Mindset profiles of secondary school students: Associations with academic achievement, motivation and school burnout symptoms.

BACKGROUND: According to Dweck's mindset theory, implicit beliefs (a.k.a. mindset) have an organizing function, bringing together mindset, achievement goals and effort beliefs in a broader meaning system. Two commonly described meaning systems are a growth-mindset meaning system with mastery goals and positive effort beliefs, and a fixed-mindset meaning system with performance goals and negative effort beliefs. AIMS: Because of assumed heterogeneity within these two meaning systems, we aim to (1) examine multiple-mindset profiles based on mindset, achievement goals and effort beliefs, by using a data-driven person-oriented approach, and (2) relate these different profiles to several outcome measures (academic achievement, motivation and school burnout symptoms). SAMPLE: Self-report questionnaire data were collected from 724 students (11.0-14.7 y.o.; 46.7% girl; 53.3% boy; Mage = 12.8 y.o.). METHODS: Latent profile analysis was conducted using mindset, achievement goals and effort beliefs. RESULTS: Four profiles were revealed: one fixed-mindset profile and three growth-mindset profiles, which differed in their performance goal levels (low, moderate and high). Growth-mindset students with low- or moderate-performance goals had more advantageous outcomes, for example, higher math grades and lower school burnout symptoms, compared to growth-mindset students with high-performance goals. Fixed-mindset students had the least advantageous outcomes, for example, lower grades, less intrinsic motivation and more school burnout symptoms. CONCLUSIONS: Our study emphasizes the importance of taking a holistic approach when examining mindset meaning systems, revealing the importance of the level of performance goals and including multiple academic outcomes.

Growth mindset and school burnout symptoms in young adolescents: the role of vagal activity as potential mediator.

Experiencing school burnout symptoms can have negative consequences for learning. A growth mindset, the belief that human qualities such as intelligence are malleable, has previously been correlated with fewer school burnout symptoms in late adolescents. This might be because adolescents with a stronger growth mindset show more adaptive self-regulation strategies and thereby increasing resilience against academic setbacks. Here we confirmed in a sample of 426 Dutch young adolescents (11-14 years old; 48% female) that this relationship between growth mindset and school burnout symptoms holds after controlling for other potential predictors of school burnout symptoms such as academic achievement, school track, gender, and socio-economic status. Our second aim was to increase our understanding of the mechanism underlying the relation between mindset and school burnout, by measuring physiological resilience (vagal activity, a measure of parasympathetic activity, also known as heart rate variability or HRV) in a subsample (n = 50). We did not find any relation between vagal activity and growth mindset or school burnout symptoms, nor could we establish a mediating effect of vagal activity in their relation. In conclusion, we found evidence for a potential protective effect of a growth mindset on school burnout symptoms in young adolescents, but not for physiological resilience (vagal activity) as an underlying mechanism. The protective effect of growth mindset as confirmed in our younger sample can be leveraged in interventions to prevent increasing school burnout symptoms.

Trajectories of early adolescents' perceptions of school motivation and effort during the pandemic in Perú: A four time point longitudinal observational study.

In this longitudinal, observational study, following 883 adolescents (aged 11-15 years, grades 6th - 8th) we tracked changes in perceived school motivation and effort across four time points during the two years of remote education in Perú as a consequence of COVID-19 (retrospective reports before the pandemic, May 2020, July 2021, and November 2021). Compared to before the pandemic, levels of perceived school motivation and effort dropped sharply in May 2020 and continued to decrease across 2 years. Perceived school motivation was positively associated with perceived school effort at almost all time points. Furthermore, students with lower levels of perceived school motivation had a steeper decline in perceived school effort. In a subsample of 380 students in 8th grade, perceived school effort in July 2021 predicted objective math performance in November 2021. Our findings suggest that COVID-19 has further compounded decreases in subjective and objective indices of school engagement and performance that are typically observed in early adolescence. Our results from a large sample of low- to middle-class Peruvian adolescents highlight the experiences of youth in a country that had particularly long school closures, and that is under-represented in the literature.

