Gaze-based attention refocusing training in virtual reality for adult attention-deficit/hyperactivity disorder

Selaskowski, Benjamin; Asché, Laura Marie; Wiebe, Annika; Kannen, Kyra; Aslan, Behrem; Gerding, Thiago Morano; Sanchez, Dario; Ettinger, Ulrich; Kölle, Markus; Lux, Silke; Philipsen, Alexandra; Braun, Niclas

Abstract:

Background: Attention-deficit/hyperactivity disorder (ADHD) is characterized by substantial interindividual heterogeneity that challenges the systematic assessment and treatment. Considering mixed evidence from previous neurofeedback research, we present a novel feedback system that relies on gaze behavior to detect signs of inattention while performing a neuropsychological attention task in a virtual seminar room. More specifically, an audiovisual feedback was given whenever participants averted their gaze from the given task. Methods: Eighteen adults with ADHD and 18 healthy controls performed a continuous performance task (CPT) in virtual reality under three counterbalanced conditions in which either gaze-based feedback, sham feedback, or no feedback was provided. In all conditions, phases of high and low virtual distraction alternated. CPT errors and reaction times, proportions of gaze dwell times (e.g., task focus or distraction focus), saccade characteristics, EEG theta/beta ratios, head movements, and an experience sampling of ADHD symptoms were analyzed. Results: While patients can be discriminated well from healthy controls in that they showed more omission errors, higher reaction times, higher distraction-related dwell times, and more head movements, the feedback did not immediately improve task performance. It was also indicated that sham feedback was rather associated with an aggravation of symptoms in patients. Conclusions: Our findings demonstrate sufficient suitability and specificity for this holistic ADHD symptom assessment. Regarding the feedback, a single-session training was insufficient to achieve learning effects based on the proposed metacognitive strategies. Future longitudinal, multi-session trials should conclusively examine the therapeutic efficacy of gaze-based virtual reality attention training in ADHD.

Patologie/Applicazioni:

• Bio – Neurofeedback (NFB)
• ADHD
• Realtà virtuale

Anno:

2023

Tipo di pubblicazione:

Articolo

Parola chiave:

NFB; ADHD; realtà virtuale; sguardo

Testata scientifica:

BMC Psychiatry

Mese:

01

Nota:

Il disturbo da deficit di attenzione/iperattività (ADHD) è caratterizzato da una sostanziale eterogeneità interindividuale che mette alla prova la valutazione e il trattamento sistematici. Considerando le prove contrastanti di precedenti ricerche sul neurofeedback, lo studio presenta un nuovo sistema di feedback che si basa sul comportamento dello sguardo per rilevare i segni di disattenzione durante l'esecuzione di un compito neuropsicologico di attenzione in un'aula di seminario virtuale. In particolare, è stato fornito un feedback audiovisivo ogni volta che i partecipanti distoglievano lo sguardo dal compito assegnato. I risultati ottenuti dimostrano una sufficiente applicapibiltà e specificità per questa valutazione olistica dei sintomi dell'ADHD. Per quanto riguarda il feedback, una singola sessione di training è stata insufficiente per ottenere effetti di apprendimento basati sulle strategie metacognitive proposte. Futuri studi longitudinali e multi-sessione dovrebbero esaminare in modo definitivo l'efficacia terapeutica dell'allenamento dell'attenzione basato sullo sguardo in realtà virtuale nell'ADHD.

DOI:

https://doi.org/10.1186%2Fs12888-023-04551-z