Predictive factors of success in neurofeedback training for children with ADHD.

INTRODUCTION: Neurofeedback (NF) training aims the enhancement of self-regulation over brain activities. While it is largely recognized as an effective treatment for attention deficit hyperactivity disorder (ADHD), the existence of non-learners has also been reported. The present study explored pre-training assessment indices that could predict learners prior to NF training. METHODS: Twenty-two children with ADHD participated in slow cortical potential (SCP) NF training and completed pre- and post-training assessments. Participants were classified into learners or non-learners based on their progress in the SCP regulation, and pre-training indices that differentiate the two groups were examined by decision tree analysis. RESULTS AND DISCUSSION: The learner rate in NF training was 45.5%. Learners were predicted by pre-training cognitive and neurophysiological measures regarding Stroop tasks, which suggested relatively intact executive function as their characteristics. Given that NF training is not universally effective for children with ADHD, further studies are necessary to establish application criteria.

Auditory agnosia as a clinical symptom of childhood adrenoleukodystrophy.

OBJECTIVE: To investigate detailed auditory features in patients with auditory impairment as the first clinical symptoms of childhood adrenoleukodystrophy (CSALD). SUBJECTS AND METHODS: Three patients who had hearing difficulty as the first clinical signs and/or symptoms of ALD. Precise examination of the clinical characteristics of hearing and auditory function was performed, including assessments of pure tone audiometry, verbal sound discrimination, otoacoustic emission (OAE), and auditory brainstem response (ABR), as well as an environmental sound discrimination test, a sound lateralization test, and a dichotic listening test (DLT). The auditory pathway was evaluated by MRI in each patient. RESULTS: Poor response to calling was detected in all patients. Two patients were not aware of their hearing difficulty, and had been diagnosed with normal hearing by otolaryngologists at first. Pure-tone audiometry disclosed normal hearing in all patients. All patients showed a normal wave V ABR threshold. Three patients showed obvious difficulty in discriminating verbal sounds, environmental sounds, and sound lateralization and strong left-ear suppression in a dichotic listening test. However, once they discriminated verbal sounds, they correctly understood the meaning. Two patients showed elongation of the I-V and III-V interwave intervals in ABR, but one showed no abnormality. MRIs of these three patients revealed signal changes in auditory radiation including in other subcortical areas. CONCLUSION: The hearing features of these subjects were diagnosed as auditory agnosia and not aphasia. It should be emphasized that when patients are suspected to have hearing impairment but have no abnormalities in pure tone audiometry and/or ABR, this should not be diagnosed immediately as psychogenic response or pathomimesis, but auditory agnosia must also be considered.

Changes in negative and positive EEG shifts during slow cortical potential training in children with attention-deficit/hyperactivity disorder: a preliminary investigation.

We examined the effects of self-regulation of slow cortical potentials (SCP) in nine children with attention-deficit/hyperactivity disorder (ADHD) by focusing on the changes in electroencephalographic (EEG) shifts during SCP sessions. In SCP training, individuals learn to increase and decrease their cortical excitabilities (enhancement of negative and positive cortical shifts). To examine the efficiency of SCP training, we conducted an attention task and measured contingent negative variation, which relates to the attention maintenance ability. Moreover, to assess training effects at the behavioral level, the Japanese ADHD rating scale (SNAP-J) was completed by the parents. In SCP training, we analyzed changes in EEG shifts during 16 training sessions by calculating the peak amplitudes of positive and negative shifts. The results of EEG data showed that peak amplitudes increased in sessions 11 and 12 for negative shifts and in sessions 9 and 13 for positive shifts. Moreover, we found an enhancement of contingent negative variation amplitude in the attention task before and after training, suggesting that the ability of these children to maintain attention could be modified by SCP training. However, significant behavioral improvements were not observed on the Japanese ADHD rating scale. It has been proposed that the number of additional training sessions may affect both physiological and behavioral improvements. Our present results, however, suggest the possibility that even low numbers of training sessions, such as 16, can bring about physiological improvement, whereas greater numbers of training sessions may be needed to have an influence on behavioral changes.

Augmented startle responses in opsoclonus-myoclonus syndrome.

We report a 3-year-old boy with opsoclonus-myoclonus syndrome (OMS) who presented with exaggerated startle responses to unexpected auditory stimuli during an episode of myoclonic status. An augmented blink reflex was also observed clinically and electrophysiologically. Based on the assumption that hyperexcitability in the lower pontine tegmentum may be responsible for the acoustic startle and blink reflex in OMS, we considered that increased excitability of independent but neighboring structures, including the pontine paramedian reticular formation, may cause OMS symptoms.

[Clinical neurophysiological study of verbal and non-verbal sound perception: normal development of P300 event-related potential to different sound stimuli].

Developmental changes of P300 event related potential were evaluated in healthy children and adults aged from 7 to 29 years old, adopting 2 pairs of oddball stimuli: a non-verbal sound (tone burst: TB) pair and a verbal sound (VS) pair. P300 was evident for the target stimuli. In adult subjects, P300 was dominant at Pz for both stimuli. Peak latency of P300 was significantly longer for VS than for TB in both groups. P300 amplitude of the child group was higher than that of the adult group, however, there was no difference in P300 amplitude between stimuli conditions. Developmental changes of P300 from each stimuli condition were simulated by a quadratic equation. The age showing the shortest P300 peak latency was younger for TB (20.3 years) than for VS (23.6 years). The P300 peak latency reduced around 10 years old more rapidly for VS than for TB. In conclusion, there was no difference of the dominancy of P300 between the stimuli. The developmental changes of P300 were regulated by several components of the sound stimuli, such as their frequency.