Explore your brain: A randomized controlled trial into the effectiveness of a growth mindset intervention with psychosocial and psychophysiological components.

BACKGROUND: Although past research demonstrated growth mindset interventions to improve school outcomes, effects were small. This may be due to the theoretical nature of psychosocial techniques (e.g., reading about brain plasticity), which may not be optimally convincing for students. AIMS: To address this issue and improve effectiveness, we developed a growth mindset intervention, which combined psychosocial and psychophysiological components. The latter adds a convincing experience of influencing one's own brain activity, using mobile electroencephalography (EEG) neurofeedback, emphasizing the controllable and malleable nature of one's brain. SAMPLE: In this randomized controlled trial (RCT), twenty high-school classes (N = 439) were randomized to either the active control condition (no mindset messaging) or our newly developed growth mindset intervention condition (4 × 50 min). METHODS: School outcomes (pre, post, 1-year follow-up) were analysed with Linear Mixed Models (LMM: variable-oriented) and Latent Transition Analysis (LTA: person-oriented). RESULTS: LMM: students in the growth mindset intervention reported increased growth mindset directly after the intervention (post, d = .38) and at 1-year follow-up (d = .25) and demonstrated a protective effect against deterioration of math grades at 1-year follow-up (d = .36), compared to controls. LTA: we identified three mindset profiles (Fixed, Growth competitive, Growth non-competitive), with more frequent transitions from fixed to one of the growth mindset profiles at 1-year follow-up for students in the growth mindset intervention compared to controls (OR 2.58-2.68). CONCLUSIONS: Compared to previous studies, we found relatively large effects of our intervention on growth mindset and math grades, which may be attributable to synergetic effects of psychosocial and psychophysiological (neurofeedback) components. The person-oriented approach demonstrated more holistic effects, involving multiple motivational constructs.

Neural correlates of error-monitoring and mindset: Back to the drawing board?

The different ways students deal with mistakes is an integral part of mindset theory. While previous error-monitoring studies found supporting neural evidence for mindset-related differences, they may have been confounded by overlapping stimulus processing. We therefore investigated the relationship between mindset and event-related potentials (ERPs) of error-monitoring (response-locked Ne, Pe), with and without overlap correction. In addition, besides behavioral measures of remedial action after errors (post-error slowing and accuracy), we investigated their neural correlates (stimulus-locked N2). Results indicated comparable Ne, but larger Pe amplitudes in fixed-minded students; however, after overlap correction, the Pe results were rendered non-significant. A likely explanation for this overlap was a near-significant effect of mindset on the preceding stimulus P3. Finally, although N2 was larger for trials following errors, mindset was unrelated. The current study shows that the relationship between error-monitoring and mindset is more complex and should be reconsidered. Future studies are advised to explore stimulus processing as well, and if needed, to correct for stimulus overlap. In addition, contextual influences on and individual variation in error-monitoring need more scrutiny, which may contribute to refining mindset theory.

Opportunities and Limitations of Mobile Neuroimaging Technologies in Educational Neuroscience.

As the field of educational neuroscience continues to grow, questions have emerged regarding the ecological validity and applicability of this research to educational practice. Recent advances in mobile neuroimaging technologies have made it possible to conduct neuroscientific studies directly in naturalistic learning environments. We propose that embedding mobile neuroimaging research in a cycle (Matusz, Dikker, Huth, & Perrodin, 2019), involving lab-based, seminaturalistic, and fully naturalistic experiments, is well suited for addressing educational questions. With this review, we take a cautious approach, by discussing the valuable insights that can be gained from mobile neuroimaging technology, including electroencephalography and functional near-infrared spectroscopy, as well as the challenges posed by bringing neuroscientific methods into the classroom. Research paradigms used alongside mobile neuroimaging technology vary considerably. To illustrate this point, studies are discussed with increasingly naturalistic designs. We conclude with several ethical considerations that should be taken into account in this unique area of research.

