Application of neurotechnology in students with ADHD: An umbrella review

 Antonio-R. Hidalgo-Muñoz, University of Salamanca (Spain)

 Daniel Acle-Vicente, University of Salamanca (Spain)

 Alejandro García-Pérez, University of Salamanca (Spain)

 Carmen Tabernero-Urbieta, University of Salamanca (Spain)

https://doi.org/10.3916/C76-2023-05

Keywords

Cognitive stimulation, hyper scanning, neuroeducation, neuroscience, neurofeedback, ADHD

Abstract

Currently, classrooms are experiencing an increase in the number of schoolchildren with a diagnosis of attention deficit hyperactivity disorder (ADHD). Numerous studies propose, as an alternative to medication, the implementation of different neurotechnology in the classroom to improve the symptomatology and enhance the cognitive abilities of children with this diagnosis. This umbrella review aims to compile the scientific evidence that exists on the application of these techniques, as well as their implementation, in schools. A systematic review was carried out, following accepted recommendations (PRISMA), which included systematic reviews in English or Spanish, published in scientific journals, which deal with ADHD, apply some neurotechnology used in this population such as neurofeedback, transcranial stimulation (tDCS) or hyper scanning, and which refer to education or school. Fourteen systematic reviews were retained, which show that neurofeedback is the most widely used neurotechnology, although its actual implementation in school has been scarcely treated or only aimed to evaluate its efficacy. In second place, tDCS appears with a more clinical approach, while hyper scanning does not appear. Despite the promising experimental results, ecological studies proposing the effective implementation of these techniques in educational centers are necessary; on the other hand, the commitment to neuroeducation would entail the emergence of new professional figures.

References

Antle, A.N., McLaren, E.S., Fiedler, H., & Johnson, N. (2019). Evaluating the impact of a mobile neurofeedback app for young children at school and home. In S. Brewster & G. Fitzpatrick (Eds), Proceedings of the 2019 CHI Conference on human factors in computing systems (pp. 1-13). https://doi.org/10.1145/3290605.3300266

Link DOI | Link Google Scholar

Arns, M., Heinrich, H., & Strehl, U. (2014). Evaluation of neurofeedback in ADHD: The long and winding road. Biological Psychology, 95, 108-115. https://doi.org/10.1016/j.biopsycho.2013.11.013

Link DOI | Link Google Scholar

Barreto, C., & Soltanlou, M. (2022). Functional near-infrared spectroscopy as a tool to assess brain activity in educational settings: An introduction for educational researchers. South African Journal of Childhood Education, 12(1), 1138. https://doi.org/10.4102/sajce.v12i1.1138

Link DOI | Link Google Scholar

Brauer, H., Breitling-Ziegler, C., Moliadze, V., Galling, B., & Prehn-Kristensen, A. (2021). Transcranial direct current stimulation in attention-deficit/hyperactivity disorder: A meta-analysis of clinical efficacy outcomes. Progress in Brain Research, 264, 91-116. https://doi.org/10.1016/bs.pbr.2021.01.013

Link DOI | Link Google Scholar

Brockington, G., Balardin, J.B., Zimeo-Morais, G.A., Malheiros, A., Lent, R., Moura, L.M., & Sato, J.R. (2018). From the laboratory to the classroom: the potential of functional near-infrared spectroscopy in educational neuroscience. Frontiers in Psychology, 9, 1840. https://doi.org/10.3389/fpsyg.2018.01840

Link DOI | Link Google Scholar

Camacho?Conde, J.A., Gonzalez?Bermudez, M.D.R., Carretero?Rey, M., & Khan, Z.U. (2022). Brain stimulation: A therapeutic approach for the treatment of neurological disorders. CNS Neuroscience & Therapeutics, 28(1), 5-18. https://doi.org/10.1111/cns.13769

Link DOI | Link Google Scholar

Cannon, R.L. (2015). Editorial perspective: Defining neurofeedback and its functional processes. NeuroRegulation, 2(2), 60-69. https://doi.org/10.15540/nr.2.2.60

