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      On the Efficiency of Individualized Theta/Beta Ratio Neurofeedback Combined with Forehead EMG Training in ADHD Children

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          Abstract

          Background: Neurofeedback training (NFT) to decrease the theta/beta ratio (TBR) has been used for treating hyperactivity and impulsivity in attention deficit hyperactivity disorder (ADHD); however, often with low efficiency. Individual variance in EEG profile can confound NFT, because it may lead to influencing non-relevant activity, if ignored. More importantly, it may lead to influencing ADHD-related activities adversely, which may even result in worsening ADHD symptoms. Electromyogenic (EMG) signal resulted from forehead muscles can also explain the low efficiency of the NFT in ADHD from both practical and psychological point-of-view. The first aim of this study was to determine EEG and EMG biomarkers most related to the main ADHD characteristics, such as impulsivity and hyperactivity. The second aim was to confirm our hypothesis that the efficiency of the TBR NFT can be increased by individual adjustment of the frequency bands and simultaneous training on forehead muscle tension.

          Methods: We recruited 94 children diagnosed with ADHD (ADHD) and 23 healthy controls (HC). All participants were male and aged between six and nine. Impulsivity and attention were assessed with Go/no-Go task and delayed gratification task, respectively; and 19-channel EEG and forehead EMG were recorded. Then, the ADHD group was randomly subdivided into (1) standard, (2) individualized, (3) individualized+EMG, and (4) sham NFT (control) groups. The groups were compared based on TBR and EEG alpha activity, as well as hyperactivity and impulsivity three times: pre-NFT, post-NFT and 6 months after the NFT (follow-up).

          Results: ADHD children were characterized with decreased individual alpha peak frequency, alpha bandwidth and alpha amplitude suppression magnitude, as well as with increased alpha1/alpha2 (a1/a2) ratio and scalp muscle tension when c (η 2 ≥ 0.212). All contingent TBR NFT groups exhibited significant NFT-related decrease in TBR not evident in the control group. Moreover, we detected a higher overall alpha activity in the individualized but not in the standard NFT group. Mixed MANOVA considering between-subject factor GROUP and within-subject factor TIME showed that the individualized+EMG group exhibited the highest level of clinical improvement, which was associated with increase in the individual alpha activity at the 6 months follow-up when comparing with the other approaches (post hoc t = 3.456, p = 0.011).

          Conclusions: This study identified various (adjusted) alpha activity metrics as biomarkers with close relationship with ADHD symptoms, and demonstrated that TBR NFT individually adjusted for variances in alpha activity is more successful and clinically more efficient than standard, non-individualized NFT. Moreover, these training effects of the individualized TBR NFT lasted longer when combined with EMG.

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          Alpha-band oscillations, attention, and controlled access to stored information

          Alpha-band oscillations are the dominant oscillations in the human brain and recent evidence suggests that they have an inhibitory function. Nonetheless, there is little doubt that alpha-band oscillations also play an active role in information processing. In this article, I suggest that alpha-band oscillations have two roles (inhibition and timing) that are closely linked to two fundamental functions of attention (suppression and selection), which enable controlled knowledge access and semantic orientation (the ability to be consciously oriented in time, space, and context). As such, alpha-band oscillations reflect one of the most basic cognitive processes and can also be shown to play a key role in the coalescence of brain activity in different frequencies.
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            Predicting adolescent cognitive and self-regulatory competencies from preschool delay of gratification: Identifying diagnostic conditions.

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              Music and emotion: electrophysiological correlates of the processing of pleasant and unpleasant music.

              Human emotion and its electrophysiological correlates are still poorly understood. The present study examined whether the valence of perceived emotions would differentially influence EEG power spectra and heart rate (HR). Pleasant and unpleasant emotions were induced by consonant and dissonant music. Unpleasant (compared to pleasant) music evoked a significant decrease of HR, replicating the pattern of HR responses previously described for the processing of emotional pictures, sounds, and films. In the EEG, pleasant (contrasted to unpleasant) music was associated with an increase of frontal midline (Fm) theta power. This effect is taken to reflect emotional processing in close interaction with attentional functions. These findings show that Fm theta is modulated by emotion more strongly than previously believed.
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                Author and article information

                Contributors
                Journal
                Front Hum Neurosci
                Front Hum Neurosci
                Front. Hum. Neurosci.
                Frontiers in Human Neuroscience
                Frontiers Media S.A.
                1662-5161
                18 January 2018
                2018
                : 12
                : 3
                Affiliations
                [1] 1Laboratory of Affective, Cognitive and Translational Neuroscience, Department of Experimental, Clinical Neuroscience, Federal State Research Institute of Physiology and Basic Medicine , Novosibirsk, Russia
                [2] 2Department of Neuroscience, Novosibirsk State University , Novosibirsk, Russia
                [3] 3Department of Psychology, Royal Holloway University of London , Egham, United Kingdom
                [4] 4MRC Cognition and Brain Sciences Unit, University of Cambridge , Cambridge, United Kingdom
                [5] 5Laboratory of Biofeedback Computer System, Research Institute of Molecular Biology and Biophysics , Novosibirsk, Russia
                [6] 6Department of Psychology, Novosibirsk State University of Economics and Management , Novosibirsk, Russia
                Author notes

                Edited by: Manousos A. Klados, Aston University, Birmingham, United Kingdom

                Reviewed by: Xiaoli Li, Beijing Normal University, China; Dimitrios Kourtis, University of Stirling, United Kingdom

                *Correspondence: Olga M. Bazanova bazanovaom@ 123456physiol.ru
                Article
                10.3389/fnhum.2018.00003
                5785729
                29403368
                1d9696de-32c8-4e90-8800-a4e0b5448169
                Copyright © 2018 Bazanova, Auer and Sapina.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 25 September 2017
                : 03 January 2018
                Page count
                Figures: 6, Tables: 3, Equations: 0, References: 70, Pages: 13, Words: 8798
                Categories
                Neuroscience
                Original Research

                Neurosciences
                neurofeedback training,adhd,individual alpha activity,emg,theta/beta ratio
                Neurosciences
                neurofeedback training, adhd, individual alpha activity, emg, theta/beta ratio

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