Probabilistic Learning in Children With Attention-Deficit/Hyperactivity Disorder.

Objective: The current study examined instrumental learning in ADHD. Method: A total of 58 children with ADHD and 58 typically developing (TD) children performed a probabilistic learning task using three reward probability conditions (100%, 85%, 70% reward). After a learning phase, application of what was learned was assessed in a test phase. Results: Results showed that children with ADHD performed less accurate compared with TD children during the learning phase, particularly in the 100% and 85% reward probability conditions. These findings were accompanied by a blunted learning rate in the first few task trials. Furthermore, children with ADHD showed poorer application of what was learned. Conclusion: To conclude, children with ADHD show initial learning problems, but increased performance in a similar manner as TD children independent of the probability of reward, although they fail to apply their knowledge. Findings are of clinical relevance as the application of knowledge is important to successfully adapt to daily challenges in life.

MEASURING BRAIN WAVES IN THE CLASSROOM.

Brain researchers used to study the workings of the brain only in special laboratories at universities or hospitals. Recently, researchers started using portable devices that people can wear on their heads outside of the laboratory. For example, these devices allow researchers to measure the brain activity of students in classrooms, as they go through the school day. This sounds futuristic, and maybe also a bit alarming. In this article, we will explain what such devices do and do not measure-for example, they cannot read your mind! We will also explain how this kind of research can be useful to you and your classmates.

EEG profiles and associated neurodevelopmental outcomes after very preterm birth.

OBJECTIVES: To assess brain oscillations in very preterm and full-term born adolescents and explore subgroups based on integrative patterns of brain oscillations with different frequencies. Additionally, subgroups were related to functional outcomes and very preterm birth. METHODS: A Dutch cohort of 53 very preterm and 61 full-term born adolescents aged 13 years participated. Resting-state electroencephalography was recorded. Absolute and relative delta, theta, alpha, and beta power were compared between groups. Latent class analysis (LCA) was used to identify subgroups with distinct activity patterns and to relate these patterns to intelligence, academic performance, motor skills, and very preterm birth. RESULTS: Very preterm adolescents exhibited decreased relative beta activity. LCA with four classes showed the best model fit. The class with the highest level of delta and lowest levels of theta, alpha, and beta power was associated with lowest intelligence, academic, and motor estimates. Very preterm born adolescents were more likely than controls to be members of this class. CONCLUSION: Very preterm born adolescents showed altered oscillatory activity, indicating long-lasting effects of very preterm birth on brain functioning. Distinct activity patterns were associated with both functional outcomes and very preterm birth. SIGNIFICANCE: Specific patterns of brain oscillations may serve as biomarkers for poor functional outcome after very preterm birth.

Alterations in the Ventral Attention Network During the Stop-Signal Task in Children With ADHD: An Event-Related Potential Source Imaging Study.

OBJECTIVE: Deficits in response inhibition figure prominently in models of ADHD; however, attentional deficiencies may better explain previous findings of impaired response inhibition in ADHD. We tested this hypothesis at the neurophysiological level. METHOD: Dense array ERPs (event-related potentials) were obtained for 46 children with ADHD and 51 controls using the stop-signal task (SST). Early and late components were compared between groups. N2 and P3 components were localized with LAURA distributed linear inverse solution. RESULTS: A success-related N1 modulation was only apparent in the ADHD group. N2 and P3 amplitudes were reduced in ADHD. During the successful inhibition N2, the ADHD group showed reduced activation in right inferior frontal gyrus (rIFG), supplementary motor area (SMA), and right temporoparietal junction (rTPJ), and during failed inhibition in the rIFG. During the successful inhibition P3, reduced activation was found in anterior cingulate cortex (ACC) and SMA. CONCLUSION: Impairments in the ventral attention network contribute to the psychopathology of ADHD and challenge the dominant view that ADHD is underpinned by impaired inhibitory control.

A 6-month follow-up of an RCT on behavioral and neurocognitive effects of neurofeedback in children with ADHD.

