Comparison of the Effectiveness of Neurofeedback and LORETA Neurofeedback in Improving Executive Functions and Sustained Attention in Children with Attention-Deficit/Hyperactivity Disorder
Keywords:
Attention-Deficit/Hyperactivity Disorder (ADHD), Neurofeedback, LORETA Neurofeedback, Executive Functions, Sustained AttentionAbstract
Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders in childhood, characterized by deficits in sustained attention and executive functions. In recent years, neurofeedback has gained attention as a non-invasive method for improving cognitive performance in children with ADHD. The present study aimed to compare the effectiveness of traditional neurofeedback and LORETA neurofeedback in improving sustained attention and components of executive functioning in this group of children. This study employed a quasi-experimental pretest-posttest design with a control group. The statistical population consisted of all children aged 8 to 12 years diagnosed with ADHD who attended Mehrdoostan Psychological and Counseling Clinic in Tehran in 2024. Sixty children were randomly selected and assigned into three groups of 20 participants each: traditional neurofeedback, LORETA neurofeedback, and control. The measurement instruments included the Continuous Performance Test (CPT), Stroop Test, Tower of London Test (TOL), NEPSY-II, and the Conners’ Parent Rating Scale. The neurofeedback interventions were conducted over 20 sessions of 45 minutes each. Data were analyzed using analysis of variance (ANOVA), post-hoc tests, and within-group t-tests. The results indicated that both interventions led to significant improvements in sustained attention, working memory, response inhibition, and cognitive flexibility (p < .001); however, LORETA neurofeedback demonstrated greater effectiveness compared to traditional neurofeedback. The therapeutic effects were sustained during the three-month follow-up period. Post-hoc analyses confirmed significant differences between the LORETA group and the other groups across all variables (p < .05). The findings suggest that LORETA neurofeedback can serve as an effective and lasting method for enhancing executive functions and sustained attention in children with ADHD. It is recommended that this approach be incorporated alongside other interventions in comprehensive treatment programs.
Downloads
References
1. Casey BN, Marston G, Vyas D. Self-Care Practices in the Context of Older Adults Living Independently. Proceedings of the Acm on Human-Computer Interaction. 2025;9(1):1-26. doi: 10.1145/3701205.
2. Mohammed AJ, Alqahtani I. Self-Care in the Older Adult Population With Chronic Disease: Concept Analysis. 2021. doi: 10.21203/rs.3.rs-960884/v1.
3. Fox SA, McAllum K, Vautrin‐Nadeau MÈ. Caring for Older Adults. 2022:1-6. doi: 10.1002/9781119678816.iehc0880.
4. Vicente MC, Cleane Rosa Ribeiro da S, Pimenta CJL, Bezerra TA, Hannah Karolyne Vieira de L, Valdevino SC, et al. Functional Capacity and Self-Care in Older Adults With Diabetes Mellitus. Aquichan. 2020;20(3):1-10. doi: 10.5294/aqui.2020.20.3.2.
5. Lee LY, Tung HH, Tsay SL, Chen YL, Lee HH, Zeng YX. Predictors for Self‐management in Older Adults With Type 2 Diabetic Nephropathy. Journal of Clinical Nursing. 2020;29(5-6):922-31. doi: 10.1111/jocn.15154.
6. Bagchegi O, Tabatabaeichehr M, Lashkardoost H, Mortazavi H. The Effect of Education Based on Kolb's Learning Style on Selfcare Behaviors of the Elderly With Type II Diabetes: A Randomized, Clinical Trial. Ethiopian Journal of Health Sciences. 2021;31(6). doi: 10.4314/ejhs.v31i6.24.
7. Bakhtiyary M, Sharifi F, Karimi K, Salehpoor-Emran M, Mirzadeh FS, Afshar PF. Happiness, Sleep Quality, and Self-Care Ability Among Community-Dwelling Older Adults in Tehran, 2023. BMC Geriatrics. 2024;24(1). doi: 10.1186/s12877-024-05623-9.
8. Arteaga NLC, Leiton Z, Villanueva BR. Self-Esteem and Self-Care Practice in Older Adults. Sciéndo. 2024;27(2):219-26. doi: 10.17268/sciendo.2024.032.
9. Jeamjitvibool T, Tanglai W. Instruments Measuring Self-Care Behaviors of Older Adults With Chronic Kidney Disease: A Scoping Review. Innovation in Aging. 2024;8(Supplement_1):153-4. doi: 10.1093/geroni/igae098.0495.