Link DOI | Link Google Scholar

Cerrillo-Urbina, A.J., García-Hermoso, A., Martínez-Vizcaíno, V., Pardo-Guijarro, M.J., Ruiz-Hermosa, A., & Sánchez-López, M. (2018). Prevalence of probable attention-deficit/hyperactivity disorder symptoms: Result from a Spanish sample of children. BMC Pediatrics, 18(111), 1-7. https://doi.org/10.1186/s12887-018-1083-1

Link DOI | Link Google Scholar

Che, X., Jong-Hwan, C., & Shang, X. (2021). Comparative efficacy and acceptability of nonpharmacotherapy in the treatment of inattention for ADHD: A network meta-analysis. Complexity, 2021, 1-14. https://doi.org/10.1155/2021/9435262

Link DOI | Link Google Scholar

Coch, D., & Daniel, D.B. (2020). Lost in translation: Educational psychologists as intermediaries between neuroscience and education. Frontiers in Education, 5, 618464. https://doi.org/10.3389/feduc.2020.618464

Link DOI | Link Google Scholar

Cosmo, C., DiBiasi, M., Lima, V., Grecco, L.C., Muszkat, M., Philip, N.S., & de Sena, E.P. (2020). A systematic review of transcranial direct current stimulation effects in attention-deficit/hyperactivity disorder. Journal of Affective Disorders, 276, 1-13. https://doi.org/10.1016/j.jad.2020.06.054

Link DOI | Link Google Scholar

Dikker, S., Wan, L., Davidesco, I., Kaggen, L., Oostrik, M., McClintock, J., Rowland, J., Michalareas, G., VanBavel, J.J., Ding, M., & Poeppel, D. (2017). Brain-to-brain synchrony tracks real-world dynamic group interactions in the classroom. Current Biology, 27(9), 1375-1380. https://doi.org/10.1016/j.cub.2017.04.002

Link DOI | Link Google Scholar

Evans, S.W., Owens, J. S., & Bunford, N. (2014). Evidence-based psychosocial treatments for children and adolescents with attention-deficit/hyperactivity disorder. Journal of Clinical Child & Adolescent Psychology, 43(4), 527-551. https://doi.org/10.1080/15374416.2013.850700

Link DOI | Link Google Scholar

Ferrés, J., & Masanet, M. (2017). Communication efficiency in education: Increasing emotions and storytelling. [La eficacia comunicativa en la educación: Potenciando las emociones y el relato]. Comunicar, 52, 51-60. https://doi.org/10.3916/C52-2017-05

Link DOI | Link Google Scholar

Francés, L., Quintero, J., Fernández, A., Ruiz, A., Caules, J., Fillon, G., Hervás, A., & Soler, C.V. (2022). Current state of knowledge on the prevalence of neurodevelopmental disorders in childhood according to the DSM-5: a systematic review in accordance with the PRISMA criteria. Child and Adolescent Psychiatry and Mental Health, 16, 1-15. https://doi.org/10.1186/s13034-022-00462-1

Link DOI | Link Google Scholar

Gavin, B., Twomey, C., Minihan, E., O’Reilly, G., & McNicholas, F. (2023). Parenting interventions, ADHD and homework: a systematic review. Irish Educational Studies, 1-21. https://doi.org/10.1080/03323315.2023.2174572

Link DOI | Link Google Scholar

González-Rodríguez, D., Vieira, M.J., & Vidal, J. (2019). La percepción del profesorado de Educación Primaria y Educación Secundaria sobre las variables que influyen en el Abandono Escolar Temprano. Revista de Investigación Educativa, 37(1), 181-200. https://doi.org/10.6018/rie.37.1.343751