To assess the long-term effects of neurofeedback (NFB) in children with attention deficit hyperactivity disorder (ADHD), we compared behavioral and neurocognitive outcomes at a 6-month naturalistic follow-up of a randomized controlled trial on NFB, methylphenidate (MPH), and physical activity (PA). Ninety-two children with a DSM-IV-TR ADHD diagnosis, aged 7-13, receiving NFB (n = 33), MPH (n = 28), or PA (n = 31), were re-assessed 6-months after the interventions. NFB comprised theta/beta training on the vertex (cortical zero). PA comprised moderate to vigorous intensity exercises. Outcome measures included parent and teacher behavioral reports, and neurocognitive measures (auditory oddball, stop-signal, and visual spatial working memory tasks). At follow-up, longitudinal hierarchical multilevel model analyses revealed no significant group differences for parent reports and neurocognitive measures (p = .058-.997), except for improved inhibition in MPH compared to NFB (p = .040) and faster response speed in NFB compared to PA (p = .012) during the stop-signal task. These effects, however, disappeared after controlling for medication use at follow-up. Interestingly, teacher reports showed less inattention and hyperactivity/impulsivity at follow-up for NFB than PA (p = .004-.010), even after controlling for medication use (p = .013-.036). Our findings indicate that the superior results previously found for parent reports and neurocognitive outcome measures obtained with MPH compared to NFB and PA post intervention became smaller or non-significant at follow-up. Teacher reports suggested superior effects of NFB over PA; however, some children had different teachers at follow-up. Therefore, this finding should be interpreted with caution. Clinical trial registration Train your brain and exercise your heart? Advancing the treatment for Attention Deficit Hyperactivity Disorder (ADHD), Ref. no. NCT01363544, https://clinicaltrials.gov/show/NCT01363544 .

Childhood Psychiatric Disorders as Risk Factor for Subsequent Substance Abuse: A Meta-Analysis.

OBJECTIVE: To assess the prospective risk of developing substance-related disorders after childhood mental health disorders (i.e., attention-deficit/hyperactivity disorder [ADHD], oppositional defiant disorder [ODD] or conduct disorder [CD], anxiety disorder, and depression) using meta-analysis. METHOD: PubMed, Embase, and PsycInfo were searched for relevant longitudinal studies that described childhood (<18 years old) ADHD, ODD or CD, anxiety, or depression in relation to later alcohol-, nicotine-, or drug-related disorders or substance use disorders (SUDs) published in peer-reviewed journals in the English language from 1986 to May 2016. Two researchers conducted all review stages. Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines were followed. RESULTS: Thirty-seven studies including more than 762,187 participants were identified for quantitative analyses. These studies included 22,029 participants with ADHD, 434 participants with ODD or CD, 1,433 participants with anxiety disorder, and 2,451 participants with depression. Ninety-seven effects sizes were extracted for analyses. Meta-analysis showed a significantly increased risk for addiction in ADHD (n = 23, odds ratio [OR] 2.27, 95% CI 1.98-3.67; OR alcohol 2.15, 95% CI 1.56-2.97; OR drugs 1.52, 95% CI 1.52-5.27; OR nicotine 2.52, 95% CI 2.01-3.15; OR SUDs 2.61, 95% CI 1.77-3.84), ODD or CD (n = 8, OR 3.18, 95% CI 1.97-5.80; OR alcohol 1.73, 95% CI 1.51-2.00; OR drugs 4.24, 95% CI 1.3.21.5.59; OR nicotine 4.22, 95% CI 3.21-5.55; OR SUDs 4.86, 95% CI 3.09-7.56), and depression (n = 13, OR 2.03, 95% CI 1.47-2.81; OR alcohol 1.10, 95% CI 1.02-1.19; OR nicotine 2.56, 95% CI 1.89-3.48; OR SUDs 2.20, 95% CI 1.41-3.43), but not for anxiety disorders (n = 15, OR 1.34, 95% CI 0.90-1.55, not significant). CONCLUSION: Childhood ADHD, ODD, CD, and depression increase the risk of developing substance-related disorders. Anxiety disorders do not seem to increase the risk for future substance-related disorders, although the findings are highly heterogeneous. These findings emphasize the need for early detection and intervention to prevent debilitating substance-related disorders in later life.

