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
Affiliations
Ali Rahimpour Jounghani
C-BRAIN Lab, Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, USA
Elveda Gozdas
C-BRAIN Lab, Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, USA
Lauren Dacorro
C-BRAIN Lab, Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, USA
Bárbara Avelar-Pereira
C-BRAIN Lab, Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, USA; Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
Samantha Reitmaier
C-BRAIN Lab, Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, USA
Hannah Fingerhut
C-BRAIN Lab, Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, USA
David S. Hong
C-BRAIN Lab, Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, USA
Glen Elliott
C-BRAIN Lab, Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, USA
Antonio Y. Hardan
C-BRAIN Lab, Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, USA
Stephen P. Hinshaw
Department of Psychology, University of California, Berkeley, Berkeley, CA, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
S.M. Hadi Hosseini
C-BRAIN Lab, Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, USA; Corresponding author
Summary: 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.