Link DOI | Link Google Scholar

Goode, A.P., Coeytaux, R.R., Maslow, G.R., Davis, N., Hill, S., Namdari, B., LaPointe, N.M.A., Befus, D., Lallinger, K.R., Bowen, S.E., Kosinski, A., McBroom, A.J., Sanders, G.D., & Kemper, A. R. (2018). Nonpharmacologic treatments for attention-deficit/hyperactivity disorder: A systematic review. Pediatrics, 141(6). https://doi.org/10.1542/peds.2018-0094

Link DOI | Link Google Scholar

Gossé, L.K., Bell, S.W., & Hosseini, S.M. (2021). Functional near-infrared spectroscopy in developmental psychiatry: a review of attention deficit hyperactivity disorder. European Archives of Psychiatry and Clinical Neuroscience, 272, 273–290. https://doi.org/10.1007/s00406-021-01288-2

Link DOI | Link Google Scholar

Graziano, P.A., Fabiano, G., Willoughby, M.T., Waschbusch, D., Morris, K., Schatz, N., & Vujnovic, R. (2017). Callous-unemotional traits among adolescents with attention-deficit/hyperactivity disorder (ADHD): Associations with parenting. Child Psychiatry & Human Development, 48, 18-31. https://doi.org/10.1007/s10578-016-0649-0

Link DOI | Link Google Scholar

Guan-Lim, C., Lim-Ashworth, N.S., & Fung, D.S. (2020). Updates in technology-based interventions for attention deficit hyperactivity disorder. Current Opinion in Psychiatry, 33(6), 577-585. https://doi.org/10.1097/YCO.0000000000000643

Link DOI | Link Google Scholar

Hodgson, K., Hutchinson, A.D., & Denson, L. (2014). Nonpharmacological treatments for ADHD: a meta-analytic review. Journal of Attention Disorders, 18(4), 275-282. https://doi.org/10.1177/1087054712444732

Link DOI | Link Google Scholar

Hurtado-Parrado, C., Pfaller-Sadovsky, N., Medina, L., Gayman, C.M., Rost, K.A., & Schofill, D. (2022). A systematic review and quantitative analysis of interteaching. Journal of Behavioral Education, 31, 157-185. https://doi.org/10.1007/s10864-021-09452-3

Link DOI | Link Google Scholar

Janssen, T.W., Grammer, J.K., Bleichner, M.G., Bulgarelli, C., Davidesco, I., Dikker, S., Jasinska, K.K., Siugzdaite, R., Vassena, E., Vatakis, A., Zion-Golumbic, E., & van-Atteveldt, N. (2021). Opportunities and limitations of mobile neuroimaging technologies in educational neuroscience. Mind, Brain, and Education, 15(4), 354-370. https://doi.org/10.1111/mbe.12302

Link DOI | Link Google Scholar

Krell, J., Todd, A., & Dolecki, P.K. (2019). Bridging the gap between theory and practice in neurofeedback training for attention. Mind, Brain, and Education, 13(4), 246-260. https://doi.org/10.1111/mbe.12220

Link DOI | Link Google Scholar

Kruppa, J.A., Reindl, V., Gerloff, C., Oberwelland Weiss, E., Prinz, J., Herpertz-Dahlmann, B., Konrad, K., & Schulte-Rüther, M. (2021). Brain and motor synchrony in children and adolescents with ASD-a fNIRS hyperscanning study. Social Cognitive and Affective Neuroscience, 16(1-2), 103-116. https://doi.org/10.1093/scan/nsaa092

Link DOI | Link Google Scholar

Kuznetsova, E., Veilahti, A.V.P., Akhundzadeh, R., Radev, S., Konicar, L., & Cowley, B.U. (2022). Evaluation of neurofeedback learning in patients with ADHD: A systematic review. Applied Psychophysiology and Biofeedback, 48, 1-15. https://doi.org/10.1007/s10484-022-09562-2

Link DOI | Link Google Scholar

Leisman, G. (2023). Neuroscience in education: a bridge too far or one that has yet to be built: introduction to the “Brain goes to school”. Brain Science. 13(1), 40. https://doi.org/10.3390/brainsci13010040

