nd ed. Elsevier; 2020; p. 1–17.
  • Cutting LE, Koth CW, Mahone EM, Denckla MB. Evidence for unexpected weaknesses in learning in children with attention-deficit/hyperactivity disorder without reading disabilities. J Learn Disabil. 2003;36(3):259–69.
  • Martínez González CL, Martínez Ortiz EJ, Moreno Escobar JJ, Durand Rivera JA. Attention deficit and hyperactivity disorder classification with EEG and machine learning. In: Biosignal processing and classification using computational learning and intelligence. Elsevier Inc.; 2022; p. 447–69.
  • N. Pop-Jordanova, S. Markovska-Simoska TZ. Neurofeedback treatment of children with attention deficit hyperactivity disorder. Children. 2005;80:71–80.
  • Wolraich ML, Hagan JF, Allan C, Chan E, Davison D, Earls M, et al. Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics. 2019;144(4).
  • Takayanagi M, Kawasaki Y, Shinomiya M, Hiroshi H, Okada S, Ino T, et al. Review of cognitive characteristics of autism spectrum disorder using performance on six subtests on four versions of the Wechsler intelligence scale for children. J Autism Dev Disord. 2022;52(1):240–53.
  • Faraone S V. The pharmacology of amphetamine and methylphenidate: Relevance to the neurobiology of attention-deficit/hyperactivity disorder and other psychiatric comorbidities. Neurosci Biobehav Rev. 2018;87:255–70.
  • Villodas MT, McBurnett K, Kaiser N, Rooney M, Pfiffner LJ. Additive effects of parent adherence on social and behavioral outcomes of a collaborative school-home behavioral intervention for ADHD. Child Psychiatry Hum Dev. 2014;45(3):348–60.
  • Swanson J, Baler RD, Volkow ND. Understanding the effects of stimulant medications on cognition in individuals with attention-deficit hyperactivity disorder: A decade of progress. Neuropsychopharmacology. 2011;36(1):207–26.
  • Arns M, Heinrich H, Ros T, Rothenberger A, Strehl U. Editorial: Neurofeedback in ADHD. Front Hum Neurosci. 2015;9(October):602.
  • Holtmann M, Sonuga-Barke E, Cortese S, Brandeis D. Neurofeedback for ADHD: A review of current evidence. Child Adolesc Psychiatr Clin N Am. 2014;23(4):789–806.
  • Angelakis E, Stathopoulou S, Frymiare JL, Green DL, Lubar JF, Kounios J. EEG neurofeedback: A brief overview and an example of peak alpha frequency training for cognitive enhancement in the elderly. Clin Neuropsychol. 2007;21(1):110–29.
  • Cortese S, Ferrin M, Brandeis D, Holtmann M, Aggensteiner P, Daley D, et al. Neurofeedback for attentiondeficit/ hyperactivity disorder: meta-analysis of clinical and neuropsychological outcomes from randomized controlled trials. J Am Acad Child Adolesc Psychiatry. 2016;55(6):444–55.
  • van Outsem R. The applicability of neurofeedback in forensic psychotherapy: A literature review. J Forensic Psychiatry Psychol. 2011;22(2):223–42.
  • Tamm L. Attention-deficit hyperactivity disorder. Curated Ref Collect Neurosci Biobehav Psychol. 2016;617– 24.
  • Sitaram R, Ros T, Stoeckel L, Haller S, Scharnowski F, Lewis-Peacock J, et al. Closed-loop brain training: The science of neurofeedback. Vol. 18, Nature Reviews Neuroscience. 2017. p. 86–100.
  • Landes JK, Reid CL, Arns M, Badcock NA, Ros T, Enriquez-Geppert S, et al. EEG neurofeedback for executive functions in children with neurodevelopmental challenges. Cochrane Database Syst Rev. 2017;(12).
  • Savaşır, I., ve Şahin N. Wechsler Çocuklar İçin Zekâ Ölçeğinin Türk kültürüne uyarlanması ve standardizasyonu. 1982;(Proje no: TAG-385).
  • Nussbaum NL. ADHD and female specific concerns: A review of the literature and clinical implications. J Atten Disord. 2012;16(2):87–100.
