Neurofeedback Learning is Skill Acquisition but does not Guarantee Treatment Benefit: Continuous-Time Analysis of Learning-Curves from a Clinical Trial for ADHD. Veilahti, A., Kovarskis, L., & Cowley, B. U. Frontiers in Human Neuroscience, 2021. jufo-1 Publisher: Frontiers
Neurofeedback Learning is Skill Acquisition but does not Guarantee Treatment Benefit: Continuous-Time Analysis of Learning-Curves from a Clinical Trial for ADHD [link]Paper  doi  abstract   bibtex   
Neurofeedback for attention deficit/hyperactivity disorder (ADHD) has long been studied as an alternative to medication, promising non-invasive treatment with minimal side-effects and sustained outcome. However, debate continues over the efficacy of neurofeedback, partly because existing evidence for efficacy is mixed and often non-specific, with unclear relationships between prognostic variables, patient performance when learning to self-regulate, and treatment outcomes. We report an extensive analysis on the understudied area of neurofeedback learning. Our data comes from a randomised controlled clinical trial in adults with ADHD (registered trial ISRCTN13915109; N=23; 13:10 female:male; age 25-57). Patients were treated with either theta-beta ratio or sensorimotor-rhythm regimes for 40 one-hour sessions. We classify 11 learners vs 12 non-learners by the significance of random slopes in a linear mixed growth-curve model. We then analyse the predictors, outcomes, and processes of learners vs non-learners, using these groups as mutual controls. Significant predictive relationships were found in anxiety disorder (GAD), dissociative experience (DES), and behavioural inhibition (BIS) scores obtained during screening. Low DES, but high GAD and BIS, predicted positive learning. Patterns of behavioural outcomes from Test Of Variables of Attention, and symptoms from adult ADHD Self-Report Scale, suggested that learning itself is not required for positive outcomes. Finally, the learning process was analysed using structural-equations modelling with continuous-time data, estimating the short-term and sustained impact of each session on learning. A key finding is that our results support the conceptualisation of neurofeedback learning as skill acquisition, and not merely operant conditioning as originally proposed in the literature.
@article{veilahti_neurofeedback_2021,
	title = {Neurofeedback {Learning} is {Skill} {Acquisition} but does not {Guarantee} {Treatment} {Benefit}: {Continuous}-{Time} {Analysis} of {Learning}-{Curves} from a {Clinical} {Trial} for {ADHD}},
	volume = {15},
	copyright = {All rights reserved},
	issn = {1662-5161},
	shorttitle = {Neurofeedback {Learning} is {Skill} {Acquisition} but does not {Guarantee} {Treatment} {Benefit}},
	url = {https://www.frontiersin.org/articles/10.3389/fnhum.2021.668780/full},
	doi = {10.3389/fnhum.2021.668780},
	abstract = {Neurofeedback for attention deficit/hyperactivity disorder (ADHD) has long been studied as an alternative to medication, promising non-invasive treatment with minimal side-effects and sustained outcome. However, debate continues over the efficacy of neurofeedback, partly because existing evidence for efficacy is mixed and often non-specific, with unclear relationships between prognostic variables, patient performance when learning to self-regulate, and treatment outcomes. We report an extensive analysis on the understudied area of neurofeedback learning. Our data comes from a randomised controlled clinical trial in adults with ADHD (registered trial ISRCTN13915109; N=23; 13:10 female:male; age 25-57). Patients were treated with either theta-beta ratio or sensorimotor-rhythm regimes for 40 one-hour sessions. We classify 11 learners vs 12 non-learners by the significance of random slopes in a linear mixed growth-curve model. We then analyse the predictors, outcomes, and processes of learners vs non-learners, using these groups as mutual controls. Significant predictive relationships were found in anxiety disorder (GAD), dissociative experience (DES), and behavioural inhibition (BIS) scores obtained during screening. Low DES, but high GAD and BIS, predicted positive learning. Patterns of behavioural outcomes from Test Of Variables of Attention, and symptoms from adult ADHD Self-Report Scale, suggested that learning itself is not required for positive outcomes. Finally, the learning process was analysed using structural-equations modelling with continuous-time data, estimating the short-term and sustained impact of each session on learning. A key finding is that our results support the conceptualisation of neurofeedback learning as skill acquisition, and not merely operant conditioning as originally proposed in the literature.},
	language = {English},
	urldate = {2021-06-15},
	journal = {Frontiers in Human Neuroscience},
	author = {Veilahti, Antti and Kovarskis, Levas and Cowley, Benjamin Ultan},
	year = {2021},
	note = {jufo-1
Publisher: Frontiers},
	keywords = {515 Psychology, 516 Educational sciences, 6162 Cognitive science, ADHD, ADULT ADHD, BIOFEEDBACK, CHILDREN, Classification, DISORDER, EEG, Learning, Neurofeedback, SYMPTOMS, THERAPY, adult ADHD, classification, clinical  trial, clinical trial, continuous-time modelling, learning, neurofeedback},
}

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