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FMRI Neurofeedback in Children with ADHD

Summary

This project will pilot a novel, non-pharmacological treatment for ADHD, called fMRI Neurofeedback, which we believe might bring lasting benefits over the long term without causing side effects. Children with ADHD have problems with the recruitment or activation of particular regions of the brain that are responsible for self-control. The new treatment involves playing a computer game that is connected to a modern brain imaging scanner. The children can see their own brain activity on the computer disguised in a computer game, and while playing the game they will then learn to improve the activity of certain areas of the brain that are connected to the computer game. By means of a playful computer game, children are expected to gain greater control of these regions.

Main aims:

We are testing whether fMRI Neurofeedback can help children with ADHD improve their self-control and overcome their ADHD problems.

Around twenty-five 10 to 14 year-old boys with ADHD are taking part in a pilot study. During fourteen 10-minute treatment sessions, the boys are lying inside an MRI scanner watching a cartoon helicopter on a computer screen, while the scanner measures their brain activity. If brain activity increases in the regions responsible for self-control, the helicopter rises and the children gain points. Through trial and error, the children learn how to control their brain activity and move the helicopter. 

We hypothesise that after the 2 weeks of Neurofeedback training of the right inferior prefrontal cortex, the key region for self-control, children with ADHD will improve in their clinical behaviours of inattention and impulsiveness, in a task battery of cognitive functions that are relevant to ADHD, and in their brain activity during self-control tasks which is usually diminished in activation relative to controls.

Why undertake this research?

Medication helps around 70% of children with ADHD, but it is far from perfect. Medication is associated with side effects such as restricted growth, loss of appetite and disturbed sleep. What’s more, while medication is often highly effective in the short term, there is little evidence that it helps in the longer term and benefits are immediately lost if children stop taking their medication. Neurofeedback using a more basic imaging tool like EEG has been shown to be effective in reducing the symptoms of ADHD. In this study we aim to test the efficacy of Neurofeedback using a modern imaging tool, i.e. FMRI, which we believe will be more effective and able to target the key brain regions that are not optimally working in ADHD. By teaching the children to upregulate their own brain activation in these brain regions that are typically under-recruited in ADHD, we hope we will be able to improve their behavioural and cognitive problems. If successful, this could be a novel side-effect free and non-pharmacological treatment for ADHD.

Who is involved?

The research is a funded by Action Medical Research and is led by PrincipaI Investigator (PI), Professor Katya Rubia. The key researchers involved in this project are Ms Analucia Alegria-Alzamora (PhD student), Dr Helen Brinson and Dr Melanie Wulf. We collaborate with Prof Gareth Barker and Dr Giampietro from the Neuroimaging department.

How is the research being undertaken?

Around thirty 12 to 17 year-old boys with ADHD are taking part in this study. During fourteen 10-minute treatment sessions, the boys are lying inside an MRI scanner watching a cartoon helicopter on a computer screen, while the scanner measures their brain activity. If brain activity increases in the regions responsible for self-control, the helicopter rises and the children gain points. Through trial and error, the children learn how to control their brain activity and move the helicopter. We will measure whether the treatment improves the behavioural symptoms of ADHD and their cognitive performance. We will, in addition, test whether efficacy is still observed after 6 months.

Where is it happening?

The study is being carried out at the Child Psychiatry Department, the Centre for Social, Genetic and Developmental Psychiatry (SGDP) and the Centre for Neuroimaging Sciences, at the Institute of Psychiatry.

What is the timescale?

This project began in October 2012 and will be completed by December 2016.

To find out more:

Contact:

analucia.alegria_alzamora@kcl.ac.uk

katya.rubia@kcl.ac.uk

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