Link DOI | Link Google Scholar

Lipka, R., Ahlers, E., Reed, T.L., Karstens, M.I., Nguyen, V., Bajbouj, M., & Kadosh, R.C. (2021). Resolving heterogeneity in transcranial electrical stimulation efficacy for attention deficit hyperactivity disorder. Experimental Neurology, 337, 113586. https://doi.org/10.1016/j.expneurol.2020.113586

Link DOI | Link Google Scholar

Liu, J., Zhang, R., Geng, B., Zhang, T., Yuan, D., Otani, S., & Li, X. (2019). Interplay between prior knowledge and communication mode on teaching effectiveness: interpersonal neural synchronization as a neural marker. NeuroImage, 193, 93-102. https://doi.org/10.1016/j.neuroimage.2019.03.004

Link DOI | Link Google Scholar

Lu, K., Qiao, X., Yun, Q., & Hao, N. (2021). Educational diversity and group creativity: Evidence from fNIRS hyperscanning. NeuroImage, 243, 118564. https://doi.org/10.1016/j.neuroimage.2021.118564

Link DOI | Link Google Scholar

Márquez, C., & Indarramendi, C. (2022). La prevención del fracaso escolar en educación secundaria desde el programa de mejora del rendimiento y del aprendizaje. Revista Internacional de Educación para la Justicia Social, 11(1), 157-173. https://doi.org/10.15366/riejs2022.11.1.009

Link DOI | Link Google Scholar

Meisel, V., Servera, M., García-Banda, G., Cardo, E., & Moreno, I. (2014). Neurofeedback and standard pharmacological intervention in ADHD: a randomized controlled trial with six-month follow-up. Biological Psychology, 94(1), 12-21. https://doi.org/10.1016/j.biopsycho.2013.04.015

Link DOI | Link Google Scholar

Ministerio de Educación y Formación Profesional (Ed.) (2021). Datos y cifras. Curso escolar 2021-2022: Informe español. Secretaría General Técnica, Subdirección General de Estadística y Estudios. https://bit.ly/3L0WNyq

Link Google Scholar

Ministerio de Educación y Formación Profesional (Ed.) (2023). Neurociencia aplicada a la educación. https://bit.ly/3SREVaU

Link Google Scholar

Moreno-García, I., Cano-Crespo, A., & Rivera, F. (2022). Results of neurofeedback in treatment of children with ADHD: A systematic review of randomized controlled trials. Applied Psychophysiology and Biofeedback, 47, 145-181. https://doi.org/10.1007/s10484-022-09547-1

Link DOI | Link Google Scholar

Nam, C.S., Choo, S., Huang, J., & Park, J. (2020). Brain-to-brain neural synchrony during social interactions: A systematic review on hyperscanning studies. Applied Sciences, 10(19), 6669. https://doi.org/10.3390/app10196669

Link DOI | Link Google Scholar

Nejati, V., Rasanan, A.H.H., Rad, J.A., Alavi, M.M., Haghi, S., & Nitsche, M.A. (2022). Transcranial direct current stimulation (tDCS) alters the pattern of information processing in children with ADHD: Evidence from drift diffusion modeling. Neurophysiologie Clinique, 52(1), 17-27. https://doi.org/10.1016/j.neucli.2021.11.005

Link DOI | Link Google Scholar

Nigg, J.T. (2017). Annual Research Review: On the relations among self?regulation, self?control, executive functioning, effortful control, cognitive control, impulsivity, risk?taking, and inhibition for developmental psychopathology. Journal of Child Psychology and Psychiatry, 58(4), 361-383. https://doi.org/10.1111/jcpp.12675

Link DOI | Link Google Scholar

Page, M.J., McKenzie, J.E., Bossuyt, P.M., Boutron, I., Hoffmann, T.C., Mulrow, C.D., & Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. International Journal of Surgery, 88, 105906. https://doi.org/10.1016/j.ijsu.2021.105906

