The Effect of Neurofeedback on Joint Attention and Brain Electrical Activity in Boys ‎with High-Functioning Autism

Document Type : Original Article

Authors

1 Department of Motor Behavior, Faculty of Sports Sciences, Ferdowsi University of Mashhad, Mashhad, Iran

2 Department of Neuroscience, Faculty of Advanced Technologies in Medicine,, Mazandaran University of Medical Sciences, Sari, Iran

Abstract

Purpose:
Autism spectrum disorder is a developmental condition. People with autism have difficulty with social skills such as joint attention. The aim of the present study was to investigate the effect of neurofeedback on joint attention and brain electrical activity in 6 to 8 year-old boys with autism.
Methods:
Thirty boys with high functioning autism in the age range of 6-8 years were selected and randomly assigned into one of the neurofeedback and control groups. The neurofeedback group received alpha increase (8-12 Hz), decrease theta (5-8 Hz) and beta (13-30 Hz) for 30 hours of neurofeedback intervention. Each training session lasted between 45 and 60 minutes. The control group received the same amount of simulated intervention. In the two stages of pre and post intervention, the participants' joint attention was measured by the initial social communication scale. Also, EEG were recorded for each participant for 5 minutes in two stages pre and post-test to compare the changes of alpha, theta and beta waves. A mixed-design ANOVA 2 (group) x 4 (phases: pre-test, post-test, short-term follow-up and long-term follow-up) and ANCOVA was used to analyze and evaluate the effect of the intervention program on participants' post-test scores and their pre-test entered as covariate variable. Statistical tests were performed by SPSS software version 23.
Results:
The statistical results showed that the neurofeedback group improved in the post-test compared to the pre-test. Also, there was a significant difference in the joint attention index between two groups in the post-test (p <0.05). In addition, participants in the neurofeedback group were able to make the desired changes in alpha, theta and beta waves compared to the control group at rest (p <0.05).
Conclusion:
According to the results of the present study, it can be concluded that non-invasive intervention programs such as neurofeedback can improve the joint attention of children with high functioning autism.