An RCT into the effects of neurofeedback on neurocognitive functioning compared to stimulant medication and physical activity in children with ADHD.

Neurofeedback (NFB) is a potential alternative treatment for children with ADHD that aims to optimize brain activity. Whereas most studies into NFB have investigated behavioral effects, less attention has been paid to the effects on neurocognitive functioning. The present randomized controlled trial (RCT) compared neurocognitive effects of NFB to (1) optimally titrated methylphenidate (MPH) and (2) a semi-active control intervention, physical activity (PA), to control for non-specific effects. Using a multicentre three-way parallel group RCT design, children with ADHD, aged 7-13, were randomly allocated to NFB (n = 39), MPH (n = 36) or PA (n = 37) over a period of 10-12 weeks. NFB comprised theta/beta training at CZ. The PA intervention was matched in frequency and duration to NFB. MPH was titrated using a double-blind placebo controlled procedure to determine the optimal dose. Neurocognitive functioning was assessed using parameters derived from the auditory oddball-, stop-signal- and visual spatial working memory task. Data collection took place between September 2010 and March 2014. Intention-to-treat analyses showed improved attention for MPH compared to NFB and PA, as reflected by decreased response speed during the oddball task [η p2  = 0.21, p < 0.001], as well as improved inhibition, impulsivity and attention, as reflected by faster stop signal reaction times, lower commission and omission error rates during the stop-signal task (range η p2  = 0.09-0.18, p values <0.008). Working memory improved over time, irrespective of received treatment (η p2  = 0.17, p < 0.001). Overall, stimulant medication showed superior effects over NFB to improve neurocognitive functioning. Hence, the findings do not support theta/beta training applied as a stand-alone treatment in children with ADHD.

Learning curves of theta/beta neurofeedback in children with ADHD.

Neurofeedback is widely applied as non-pharmacological intervention aimed at reducing symptoms of ADHD, even though efficacy has not been unequivocally established. Neuronal changes during the neurofeedback intervention that resemble learning can provide crucial evidence for the feasibility and specificity of this intervention. A total of 38 children (aged between 7 and 13 years) with a DSM-IV-TR diagnosis of ADHD, completed on average 29 sessions of theta (4-8 Hz)/beta (13-20 Hz) neurofeedback training. Dependent variables included training-related measures as well as theta and beta power during baseline and training runs for each session. Learning effects were analyzed both within and between sessions. To further specify findings, individual learning curves were explored and correlated with behavioral changes in ADHD symptoms. Over the course of the training, there was a linear increase in participants' mean training level, highest obtained training level and the number of earned credits (range b = 0.059, -0.750, p < 0.001). Theta remained unchanged over the course of the training, while beta activity increased linearly within training sessions (b = 0.004, 95% CI = [0.0013-0.0067], p = 0.005) and over the course of the intervention (b = 0.0052, 95% CI = [0.0039-0.0065], p < 0.001). In contrast to the group analyses, significant individual learning curves were found for both theta and beta over the course of the intervention in 39 and 53%, respectively. Individual learning curves were not significantly correlated with behavioral changes. This study shows that children with ADHD can gain control over EEG states during neurofeedback, although a lack of behavioral correlates may indicate insufficient transfer to daily functioning, or to confounding reinforcement of electromyographic activity. CLINICAL TRIALS REGISTRATION: This trial is registered at the US National Institutes of Health (ClinicalTrials.gov, ref. no: NCT01363544); https://clinicaltrials.gov/show/NCT01363544 .

1-year follow-up of neurofeedback treatment in adolescents with attention-deficit hyperactivity disorder: randomised controlled trial.

