The Effects of Different Theta and Beta Neurofeedback Training Protocols on Cognitive Control in ADHD.

Neurofeedback (NF) is an important treatment for attention deficit/hyperactivity disorder (ADHD). In ADHD, cognitive control deficits pose considerable problems to patients. However, NF protocols are not yet optimized to enhance cognitive control alongside with clinical symptoms, partly because they are not driven by basic cognitive neuroscience. In this study, we evaluated different EEG theta and/or beta frequency band NF protocols designed to enhance cognitive control. Participants were n = 157 children and adolescents, n = 129 of them were patients with ADHD (n = 28 typically developing (TD) controls). Patients with ADHD were divided into five groups in the order of referral, with four of them taking part in different NF protocols systematically varying theta and beta power. The fifth ADHD group and the TD group did not undergo NF. All NF protocols resulted in reductions of ADHD symptoms. Importantly, only when beta frequencies were enhanced during NF (without any theta regulation or in combination with theta upregulation), consistent enhancing effects in both response inhibition and conflict control were achieved. The theta/beta NF protocol most widely used in clinical settings revealed comparatively limited effects. Enhancements in beta band activity are key when aiming to improve cognitive control functions in ADHD. This calls for a change in the use of theta/beta NF protocols and shows that protocols differing from the current clinical standard are effective in enhancing important facets of cognitive control in ADHD. Further studies need to examine regulation data within the neurofeedback sessions to provide more information about the mechanisms underlying the observed effects. Supplementary Information: The online version contains supplementary material available at 10.1007/s41465-022-00255-6.

Mattering and parental presence in systemic therapy using nonviolent resistance: The utilization of imaginary methods.

An empowered sense of "self" is crucial for emotional well-being and positive relationships. Certain family interaction patterns can disrupt the adult's sense of "mattering" to the child, eroding their perceived self-efficacy. Mattering can be understood as a felt sense of relational agency which is necessary for experiencing one's interactions as meaningful, effective, and self-determined. When parents generate more positive future narratives in co-creation with their therapist, their sense of relevance to a child can be restored. In this way, more constructive forms of interaction can emerge with their child which has hitherto eschewed their care. This article aims to provide a conceptual basis for addressing an absence of reciprocity, where children demonstrate harmful or self-destructive behavior and refuse to cooperate in therapy. In such instances, one-sided parental action, utilizing nonviolent resistance methods, can influence relational dynamics. Imaginary methods can then facilitate shifts to psychological states in which the parent internally experiences efficacy and mattering more often without requiring validation from the "physical child" in the here and now. We introduce examples of specific imaginary techniques, which in our clinical practice have shown to facilitate such shifts in parents. We discuss neuroscientific theories that may account for their powerful impact we witness in our clinical experience.

Una sensación fortalecida del yo es fundamental para el bienestar emocional y las relaciones positivas. Ciertos patrones de interacción familiar pueden alterar la sensación del adulto de importarle al niño, deteriorando su autoeficacia percibida. La sensación de importarles a los demás puede entenderse como una percepción sentida de voluntad relacional que es necesaria para vivir las interacciones propias como significativas, eficaces y autodeterminadas. Cuando los padres generan narrativas futuras más positivas junto con su terapeuta, se puede recuperar su sensación de importancia para un niño. De esa manera, pueden surgir formas más constructivas de interacción con su hijo que hasta el momento ha eludido su cuidado. Este artículo tiene como finalidad ofrecer una base conceptual para abordar una ausencia de reciprocidad, donde los niños demuestran una conducta perjudicial o autodestructiva y se niegan a cooperar en la terapia. En esos casos, la acción de uno de los padres mediante el uso de métodos de resistencia no violenta puede influir en la dinámica relacional. Los métodos imaginarios pueden entonces facilitar cambios a estados psicológicos en los cuales el padre siente internamente su eficacia y tiene la sensación de importarle al niño con más frecuencia sin necesitar confirmación del niño físico en el aquí y ahora. Presentamos ejemplos de técnicas imaginarias específicas que en nuestra práctica clínica han demostrado facilitar dichos cambios en los padres. Comentamos las teorías neurocientíficas que pueden explicar el enorme efecto que observamos en nuestra experiencia clínica.

A distinct electrophysiological signature for synaesthesia that is independent of individual differences in sensory sensitivity.