10. Floriano DR, Darlene Mara dos Santos T. Health Self-Care Practices Among Community Older Adults With Morbidity. Revista Brasileira De Enfermagem. 2022;75(suppl 4). doi: 10.1590/0034-7167-2021-0545.
11. Lopes LP, Santi DB, Francielle Renata Danielli Martins M, Salci MA, Carreira Lg, Baldissera VDA. The Self-Care Process of Community-Dwelling Older Adults During the COVID-19 Pandemic. Revista Brasileira De Enfermagem. 2023;76(suppl 1). doi: 10.1590/0034-7167-2022-0644.
12. Gonzalez EC, Hernández CR, Barbosa F. Examining the Influence of Self-Care Practices on Brain Activity in Healthy Older Adults. Frontiers in Aging Neuroscience. 2024;16. doi: 10.3389/fnagi.2024.1420072.
13. González EG. Self-Care Practices of Healthy Older Adults [Dataset]. 2023. doi: 10.18002/10612/16428.
14. Polacsek M, Boardman G, McCann TV. A Theory on the Components of Depression Self-Management in Older Adults. Qualitative Health Research. 2020;31(1):160-71. doi: 10.1177/1049732320961060.
15. Strandberg S, Ekstedt M, Fagerström C, Backåberg S. Cocreation of a Video Feedback Tool for Managing Self-Care at Home With Pairs of Older Adults: Remote Experience-Based Co-Design Study. Jmir Formative Research. 2024;8:e57219. doi: 10.2196/57219.
16. Savage B, Foli KJ, Edwards NE, Abrahamson K. Familism and Health Care Provision to Hispanic Older Adults. Journal of Gerontological Nursing. 2016;42(1):21-9. doi: 10.3928/00989134-20151124-03.
17. Ibrahim S, Elhgry GMA, Saad M. Effect of Supportive Nursing Intervention on Feeling of Stigmatization and Quality of Life Among Older Adults With Psoriasis. Niles Journal for Geriatric and Gerontology. 2024;7(1):202-25. doi: 10.21608/niles.2024.339622.
18. Jin Y, Brown R, Bhattarai M, Kuo Wc, Chen Y. Psychometric Properties of the Self‐care of Chronic Illness Inventory in Chinese Older Adults With Multiple Chronic Conditions. International Journal of Older People Nursing. 2023;18(3). doi: 10.1111/opn.12536.
19. Baixinho CL, Madeira C, Alves S, Henriques MA, Dixe MdA. Falls and Preventive Practices Among Institutionalized Older People. International Journal of Environmental Research and Public Health. 2022;19(13):7577. doi: 10.3390/ijerph19137577.
20. Jung SY, Moon KJ. Factors Affecting Self‐care Among Community‐dwelling Hypertensive Older Adults: A Cross‐sectional Study. Nursing Open. 2023;10(6):3892-905. doi: 10.1002/nop2.1647.
21. Matlala SF. Older Adults’ Narratives of Self-Care Using Steam Inhalation During COVID-19 Pandemic in KwaZulu-Natal Province, South Africa. 2024. doi: 10.20944/preprints202412.2464.v1.
22. Troya MI, Chew‐Graham C, Babatunde O, Bartlam B, Mughal F, Dikomitis L. Role of Primary Care in Supporting Older Adults Who Self-Harm: A Qualitative Study in England. British Journal of General Practice. 2019;69(688):e740-e51. doi: 10.3399/bjgp19x706049.
23. Yoon H, Kim H, Shin H, Kim Y. The Effect of Older Adults' Self-Efficacy on Acceptance of Care Robot: Focusing on Gender Comparison. Korea Gerontol Soc. 2023;43(6):1027-44. doi: 10.31888/jkgs.2023.43.6.1027.
24. Sable‐Morita S, Arai Y, Takanashi S, Aimoto K, Okura M, Tanikawa T, et al. Development and Testing of the Foot Care Scale for Older Japanese Diabetic Patients. The International Journal of Lower Extremity Wounds. 2021;23(1):140-7. doi: 10.1177/15347346211045033.
25. Guo Y, Wang T, Ge T, Jiang Q. Prevalence of Self-Care Disability Among Older Adults in China. BMC Geriatrics. 2022;22(1). doi: 10.1186/s12877-022-03412-w.
Downloads
Published
Submitted
Revised
Accepted
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