BACKGROUND: Estimates of the effectiveness of neurofeedback as a treatment for attention-deficit hyperactivity disorder (ADHD) are mixed. AIMS: To investigate the long-term additional effects of neurofeedback (NFB) compared with treatment as usual (TAU) for adolescents with ADHD. METHOD: Using a multicentre parallel-randomised controlled trial design, 60 adolescents with a DSM-IV-TR diagnosis of ADHD receiving NFB+TAU (n=41) or TAU (n=19) were followed up. Neurofeedback treatment consisted of approximately 37 sessions of theta/sensorimotor rhythm (SMR)-training on the vertex (Cz). Outcome measures included behavioural self-reports and neurocognitive measures. Allocation to the conditions was unmasked. RESULTS: At 1-year follow-up, inattention as reported by adolescents was decreased (range ηp2=0.23-0.36, P<0.01) and performance on neurocognitive tasks was faster (range ηp2=0.20-0.67, P<0.005) irrespective of treatment group. CONCLUSIONS: Overall, NFB+TAU was as effective as TAU. Given the absence of robust additional effects of neurofeedback in the current study, results do not support the use of theta/SMR neurofeedback as a treatment for adolescents with ADHD and comorbid disorders in clinical practice. DECLARATION OF INTEREST: None. COPYRIGHT AND USAGE: © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.

Behavioral Effects of Neurofeedback Compared to Stimulants and Physical Activity in Attention-Deficit/Hyperactivity Disorder: A Randomized Controlled Trial.

OBJECTIVE: The efficacy of neurofeedback as a treatment for attention-deficit/hyperactivity disorder (ADHD), and whether neurofeedback is a viable alternative for stimulant medication, is still an intensely debated subject. The current randomized controlled trial compared neurofeedback to (1) optimally titrated methylphenidate and (2) a semi-active control intervention, physical activity, to account for nonspecific effects. METHODS: A multicenter 3-way parallel-group study with balanced randomization was conducted. Children with a DSM-IV-TR diagnosis of ADHD, aged 7-13 years, were randomly allocated to receive neurofeedback (n = 39), methylphenidate (n = 36), or physical activity (n = 37) over a period of 10-12 weeks. Neurofeedback comprised theta/beta training on the vertex (Cz). Physical activity consisted of moderate to vigorous intensity exercises. Neurofeedback and physical activity were balanced in terms of number (~30) and duration of sessions. A double-blind pseudorandomized placebo-controlled crossover titration procedure was used to determine an optimal dose in the methylphenidate intervention. Parent and teacher ratings on the Strengths and Difficulties Questionnaire (SDQ) and Strengths and Weaknesses of ADHD Symptoms and Normal Behavior (SWAN) were used to assess intervention outcomes. Data collection took place between September 2010 and March 2014. RESULTS: Intention-to-treat analyses revealed an improvement in parent-reported behavior on the SDQ and the SWAN Hyperactivity/Impulsivity scale, irrespective of received intervention (ηp² = 0.21-0.22, P ≤ .001), whereas the SWAN Inattention scale revealed more improvement in children who received methylphenidate than neurofeedback and physical activity (ηp² = 0.13, P ≤ .001). Teachers reported a decrease of ADHD symptoms on all measures for methylphenidate, but not for neurofeedback or physical activity (range of ηp² = 0.14-0.29, P < .001). CONCLUSIONS: The current study found that optimally titrated methylphenidate is superior to neurofeedback and physical activity in decreasing ADHD symptoms in children with ADHD. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01363544.

A randomized controlled trial into the effects of neurofeedback, methylphenidate, and physical activity on EEG power spectra in children with ADHD.