People with synaesthesia have been reported to show atypical electrophysiological responses to certain simple sensory stimuli, even if these stimuli are not inducers of synaesthesia. However, it is unclear whether this constitutes a neural marker that is relatively specific to synaesthesia or whether it reflects some other trait that co-occurs with synaesthesia, but is not specific to it. One candidate is atypical sensory sensitivity (e.g., strong aversion to certain lights and sounds, 'sensory overload') which is a feature of both synaesthesia and autism and that varies greatly in the neurotypical population. Using visual evoked-potentials (to stimuli varying in spatial frequency) and auditory-evoked potentials (to stimuli varying in auditory frequency), we found that synaesthetes had a modulated visual evoked-potential around P1/N1 (emanating from fusiform cortex), a greater auditory N1, as well as differences in the time-frequency domain (increased alpha and beta induced power for visual stimuli). This was distinct from that found in non-synaesthetes. By contrast, no significant electrophysiological differences were found that were linked to neurotypical variation in sensory sensitivity.

Cardiac cycle gated cognitive-emotional control in superior frontal cortices.

Accumulating evidence suggests that peripheral physiological processes, such as the cardiac cycle, impact the individual's ability to appropriately exert control over behavior and emotional responses. We examine, whether response selection processes during cognitive-emotional control and its neurophysiological correlates, can be experimentally controlled in a cardiac-cycle dependent manner. To this end, we designed an experimental setup in which the EEG experiment, an emotional Stroop task, was controlled by the individual's electrocardiogram (ECG). Since theoretical considerations suggest that the effects of the cardiac cycle may affect only specific aspects during information processing, we apply EEG signal decomposition before examining functional neuroanatomical regions associated with cardiac-cycle dependent effects with EEG-beamforming approaches. Analyzing N = 27 healthy participants, we show that the cardiac-cycle specifically affects response selection processes, when demands on cognitive-emotional control are low. Response execution processes are sped up when trials are presented shortly after the ECG R peak. These effects were confined to conditions were response selection is not modulated by cognitive-emotional conflicts, which is in line with theoretical concepts on response selection. Corroborating the behavioural data, the EEG data show that particularly motor response-related processes encoded in the theta frequency band in middle and superior frontal regions (BA6) are differentially modulated by cardiac phase and difficulty to select a response. The presented work has an essential methodological focus in cognitive neuroscience for investigating brain-body interaction. It shows how peripheral-physiological parameters can be used to control EEG experiments and that the cardiac cycle has very specific effects in neurophysiological processes and associated functional neuroanatomical structures.

How non-veridical perception drives actions in healthy humans: evidence from synaesthesia.

We continually perform actions that are driven by our perception and it is a commonly held view that only objectively perceived changes within the 'real' world affect behaviour. Exceptions are generally only made for mental health disorders associated with delusions and hallucinations where behaviour may be triggered by the experience of objectively non-existent percepts. Here, we demonstrate, using synaesthesia as a model condition (in N = 19 grapheme-colour synaesthetes), how objectively non-existent (i.e. non-veridical) but still non-pathological perceptions affect actions in healthy humans. Using electroencephalography, we determine whether early-stage perceptual processes (reflected by P1 and N1 event-related potential (ERP) components), or late-stage-integration processes (reflected by N2 component), underlie the effects of non-veridical perceptions on action control. ERP analysis suggests that even though the examined peculiarities and experimental variations are perceptual in nature, it is not early-stage perceptual processes, but rather higher-order executive control processes linking perceptions to the appropriate motor response underlying this effect. Source localization analysis implicates activation within medial frontal cortices in the effect of how irrelevant non-veridical perceptions modulate behaviour. Our results challenge common conceptions about the determinants of human behaviour but can be explained by well-established theoretical frameworks detailing the link between perception and action. This article is part of a discussion meeting issue 'Bridging senses: novel insights from synaesthesia'.

How the depth of processing modulates emotional interference - evidence from EEG and pupil diameter data.

The ability to process emotionally conflicting information is an important requirement for emotional self-control. While it seems obvious that the impact of interfering emotional information critically depends on how deeply this interfering information is processed, it is still unknown what cognitive subprocesses are most affected by manipulating the depth of processing of emotionally interfering information. We examine these aspects integrating neurophysiological (EEG) and source localization data with pupil diameter data as an indirect index of the norepinephrine (NE) system activity. We show that when processing depth of interfering emotional stimulus dimensions is increased, emotional Stroop effects become stronger. The EEG data show that this was associated with modulations of decision-making processes, as reflected by the P3 event-related potential. Notably, the integration with pupil diameter data suggests that these decision processes were modulated by the NE system, especially when the depth of processing of interfering emotional stimulus dimensions was increased. This likely reflects gain modulation processes to facilitate processing of complex interfering, emotional information. The source localization results suggest that regions in the parietal (BA7) and insular cortex (BA13) are associated with these modulatory effects. The results suggest that overcoming more complex emotional interference triggers engagement of the norepinephrine system (indexed by pupil diameter) to facilitate action control mechanisms in a time-specific manner when deeper processing of emotional stimulus dimensions is required.