  • Strehl U, Leins U, Goth G, Klinger C, Hinterberger T, Birbaumer N. Self-regulation of slow cortical potentials: A new treatment for children with attention-deficit/hyperactivity disorder. Pediatrics. 2006;118(5).
  • Subandriyo APEP, Jongsma MLA, Wijaya DA, Trisnadewi BAP, Paravoti A, Novihartanti BL, et al. Offering Neurofeedback as an intervention for children with attention deficit/hyperactivity disorder in Indonesia: A feasibility study. Kobe J Med Sci. 2021;67(4):E125–36.
  • Lubar JF, Swartwood MO, Swartwood JN, O’Donnell PH. Evaluation of the effectiveness of EEG neurofeedback training for ADHD in a clinical setting as measured by changes in T.O.V.A. scores, behavioral ratings, and WISC-R performance. Biofeedback Self Regul. 1995;20(1):83–99.
  • Tansey MA. Wechsler (WISC‐R) changes following treatment of learning disabilities via EEG biofeedback training in a private practice setting. Aust J Psychol. 1991;43(3):147–53.
  • Fuchs T, Birbaumer N, Lutzenberger W, Gruzelier JH, Kaiser J. Neurofeedback treatment for attentiondeficit/ hyperactivity disorder in children: A comparison with methylphenidate. Appl Psychophysiol Biofeedback. 2003;28(1):1–12.
  • Rubia, K. Westwood, S. Aggensteiner, P.-M. Brandeis D. Neurotherapeutics for attention deficit/hyperactivity disorder (ADHD): A review. Cells. 2021;10(2156):1–34.
  • Arnold LE, Lofthouse N, Hersch S, Pan X, Hurt E, Bates B, et al. EEG neurofeedback for ADHD: double-blind sham-controlled randomized pilot feasibility Trial. J Atten Disord. 2013;17(5):410–9.
  • Marzbani H, Marateb HR, Mansourian M. Methodological note: Neurofeedback: A comprehensive review on system design, methodology and clinical applications. Basic Clin Neurosci. 2016;7(2):143–58.
  • Thibault RT, Raz A. The psychology of neurofeedback: Clinical intervention even if applied placebo. Am Psychol. 2017;72(7):679–88.
  • Thompson L, Thompson M. Neurofeedback combined with training in metacognitive strategies: Effectiveness in students with ADD. Appl Psychophysiol Biofeedback. 1998;23(4):243–63.
  • Roberts AH, Kewman DG, Mercier L, Hovell M. The power of nonspecific effects in healing: Implications for psychosocial and biological treatments. Clin Psychol Rev. 1993;13(5):375–91.
  • Arnold LE, Arns M, Barterian J, Bergman R, Black S, Conners CK, et al. Double-blind placebo-controlled randomized clinical trial of neurofeedback for attention-deficit/hyperactivity disorder with 13-month follow-up. J Am Acad Child Adolesc Psychiatry. 2021;60(7):841–55.
  • Grin-Yatsenko VA, Othmer S, Ponomarev VA, Evdokimov SA, Konoplev YY, Kropotov JD. Infra-low frequency neurofeedback in depression: Three case studies. NeuroRegulation. 2018;5(1):30–42.
  • Birbaumer N. Slow cortical potentials: Plasticity, operant control, and behavioral effects. Vol. 5, Neuroscientist. 1999. p. 74–8.
  • Kirk HW. Restoring the brain: Neurofeedback as an integrative approach to health. Restoring the brain: neurofeedback as an integrative approach to health. Taylor and Francis.; 2020. 1–328 p.
  • Golant M, Loscalzo M, Walsh MW. Nonpharmacological Interventions. Psychooncology. 2015;170(3):27–34.
  • Holtmann M, Pniewski B, Wachtlin D, Wörz S, Strehl U. Neurofeedback in children with attentiondeficit/ hyperactivity disorder (ADHD) - a controlled multicenter study of a non-pharmacological treatment approach. BMC Pediatr. 2014;14(1):202.
  • Van Doren J, Arns M, Heinrich H, Vollebregt MA, Strehl U, K. Loo S. Sustained effects of neurofeedback in ADHD: a systematic review and meta-analysis. Eur Child Adolesc Psychiatry. 2019;28(3):293–305.