Link DOI | Link Google Scholar

Patil, A.U., Madathil, D., Fan, Y.T., Tzeng, O.J., Huang, C.M., & Huang, H.W. (2022). Neurofeedback for the education of children with ADHD and specific learning disorders: A Review. Brain Sciences, 12(9), 1238. https://doi.org/10.3390/brainsci12091238

Link DOI | Link Google Scholar

Quintero, J., & Castaño-de-la-Mota, C. (2014). Introducción y etiopatogenia del trastorno por déficit de atención e hiperactividad (TDA-H). Pediatría integral, 18(9), 600-608. https://bit.ly/3yjkjPy

Link Google Scholar

Razoki, B. (2018). Neurofeedback versus psychostimulants in the treatment of children and adolescents with attention-deficit/hyperactivity disorder: a systematic review. Neuropsychiatric Disease and Treatment, 14, 2905-2913. https://doi.org/10.2147/NDT.S178839

Link DOI | Link Google Scholar

Rubio, B., Boes, A.D., Laganiere, S., Rotenberg, A., Jeurissen, D., & Pascual-Leone, A. (2016). Noninvasive brain stimulation in pediatric attention-deficit hyperactivity disorder (ADHD) a review. Journal of Child Neurology, 31(6), 784-796. https://doi.org/10.1177/0883073815615672

Link DOI | Link Google Scholar

Rusca-Jordán, F., & Cortez-Vergara, C. (2020). Trastorno por déficit de atención con hiperactividad (TDA-H) en niños y adolescentes. Una revisión clínica. Revista de Neuro-Psiquiatría, 83(3), 148-156. https://doi.org/10.20453/rnp.v83i3.3794

Link DOI | Link Google Scholar

Salehinejad, M.A., Nejati, V., Mosayebi-Samani, M., Mohammadi, A., Wischnewski, M., Kuo, M.F., Avenanti, A., Vicario, C.M., & Nitsche, M.A. (2020). Transcranial direct current stimulation in ADHD: A systematic review of efficacy, safety, and protocol-induced electrical field modeling results. Neuroscience Bulletin, 36, 1191-1212. https://doi.org/10.1007/s12264-020-00501-x

Link DOI | Link Google Scholar

Schlechter, F., Calzado, I. W., Siemann, J., Krauel, K., Pereira, H. C., Luckhardt, C., Salvador, R., Puonti, O., Dempfle, A., & Siniatchkin, M. (2023). Personalized transcranial direct current stimulation at home in patients with ADHD: feasibility and efficacy. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation, 16(1), 199-200. https://doi.org/10.1016/j.brs.2023.01.255

Link DOI | Link Google Scholar

Sibley, M.H., Kuriyan, A.B., Evans, S.W., Waxmonsky, J.G., & Smith, B.H. (2014). Pharmacological and psychosocial treatments for adolescents with ADHD: An updated systematic review of the literature. Clinical Psychology Review, 34(3), 218-232. https://doi.org/10.1016/j.cpr.2014.02.001

Link DOI | Link Google Scholar

Siciliano, R., Hirata, Y., & Kelly, S.D. (2016). Electrical stimulation over left inferior frontal gyrus disrupts hand gesture’s role in foreign vocabulary learning. Educational Neuroscience, 1, 2377616116652402. https://doi.org/10.1177/2377616116652402

Link DOI | Link Google Scholar

Sierawska, A., Prehn-Kristensen, A., Moliadze, V., Krauel, K, Nowak, F., Freitag, C.M., Siniatchkin, M., & Buyx, A. (2019). Unmet Needs in children with attention deficit hyperactivity disorder-can transcranial direct current stimulation fill the gap? Promises and ethical challenges. Frontiers in Psychiatry,10, 334. https://doi.org/10.3389/fpsyt.2019.00334

Link DOI | Link Google Scholar

Simoes, E.M., & Nogaro, A. (2019). Ética, neuroética y prácticas de enseñanza. Revista Bioética, 27(2), 268-75. https://doi.org/10.1590/1983-80422019272309