A comparative study on the neurophysiological mechanisms underlying effects of methylphenidate and neurofeedback on inhibitory control in attention deficit hyperactivity disorder.

In Attention Deficit Hyperactivity Disorder (AD(H)D), treatments using methylphenidate (MPH) and behavioral interventions like neurofeedback (NF) reflect major therapeutic options. These treatments also ameliorate executive dysfunctions in AD(H)D. However, the mechanisms underlying effects of MPH and NF on executive functions in AD(H)D (e.g. the ability to inhibit prepotent responses) are far from understood. It is particularly unclear whether these interventions affect similar or dissociable neural mechanisms and associated functional neuroanatomical structures. This, however, is important when aiming to further improve these treatments. We compared the neurophysiological mechanisms of MPH and theta/beta NF treatments on inhibitory control on the basis of EEG recordings and source localization analyses. The data show that MPH and theta/beta NF both increase the ability to inhibit pre-potent responses to a similar extent. However, the data suggest that MPH and NF target different neurophysiological mechanisms, especially when it comes to functional neuroanatomical structures associated with these effects. Both treatments seem to affect neurophysiological correlates of a 'braking function' in medial frontal areas. However, in case of the NF intervention, inferior parietal areas are also involved. This likely reflects the updating and stabilisation of efficient internal representations in order to initiate appropriate actions. No effects were seen in correlates of perceptual and attentional selection processes. Notably, reliable effects were only obtained after accounting for intra-individual variability in the neurophysiological data, which may also explain the diversity of findings in studies on treatment effects in AD(H)D, especially concerning neurofeedback.

How socioemotional setting modulates late-stage conflict resolution processes in the lateral prefrontal cortex.

The goal-directed control of behaviour critically depends on emotional regulation and constitutes the basis of mental well-being and social interactions. Within a socioemotional setting, it is necessary to prioritize effectively the relevant emotional information over interfering irrelevant emotional information to orchestrate cognitive resources and achieve appropriate behavior. Currently, it is elusive whether and how different socioemotional stimulus dimensions modulate cognitive control and conflict resolution. Theoretical considerations suggest that interference effects are less detrimental when conflicting emotional information is presented within a "positive socioemotional setting" compared with a "negative socioemotional setting." Using event-related potentials (ERPs) and source localization methods, we examined the basic system neurophysiological mechanisms and functional neuroanatomical structures associated with interactive effects of different interfering facial, socioemotional stimulus dimensions on conflict resolution. We account for interactive effects of different interfering socioemotional stimulus dimensions on conflict resolution, i.e., we show how the socioemotional valence modulates cognitive control (conflict processing). The data show that conflicts are stronger and more difficult to resolve in a negative emotional task-relevant setting than in a positive emotional task-relevant setting, where incongruent information barely induced conflicts. The degree of emotional conflict critically depends on the contextual emotional valence (positive or negative) in which this conflict occurs. The neurophysiological data show that these modulations were only reflected by late-stage conflict resolution processes associated with the middle (MFG) and superior frontal gyrus (SFG). Attentional selection processes and early-stage conflict monitoring do not seem to be modulated by interactive effects of different interfering socioemotional stimulus dimensions on conflict resolution.

Neurophysiological processes and functional neuroanatomical structures underlying proactive effects of emotional conflicts.

There is a strong inter-relation of cognitive and emotional processes as evidenced by emotional conflict monitoring processes. In the cognitive domain, proactive effects of conflicts have widely been studied; i.e. effects of conflicts in the n-1 trial on trial n. Yet, the neurophysiological processes and associated functional neuroanatomical structures underlying such proactive effects during emotional conflicts have not been investigated. This is done in the current study combining EEG recordings with signal decomposition methods and source localization approaches. We show that an emotional conflict in the n-1 trial differentially influences processing of positive and negative emotions in trial n, but not the processing of conflicts in trial n. The dual competition framework stresses the importance of dissociable 'perceptual' and 'response selection' or cognitive control levels for interactive effects of cognition and emotion. Only once these coding levels were isolated in the neurophysiological data, processes explaining the behavioral effects were detectable. The data show that there is not only a close correspondence between theoretical propositions of the dual competition framework and neurophysiological processes. Rather, processing levels conceptualized in the framework operate in overlapping time windows, but are implemented via distinct functional neuroanatomical structures; the precuneus (BA31) and the insula (BA13). It seems that decoding of information in the precuneus, as well as the integration of information during response selection in the insula is more difficult when confronted with angry facial emotions whenever cognitive control resources have been highly taxed by previous conflicts.