Dikkat eksikliği/hiperaktivite bozukluğu olan çocuklarda nöro-geribildirim uygulamasına bağlı davranış değişikliklerinin Wechsler Çocuklar İçin Zekâ Ölçeği ile araştırılması: randomize tek körlü ön çalışma

Year 2023, Volume: 62 Issue: 2, 184 - 194, 12.06.2023

Rukiye Ölçüoğlu , İlknur Kozanoğlu , Eylem Gül

https://doi.org/10.19161/etd.1310383

Abstract

Amaç: Bu çalışmanın amacı, nöro-geribildirim sistemi aracılığıyla yapılan eğitimin etkilerini, 8-12 yaş arası dikkat eksikliği olan çocuklarda Wechsler çocuklar için zekâ ölçeği ile bilişsel becerileri açısından incelemektir.
Gereç ve Yöntem: Bu amaçla, Mayıs 2021- Aralık 2021 tarihleri arasında özel eğitim merkezine tanılı olarak başvuran katılımcılardan rastgele örnekleme ile nöro-geribildirim eğitimi alacak deney grubu (n=20) ve simülasyon alan sham grubundan (n=20) oluşturulmuştur. Çalışmanın ilk aşamasında her iki gruba da katılımcıların zihinsel performanslarını belirlemek için Wechsler çocuklar için zekâ ölçeği ön test olarak uygulanmış, daha sonra deney grubunda 5 ay boyunca haftanın 3 günü yarım saatlik seanslarla toplam 60 seanslık çok düşük frekans nöro-geribildirim protokolü yürütülmüştür. Altıncı ayın sonunda son test olarak Wechsler çocuklar için zekâ ölçeği tekrar uygulanarak, veriler analiz edilmiştir.
Bulgular: Gruplar arası karşılaştırmada deney ve kontrol gruplarının ön test ve son test puanları arasında herhangi bir farklılık bulunamamıştır (p>0,05). Ancak grup içi farklılıklar incelendiğinde; sözel IQ skorları deney grubunda farklılık göstermezken (p=0,121), kontrol grubunda skorlar farklıdır (p=0,011). Performans IQ skorları, hem deney grubunda (p=0,011) hem de kontrol grubunda (p=0,003) değişmektedir. Total IQ skoru yönünden ise yine hem deney grubunda (p<0,001) hem de kontrol grubunda test öncesi ve test sonrası skorlar farklıdır (p=0,007).
Sonuç: Wechsler çocuklar için zekâ ölçeği açısından nöro-geribildirim uygulanan grubun kendi içinde performans IQ ve toplam IQ yönünden zihinsel performanslarının artarak dikkat eksikliklerinin azaldığı saptanmıştır. Ancak, bu bulgu sham-grubu ile istatistiksel olarak doğrulanamamıştır.

Keywords

Dikkat eksikliği hiperaktivite bozukluğu nöro-geribildirim Wechsler çocuklar için zekâ ölçeği

Thanks

Bu yayının ortaya çıkmasında emeği geçen uzman klinik psikolog Mehmet Mıdık ile Özem özel eğitim ve rehabilitasyon merkezi çalışanlarına ve verilerimizi oluşturmada gönüllü olan tüm çocuklara yaptıkları katkı ve ayırdıkları değerli zaman için en içten teşekkürlerimizi sunarız.

