<em id="wipnf"><strike id="wipnf"></strike></em>

<th id="wipnf"><track id="wipnf"></track></th>
<dd id="wipnf"><pre id="wipnf"></pre></dd>

<em id="wipnf"></em>

<button id="wipnf"></button><button id="wipnf"></button><rp id="wipnf"></rp>
  • 腦電生物反饋治療文獻刊登于2014年2月《美國兒科學雜志》

     部分譯文如下:

    ——Neurofeedback for ADHD: Significant, lasting improvement腦電生物反饋治療多動癥:顯著而持續的療效,作者Dr Naomi Steiner博士工作于美國波斯頓塔夫咨兒童醫療中心

           注意缺陷多動障礙(ADHD)簡稱多動癥,是最常見的兒童精神行為障礙性疾病,主要表現為注意力渙散、活動過度、沖動任性等,是一種慢性終身性疾病,如不能得到及時有效的治療,會嚴重影響孩子的學業發展和事業成就,給家庭和社會帶來沉重的精神和經濟負擔。權威調查結果顯示,我國學齡兒童的多動癥患病率為4.31%-5.83%,估計全國共有患兒1461-1979萬,其中約65%的ADHD的癥狀會持續到青春期乃至成年,患兒在成年后發展為反社會人格障礙、犯罪行為和酗酒、吸(毒)的風險是正常兒童的5-10倍。
           目前,國內ADHD治療的主要手段是藥物與行為聯合治療,即在藥物治療的同時,輔以正確的家庭教育、學校輔導教育、社會支持的接納。目前國內臨床常見藥物治療
    ,中樞興奮劑是屬國家嚴格控制使用的藥物,也就是通常所說的“紅處方”,具有一定的藥物依賴風險,一旦停藥容易引起反彈。且由于相當一部分患兒對于藥物治療沒有效果,因此臨床多采用其它中樞興奮劑聯合治療的方法。腦電生物反饋是一種新型安全有效的物理治療方法,通過將患兒腦電節律的實時展現,訓練提高兒童對于腦電節律的自我調節能力,從而控制大腦的精神狀態和行為。據美國兒科雜志所發表的多動癥治療臨床研究數據顯示,多動癥患兒經腦電生物反饋治療40次后(每周治療三次,每次45分鐘),治療起效快,6個月內持續有效率>90%,  是一種非常重要的藥物替代或補充治療方法。

    Neurofeedback for ADHD: Significant, 
    Lasting Improvement
     
    (doi: 10.1542/peds.2013-2059d) In-School Neurofeedback
    Training for ADHD: Sustained Improvements From a Randomized Control Trial
     
    OBJECTIVE: To evaluate sustained improvements  6 months after a  40-session, in-school computer attention training intervention using neurofeedback or cognitive training (CT) administered to 7- to 11-year-olds with attention-deficit/hyperactivity disorder (ADHD).
     
    METHODS: One hundred four children were randomly assigned to receive neurofeedback, CT, or a control condition and were evaluated 6 months postintervention. A 3-point growth model assessed change over time across the conditions on the Conners 3-Parent Assessment Report (Conners 3-P), the Behavior Rating Inventory of Executive Function Parent Form  (BRIEF), and a systematic doubleblinded classroom observation (Behavioral Observation of Students in Schools). Analysis of variance assessed community-initiated changes in stimulant medication.
     
    RESULTS: Parent response rates were  90% at the  6-month follow-up. Six months postintervention, 
    neurofeedback participants maintained significant gains on Conners 3-P (Inattention effect size [ES] 
    = 0.34, Executive Functioning ES = 0.25, Hyperactivity/Impulsivity ES = 0.23)and BRIEF subscales 
    including the Global Executive  Composite  (ES= 0.31), which remained significantly greater than 
    gains found among children in CT and control conditions. Children in the CT condition showed 
    delayed improvement over immediate postintervention ratings only on Conners 3-P Executive
    Functioning (ES = 0.18)  and 2  BRIEF  subscales.  At  the 6-month  follow-up,  neurofeedback
    participants maintained the same stimulant medication dosage, whereas participants in both CT and control conditions showed statistically and clinically significant increases  (9 mg [P = .002] and  13 mg [P < .001], respectively).
     
    CONCLUSIONS: Neurofeedback participants made more prompt and greater improvements in ADHD symptoms, which were sustained at the 6-month follow-up, than did CT participants or those in the control group. This finding suggests that neurofeedback is a promising attention training treatment for children with ADHD.
     
    Medscape: Megan Brooks
     
    February 26, 2014
     
    Computer-based neurofeedback can produce significant and lasting improvement in attention and focus in children with
    attention-deficit/hyperactivity disorder (ADHD) and is superior to computer-based cognitive training (CT), new research shows.
     