Link DOI | Link Google Scholar

Sjöwall, D., Roth, L., Lindqvist, S., & Thorell, L.B. (2013). Multiple deficits in ADHD: Executive dysfunction, delay aversion, reaction time variability, and emotional deficits. Journal of Child Psychology and Psychiatry, 54(6), 619-627. https://doi.org/10.1111/jcpp.12006

Link DOI | Link Google Scholar

Smith, V., Devane, D., Begley, C.M., & Clarke, M. (2011). Methodology in conducting a systematic review of systematic reviews of healthcare interventions. BMC Medical Research Methodology, 11, 1-6. https://doi.org/10.1186/1471-2288-11-15

Link DOI | Link Google Scholar

Soroa, M., Gorostiaga, A., & Balluerka, N. (2016). Conocimiento de los docentes sobre el TDA-H: Relevancia de la formación y de las percepciones individuales. Revista de Psicodidáctica, 21(2), 205-226. https://doi.org/10.1387/RevPsicodidact.14023

Link DOI | Link Google Scholar

Steiner, N.J., Frenette, E.C., Rene, K.M., Brennan, R.T., & Perrin, E.C. (2014). In-school neurofeedback training for ADHD: Sustained improvements from a randomized control trial. Pediatrics, 133(3), 483-492. https://doi.org/10.1542/peds.2013-2059

Link DOI | Link Google Scholar

Sudnawa, K.K., Chirdkiatgumchai, V., Ruangdaraganon, N., Khongkhatithum, C., Udomsubpayakul, U., Jirayucharoensak, S., & Israsena, P. (2018). Effectiveness of neurofeedback versus medication for attention?deficit/hyperactivity disorder. Pediatrics International, 60(9), 828-834. https://doi.org/10.1111/ped.13641

Link DOI | Link Google Scholar

Van-Doren, J., Arns, M., Heinrich, H., Vollebregt, M.A., Strehl, U., & Loo, S. (2019). Sustained effects of neurofeedback in ADHD: a systematic review and meta-analysis. European Child & Adolescent Psychiatry, 28, 293-305. https://doi.org/10.1007/s00787-018-1121-4

Link DOI | Link Google Scholar

Weinstein, C.S. (1994). Cognitive remediation strategies: An adjunct to the psychotherapy of adults with attention-deficit hyperactivity disorder. The Journal of Psychotherapy Practice and Research, 3(1), 44-57. https://bit.ly/3F8A8MN

Link Google Scholar

Willis, W.G., Weyandt, L.L., Lubiner, A.G., & Schubart, C.D. (2011). Neurofeedback as a treatment for attention-deficit/hyperactivity disorder: A systematic review of evidence for practice. Journal of Applied School Psychology, 27(3), 201-227. https://doi.org/10.1080/15377903.2011.590746

Link DOI | Link Google Scholar

Zhang, L., Xu, X., Li, Z., Chen, L., & Feng, L. (2022). Interpersonal neural synchronization predicting learning outcomes from teaching-learning interaction: A meta-analysis. Frontiers in Psychology, 637. https://doi.org/10.3389/fpsyg.2022.835147

Link DOI | Link Google Scholar

Fundref

Recognized Research Groups of the University of Salamanca (GIR-PROMOSALUD and GIR-NAES); Consolidated Research Unit of the Junta de Castilla y León (UIC-249); Research Project (Ref TED2021-130924B-I00) funded by the Ministry of Science and Innovation, Government of Spain.

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Technical information

Received: 26-12-2022

Revised: 02-02-2023

Accepted: 23-02-2023

OnlineFirst: 30-05-2023

Publication date: 01-07-2023

Article revision time: 38 days | Average time revision issue 76: -6 days

Article acceptance time: 59 days | Average time of acceptance issue 76: 72 days

Preprint editing time: 142 days | Average editing time preprint issue 76: 155 days

Article editing time: 187 days | Average editing time issue 76: 200 days

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