References

  • Owens JS, Hustus CL, Everly EL, Evans SW, Margherio SM. Attention deficit hyperactivity disorder: evidence-based assessment and treatment for children and adolescents. In: Reference module in neuroscience and biobehavioral psychology. 2nd ed. Elsevier; 2020; p. 1–17.
  • Cutting LE, Koth CW, Mahone EM, Denckla MB. Evidence for unexpected weaknesses in learning in children with attention-deficit/hyperactivity disorder without reading disabilities. J Learn Disabil. 2003;36(3):259–69.
  • Martínez González CL, Martínez Ortiz EJ, Moreno Escobar JJ, Durand Rivera JA. Attention deficit and hyperactivity disorder classification with EEG and machine learning. In: Biosignal processing and classification using computational learning and intelligence. Elsevier Inc.; 2022; p. 447–69.
  • N. Pop-Jordanova, S. Markovska-Simoska TZ. Neurofeedback treatment of children with attention deficit hyperactivity disorder. Children. 2005;80:71–80.
  • Wolraich ML, Hagan JF, Allan C, Chan E, Davison D, Earls M, et al. Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics. 2019;144(4).
  • Takayanagi M, Kawasaki Y, Shinomiya M, Hiroshi H, Okada S, Ino T, et al. Review of cognitive characteristics of autism spectrum disorder using performance on six subtests on four versions of the Wechsler intelligence scale for children. J Autism Dev Disord. 2022;52(1):240–53.
  • Faraone S V. The pharmacology of amphetamine and methylphenidate: Relevance to the neurobiology of attention-deficit/hyperactivity disorder and other psychiatric comorbidities. Neurosci Biobehav Rev. 2018;87:255–70.
  • Villodas MT, McBurnett K, Kaiser N, Rooney M, Pfiffner LJ. Additive effects of parent adherence on social and behavioral outcomes of a collaborative school-home behavioral intervention for ADHD. Child Psychiatry Hum Dev. 2014;45(3):348–60.
  • Swanson J, Baler RD, Volkow ND. Understanding the effects of stimulant medications on cognition in individuals with attention-deficit hyperactivity disorder: A decade of progress. Neuropsychopharmacology. 2011;36(1):207–26.
  • Arns M, Heinrich H, Ros T, Rothenberger A, Strehl U. Editorial: Neurofeedback in ADHD. Front Hum Neurosci. 2015;9(October):602.
  • Holtmann M, Sonuga-Barke E, Cortese S, Brandeis D. Neurofeedback for ADHD: A review of current evidence. Child Adolesc Psychiatr Clin N Am. 2014;23(4):789–806.
  • Angelakis E, Stathopoulou S, Frymiare JL, Green DL, Lubar JF, Kounios J. EEG neurofeedback: A brief overview and an example of peak alpha frequency training for cognitive enhancement in the elderly. Clin Neuropsychol. 2007;21(1):110–29.
  • Cortese S, Ferrin M, Brandeis D, Holtmann M, Aggensteiner P, Daley D, et al. Neurofeedback for attentiondeficit/ hyperactivity disorder: meta-analysis of clinical and neuropsychological outcomes from randomized controlled trials. J Am Acad Child Adolesc Psychiatry. 2016;55(6):444–55.
  • van Outsem R. The applicability of neurofeedback in forensic psychotherapy: A literature review. J Forensic Psychiatry Psychol. 2011;22(2):223–42.
  • Tamm L. Attention-deficit hyperactivity disorder. Curated Ref Collect Neurosci Biobehav Psychol. 2016;617– 24.
  • Sitaram R, Ros T, Stoeckel L, Haller S, Scharnowski F, Lewis-Peacock J, et al. Closed-loop brain training: The science of neurofeedback. Vol. 18, Nature Reviews Neuroscience. 2017. p. 86–100.
  • Landes JK, Reid CL, Arns M, Badcock NA, Ros T, Enriquez-Geppert S, et al. EEG neurofeedback for executive functions in children with neurodevelopmental challenges. Cochrane Database Syst Rev. 2017;(12).
  • Savaşır, I., ve Şahin N. Wechsler Çocuklar İçin Zekâ Ölçeğinin Türk kültürüne uyarlanması ve standardizasyonu. 1982;(Proje no: TAG-385).
  • Nussbaum NL. ADHD and female specific concerns: A review of the literature and clinical implications. J Atten Disord. 2012;16(2):87–100.
  • Strehl U, Leins U, Goth G, Klinger C, Hinterberger T, Birbaumer N. Self-regulation of slow cortical potentials: A new treatment for children with attention-deficit/hyperactivity disorder. Pediatrics. 2006;118(5).