    Results from a randomized controlled trial showed that children who received computer-based neurofeedback made faster and greater improvements in ADHD symptoms, which were sustained at the 6- month follow-up, than their peers who received 
    computer CT.
     
    "Sustainability of improvements after a behavioral intervention is not usually found, and an important finding," Naomi Steiner, 
    MD, of the Floating Hospital for Children at Tufts Medical Center in Boston, Massachusetts, told Medscape Medical News.
     
    Dr. Steiner noted that it was also important that the study was carried out in the school setting.
     
    "Most neurofeedback studies take place in the lab or in a clinic setting. This is translational research," she said.

    The study was published online February 17 in Pediatrics.
     
    Helpful With or Without Meds
     
    Neurofeedback and CT are 2 forms of computer-based attention training. Neurofeedback trains users with
    electroencephalographic sensors embedded in a bicycle helmet to increase their beta waves (an attentive state) and to suppress
    theta waves (a drowsy state) when viewing their brain waves on a computer screen. CT involves cognitive exercises that focus on attention and working memory with computer feedback to reinforce correct responses.
     
    The Boston team randomly assigned 104 children in second and fourth grade with ADHD to receive in-school neurofeedback (Play Attention, Unique Logic and Technology Inc), CT (Captain's Log, BrainTrain), or a control condition.
     
    Both neurofeedback and CT groups received 3 45-minute intervention sessions each week in the classroom for a total of 40 sessions under the supervision of a research assistant.
     
    Observations before and immediately after the interventions, reported previously by the investigators, showed significantly. 
    greater improvements in ADHD symptoms, including attention and executive functioning, in the neurofeedback group relative to the CT or control condition groups.
     
    The investigators now report outcomes at 6 months postintervention, which show a similar pattern.
     
    Children who received neurofeedback maintained significant gains on the Conners 3-Parent Assessment Report for inattention 
    (effect size [ES] = 0.34), executive functioning (ES = 0.25), and hyperactivity/impulsivity (ES = 0.23) and on the Behavior 
    Rating Inventory of Executive Function Parent Form (BRIEF) subscales, including the global executive composite (ES = 0.31), 
    "which remained significantly greater than gains found among children in CT and control conditions," they report.
     
    Children who received CT showed delayed improvement over immediate postintervention ratings only on Conners 3-Parent Assessment Report executive functioning (ES = 0.18) and 2 BRIEF subscales.
     
    There were no differences between neurofeedback and CT on classroom observation measures.
     
    The investigators say that it is "noteworthy" that children in the neurofeedback group maintained their stimulant medication dose while presumably experiencing the same physical growth and increased school demands as children in the CT and control 
    groups, whose medication dosage increased by 9 to 13 mg methylphenidate-equivalent units.
     
    It is also worth noting that the study included children who were on and off stimulant medication.
     
    "Most studies do not included children on medication. However, we found that children on stimulant medication in the neurofeedback group improved as much as the children who were not on medication.
     
    "This is very important clinically because it suggests that children on stimulant medication can also benefit from doing neurofeedback to train their attention and executive function," Dr. Steiner said.
     
    Both neurofeedback and CT systems are currently being used in school systems across the United States, the investigators note in their article.
     
    "Per session," Dr. Steiner said, "computer cognitive attention training is going to be cheaper than neurofeedback. However, as the results in the neurofeedback group are not only greater but also in more areas and were sustained, the long-term cost/benefit 
    calculation might shift."
     
    Promising Treatment
     
    Commenting on the findings for Medscape Medical News, Martijn Arns, PhD, researcher in the Department of Experimental
    Psychology at Utrecht University in the Netherlands and director of the Research Institute Brainclinics, said the study contributes more evidence that "neurofeedback in the treatment of ADHD has clinical benefit, and that these effects seem to be maintained 
    across time."
     
    Dr. Arns, who was not involved in this research, noted that the effect sizes reported for neurofeedback in this study are "slightly 
    lower" than what he and his colleagues found in a previous meta-analysis (Arns et al, Clin EEG Neurosci, 2009;40:180-189).
     
    "Most likely, the fact that neurofeedback was implemented in a school setting in a standardized way might explain the slightly lower effects as compared to studies that employed neurofeedback in a clinical setting. On the other hand, it does demonstrate that such a treatment can be implemented in a school setting," Dr. Arns said.
     
    "Recent studies have demonstrated limitations of medication in the long term; hence, treatments that have more sustained effects 
    in ADHD are much needed," Dr. Arns added. Neurofeedback is a "promising avenue for the treatment of ADHD," he concluded.
     
    The study was supported by an Institute of Education Sciences grant. The authors and Dr. Arns report no relevant financial relationships.
     
    Pediatrics. 2014;133:483-492. Abstract

    廣州潤之杰醫療科技有限公司 版權所有 粵ICP備17148402號

    粵公網安備 44011202000728號

    澳门精选免费资料大全197期