BACKGROUND: The clinical and neurophysiological effects of neurofeedback (NF) as treatment for children with ADHD are still unclear. This randomized controlled trial (RCT) examined electroencephalogram (EEG) power spectra before and after NF compared to methylphenidate (MPH) treatment and physical activity (PA) - as semi-active control group - during resting and active (effortful) task conditions to determine whether NF can induce sustained alterations in brain function. METHODS: Using a multicentre three-way parallel group RCT design, 112 children with a DSM-IV diagnosis of ADHD, aged between 7 and 13 years, were initially included. NF training consisted of 30 sessions of theta/beta training at Cz over a 10-week period. PA training was a semi-active control group, matched in frequency and duration. Methylphenidate was titrated using a double-blind placebo controlled procedure in 6 weeks, followed by a stable dose for 4 weeks. EEG power spectra measures during eyes open (EO), eyes closed (EC) and task (effortful) conditions were available for 81 children at pre- and postintervention (n = 29 NF, n = 25 MPH, n = 27 PA). CLINICAL TRIALS REGISTRATION: Train Your Brain? Exercise and Neurofeedback Intervention for ADHD, https://clinicaltrials.gov/show/;NCT01363544, Ref. No. NCT01363544. RESULTS: Both NF and MPH resulted in comparable reductions in theta power from pre- to postintervention during the EO condition compared to PA (ηp (2)  = .08 and .12). For NF, greater reductions in theta were related to greater reductions in ADHD symptoms. During the task condition, only MPH showed reductions in theta and alpha power compared to PA (ηp (2)  = .10 and .12). CONCLUSIONS: This study provides evidence for specific neurophysiological effects after theta/beta NF and MPH treatment in children with ADHD. However, for NF these effects did not generalize to an active task condition, potentially explaining reduced behavioural effects of NF in the classroom.

Neural correlates of response inhibition in children with attention-deficit/hyperactivity disorder: A controlled version of the stop-signal task.

The stop-signal task has been used extensively to investigate the neural correlates of inhibition deficits in children with ADHD. However, previous findings of atypical brain activation during the stop-signal task in children with ADHD may be confounded with attentional processes, precluding strong conclusions on the nature of these deficits. In addition, there are recent concerns on the construct validity of the SSRT metric. The aim of this study was to control for confounding factors and improve the specificity of the stop-signal task to investigate inhibition mechanisms in children with ADHD. FMRI was used to measure inhibition related brain activation in 17 typically developing children (TD) and 21 children with ADHD, using a highly controlled version of the stop-signal task. Successful inhibition trials were contrasted with control trials that were comparable in frequency, visual presentation and absence of motor response. We found reduced brain activation in children with ADHD in key inhibition areas, including the right inferior frontal gyrus/insula, and anterior cingulate/dorsal medial prefrontal cortex. Using a more stringent controlled design, this study replicated and specified previous findings of atypical brain activation in ADHD during motor response inhibition.

Neurofeedback to improve neurocognitive functioning of children treated for a brain tumor: design of a randomized controlled double-blind trial.

BACKGROUND: Neurotoxicity caused by treatment for a brain tumor is a major cause of neurocognitive decline in survivors. Studies have shown that neurofeedback may enhance neurocognitive functioning. This paper describes the protocol of the PRISMA study, a randomized controlled trial to investigate the efficacy of neurofeedback to improve neurocognitive functioning in children treated for a brain tumor. METHODS/DESIGN: Efficacy of neurofeedback will be compared to placebo training in a randomized controlled double-blind trial. A total of 70 brain tumor survivors in the age range of 8 to 18 years will be recruited. Inclusion also requires caregiver-reported neurocognitive problems and being off treatment for more than two years. A group of 35 healthy siblings will be included as the control group. On the basis of a qEEG patients will be assigned to one of three treatment protocols. Thereafter patients will be randomized to receive either neurofeedback training (n=35) or placebo training (n=35). Neurocognitive tests, and questionnaires administered to the patient, caregivers, and teacher, will be used to evaluate pre- and post-intervention functioning, as well as at 6-month follow-up. Siblings will be administered the same tests and questionnaires once. DISCUSSION: If neurofeedback proves to be effective for pediatric brain tumor survivors, this can be a valuable addition to the scarce interventions available to improve neurocognitive and psychosocial functioning. TRIAL REGISTRATION: ClinicalTrials.gov NCT00961922.