Neuromonitoring-guided working memory intervention in children with ADHD

Ali Rahimpour Jounghani; Elveda Gozdas; Lauren Dacorro; Bárbara Avelar-Pereira; Samantha Reitmaier; Hannah Fingerhut; David S Hong; Glen Elliott; Antonio Y Hardan; Stephen P Hinshaw; S M Hadi Hosseini

doi:10.1016/j.isci.2024.111087

Neuromonitoring-guided working memory intervention in children with ADHD

iScience. 2024 Sep 30;27(11):111087. doi: 10.1016/j.isci.2024.111087. eCollection 2024 Nov 15.

Affiliations

¹ C-BRAIN Lab, Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, USA.
² Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
³ Department of Psychology, University of California, Berkeley, Berkeley, CA, USA.
⁴ Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA.

Abstract

We proposed a personalized intervention that integrates computerized working memory (WM) training with real-time functional neuromonitoring and neurofeedback (NFB) to enhance frontoparietal activity and improve cognitive and clinical outcomes in children with attention-deficit/hyperactivity disorder (ADHD). The study involved 77 children with ADHD aged 7-11 years, who were assigned to either 12 sessions of NFB or treatment-as-usual (i.e., received standard clinical care) groups. Real-time neuromonitoring with functional near-infrared spectroscopy (fNIRS) and fMRI measured frontoparietal activity during n-back task at baseline and post-intervention. Thirty-six participants (21 NFB, 15 treatment-as-usual) completed the study. Significant improvements in NFB group were observed in frontoparietal brain activity and WM performance (primary outcomes). NFB group also showed improvements in Behavior Rating Inventory of Executive Function (BRIEF-2) WM t-scores and Conners 3 ADHD index scores (secondary outcomes) compared to treatment-as-usual group. These findings suggest that neuromonitoring-guided NFB effectively enhances cognitive and clinical outcomes in children with ADHD by targeting brain mechanisms underlying WM deficits.

Keywords: Clinical neuroscience; Cognitive neuroscience; Neuroscience.