Keywords


  1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing 2013.
  2. Samadi SA, McConkey R. Screening for autism in Iranian preschoolers: Contrasting M-CHAT and a scale developed in Iran. Journal of autism and developmental disorders 2015; 45(9): 2908-2916.
  3. Hazlett HC, Gu H, Munsell BC, Kim SH, et al. Early brain development in infants at high risk for autism spectrum disorder. Nature 2017; 542(7641); 348-351.
  4. Jansiewicz EM, Goldberg MC, Newschaffer CJ, Denckla  MB, et al. Motor signs distinguish children with high functioning autism and Asperger’s syndrome from controls. Journal of autism and developmental disorders 2006; 36(5): 613-621.
  5. Perkins TJ, Bittar RG, McGillivray JA, Cox II, et al. Increased premotor cortex activation in high functioning autism during action observation. Journal of clinical neuroscience: official journal of the Neurosurgical Society of Australasia 2015; 22(4): 664-669.
  6. Charman T. Why is joint attention a pivotal skill in autism?. Philosophical Transactions of the Royal Society of London. Series B: Biological Sciences 2003; 358(1430): 315-324.
  7. Mundy P, Kim K, McIntyre N, Lerro L, et al. Joint Attention and Information Processing in Children with Higher Functioning Autism Spectrum Disorders. Journal of Autism and Developmental Disorders 2016; 46(7): 2555-2560.
  8. Sigman M, McGovern CW. Improvement in cognitive and language skills from preschool to adolescence in autism. Journal of autism and developmental disorders 2005; 35(1):15-23.
  9. Alotaibi AG. The effect of teacher implemented Joint Attention intervention on improving teacher-child communication and social interaction among children with ASD. Amazonia Investiga 2020; 9(26): 228-235.
  10. Hickok G. Eight problems for the mirror neuron theory of action understanding in monkeys and humans. J Cognitive Neurosciense 2009; 21: 1229–1243.
  11. Marsh LE, Hamilton AFD. Dissociation of mirroring and mentalizing systems in autism. Neuroimage 2011; 56(3): 1511-1519.
  12. Oberman LM, McCleery JP, Hubbard EM, Bernier R, Wiersema, et al. Developmental changes in mu suppression to observed and executed actions in autism spectrum disorders.Social cognitive and affective neuroscience 2013; 8(3): 300-304.
  13. Martineau J, Andersson F, Barthelemy C, Cottier JP, et al. Atypical activation of the mirror neuron system during perception of hand motion in autism. Brain Res 2010; 1320: 168–175.
  14. Plata Bello J, Modrono C, González JL. The role of mirror neurons in neurosurgical patients: A few general considerations and rehabilitation perspectives. Neuro Rehabilitation 2014; 35(4): 665-671.
  15. Pineda JA. The functional significance of mu rhythms: translating seeing and hearing into doing. Brain Research Reviews 2005; 50(1): 57-68.
  16. Francuz P, Zapala D. The suppression of the mu rhythm during the creation of imagery representation of movement. Neuroscince Letters 2011; 495: 39–43.
  17. Raymaekers R, Wiersema JR, Roeyers H. EEG study of the mirror neuron system in children with high functioning autism. Brain Research 2009; 1304: 113-121.
  18. Bagherzadeh Y, Baldauf D, Pantazis D, Desimone R. Alpha synchrony and the neurofeedback control of spatial attention. Neuron 2020; 105(3): 577-587.
  19. Coben R, Linden M, Myers TE. Neurofeedback for autistic spectrum disorder (review). Psychophysiol. Biofeedback 2010; 35: 83–105.
  20. Kamiya J, Conscious control of brain waves. Psychology Today 1968; 1: 57-60.
  21. Scolnick B. Effects of electroencephalogram biofeedback with Asperger's syndrome. International Journal of Rehabilitation Research 2005; 28(2): 159-163.
  22. Kouijzer ME, van Schie HT, Gerrits BJ, Buitelaar JK, et al. Is EEG-biofeedback an effective treatment in autism spectrum disorders? A randomized controlled trial. Applied psychophysiology and biofeedback 2013; 38(1): 17-28.
  23. Thompson L., Thompson M. Neurofeedback outcomes in clients with Asperger’s syndrome. Applied psychophysiology and biofeedback 2010; 35(1): 63.
  24. Ramachandran VS, Oberman LM. Broken mirrors: a theory of autism. Scientific American. 2006; 295(5): 62-69.
  25. Ikeda Y, Nishimura Y, Shin N, Higuchi S. A study of EEG mu neurofeedback during action observation. Experimental Brain Research 2020; 1-8.
  26. Pineda JA, Carrasco K, Datko M, Pillen S, Schalles M. Neurofeedback training produces normalization in behavioural and electrophysiological measures of high-functioning autism. Philosophical Transactions of the Royal Society B: Biological Sciences 2014; 369: 20.
  27. Rozengurt R, Barnea A, Uchida S, Levy DA. Theta EEG neurofeedback benefits early consolidation of motor sequence learning. Psychophysiology 2016; 53(7): 965-973.
  28. Vosooghifard F, Alizadeh Zarei M, Nazari MA, Kamali M. The effect of neurofeedback training and neurofeedback with occupational therapy based on cognitive rehabilitation on executive functions in autistic children. Journal of Modern Rehabilitation 2014; 7(2): 28-35. [ Persian]
  29. Mercado J, Escobedo L, Tentori M. A BCI video game using neurofeedback improves the attention of children with autism. Journal on Multimodal User Interfaces 2020; 1-9.
  30. Baron-Cohen S, Lombardo MV, Auyeung B, Ashwin E, et al. Why are autism spectrum conditions more prevalent in males?. PLoS biology. 2011; 9(6): e1001081.
  31. Siegel DJ. Commentary on ‘integrating interpersonal neurobiology with group psychotherapy’: reflections on mind, brain, and relationships in group psychotherapy. Int. J. Group Psych other 2010; 60: 483-485.
  32. Dinstein I, ThomasC, Humphreys K, Minshew N, et al. Normal movement selectivity in autism. Neuron 2010; 66(3): 461-469.
  33. Bastiaansen JA, Thioux M, Nanetti L, van der Gaag C, Ketelaars, et al. Age-related increase in inferior frontal gyrus activity and social functioning inautism spectrum disorder. Biological Psychiatry 2011;69 (9): 832- 838.
  34. Keuken MC, Hardie A, Dorn BT, Dev S, et al. The role of the left inferior frontal gyrus in social perception: an rTMS study. Brain Res 2011; 1383: 196-205.
  35. Arnstein D, Cui F, Keysers C, Maurits NM, et al. Mu-suppression during action observation and execution correlates with BOLD in dorsal premotor, inferior parietal, and SI cortices. J. Neurosci. 2011; 31(14): 243-249.