Atypical Dorsolateral Prefrontal Activity in Female Adolescents With Conduct Disorder During Effortful Emotion Regulation.

BACKGROUND: Conduct disorder (CD), which is characterized by severe aggressive and antisocial behavior, is linked to emotion processing and regulation deficits. However, the neural correlates of emotion regulation are yet to be investigated in adolescents with CD. Furthermore, it remains unclear whether CD is associated with deficits in emotional reactivity, emotion regulation, or both. METHODS: We used functional magnetic resonance imaging to study effortful emotion regulation by cognitive reappraisal in 59 female adolescents 15 to 18 years of age (30 with a CD diagnosis and 29 typically developing (TD) control adolescents). RESULTS: Behaviorally, in-scanner self-report ratings confirmed successful emotion regulation within each group individually but significant group differences in emotional reactivity and reappraisal success when comparing the groups (CD < TD). Functional magnetic resonance imaging results revealed significantly lower activation in left dorsolateral prefrontal cortex and angular gyrus in CD compared with TD adolescents during emotion regulation, but no group differences for emotional reactivity. Furthermore, connectivity between left dorsolateral prefrontal cortex and the bilateral putamen, right prefrontal cortex, and amygdala was reduced in CD compared with TD adolescents during reappraisal. Callous-unemotional traits were unrelated to neural activation, but these traits correlated negatively with behavioral reports of emotional reactivity. CONCLUSIONS: Our results demonstrate reduced prefrontal brain activity and functional connectivity during effortful emotion regulation in female adolescents with CD. This sheds light on the neural basis of the behavioral deficits that have been reported previously. Future studies should investigate whether cognitive interventions are effective in enhancing emotion-regulation abilities and/or normalizing prefrontal and temporoparietal activity in female adolescents with CD.

Electroencephalographic biofeedback for the treatment of attention-deficit hyperactivity disorder in childhood and adolescence.

Considerable scientific effort has been directed at developing effective treatments for attention-deficit hyperactivity disorder (ADHD). Among alternative treatment approaches, electroencephalographic (EEG) biofeedback has gained promising empirical support in recent years. Short-term effects were shown to be comparable to those of stimulant medication at the behavioral and neuropsychological level, leading to significant decreases of inattention, hyperactivity and impulsivity. In addition, EEG biofeedback results in concomitant improvement of neurophysiological patterns. EEG biofeedback may already be used within a multimodal setting, providing affected children and adolescents with a means of learning to counterbalance their ADHD symptoms without side effects. However, there is still a strong need for more empirically and methodologically sound evaluation studies.

[Neurofeedback for the treatment of attention-deficit/hyperactivity disorder (ADHD) in childhood and adolescence]. / Neurofeedback in der Behandlung der Aufmerksamkeitsdefizit-Hyperaktivitätsstorung (ADHS) im Kindes- und Jugendalter.

INTRODUCTION: A variety of non-pharmacological treatments for ADHD have failed to prove their effectiveness. The basis of evidence for neurofeedback (or EEG-biofeedback) has improved recently. Neurofeedback is aiming at an improvement of ADHD core-symptoms via the voluntary modification of abnormal neurophysiologic parameters, e.g. EEG-frequency spectrum and event-related potentials. METHODS: Our review presents an overview of the current research on neurofeedback for the treatment of ADHD. RESULTS: In three controlled studies short-term effects of feedback matched those of stimulant treatment. Neurofeedback lead to significant improvement of attention, impulsivity and hyperactivity, without adversive side effects. Additionally, there was a persistent amelioration of EEG parameters, while stimulants did not lead to a comparable normalization. Results on the stability of feedback effects are encouraging but are based on small numbers of patients. CONCLUSION: Neurofeedback is a promising approach for the treatment of children with ADHD. However, there is a demand for further controlled studies using standardized diagnostic criteria, sufficient sample sizes and appropriate measures and follow-up.