  • Subandriyo APEP, Jongsma MLA, Wijaya DA, Trisnadewi BAP, Paravoti A, Novihartanti BL, et al. Offering Neurofeedback as an intervention for children with attention deficit/hyperactivity disorder in Indonesia: A feasibility study. Kobe J Med Sci. 2021;67(4):E125–36.
  • Lubar JF, Swartwood MO, Swartwood JN, O’Donnell PH. Evaluation of the effectiveness of EEG neurofeedback training for ADHD in a clinical setting as measured by changes in T.O.V.A. scores, behavioral ratings, and WISC-R performance. Biofeedback Self Regul. 1995;20(1):83–99.
  • Tansey MA. Wechsler (WISC‐R) changes following treatment of learning disabilities via EEG biofeedback training in a private practice setting. Aust J Psychol. 1991;43(3):147–53.
  • Fuchs T, Birbaumer N, Lutzenberger W, Gruzelier JH, Kaiser J. Neurofeedback treatment for attentiondeficit/ hyperactivity disorder in children: A comparison with methylphenidate. Appl Psychophysiol Biofeedback. 2003;28(1):1–12.
  • Rubia, K. Westwood, S. Aggensteiner, P.-M. Brandeis D. Neurotherapeutics for attention deficit/hyperactivity disorder (ADHD): A review. Cells. 2021;10(2156):1–34.
  • Arnold LE, Lofthouse N, Hersch S, Pan X, Hurt E, Bates B, et al. EEG neurofeedback for ADHD: double-blind sham-controlled randomized pilot feasibility Trial. J Atten Disord. 2013;17(5):410–9.
  • Marzbani H, Marateb HR, Mansourian M. Methodological note: Neurofeedback: A comprehensive review on system design, methodology and clinical applications. Basic Clin Neurosci. 2016;7(2):143–58.
  • Thibault RT, Raz A. The psychology of neurofeedback: Clinical intervention even if applied placebo. Am Psychol. 2017;72(7):679–88.
  • Thompson L, Thompson M. Neurofeedback combined with training in metacognitive strategies: Effectiveness in students with ADD. Appl Psychophysiol Biofeedback. 1998;23(4):243–63.
  • Roberts AH, Kewman DG, Mercier L, Hovell M. The power of nonspecific effects in healing: Implications for psychosocial and biological treatments. Clin Psychol Rev. 1993;13(5):375–91.
  • Arnold LE, Arns M, Barterian J, Bergman R, Black S, Conners CK, et al. Double-blind placebo-controlled randomized clinical trial of neurofeedback for attention-deficit/hyperactivity disorder with 13-month follow-up. J Am Acad Child Adolesc Psychiatry. 2021;60(7):841–55.
  • Grin-Yatsenko VA, Othmer S, Ponomarev VA, Evdokimov SA, Konoplev YY, Kropotov JD. Infra-low frequency neurofeedback in depression: Three case studies. NeuroRegulation. 2018;5(1):30–42.
  • Birbaumer N. Slow cortical potentials: Plasticity, operant control, and behavioral effects. Vol. 5, Neuroscientist. 1999. p. 74–8.
  • Kirk HW. Restoring the brain: Neurofeedback as an integrative approach to health. Restoring the brain: neurofeedback as an integrative approach to health. Taylor and Francis.; 2020. 1–328 p.
  • Golant M, Loscalzo M, Walsh MW. Nonpharmacological Interventions. Psychooncology. 2015;170(3):27–34.
  • Holtmann M, Pniewski B, Wachtlin D, Wörz S, Strehl U. Neurofeedback in children with attentiondeficit/ hyperactivity disorder (ADHD) - a controlled multicenter study of a non-pharmacological treatment approach. BMC Pediatr. 2014;14(1):202.
  • Van Doren J, Arns M, Heinrich H, Vollebregt MA, Strehl U, K. Loo S. Sustained effects of neurofeedback in ADHD: a systematic review and meta-analysis. Eur Child Adolesc Psychiatry. 2019;28(3):293–305.
There are 37 citations in total.

Details

Primary Language Turkish
Subjects Medical Physiology (Other)
Journal Section Research Articles
Authors

Rukiye Ölçüoğlu 0000-0002-0429-008X

İlknur Kozanoğlu 0000-0002-5268-1210

Eylem Gül 0000-0002-6166-2601

Publication Date June 12, 2023
Submission Date June 2, 2022
Published in Issue Year 2023Volume: 62 Issue: 2

Cite

Vancouver Ölçüoğlu R, Kozanoğlu İ, Gül E. Dikkat eksikliği/hiperaktivite bozukluğu olan çocuklarda nöro-geribildirim uygulamasına bağlı davranış değişikliklerinin Wechsler Çocuklar İçin Zekâ Ölçeği ile araştırılması: randomize tek körlü ön çalışma. EJM. 2023;62(2):184-9.
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